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Sample records for adjusted relative risks

  1. Fire-related cognitions moderate the impact of risk factors on adjustment following wildfire disaster.

    PubMed

    Scher, Christine D; Ellwanger, Joel

    2009-10-01

    This study builds upon current understanding of risk and protective factors for post-disaster adjustment by examining relationships between disaster-related cognitions, three empirically supported risk factors for poorer adjustment (i.e., greater disaster impact, female gender, and racial/ethnic minority status), and three common post-disaster outcomes (i.e., depression, anxiety, and somatic complaints). Participants were 200 students exposed to wildfire disaster. Simultaneous hierarchical regression analyses revealed that, during the acute stress period: (1) disaster-related cognitions in interaction with fire impact and minority status, as well as gender, were related to anxiety symptoms, (2) cognitions were related to depression symptoms, and (3) cognitions in interaction with minority status, as well as fire impact, were related to somatic symptoms. No examined variables predicted symptom change.

  2. Capping risk adjustment?

    PubMed

    Eugster, Patrick; Sennhauser, Michèle; Zweifel, Peter

    2010-07-01

    When premiums are community-rated, risk adjustment (RA) serves to mitigate competitive insurers' incentive to select favorable risks. However, unless fully prospective, it also undermines their incentives for efficiency. By capping its volume, one may try to counteract this tendency, exposing insurers to some financial risk. This in term runs counter the quest to refine the RA formula, which would increase RA volume. Specifically, the adjuster, "Hospitalization or living in a nursing home during the previous year" will be added in Switzerland starting 2012. This paper investigates how to minimize the opportunity cost of capping RA in terms of increased incentives for risk selection.

  3. Relations of Growth in Effortful Control to Family Income, Cumulative Risk, and Adjustment in Preschool-age Children

    PubMed Central

    Lengua, Liliana J.; Moran, Lyndsey; Zalewski, Maureen; Ruberry, Erika; Kiff, Cara; Thompson, Stephanie

    2014-01-01

    The study examined growth in effortful control (executive control, delay ability) in relation to income, cumulative risk (aggregate of demographic and psychosocial risk factors), and adjustment in 306 preschool-age children (50% girls, 50% boys) from families representing a range of income (29% at- or near-poverty; 28% lower-income; 25% middle-income; 18% upper-income), with 4 assessments starting at 36–40 mos. Income was directly related to levels of executive control and delay ability. Cumulative risk accounted for the effects of income on delay ability but not executive control. Higher initial executive control and slope of executive control and delay ability predicted academic readiness, whereas levels, but not growth, of executive control and delay ability predicted social competence and adjustment problems. Low income is a marker for lower effortful control, which demonstrates additive or mediating effects in the relation of income to children’s preschool adjustment. PMID:25253079

  4. Relations of growth in effortful control to family income, cumulative risk, and adjustment in preschool-age children.

    PubMed

    Lengua, Liliana J; Moran, Lyndsey; Zalewski, Maureen; Ruberry, Erika; Kiff, Cara; Thompson, Stephanie

    2015-05-01

    The study examined growth in effortful control (executive control, delay ability) in relation to income, cumulative risk (aggregate of demographic and psychosocial risk factors), and adjustment in 306 preschool-age children (50 % girls, 50 % boys) from families representing a range of income (29 % at- or near-poverty; 28 % lower-income; 25 % middle-income; 18 % upper-income), with 4 assessments starting at 36-40 month. Income was directly related to levels of executive control and delay ability. Cumulative risk accounted for the effects of income on delay ability but not executive control. Higher initial executive control and slope of executive control and delay ability predicted academic readiness, whereas levels, but not growth, of executive control and delay ability predicted social competence and adjustment problems. Low income is a marker for lower effortful control, which demonstrates additive or mediating effects in the relation of income to children's preschool adjustment.

  5. Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems.

    PubMed

    Lengua, Liliana J; Bush, Nicole R; Long, Anna C; Kovacs, Erica A; Trancik, Anika M

    2008-01-01

    Effortful control was examined as a moderator of the relations of three domains of contextual risk factors to growth in internalizing and externalizing problems in a community sample (N = 189) of children (8-12 years at Time 1). Socioeconomic, maternal, and environmental risk factors were examined as predictors of initial levels and growth in children's adjustment problems across 3 years. The effects of the risk factors depended on children's level of effortful control. For children lower in effortful control, socioeconomic risk was related to significantly higher initial levels of internalizing and externalizing problems and decreases over time. However, children lower in effortful control had higher levels of problems at all three time points than children higher in effortful control. Maternal risk was associated with increases in internalizing for children lower in effortful control, and environmental risk was related to increases in internalizing and externalizing problems for children lower in effortful control, but not those higher in effortful control. Children who were lower in effortful control appeared to experience more adverse effects of contextual risk than those higher in effortful control, suggesting that interventions aimed at improving children's effortful control might serve to protect children from increased risk of adjustment problems associated with contextual risk factors.

  6. Risk and Resilience Factors for Combat-Related Posttraumatic Psychopathology and Post Combat Adjustment

    DTIC Science & Technology

    2010-06-01

    Agoraphobia  without  a  History  of  Panic  Disorder...or  II   Adjustment  Disorder   Agoraphobia  without  a  History  of  Panic  Disorder   Obsessive  Compulsive  Disorder...disorder,  specific  phobia,  panic  disorder,  obsessive  compulsive  disorder,   agoraphobia  with  a  history  of  

  7. Risk and Resilience Factors for Combat-Related Posttraumatic Psychopathology and Post Combat Adjustment

    DTIC Science & Technology

    2012-05-01

    SUBJECT TERMS Risk, Resilience, Combat, Posttraumatic Stress Disorder, Ohio National Guard, Mental Health, Genetics, Alcohol Use Disorders, Suicide 16...have continued to focus on alcohol use disorders and suicide as areas of unmet need in the National Guard. For example, 10% of our study sample...qualified for wave 1 depression, and 9% of those soldiers had suicidal ideation at the 1-year follow-up, as compared to only 2% among those with no

  8. Risk adjustment for a children's capitation rate.

    PubMed

    Newhouse, J P; Sloss, E M; Manning, W G; Keeler, E B

    1993-01-01

    Few capitation arrangements vary premiums by a child's health characteristics, yielding an incentive to discriminate against children with predictably high expenditures from chronic diseases. In this article, we explore risk adjusters for the 35 percent of the variance in annual out-patient expenditure we find to be potentially predictable. Demographic factors such as age and gender only explain 5 percent of such variance; health status measures explain 25 percent, prior use and health status measures together explain 65 to 70 percent. The profit from risk selection falls less than proportionately with improved ability to adjust for risk. Partial capitation rates may be necessary to mitigate skimming and dumping.

  9. Long-Term Ambient Residential Traffic–Related Exposures and Measurement Error–Adjusted Risk of Incident Lung Cancer in the Netherlands Cohort Study on Diet and Cancer

    PubMed Central

    Spiegelman, Donna; Beelen, Rob; Hoek, Gerard; Brunekreef, Bert; Schouten, Leo J.; van den Brandt, Piet

    2015-01-01

    Background The International Agency for Research on Cancer (IARC) recently declared air pollution carcinogenic to humans. However, no study of air pollution and lung cancer to date has incorporated adjustment for exposure measurement error, and few have examined specific histological subtypes. Objectives Our aim was to assess the association of air pollution and incident lung cancer in the Netherlands Cohort Study on Diet and Cancer and the impact of measurement error on these associations. Methods The cohort was followed from 1986 through 2003, and 3,355 incident cases were identified. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals, for long-term exposures to nitrogen dioxide (NO2), black smoke (BS), PM2.5 (particulate matter with diameter ≤ 2.5 μm), and measures of roadway proximity and traffic volume, adjusted for potential confounders. Information from a previous validation study was used to correct the effect estimates for measurement error. Results We observed elevated risks of incident lung cancer with exposure to BS [hazard ratio (HR) = 1.16; 95% CI: 1.02, 1.32, per 10 μg/m3], NO2 (HR = 1.29; 95% CI: 1.08, 1.54, per 30 μg/m3), PM2.5 (HR = 1.17; 95% CI: 0.93, 1.47, per 10 μg/m3), and with measures of traffic at the baseline address. The exposures were positively associated with all lung cancer subtypes. After adjustment for measurement error, the HRs increased and the 95% CIs widened [HR = 1.19 (95% CI: 1.02, 1.39) for BS and HR = 1.37 (95% CI: 0.86, 2.17) for PM2.5]. Conclusions These findings add support to a growing body of literature on the effects of air pollution on lung cancer. In addition, they highlight variation in measurement error by pollutant and support the implementation of measurement error corrections when possible. Citation Hart JE, Spiegelman D, Beelen R, Hoek G, Brunekreef B, Schouten LJ, van den Brandt P. 2015. Long-term ambient residential traffic–related exposures and

  10. 45 CFR 153.330 - State alternate risk adjustment methodology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false State alternate risk adjustment methodology. 153.330 Section 153.330 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO... behavior among providers and health plans and discourages unfavorable behavior; (iv) Uses data that...

  11. Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas

    PubMed Central

    Ellis, Randall P.; Fernandez, Juan Gabriel

    2013-01-01

    Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

  12. 45 CFR 800.204 - Reinsurance, risk corridors, and risk adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Reinsurance, risk corridors, and risk adjustment. 800.204 Section 800.204 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF PERSONNEL MANAGEMENT MULTI-STATE PLAN PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and...

  13. 45 CFR 800.204 - Reinsurance, risk corridors, and risk adjustment.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Reinsurance, risk corridors, and risk adjustment. 800.204 Section 800.204 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF PERSONNEL MANAGEMENT MULTI-STATE PLAN PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and...

  14. 77 FR 21775 - Risk Adjustment Meeting-May 7, 2012 and May 8, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... payments and charges, data collection approach, and the schedule for running risk adjustment. This meeting..., data collection approach, and the schedule for running risk adjustment. The Risk Adjustment...

  15. Favorable Selection, Risk Adjustment, and the Medicare Advantage Program

    PubMed Central

    Morrisey, Michael A; Kilgore, Meredith L; Becker, David J; Smith, Wilson; Delzell, Elizabeth

    2013-01-01

    Objectives To examine the effects of changes in payment and risk adjustment on (1) the annual enrollment and switching behavior of Medicare Advantage (MA) beneficiaries, and (2) the relative costliness of MA enrollees and disenrollees. Data From 1999 through 2008 national Medicare claims data from the 5 percent longitudinal sample of Parts A and B expenditures. Study Design Retrospective, fixed effects regression analysis of July enrollment and year-long switching into and out of MA. Similar regression analysis of the costliness of those switching into (out of) MA in the 6 months prior to enrollment (after disenrollment) relative to nonswitchers in the same county over the same period. Findings Payment generosity and more sophisticated risk adjustment were associated with substantial increases in MA enrollment and decreases in disenrollment. Claims experience of those newly switching into MA was not affected by any of the policy reforms, but disenrollment became increasingly concentrated among high-cost beneficiaries. Conclusions Enrollment is very sensitive to payment levels. The use of more sophisticated risk adjustment did not alter favorable selection into MA, but it did affect the costliness of disenrollees. PMID:23088500

  16. Affordable Care Act risk adjustment: overview, context, and challenges.

    PubMed

    Kautter, John; Pope, Gregory C; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences.

  17. Children's Adjustment Following Divorce: Risk and Resilience Perspectives.

    ERIC Educational Resources Information Center

    Kelly, Joan B.; Emery, Robert E.

    2003-01-01

    Reviews the empirical literature on the longer-term adjustment of children of divorce from the perspective of (a) the stressors and elevated risks that divorce presents for children and (b) protective factors associated with better adjustment. The resiliency demonstrated by the majority of children is discussed, as are controversies regarding the…

  18. Relative Risk Aversion.

    DTIC Science & Technology

    1981-01-01

    strength of preference notion. Some of these developments relate to multiattribute utility theory and to the collective choice problem. In subsequent... multiattribute utility theory , utility func- tions have been assessed that indicate a decision maker is risk prone on one attribute and risk averse on...research with tradi- tional developments in utility theory . 3.1 Relative Risk Attitude We will introduce the concept of a relative risk attitude to analyze

  19. Medicare's risk-adjusted capitation method.

    PubMed

    Grimaldi, Paul L

    2002-01-01

    Since 1997, the method to establish capitation rates for Medicare beneficiaries who are members of risk-bearing managed care plans has undergone several important developments. This includes the factoring of beneficiary health status into the rate-setting calculations. These changes were expected to increase the number of participating health plans, accelerate Medicare enrollment growth, and slice Medicare spending.

  20. Appraisal and coping as mediators of the effects of cumulative risk on preadolescent adjustment.

    PubMed

    Thompson, Stephanie F; Lengua, Liliana J; Garcia, Connie Meza

    2016-05-01

    This study examined the concurrent and longitudinal relations among cumulative risk, appraisal, coping, and adjustment. Longitudinal path models were tested in a community sample of 316 children in preadolescence to examine hypotheses that threat appraisal and avoidant coping mediate the effects of cumulative risk on child adjustment, whereas positive appraisal and active coping were hypothesized to predict better adjustment independently. Children and their mothers were assessed during in-home interviews at three time points at one-year intervals. Children reported on appraisal and coping strategies. Mothers and children reported on child adjustment problems and positive adjustment. Rank-order changes in appraisal and coping predicted rank-order changes in adjustment. Cumulative risk was concurrently related to higher threat appraisal and avoidant coping at each time point. Threat appraisal and avoidant coping mediated the relations of cumulative risk to rank-order changes in adjustment. There is specificity in the relations of cumulative risk to threat appraisal and avoidant coping, whereas positive appraisal and active coping are independent of risk and operate as individual resource factors.

  1. A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

    PubMed Central

    Juhnke, Christin; Bethge, Susanne

    2016-01-01

    Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

  2. Integrating Risk Adjustment and Enrollee Premiums in Health Plan Payment

    PubMed Central

    McGuire, Thomas G.; Glazer, Jacob; Newhouse, Joseph P.; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D.; Zuvekas, Samuel

    2013-01-01

    In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878

  3. Risk-adjusted outcomes in Medicare inpatient nephrectomy patients

    PubMed Central

    Fry, Donald E.; Pine, Michael; Nedza, Susan M.; Locke, David G.; Reband, Agnes M.; Pine, Gregory

    2016-01-01

    Abstract Without risk-adjusted outcomes of surgical care across both the inpatient and postacute period of time, hospitals and surgeons cannot evaluate the effectiveness of current performance in nephrectomy and other operations, and will not have objective metrics to gauge improvements from care redesign efforts. We compared risk-adjusted hospital outcomes following elective total and partial nephrectomy to demonstrate differences that can be used to improve care. We used the Medicare Limited Dataset for 2010 to 2012 for total and partial nephrectomy for benign and malignant neoplasms to create prediction models for the adverse outcomes (AOs) of inpatient deaths, prolonged length-of-stay outliers, 90-day postdischarge deaths without readmission, and 90-day relevant readmissions. From the 4 prediction models, total predicted adverse outcomes were determined for each hospital in the dataset that met a minimum of 25 evaluable cases for the study period. Standard deviations (SDs) for each hospital were used to identify specific z-scores. Risk-adjusted adverse outcomes rates were computed to permit benchmarking each hospital's performance against the national standard. Differences between best and suboptimal performing hospitals defined the potential margin of preventable adverse outcomes for this operation. A total of 449 hospitals with 23,477 patients were evaluated. Overall AO rate was 20.8%; 17 hospitals had risk-adjusted AO rates that were 2 SDs poorer than predicted and 8 were 2 SDs better. The top performing decile of hospitals had a risk-adjusted AO rate of 10.2% while the lowest performing decile had 32.1%. With a minimum of 25 cases for each study hospital, no statistically valid improvement in outcomes was seen with increased case volume. Inpatient and 90-day postdischarge risk-adjusted adverse outcomes demonstrated marked variability among study hospitals and illustrate the opportunities for care improvement. This analytic design is applicable for comparing

  4. Risk-adjusted outcomes in Medicare inpatient nephrectomy patients.

    PubMed

    Fry, Donald E; Pine, Michael; Nedza, Susan M; Locke, David G; Reband, Agnes M; Pine, Gregory

    2016-09-01

    Without risk-adjusted outcomes of surgical care across both the inpatient and postacute period of time, hospitals and surgeons cannot evaluate the effectiveness of current performance in nephrectomy and other operations, and will not have objective metrics to gauge improvements from care redesign efforts.We compared risk-adjusted hospital outcomes following elective total and partial nephrectomy to demonstrate differences that can be used to improve care. We used the Medicare Limited Dataset for 2010 to 2012 for total and partial nephrectomy for benign and malignant neoplasms to create prediction models for the adverse outcomes (AOs) of inpatient deaths, prolonged length-of-stay outliers, 90-day postdischarge deaths without readmission, and 90-day relevant readmissions. From the 4 prediction models, total predicted adverse outcomes were determined for each hospital in the dataset that met a minimum of 25 evaluable cases for the study period. Standard deviations (SDs) for each hospital were used to identify specific z-scores. Risk-adjusted adverse outcomes rates were computed to permit benchmarking each hospital's performance against the national standard. Differences between best and suboptimal performing hospitals defined the potential margin of preventable adverse outcomes for this operation.A total of 449 hospitals with 23,477 patients were evaluated. Overall AO rate was 20.8%; 17 hospitals had risk-adjusted AO rates that were 2 SDs poorer than predicted and 8 were 2 SDs better. The top performing decile of hospitals had a risk-adjusted AO rate of 10.2% while the lowest performing decile had 32.1%. With a minimum of 25 cases for each study hospital, no statistically valid improvement in outcomes was seen with increased case volume.Inpatient and 90-day postdischarge risk-adjusted adverse outcomes demonstrated marked variability among study hospitals and illustrate the opportunities for care improvement. This analytic design is applicable for comparing provider

  5. Sensitivity of health risk estimates to air quality adjustment procedure

    SciTech Connect

    Whitfield, R.G.

    1997-06-30

    This letter is a summary of risk results associated with exposure estimates using two-parameter Weibull and quadratic air quality adjustment procedures (AQAPs). New exposure estimates were developed for children and child-occurrences, six urban areas, and five alternative air quality scenarios. In all cases, the Weibull and quadratic results are compared to previous results, which are based on a proportional AQAP.

  6. Granular risk adjustment may hasten reacceptance of capitation.

    PubMed

    2001-10-01

    Where did the notion of three-tier risk adjustment come from? What's magic about three groupings? EbenX asks why we don't do what the actuaries do and break a population into 32 groups--a change that would makes for better payment to physicians.

  7. Adolescent Adjustment Before and After HIV-Related Parental Death.

    ERIC Educational Resources Information Center

    Rotheram-Borus, Mary Jane; Weiss, Robert; Alber, Susan; Lester, Patricia

    2005-01-01

    The impact of HIV-related parental death on 414 adolescents was examined over a period of 6 years. The adjustment of bereaved adolescents was compared over 4 time periods relative to parental death and was also compared with the adjustment of nonbereaved adolescents. Bereaved adolescents had significantly more emotional distress, negative life…

  8. Continuing Bonds, Risk Factors for Complicated Grief, and Adjustment to Bereavement

    ERIC Educational Resources Information Center

    Field, Nigel P.; Filanosky, Charles

    2010-01-01

    This study examined type of continuing bonds (CB) expression in relation to risk factors for complicated grief and measures of bereavement-related adjustment. Externalized CB expressions involving illusions and hallucinations with the deceased were distinguished from internalized CB expressions involving use of the deceased as an autonomy…

  9. Risk adjustment and risk selection on the sickness fund insurance market in five European countries.

    PubMed

    van de Ven, Wynand P M M; Beck, Konstantin; Buchner, Florian; Chernichovsky, Dov; Gardiol, Lucien; Holly, Alberto; Lamers, Leida M; Schokkaert, Erik; Shmueli, Amir; Spycher, Stephan; Van de Voorde, Carine; van Vliet, René C J A; Wasem, Jürgen; Zmora, Irith

    2003-07-01

    From the mid-1990s citizens in Belgium, Germany, Israel, the Netherlands and Switzerland have a guaranteed periodic choice among risk-bearing sickness funds, who are responsible for purchasing their care or providing them with medical care. The rationale of this arrangement is to stimulate the sickness funds to improve efficiency in health care production and to respond to consumers' preferences. To achieve solidarity, all five countries have implemented a system of risk-adjusted premium subsidies (or risk equalization across risk groups), along with strict regulation of the consumers' direct premium contribution to their sickness fund. In this article we present a conceptual framework for understanding risk adjustment and comparing the systems in the five countries. We conclude that in the case of imperfect risk adjustment-as is the case in all five countries in the year 2001-the sickness funds have financial incentives for risk selection, which may threaten solidarity, efficiency, quality of care and consumer satisfaction. We expect that without substantial improvements in the risk adjustment formulae, risk selection will increase in all five countries. The issue is particularly serious in Germany and Switzerland. We strongly recommend therefore that policy makers in the five countries give top priority to the improvement of the system of risk adjustment. That would enhance solidarity, cost-control, efficiency and client satisfaction in a system of competing, risk-bearing sickness funds.

  10. Cumulative Family Risk Predicts Sibling Adjustment to Childhood Cancer

    PubMed Central

    Long, Kristin A.; Marsland, Anna L.; Alderfer, Melissa A.

    2013-01-01

    Background Prolonged, intensive treatment regimens often disrupt families of children with cancer. Siblings are at increased risk for distress, but factors underlying this risk have received limited empirical attention. This study examined associations between the family context and sibling distress. Methods Siblings of children with cancer (ages 8–18, N=209) and parents (186 mothers, 70 fathers) completed measures of sibling distress, family functioning, parenting, and parent posttraumatic stress. Associations between sibling distress and each family risk factor were evaluated. Then, family risks were considered simultaneously by calculating cumulative family risk index scores. Results After controlling for socio-demographic covariates, greater sibling distress was associated with more sibling-reported problems with family functioning and parental psychological control, lower sibling-reported maternal acceptance, and lower paternal self-reported acceptance. When risk factors were considered together, results supported a quadratic model in which associations between family risk and sibling distress were stronger at higher levels of risk. Conclusions Findings support a contextual model of sibling adjustment to childhood cancer in which elevated distress is predicted by family risk factors, alone and in combination. PMID:23576115

  11. Risk algorithms that include pathology adjustment for HER2 amplification need to make further downward adjustments in likelihood scores.

    PubMed

    Evans, D G; Woodward, E R; Howell, S J; Verhoef, S; Howell, A; Lalloo, F

    2017-04-01

    To assess the need for adjustment in the likelihood of germline BRCA1/2 mutations in women with HER2+ breast cancers. We analysed primary mutation screens on women with breast cancer with unequivocal HER2 overexpression and assessed the likelihood of BRCA1/BRCA2 mutations by age, oestrogen receptor status and Manchester score. Of 1111 primary BRCA screens with confirmed HER2 status only 4/161 (2.5%) of women with HER2 amplification had a BRCA1 mutation identified and 5/161 (3.1%) a BRCA2 mutation. The pathology adjusted Manchester score between 10 and 19% and 20%+ thresholds resulted in a detection rate of only 6.5 and 15% respectively. BOADICEA examples appeared to make even less downward adjustment. There is a very low detection rate of BRCA1 and BRCA2 mutations in women with HER2 amplified breast cancers. The Manchester score and BOADICEA do not make sufficient downward adjustment for HER2 amplification. For unaffected women, assessment of breast cancer risk and BRCA1/2 probability should take into account the pathology of the most relevant close relative. Unaffected women undergoing mutation testing for BRCA1/2 should be advised that there is limited reassurance from a negative test result if their close relative had a HER2+ breast cancer.

  12. Effects of Relational Authenticity on Adjustment to College

    ERIC Educational Resources Information Center

    Lenz, A. Stephen; Holman, Rachel L.; Lancaster, Chloe; Gotay, Stephanie G.

    2016-01-01

    The authors examined the association between relational health and student adjustment to college. Data were collected from 138 undergraduate students completing their 1st semester at a large university in the mid-southern United States. Regression analysis indicated that higher levels of relational authenticity were a predictor of success during…

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

    PubMed Central

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

    2014-01-01

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

  14. Reciprocal Relations between Children's Sleep and Their Adjustment over Time

    ERIC Educational Resources Information Center

    Kelly, Ryan J.; El-Sheikh, Mona

    2014-01-01

    Child sleep and adjustment research with community samples is on the rise with a recognized need of explicating this association. We examined reciprocal relations between children's sleep and their internalizing and externalizing symptoms using 3 waves of data spanning 5 years. Participants included 176 children at Time 1 (M = 8.68 years; 69%…

  15. Width adjustment: relative dominance in unstable alluvial streams

    USGS Publications Warehouse

    Simon, Andrew

    1994-01-01

    The mechanisms that control the relative dominance of width adjustment in unstable streams are described. Specifically, the role of the following factors affecting the fluvial environment were investigated: vertical processes and fluvial action, bed-material particle, cohesive strength of bank material, and riparian vegetation.

  16. Response Monitoring and Adjustment: Differential Relations with Psychopathic Traits

    PubMed Central

    Bresin, Konrad; Finy, M. Sima; Sprague, Jenessa; Verona, Edelyn

    2014-01-01

    Studies on the relation between psychopathy and cognitive functioning often show mixed results, partially because different factors of psychopathy have not been considered fully. Based on previous research, we predicted divergent results based on a two-factor model of psychopathy (interpersonal-affective traits and impulsive-antisocial traits). Specifically, we predicted that the unique variance of interpersonal-affective traits would be related to increased monitoring (i.e., error-related negativity) and adjusting to errors (i.e., post-error slowing), whereas impulsive-antisocial traits would be related to reductions in these processes. Three studies using a diverse selection of assessment tools, samples, and methods are presented to identify response monitoring correlates of the two main factors of psychopathy. In Studies 1 (undergraduates), 2 (adolescents), and 3 (offenders), interpersonal-affective traits were related to increased adjustment following errors and, in Study 3, to enhanced monitoring of errors. Impulsive-antisocial traits were not consistently related to error adjustment across the studies, although these traits were related to a deficient monitoring of errors in Study 3. The results may help explain previous mixed findings and advance implications for etiological models of psychopathy. PMID:24933282

  17. Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

    PubMed

    Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

    2017-04-01

    The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets.

  18. Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

    PubMed Central

    Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

    2004-01-01

    This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

  19. Level of education and multiple sclerosis risk after adjustment for known risk factors: The EnvIMS study

    PubMed Central

    Bjørnevik, Kjetil; Riise, Trond; Cortese, Marianna; Holmøy, Trygve; Kampman, Margitta T; Magalhaes, Sandra; Myhr, Kjell-Morten; Wolfson, Christina; Pugliatti, Maura

    2016-01-01

    Background: Several recent studies have found a higher risk of multiple sclerosis (MS) among people with a low level of education. This has been suggested to reflect an effect of smoking and lower vitamin D status in the social class associated with lower levels of education. Objective: The objective of this paper is to investigate the association between level of education and MS risk adjusting for the known risk factors smoking, infectious mononucleosis, indicators of vitamin D levels and body size. Methods: Within the case-control study on Environmental Factors In MS (EnvIMS), 953 MS patients and 1717 healthy controls from Norway reported educational level and history of exposure to putative environmental risk factors. Results: Higher level of education were associated with decreased MS risk (p trend = 0.001) with an OR of 0.53 (95% CI 0.41–0.68) when comparing those with the highest and lowest level of education. This association was only moderately reduced after adjusting for known risk factors (OR 0.61, 95% CI 0.44–0.83). The estimates remained similar when cases with disease onset before age 28 were excluded. Conclusion: These findings suggest that factors related to lower socioeconomic status other than established risk factors are associated with MS risk. PMID:26014605

  20. Assessing geomorphic sensitivity in relation to river capacity for adjustment

    NASA Astrophysics Data System (ADS)

    Reid, H. E.; Brierley, G. J.

    2015-12-01

    River sensitivity describes the nature and rate of channel adjustments. An approach to analysis of geomorphic river sensitivity outlined in this paper relates potential sensitivity based on the expected capacity of adjustment for a river type to the recent history of channel adjustment. This approach was trialled to assess low, moderate and high geomorphic sensitivity for four different types of river (10 reaches in total) along the Lower Tongariro River, North Island, New Zealand. Building upon the River Styles framework, river types were differentiated based upon valley setting (width and confinement), channel planform, geomorphic unit assemblages and bed material size. From this, the behavioural regime and potential for adjustment (type and extent) were determined. Historical maps and aerial photographs were geo-rectified and the channel planform digitised to assess channel adjustments for each reach from 1928 to 2007. Floodplain width controlled by terraces, exerted a strong influence upon reach scale sensitivity for the partly-confined, wandering, cobble-bed river. Although forced boundaries occur infrequently, the width of the active channel zone is constrained. An unconfined braided river reach directly downstream of the terrace-confined section was the most geomorphically sensitive reach. The channel in this reach adjusted recurrently to sediment inputs that were flushed through more confined, better connected upstream reaches. A meandering, sand-bed river in downstream reaches has exhibited negligible rates of channel migration. However, channel narrowing in this reach and the associated delta indicate that the system is approaching a threshold condition, beyond which channel avulsion is likely to occur. As this would trigger more rapid migration, this reach is considered to be more geomorphically sensitive than analysis of its low migration rate alone would indicate. This demonstrates how sensitivity is fashioned both by the behavioural regime of a reach

  1. School-related adjustment in children and adolescents with CHD.

    PubMed

    Im, Yu-Mi; Lee, Sunhee; Yun, Tae-Jin; Choi, Jae Young

    2017-03-20

    Advancements in medical and surgical treatment have increased the life expectancy of patients with CHD. Many patients with CHD, however, struggle with the medical, psychosocial, and behavioural challenges as they transition from childhood to adulthood. Specifically, the environmental and lifestyle challenges in school are very important factors that affect children and adolescents with CHD. This study aimed to evaluate school-related adjustments depending on school level and disclosure of disease in children and adolescents with CHD. This was a descriptive and exploratory study with 205 children and adolescents, aged 7-18 years, who were recruited from two congenital heart clinics from 5 January to 27 February, 2015. Data were analysed using the Student's t-test, analysis of variance, and a univariate general linear model. School-related adjustment scores were significantly different according to school level and disclosure of disease (p<0.001) when age, religion, experience being bullied, and parents' educational levels were assigned as covariates. The school-related adjustment score of patients who did not disclose their disease dropped significantly in high school. This indicated that it is important for healthcare providers to plan developmentally appropriate educational transition programmes for middle-school students with CHD in order for students to prepare themselves before entering high school.

  2. Developmental risks and psychosocial adjustment among low-income Brazilian youth.

    PubMed

    Raffaelli, Marcela; Koller, Silvia H; Cerqueira-Santos, Elder; De Morais, Normanda Araújo

    2007-01-01

    Exposure to developmental risks in three domains (community, economic, and family), and relations between risks and psychosocial well-being, were examined among 918 impoverished Brazilian youth aged 14-19 (M = 15.8 years, 51.9% female) recruited in low-income neighborhoods in one city in Southern Brazil. High levels of developmental risks were reported, with levels and types of risks varying by gender, age, and (to a lesser extent) race. Associations between levels of risks in the various domains and indicators of psychological (e.g., self-esteem, negative emotionality) and behavioral (e.g., substance use) adjustment differed for male and female respondents. Findings build on prior research investigating the development of young people in conditions of pervasive urban poverty and reinforce the value of international research in this endeavor.

  3. Net Efficacy Adjusted for Risk (NEAR): A Simple Procedure for Measuring Risk:Benefit Balance

    PubMed Central

    Boada, José N.; Boada, Carlos; García-Sáiz, Mar; García, Marcelino; Fernández, Eduardo; Gómez, Eugenio

    2008-01-01

    Background Although several mathematical models have been proposed to assess the risk:benefit of drugs in one measure, their use in practice has been rather limited. Our objective was to design a simple, easily applicable model. In this respect, measuring the proportion of patients who respond favorably to treatment without being affected by adverse drug reactions (ADR) could be a suitable endpoint. However, remarkably few published clinical trials report the data required to calculate this proportion. As an approach to the problem, we calculated the expected proportion of this type of patients. Methodology/Principal Findings Theoretically, responders without ADR may be obtained by multiplying the total number of responders by the total number of subjects that did not suffer ADR, and dividing the product by the total number of subjects studied. When two drugs are studied, the same calculation may be repeated for the second drug. Then, by constructing a 2×2 table with the expected frequencies of responders with and without ADR, and non-responders with and without ADR, the odds ratio and relative risk with their confidence intervals may be easily calculated and graphically represented on a logarithmic scale. Such measures represent “net efficacy adjusted for risk” (NEAR). We assayed the model with results extracted from several published clinical trials or meta-analyses. On comparing our results with those originally reported by the authors, marked differences were found in some cases, with ADR arising as a relevant factor to balance the clinical benefit obtained. The particular features of the adverse reaction that must be weighed against benefit is discussed in the paper. Conclusion NEAR representing overall risk-benefit may contribute to improving knowledge of drug clinical usefulness. As most published clinical trials tend to overestimate benefits and underestimate toxicity, our measure represents an effort to change this trend. PMID:18974868

  4. Adjusted Age-Adjusted Charlson Comorbidity Index Score as a Risk Measure of Perioperative Mortality before Cancer Surgery

    PubMed Central

    Chang, Chun-Ming; Yin, Wen-Yao; Wei, Chang-Kao; Wu, Chin-Chia; Su, Yu-Chieh; Yu, Chia-Hui; Lee, Ching-Chih

    2016-01-01

    Background Identification of patients at risk of death from cancer surgery should aid in preoperative preparation. The purpose of this study is to assess and adjust the age-adjusted Charlson comorbidity index (ACCI) to identify cancer patients with increased risk of perioperative mortality. Methods We identified 156,151 patients undergoing surgery for one of the ten common cancers between 2007 and 2011 in the Taiwan National Health Insurance Research Database. Half of the patients were randomly selected, and a multivariate logistic regression analysis was used to develop an adjusted-ACCI score for estimating the risk of 90-day mortality by variables from the original ACCI. The score was validated. The association between the score and perioperative mortality was analyzed. Results The adjusted-ACCI score yield a better discrimination on mortality after cancer surgery than the original ACCI score, with c-statics of 0.75 versus 0.71. Over 80 years of age, 70–80 years, and renal disease had the strongest impact on mortality, hazard ratios 8.40, 3.63, and 3.09 (P < 0.001), respectively. The overall 90-day mortality rates in the entire cohort varied from 0.9%, 2.9%, 7.0%, and 13.2% in four risk groups stratifying by the adjusted-ACCI score; the adjusted hazard ratio for score 4–7, 8–11, and ≥ 12 was 2.84, 6.07, and 11.17 (P < 0.001), respectively, in 90-day mortality compared to score 0–3. Conclusions The adjusted-ACCI score helps to identify patients with a higher risk of 90-day mortality after cancer surgery. It might be particularly helpful for preoperative evaluation of patients over 80 years of age. PMID:26848761

  5. Cumulative Family Risk Predicts Increases in Adjustment Difficulties across Early Adolescence

    ERIC Educational Resources Information Center

    Buehler, Cheryl; Gerard, Jean M.

    2013-01-01

    Family is an important socialization context for youth as they move through early adolescence. A significant feature of this complex socialization context is the accumulation of potential family risk factors that may compromise youth adjustment. This study examined cumulative family risk and adolescents' adjustment difficulties in 416 two-parent…

  6. Do insurers respond to risk adjustment? A long-term, nationwide analysis from Switzerland.

    PubMed

    von Wyl, Viktor; Beck, Konstantin

    2016-03-01

    Community rating in social health insurance calls for risk adjustment in order to eliminate incentives for risk selection. Swiss risk adjustment is known to be insufficient, and substantial risk selection incentives remain. This study develops five indicators to monitor residual risk selection. Three indicators target activities of conglomerates of insurers (with the same ownership), which steer enrollees into specific carriers based on applicants' risk profiles. As a proxy for their market power, those indicators estimate the amount of premium-, health care cost-, and risk-adjustment transfer variability that is attributable to conglomerates. Two additional indicators, derived from linear regression, describe the amount of residual cost differences between insurers that are not covered by risk adjustment. All indicators measuring conglomerate-based risk selection activities showed increases between 1996 and 2009, paralleling the establishment of new conglomerates. At their maxima in 2009, the indicator values imply that 56% of the net risk adjustment volume, 34% of premium variability, and 51% cost variability in the market were attributable to conglomerates. From 2010 onwards, all indicators decreased, coinciding with a pre-announced risk adjustment reform implemented in 2012. Likewise, the regression-based indicators suggest that the volume and variance of residual cost differences between insurers that are not equaled out by risk adjustment have decreased markedly since 2009 as a result of the latest reform. Our analysis demonstrates that risk-selection, especially by conglomerates, is a real phenomenon in Switzerland. However, insurers seem to have reduced risk selection activities to optimize their losses and gains from the latest risk adjustment reform.

  7. The risk-adjusted vision beyond casemix (DRG) funding in Australia. International lessons in high complexity and capitation.

    PubMed

    Antioch, Kathryn M; Walsh, Michael K

    2004-06-01

    Hospitals throughout the world using funding based on diagnosis-related groups (DRG) have incurred substantial budgetary deficits, despite high efficiency. We identify the limitations of DRG funding that lack risk (severity) adjustment for State-wide referral services. Methods to risk adjust DRGs are instructive. The average price in casemix funding in the Australian State of Victoria is policy based, not benchmarked. Average cost weights are too low for high-complexity DRGs relating to State-wide referral services such as heart and lung transplantation and trauma. Risk-adjusted specified grants (RASG) are required for five high-complexity respiratory, cardiology and stroke DRGs incurring annual deficits of $3.6 million due to high casemix complexity and government under-funding despite high efficiency. Five stepwise linear regressions for each DRG excluded non-significant variables and assessed heteroskedasticity and multicollinearlity. Cost per patient was the dependent variable. Significant independent variables were age, length-of-stay outliers, number of disease types, diagnoses, procedures and emergency status. Diagnosis and procedure severity markers were identified. The methodology and the work of the State-wide Risk Adjustment Working Group can facilitate risk adjustment of DRGs State-wide and for Treasury negotiations for expenditure growth. The Alfred Hospital previously negotiated RASG of $14 million over 5 years for three trauma and chronic DRGs. Some chronic diseases require risk-adjusted capitation funding models for Australian Health Maintenance Organizations as an alternative to casemix funding. The use of Diagnostic Cost Groups can facilitate State and Federal government reform via new population-based risk adjusted funding models that measure health need.

  8. New ventures require accurate risk analyses and adjustments.

    PubMed

    Eastaugh, S R

    2000-01-01

    For new business ventures to succeed, healthcare executives need to conduct robust risk analyses and develop new approaches to balance risk and return. Risk analysis involves examination of objective risks and harder-to-quantify subjective risks. Mathematical principles applied to investment portfolios also can be applied to a portfolio of departments or strategic business units within an organization. The ideal business investment would have a high expected return and a low standard deviation. Nonetheless, both conservative and speculative strategies should be considered in determining an organization's optimal service line and helping the organization manage risk.

  9. 48 CFR 215.404-71-3 - Contract type risk and working capital adjustment.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Contract type risk and... CONTRACTING BY NEGOTIATION Contract Pricing 215.404-71-3 Contract type risk and working capital adjustment. (a) Description. The contract type risk factor focuses on the degree of cost risk accepted by the contractor...

  10. Coherent Risk-Adjusted Decisions Over Time: a Bilevel Programming Approach

    DTIC Science & Technology

    2015-03-23

    AFRL-AFOSR-VA-TR-2015-0310 Coherent Risk -Adjusted Decisions Over Time: a Bilevel Programming Approach Jonathan Eckstein RUTGERS THE STATE UNIVERSITY...14/2015 4. TITLE AND SUBTITLE Final Project Report: Coherent Risk -Adjusted Decisions over Time: a Bilevel Programming Approach 5a. CONTRACT NUMBER...tested two techniques for approximating a time-inconsistent risk -averse objective function with a time-consistent one. We also investigated rolling

  11. 78 FR 70623 - Adjustment of Nationwide Significant Risk Threshold

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... zone in comparison to the Risk Index With Horns, which is defined in 49 CFR 222.9 as a measure of risk... appendix D to 49 CFR part 222. In making this recalculation, FRA noted that the total number of...

  12. Prior use of durable medical equipment as a risk adjuster for health-based capitation.

    PubMed

    van Kleef, Richard C; van Vliet, René C J A

    This paper examines a new risk adjuster for capitation payments to Dutch health plans, based on the prior use of durable medical equipment (DME). The essence is to classify users of DME in a previous year into clinically homogeneous classes and to apply the resulting classification as a risk adjuster for capitation payments in the subsequent year. We evaluate 143 DME types in terms of incentives, validity, predictive value, and measurability, resulting in 14 functional disability classes (FDCs). We conclude that FDCs can significantly improve the Dutch risk adjustment model, although possible incentives for oversupply have to be monitored.

  13. 75 FR 82136 - Adjustment of Nationwide Significant Risk Threshold

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... alternative, a community can establish its quiet zone in comparison to the Risk Index With Horns, which is a... making this recalculation, FRA noted that the total number of gated, non-whistle-ban crossings was...

  14. 77 FR 546 - Adjustment of Nationwide Significant Risk Threshold

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... community can establish its quiet zone in comparison to the Risk Index With Horns, which is a corridor... total number of gated, non-whistle-ban crossings was 42,150. ] TN05JA12.011 Applying the fatality...

  15. 20 CFR 418.1101 - What is the income-related monthly adjustment amount?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What is the income-related monthly adjustment amount? 418.1101 Section 418.1101 Employees' Benefits SOCIAL SECURITY ADMINISTRATION MEDICARE SUBSIDIES... Adjustment Amount § 418.1101 What is the income-related monthly adjustment amount? (a) The...

  16. 20 CFR 418.1101 - What is the income-related monthly adjustment amount?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What is the income-related monthly adjustment amount? 418.1101 Section 418.1101 Employees' Benefits SOCIAL SECURITY ADMINISTRATION MEDICARE SUBSIDIES... Adjustment Amount § 418.1101 What is the income-related monthly adjustment amount? (a) The...

  17. Kinship Support, Family Relations, and Psychological Adjustment among Low-Income African American Mothers and Adolescents

    ERIC Educational Resources Information Center

    Taylor, Ronald D.; Seaton, Eleanor; Dominguez, Antonio

    2008-01-01

    The association of kin social support with mothers' adjustment and family relations was assessed among 204 African American mothers and adolescents who were on average 14.45 years of age. Also examined was the association of mothers' adjustment with family relations and adolescents' adjustment. Findings revealed that kin social and emotional…

  18. 48 CFR 1.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-related dollar thresholds-adjustment for inflation. 1.109 Section 1.109 Federal Acquisition Regulations..., Issuance 1.109 Statutory acquisition-related dollar thresholds—adjustment for inflation. (a) 41 U.S.C. 431a... the FAR for inflation, except as provided in paragraph (c) of this section. This adjustment...

  19. 48 CFR 1.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-related dollar thresholds-adjustment for inflation. 1.109 Section 1.109 Federal Acquisition Regulations..., Issuance 1.109 Statutory acquisition-related dollar thresholds—adjustment for inflation. (a) 41 U.S.C. 431a... the FAR for inflation, except as provided in paragraph (c) of this section. This adjustment...

  20. The development of a risk-adjusted capitation payment system: the Maryland Medicaid model.

    PubMed

    Weiner, J P; Tucker, A M; Collins, A M; Fakhraei, H; Lieberman, R; Abrams, C; Trapnell, G R; Folkemer, J G

    1998-10-01

    This article describes the risk-adjusted payment methodology employed by the Maryland Medicaid program to pay managed care organizations. It also presents an empirical simulation analysis using claims data from 230,000 Maryland Medicaid recipients. This simulation suggests that the new payment model will help adjust for adverse or favorable selection. The article is intended for a wide audience, including state and national policy makers concerned with the design of managed care Medicaid programs and actuaries, analysts, and researchers involved in the design and implementation of risk-adjusted capitation payment systems.

  1. Relational contexts in adjustment to pregnancy of HIV-positive women: relationships, social support and personal adjustment.

    PubMed

    Pereira, Marco; Canavarro, Maria Cristina

    2009-03-01

    Relational contexts are a central issue in most people's lives, and people usually rely on the support of others in everyday circumstances. Social support, as a relational context, could have a positive influence on personal adjustment, and is particularly relevant in the psychological well-being of HIV patients. Guided by the Convoy Model of social networks, in a sample of 31 HIV-positive pregnant women we try to assess the role of social support and social network in the adjustment to pregnancy. Profile analysis suggests a greater importance of social support provided by the partner and both parents, especially the support provided by the mother. At the same time, it seems to highlight the buffering hypothesis of social support, which could be understood as a protection factor in the adjustment of HIV-infected women' to pregnancy.

  2. Preschoolers' Emotion Expression and Regulation: Relations with School Adjustment

    ERIC Educational Resources Information Center

    Herndon, Kristina J.; Bailey, Craig S.; Shewark, Elizabeth A.; Denham, Susanne A.; Bassett, Hideko H.

    2013-01-01

    Children's expression and regulation of emotions are building blocks of their experiences in classrooms. Thus, the authors' primary goal was to investigate whether preschoolers' expression or ability to regulate emotions were associated with teachers' ratings of school adjustment. A secondary goal was to investigate how boys and girls differed…

  3. Friendship Expectations and Children's Friendship-Related Behavior and Adjustment

    ERIC Educational Resources Information Center

    MacEvoy, Julie Paquette; Papadakis, Alison A.; Fedigan, Shea K.; Ash, Sarah E.

    2016-01-01

    Although relationship expectations are thought to influence all social interactions, little is known about the function of children's friendship expectations. This study examined the associations among children's friendship expectations and their behavior within their friendships, their friendship adjustment, and their socioemotional functioning.…

  4. Sickle Cell Disease Pain: Relation of Coping Strategies to Adjustment.

    ERIC Educational Resources Information Center

    Gil, Karen M.; And Others

    1989-01-01

    Examined pain coping strategies in 79 adult sickle cell disease (SCD) patients. Results revealed that coping strategies factors were important predictors of pain and adjustment. Subjects high on Negative Thinking and Passive Adherence had more severe pain, were less active and more distressed, and used more health services. Individuals high on…

  5. Coping Styles, Social Support, Relational Self-Construal, and Resilience in Predicting Students' Adjustment to University Life

    ERIC Educational Resources Information Center

    Rahat, Enes; Ilhan, Tahsin

    2016-01-01

    The purpose of the present study is to investigate how well coping styles, social support, relational self-construal, and resilience characteristics predict first year university students' ability to adjust to university life. Participants consisted of 527 at-risk students attending a state university in Turkey. The Personal Information Form, Risk…

  6. Child effects and child care: Implications for risk and adjustment.

    PubMed

    Snell, Emily K; Hindman, Annemarie H; Belsky, Jay

    2015-11-01

    Evocative effects of child characteristics on the quality and quantity of child care were assessed in two studies using longitudinal data from the NICHD Study of Early Child Care. We focus on the influence of child characteristics on two important aspects of the child care experience: language stimulation provided by caregivers and quantity of care. In Study 1, associations between the developmental status of children aged 15 to 54 months and the language stimulation provided by their caregivers were examined using path models, and longitudinal child effects were detected across the earliest time points of the study. In Study 2, the associations among child behavior, temperament, development, and time in care were examined. Little evidence was found for such child effects on time in care. The results are discussed in terms of the effects of child care on child development and implications for developmental processes, particularly for children at greatest risk for developmental delay or psychopathology.

  7. A methodological approach to identify external factors for indicator-based risk adjustment illustrated by a cataract surgery register

    PubMed Central

    2014-01-01

    Background Risk adjustment is crucial for comparison of outcome in medical care. Knowledge of the external factors that impact measured outcome but that cannot be influenced by the physician is a prerequisite for this adjustment. To date, a universal and reproducible method for identification of the relevant external factors has not been published. The selection of external factors in current quality assurance programmes is mainly based on expert opinion. We propose and demonstrate a methodology for identification of external factors requiring risk adjustment of outcome indicators and we apply it to a cataract surgery register. Methods Defined test criteria to determine the relevance for risk adjustment are “clinical relevance” and “statistical significance”. Clinical relevance of the association is presumed when observed success rates of the indicator in the presence and absence of the external factor exceed a pre-specified range of 10%. Statistical significance of the association between the external factor and outcome indicators is assessed by univariate stratification and multivariate logistic regression adjustment. The cataract surgery register was set up as part of a German multi-centre register trial for out-patient cataract surgery in three high-volume surgical sites. A total of 14,924 patient follow-ups have been documented since 2005. Eight external factors potentially relevant for risk adjustment were related to the outcome indicators “refractive accuracy” and “visual rehabilitation” 2–5 weeks after surgery. Results The clinical relevance criterion confirmed 2 (“refractive accuracy”) and 5 (“visual rehabilitation”) external factors. The significance criterion was verified in two ways. Univariate and multivariate analyses revealed almost identical external factors: 4 were related to “refractive accuracy” and 7 (6) to “visual rehabilitation”. Two (“refractive accuracy”) and 5 (“visual rehabilitation”) factors

  8. Some Physiological Adjustments Relating to Nutrition in Pregnancy

    PubMed Central

    Beaton, George H.

    1966-01-01

    Information from human and animal studies clearly indicates that a number of adjustments in protein, fat, iron and calcium metabolism occur during pregnancy. Recognition of these adjustments has led to a reappraisal of nutrient requirements during pregnancy. The existence of significant protein storage during pregnancy is called into question; in contrast, the evidence suggests that the major storage component is fat, perhaps in anticipation of the energy costs of lactation. In women who will not lactate, this storage is of no benefit and is an etiologic factor in obesity. From a consideration of iron metabolism in pregnancy, it is concluded that it is better to prevent iron depletion in non-pregnant women, especially that associated with excessive menstrual loss, than to administer iron therapy to pregnant women. PMID:5330280

  9. 48 CFR 201.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Statutory acquisition-related dollar thresholds-adjustment for inflation. 201.109 Section 201.109 Federal Acquisition...-adjustment for inflation. (d) A matrix showing the most recent escalation adjustments of...

  10. 48 CFR 201.109 - Statutory acquisition-related dollar thresholds-adjustment for inflation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Statutory acquisition-related dollar thresholds-adjustment for inflation. 201.109 Section 201.109 Federal Acquisition...-adjustment for inflation. (d) A matrix showing the most recent escalation adjustments of...

  11. The Experience of Risk-Adjusted Capitation Payment for Family Physicians in Iran: A Qualitative Study

    PubMed Central

    Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien

    2016-01-01

    Background When a country’s health system is faced with fundamental flaws that require the redesign of financing and service delivery, primary healthcare payment systems are often reformed. Objectives This study was conducted with the purpose of exploring the experiences of risk-adjusted capitation payment of urban family physicians in Iran when it comes to providing primary health care (PHC). Materials and Methods This is a qualitative study using the framework method. Data were collected via digitally audio-recorded semi-structured interviews with 24 family physicians and 5 executive directors in two provinces of Iran running the urban family physician pilot program. The participants were selected using purposive and snowball sampling. The codes were extracted using inductive and deductive methods. Results Regarding the effects of risk-adjusted capitation on the primary healthcare setting, five themes with 11 subthemes emerged, including service delivery, institutional structure, financing, people’s behavior, and the challenges ahead. Our findings indicated that the health system is enjoying some major changes in the primary healthcare setting through the implementation of risk-adjusted capitation payment. Conclusions With regard to the current challenges in Iran’s health system, using risk-adjusted capitation as a primary healthcare payment system can lead to useful changes in the health system’s features. However, future research should focus on the development of the risk-adjusted capitation model. PMID:27340558

  12. Daily mood and sleep: reciprocal relations and links with adjustment problems.

    PubMed

    Kouros, Chrystyna D; El-Sheikh, Mona

    2015-02-01

    Children's sleep problems are common and associated with increased risk for adjustment problems. We examined daily links between children's sleep and mood, using a daily diary method and actigraphy. We also tested children's daily mood as a mediator of relations among sleep and children's broader internalizing and externalizing symptoms. A community sample of 142 children (mean age = 10.69 years; 57% girls; 69% European American, 31% African American) and their parents participated. For 1 week, children wore actigraphs and parents completed a daily telephone interview about their child's mood. Following the week of actigraphy, mothers and fathers reported on their child's adjustment. Multi-level models indicated within-person relations between children's mood and subsequent sleep fragmentation (indicated by increased activity) and sleep latency, and between-person relations between sleep latency and subsequent mood on the next day. Significant indirect effects were found such that a more negative daily mood (aggregated across diary days) mediated relations between poor sleep efficiency and longer sleep latency and parent-reported internalizing and externalizing symptoms. Findings extend previous research by highlighting disruptions to children's daily mood as a potential mechanism linking sleep problems to children's mental health.

  13. Personality drives physiological adjustments and is not related to survival.

    PubMed

    Bijleveld, Allert I; Massourakis, Georgina; van der Marel, Annemarie; Dekinga, Anne; Spaans, Bernard; van Gils, Jan A; Piersma, Theunis

    2014-05-22

    The evolutionary function and maintenance of variation in animal personality is still under debate. Variation in the size of metabolic organs has recently been suggested to cause and maintain variation in personality. Here, we examine two main underlying notions: (i) that organ sizes vary consistently between individuals and cause consistent behavioural patterns, and (ii) that a more exploratory personality is associated with reduced survival. Exploratory behaviour of captive red knots (Calidris canutus, a migrant shorebird) was negatively rather than positively correlated with digestive organ (gizzard) mass, as well as with body mass. In an experiment, we reciprocally reduced and increased individual gizzard masses and found that exploration scores were unaffected. Whether or not these birds were resighted locally over the 19 months after release was negatively correlated with their exploration scores. Moreover, a long-term mark-recapture effort on free-living red knots with known gizzard masses at capture confirmed that local resighting probability (an inverse measure of exploratory behaviour) was correlated with gizzard mass without detrimental effects on survival. We conclude that personality drives physiological adjustments, rather than the other way around, and suggest that physiological adjustments mitigate the survival costs of exploratory behaviour. Our results show that we need to reconsider hypotheses explaining personality variation based on organ sizes and differential survival.

  14. Mesoscale coastal behavior related to morphological self-adjustment

    NASA Astrophysics Data System (ADS)

    Cooper, J. A. G.; McKenna, J.; Jackson, D. W. T.; O'Connor, M.

    2007-02-01

    High-energy events (extratropical storms, tsunamis, and hurricanes), sediment supply variability, and sea-level rise are regarded as major drivers of coastal geomorphic behavior. In this paper we document a 170 yr record of cyclic coastal changes that occur independently of such external drivers. In a geologically constrained situation with no external sediment input, two end-member morphological configurations (attractors) are identified between which the system alternates. Although neither configuration is stable, the system as a whole exhibits century-scale equilibrium. Our findings present a hitherto unreported form of decadal scale self-adjustment in a coastal system that has occurred under a stable sea level with a consistent wave and tidal regime.

  15. The Impact of Extreme-Risk Cases on Hospitals’ Risk-Adjusted Percutaneous Coronary Intervention Mortality Ratings

    PubMed Central

    Sherwood, Matthew W.; Brennan, J. Matthew; Ho, Kalon K.; Masoudi, Frederick A.; Messenger, John C.; Weaver, W. Douglas; Dai, David; Peterson, Eric D.

    2017-01-01

    OBJECTIVES The goal of this study was to examine the calibration of a validated risk-adjustment model in very high-risk percutaneous coronary intervention (PCI) cases and assess whether sites’ case mix affects their performance ratings. BACKGROUND There are concerns that treating PCI patients with particularly high-risk features such as cardiogenic shock or prior cardiac arrest may adversely impact hospital performance ratings. However, there is little investigation on the validity of these concerns. METHODS We examined 624,286 PCI procedures from 1,168 sites that participated in the CathPCI Registry in 2010. Procedural risk was estimated using the recently published Version 4 National Cardiovascular Data Registry (NCDR) PCI risk-adjusted mortality (RAM) model. We calculated observed/expected mortality using several risk classification methods, and simulated hospital performance after combining their highest risk cases over 2 years into a single year. RESULTS In 2010, crude in-hospital PCI mortality was 1.4%. The NCDR model was generally well calibrated among high risk, however there was slight overprediction of risk in extreme cases. Hospitals treating the highest overall expected risk PCI patients or those treating the top 20% of high-risk cases had lower (better) RAM ratings than centers treating lower-risk cases (1.25% vs. 1.51%). The observed/expected ratio for top-risk quintile versus low-risk quintile was 0.91 (0.87 to 0.96) versus 1.10 (1.03 to 1.17). Combining all the high-risk patients over a 2-year period into a single year also did not negatively impact the site’s RAM ratings. CONCLUSIONS Evaluation of a contemporary sample of PCI cases across the United States showed no evidence that treating high-risk PCI cases adversely affects hospital RAM rates. PMID:25499301

  16. The HHS-HCC Risk Adjustment Model for Individual and Small Group Markets under the Affordable Care Act

    PubMed Central

    Kautter, John; Pope, Gregory C; Ingber, Melvin; Freeman, Sara; Patterson, Lindsey; Cohen, Michael; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses are able to purchase private health insurance through competitive Marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the second of three in this issue of the Review that describe the Department of Health and Human Services (HHS) risk adjustment methodology and focuses on the risk adjustment model. In our first companion article, we discuss the key issues and choices in developing the methodology. In this article, we present the risk adjustment model, which is named the HHS-Hierarchical Condition Categories (HHS-HCC) risk adjustment model. We first summarize the HHS-HCC diagnostic classification, which is the key element of the risk adjustment model. Then the data and methods, results, and evaluation of the risk adjustment model are presented. Fifteen separate models are developed. For each age group (adult, child, and infant), a model is developed for each cost sharing level (platinum, gold, silver, and bronze metal levels, as well as catastrophic plans). Evaluation of the risk adjustment models shows good predictive accuracy, both for individuals and for groups. Lastly, this article provides examples of how the model output is used to calculate risk scores, which are an input into the risk transfer formula. Our third companion paper describes the risk transfer formula. PMID:25360387

  17. Risk adjusting survival outcomes of hospitals that treat cancer patients without information on cancer stage

    PubMed Central

    Pfister, David G.; Rubin, David M.; Elkin, Elena B.; Neill, Ushma S.; Duck, Elaine; Radzyner, Mark; Bach, Peter B.

    2016-01-01

    Importance Instituting widespread measurement of outcomes for cancer hospitals using administrative data is difficult due to the lack of cancer specific information such as disease stage. Objective To evaluate the performance of hospitals that treat cancer patients using Medicare data for outcome ascertainment and risk adjustment, and to assess whether hospital rankings based on these measures are influenced by the addition of cancer-specific information. Design Risk adjusted cumulative mortality of patients with cancer captured in Medicare claims from 2005–2009 nationally were assessed at the hospital level. Similar analyses were conducted in the Surveillance, Epidemiology and End Result (SEER)-Medicare data for the subset of the US covered by the SEER program to determine whether the exclusion of cancer specific information (only available in cancer registries) from risk adjustment altered measured hospital performance. Setting Administrative claims data and SEER cancer registry data Participants Sample of 729,279 fee-for-service Medicare beneficiaries treated for cancer in 2006 at hospitals treating 10+ patients with each of the following cancers, according to Medicare claims: lung, prostate, breast, colon. An additional sample of 18,677 similar patients in SEER-Medicare administrative data. Main Outcomes and Measures Risk-adjusted mortality overall and by cancer type, stratified by type of hospital; measures of correlation and agreement between hospital-level outcomes risk adjusted using Medicare data alone and Medicare data with SEER data. Results There were large outcome differences between different types of hospitals that treat Medicare patients with cancer. At one year, cumulative mortality for Medicare-prospective-payment-system exempt hospitals was 10% lower than at community hospitals (18% versus 28%) across all cancers, the pattern persisted through five years of follow-up and within specific cancer types. Performance ranking of hospitals was

  18. 75 FR 45072 - Defense Federal Acquisition Regulation Supplement; Inflation Adjustment of Acquisition-Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-02

    ...; Inflation Adjustment of Acquisition-Related Thresholds (DFARS Case 2009-D003) AGENCY: Defense Acquisition... the adjustment of acquisition-related thresholds for inflation just maintains the status quo. No... thresholds for inflation: 0704-0229--Defense Federal Acquisition Regulation Supplement Part 225,...

  19. Health-related quality of life and life satisfaction in colorectal cancer survivors: trajectories of adjustment

    PubMed Central

    2013-01-01

    Background This longitudinal study describes the five year trajectories of health-related quality of life (HR-QOL) and life satisfaction in long term colorectal cancer survivors. Patients and methods A population-based sample of 1966 colorectal cancer survivors were surveyed at six time points from five months to five years post-diagnosis. Predictor variables were: socio-demographic variables, optimism; cancer threat appraisal; perceived social support. Quality of life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HR-QOL); and the Satisfaction with Life Scale. Growth mixture models were applied to identify trajectory classes and their predictors. Results Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. Lower optimism, poorer social support, a more negative cognitive appraisal, and younger age were associated with poorer life satisfaction, while survivors with less than 8 years of education had higher life satisfaction. This pattern was similar for overall HR-QOL except that educational level was not a significant predictor and later stage disease and female gender emerged as related to poorer outcomes. One in five survivors reported poorer constant HR-QOL (19.2%) and a small group had poor life satisfaction (7.2%); 26.2% reported constant high HR-QOL and 48.8% had high constant life satisfaction. Socioeconomic disadvantage and remoteness of residence uniquely predicted poorer outcomes in the colorectal cancer specific HR-QOL sub domain. Conclusion Although HR-QOL and subjective cognitive QOL share similar antecedents their trajectory patterns suggested they are distinct adjustment outcomes; with life satisfaction emerging as temporally stable phenomenon. Unique patterns of risk support suggest the need to account for heterogeneity in adjustment in longitudinal QOL studies with cancer survivors. PMID:23497387

  20. What's the Risk? A Simple Approach for Estimating Adjusted Risk Measures from Nonlinear Models Including Logistic Regression

    PubMed Central

    Kleinman, Lawrence C; Norton, Edward C

    2009-01-01

    Objective To develop and validate a general method (called regression risk analysis) to estimate adjusted risk measures from logistic and other nonlinear multiple regression models. We show how to estimate standard errors for these estimates. These measures could supplant various approximations (e.g., adjusted odds ratio [AOR]) that may diverge, especially when outcomes are common. Study Design Regression risk analysis estimates were compared with internal standards as well as with Mantel–Haenszel estimates, Poisson and log-binomial regressions, and a widely used (but flawed) equation to calculate adjusted risk ratios (ARR) from AOR. Data Collection Data sets produced using Monte Carlo simulations. Principal Findings Regression risk analysis accurately estimates ARR and differences directly from multiple regression models, even when confounders are continuous, distributions are skewed, outcomes are common, and effect size is large. It is statistically sound and intuitive, and has properties favoring it over other methods in many cases. Conclusions Regression risk analysis should be the new standard for presenting findings from multiple regression analysis of dichotomous outcomes for cross-sectional, cohort, and population-based case–control studies, particularly when outcomes are common or effect size is large. PMID:18793213

  1. School Adjustment of Pupils with ADHD: Cognitive, Emotional and Temperament Risk Factors

    ERIC Educational Resources Information Center

    Sanchez-Perez, Noelia; Gonzalez-Salinas, Carmen

    2013-01-01

    From different research perspectives, the cognitive and emotional characteristics associated with ADHD in children have been identified as risk factors for the development of diverse adjustment problems in the school context. Research in nonclinical population can additionally help in understanding ADHD deficits, since children with specific…

  2. Comparison of the Properties of Regression and Categorical Risk-Adjustment Models

    PubMed Central

    Averill, Richard F.; Muldoon, John H.; Hughes, John S.

    2016-01-01

    Clinical risk-adjustment, the ability to standardize the comparison of individuals with different health needs, is based upon 2 main alternative approaches: regression models and clinical categorical models. In this article, we examine the impact of the differences in the way these models are constructed on end user applications. PMID:26945302

  3. Adjustment before Learning: The Curricular Dilemma in Programs for At-Risk Students.

    ERIC Educational Resources Information Center

    Smith, Gregory A.

    This paper argues that programs for at-risk youth tend to overemphasize student adjustment and the mastery of institutional customs at the expense of instilling learning dispositions that might lead to the postsecondary educational training now required to find adequate adult employment. Programs often focus on drawing students into a more…

  4. Assessing At-Risk Youth Using the Reynolds Adolescent Adjustment Screening Inventory with a Latino Population

    ERIC Educational Resources Information Center

    Balkin, Richard S.; Cavazos, Javier, Jr.; Hernandez, Arthur E.; Garcia, Roberto; Dominguez, Denise L.; Valarezo, Alexandra

    2013-01-01

    Factor analyses were conducted on scores from the Reynolds Adolescent Adjustment Screening Inventory (RAASI; Reynolds, 2001) representing at-risk Latino youth. The 4-factor model of the RAASI did not exhibit a good fit. However, evidence of generalizability for Latino youth was noted. (Contains 3 tables.)

  5. Measuring Profitability Impacts of Information Technology: Use of Risk Adjusted Measures.

    ERIC Educational Resources Information Center

    Singh, Anil; Harmon, Glynn

    2003-01-01

    Focuses on understanding how investments in information technology are reflected in the income statements and balance sheets of firms. Shows that the relationship between information technology investments and corporate profitability is much better explained by using risk-adjusted measures of corporate profitability than using the same measures…

  6. Risk-Adjustment Simulation: Plans May Have Incentives To Distort Mental Health And Substance Use Coverage

    PubMed Central

    Montz, Ellen; Layton, Tim; Busch, Alisa B.; Ellis, Randall P.; Rose, Sherri; McGuire, Thomas G.

    2016-01-01

    Under the Affordable Care Act, the risk-adjustment program is designed to compensate health plans for enrolling people with poorer health status so that plans compete on cost and quality rather than the avoidance of high-cost individuals. This study examined health plan incentives to limit covered services for mental health and substance use disorders under the risk-adjustment system used in the health insurance Marketplaces. Through a simulation of the program on a population constructed to reflect Marketplace enrollees, we analyzed the cost consequences for plans enrolling people with mental health and substance use disorders. Our assessment points to systematic underpayment to plans for people with these diagnoses. We document how Marketplace risk adjustment does not remove incentives for plans to limit coverage for services associated with mental health and substance use disorders. Adding mental health and substance use diagnoses used in Medicare Part D risk adjustment is one potential policy step toward addressing this problem in the Marketplaces. PMID:27269018

  7. Association between firearm ownership, firearm-related risk and risk reduction behaviours and alcohol-related risk behaviours.

    PubMed

    Wintemute, Garen J

    2011-12-01

    Alcohol use and firearm ownership are risk factors for violent injury and death. To determine whether firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours, the author conducted a cross-sectional study using Behavioral Risk Factor Surveillance System data for eight states in the USA from 1996 to 1997 (the most recent data available). Altogether, 15 474 respondents provided information on firearm exposure. After adjustment for demographics and state of residence, firearm owners were more likely than those with no firearms at home to have ≥5 drinks on one occasion (OR 1.32; 95% CI 1.16 to 1.50), to drink and drive (OR 1.79; 95% CI 1.34 to 2.39) and to have ≥60 drinks per month (OR 1.45; 95% CI 1.14 to 1.83). Heavy alcohol use was most common among firearm owners who also engaged in behaviours such as carrying a firearm for protection against other people and keeping a firearm at home that was both loaded and not locked away. The author concludes that firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours.

  8. 27 CFR 24.279 - Tax adjustments related to wine credit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... wine credit. 24.279 Section 24.279 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Removal, Return and Receipt of Wine Taxpaid Removals § 24.279 Tax adjustments related to wine credit. (a) Increasing adjustments. Persons who...

  9. 27 CFR 24.279 - Tax adjustments related to wine credit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... wine credit. 24.279 Section 24.279 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Removal, Return and Receipt of Wine Taxpaid Removals § 24.279 Tax adjustments related to wine credit. (a) Increasing adjustments. Persons who...

  10. 27 CFR 24.279 - Tax adjustments related to wine credit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... wine credit. 24.279 Section 24.279 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Removal, Return and Receipt of Wine Taxpaid Removals § 24.279 Tax adjustments related to wine credit. (a) Increasing adjustments. Persons who...

  11. 27 CFR 24.279 - Tax adjustments related to wine credit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... wine credit. 24.279 Section 24.279 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Removal, Return and Receipt of Wine Taxpaid Removals § 24.279 Tax adjustments related to wine credit. (a) Increasing adjustments. Persons who...

  12. 27 CFR 24.279 - Tax adjustments related to wine credit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... wine credit. 24.279 Section 24.279 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL WINE Removal, Return and Receipt of Wine Taxpaid Removals § 24.279 Tax adjustments related to wine credit. (a) Increasing adjustments. Persons who...

  13. Relation between Severity of Chronic Illness and Adjustment in Children and Adolescents with Sickle Cell Disease.

    ERIC Educational Resources Information Center

    Hurtig, Anita Landau; And Others

    1989-01-01

    The study with 70 children and adolescents with sickle cell disease did not support the hypothesis that illness severity (measured by frequency of hospitalization) would affect adjustment (measured by IQ, self-esteem, social and personal adjustment, behavioral problems, school performance, and peer relations). (Author/DB)

  14. 76 FR 81432 - Revision of Patent Term Adjustment Provisions Relating to Appellate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... Provisions Relating to Appellate Review AGENCY: United States Patent and Trademark Office, Commerce. ACTION... proposing to revise the patent term adjustment provisions of the rules of practice in patent cases. The patent term adjustment provisions of the American Inventors Protection Act of 1999 (AIPA) provide...

  15. Psychosocial Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorder: Risk and Protective Factors.

    PubMed

    Walton, Katherine M; Ingersoll, Brooke R

    2015-09-01

    This study compared sibling adjustment and relationships in siblings of children with Autism Spectrum Disorder (ASD-Sibs; n = 69) and siblings of children with typical development (TD-Sibs; n = 93). ASD-Sibs and TD-Sibs demonstrated similar emotional/behavioral adjustment. Older male ASD-Sibs were at increased risk for difficulties. Sibling relationships of ASD-Sibs involved less aggression, less involvement, and more avoidance than those of TD-Sibs. Partial support for a diathesis-stress conceptualization of sibling difficulties was found for ASD-Sibs. For TD-Sibs, broader autism phenotype (BAP) was related to psychosocial difficulties regardless of family stressors. For ASD-Sibs, BAP was related to difficulties only when family stressors were present. This suggests that having a sibling with ASD may be a protective factor that attenuates the negative impact of sibling BAP.

  16. ADJUSTMENT AMONG CHILDREN WITH RELATIVES WHO PARTICIPATED IN THE MANHUNT FOLLOWING THE BOSTON MARATHON ATTACK

    PubMed Central

    Comer, Jonathan S.; Kerns, Caroline E.; Elkins, R. Meredith; Edson, Aubrey L.; Chou, Tommy; Dantowitz, Annie; Miguel, Elizabeth; Brown, Bonnie; Coxe, Stefany; Green, Jennifer Greif

    2014-01-01

    Background Following the Boston Marathon attack, the extraordinary interagency manhunt and shelter-in-place made for a truly unprecedented experience for area families. Although research on Boston youth has found robust associations between manhunt-related experiences and post-attack functioning, such work does little to identify the specific needs of a particularly vulnerable population—i.e., children with a relative who participated in the manhunt. Understanding the adjustment of these youth is critical for informing clinical efforts. Methods Survey of Boston-area parents/caretakers (N = 460) reporting on their child’s attack/manhunt-related experiences, as well as psychosocial functioning in the first six post-attack months; analyses compared youth with and without a relative in law enforcement or the armed services who participated in the manhunt. Results The proportion of youth with likely PTSD was 5.7 times higher among youth with relatives in the manhunt than among youth without. After accounting for child demographics, blast exposure, and children’s own exposure to manhunt events (e.g., hearing/seeing gunfire/explosions, having officers enter/search home), having a relative in the manhunt significantly predicted child PTSD symptoms, emotional symptoms, and hyperactivity/inattention. Fear during the manhunt that a loved one could be hurt mediated relationships between having a relative in the manhunt and clinical outcomes; living within the zone of greatest manhunt activity did not moderate observed relationships. Conclusions Children with relatives called upon to participate in the unprecedented interagency manhunt following the Boston Marathon attack carried a particularly heavy mental health burden. Continued research is needed to clarify the clinical needs of youth with relatives in high-risk occupations. PMID:24865569

  17. Preschool children's cardiac reactivity moderates relations between exposure to family violence and emotional adjustment.

    PubMed

    Cipriano, Elizabeth A; Skowron, Elizabeth A; Gatzke-Kopp, Lisa M

    2011-08-01

    This study examined relations between cardiac reactivity, family violence exposure (i.e., child maltreatment [CM] and inter-partner violence [IPV]), and preschool children's emotional adjustment. A sample of 92 mother-preschooler dyads was drawn from predominantly low-income, rural communities. Dyads participated in a laboratory session in which children's Electrocardiograph (ECG) monitoring occurred during a resting baseline, joint-challenge, and individual emotional and cognitive tasks. Mothers consented to review of Children & Youth Services (CYS) records for CM and completed an IPV measure. Mothers rated children's emotional adjustment, and observers rated children on their frustration and positive affect. Children's vagal suppression was shown to moderate relations between family violence exposure and emotional adjustment. Findings indicated that children greater in vagal suppression showed better emotional adjustment when from families low in violence. However, regardless of children's level of vagal suppression, all children showed poorer emotional adjustment when from families high in violence.

  18. Using Quantile and Asymmetric Least Squares Regression for Optimal Risk Adjustment.

    PubMed

    Lorenz, Normann

    2016-06-13

    In this paper, we analyze optimal risk adjustment for direct risk selection (DRS). Integrating insurers' activities for risk selection into a discrete choice model of individuals' health insurance choice shows that DRS has the structure of a contest. For the contest success function (csf) used in most of the contest literature (the Tullock-csf), optimal transfers for a risk adjustment scheme have to be determined by means of a restricted quantile regression, irrespective of whether insurers are primarily engaged in positive DRS (attracting low risks) or negative DRS (repelling high risks). This is at odds with the common practice of determining transfers by means of a least squares regression. However, this common practice can be rationalized for a new csf, but only if positive and negative DRSs are equally important; if they are not, optimal transfers have to be calculated by means of a restricted asymmetric least squares regression. Using data from German and Swiss health insurers, we find considerable differences between the three types of regressions. Optimal transfers therefore critically depend on which csf represents insurers' incentives for DRS and, if it is not the Tullock-csf, whether insurers are primarily engaged in positive or negative DRS. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Are emotion regulation skills related to adjustment among people with chronic pain, independent of pain coping?

    PubMed

    Agar-Wilson, M; Jackson, T

    2012-01-01

    Although emotion regulation capacities have been linked to adjustment among people with chronic pain, researchers have yet to determine whether these capacities are related to functioning independent of established facets of pain coping. The present study was designed to address this gap. A sample 128 Australian adults with chronic pain (44 men, 84 women) completed self-report measures of adjustment (quality of life, negative affect, and pain-related disability), pain coping, and features of emotion regulation (emotion appraisal, perceived efficacy in emotion regulation, emotion utilization). Hierarchical multiple regression analyses indicated that efficacy in emotion regulation was related to quality of life and reduced negative affect even after statistically controlling for effects of other measures of adjustment, pain coping efficacy, and pain coping. Conversely, features of emotion regulation did not improve the prediction model for pain-related disability. Findings suggest emotion regulation capacities may have a unique role in the prediction of specific facets of adjustment among people with chronic pain.

  20. Appraisal of transplant-related stressors, coping strategies, and psychosocial adjustment following kidney transplantation.

    PubMed

    Pisanti, Renato; Lombardo, Caterina; Luszczynska, Aleksandra; Poli, Luca; Bennardi, Linda; Giordanengo, Luca; Berloco, Pasquale Bartolomeo; Violani, Cristiano

    2016-11-09

    This study examined the relations between appraisal of transplant-related stressors, coping, and adjustment dimensions following kidney transplantation (KT). Two models were tested: (1) the main effects model proposing that stress appraisal and coping strategies are directly associated with adjustment dimensions; and (2) the moderating model of stress proposing that each coping strategy interacts with stress appraisal. Importantly, there is a lack of research examining the two models simultaneously among recipients of solid organ transplantation. A total of 174 KT recipients completed the questionnaires. Predictors of post-transplant adjustment included appraisal of transplant-related stressors and coping strategies (task-, emotion-, and avoidance-focused). Adjustment dimensions were psychological distress, worries about the transplant, feelings of guilt, fear of disclosure of transplant, adherence, and responsibility for the functioning of the new organ. The main and moderating effects were tested with regression analyses. Appraisal of transplant-related stressors and emotion-oriented coping were related to all adjustment dimensions, except of adherence and responsibility. Task-oriented coping was positively related to responsibility. Avoidance-oriented coping was negatively correlated with adherence. Only 1 out of 18 hypothesized interactive terms was significant, yielding a synergistic interaction between appraisal of transplant-related stressors and emotion-oriented coping on the sense of guilt. The findings have the potential to inform interventions promoting psychosocial adjustment among KT recipients.

  1. The Relation between Parenting Transitions and Adjustment in Young Adolescents: A Multisample Investigation.

    ERIC Educational Resources Information Center

    Kurdek, Lawrence A.; And Others

    1994-01-01

    Investigated the effects of and relationship between the number of parenting transitions (divorce, remarriage) and adjustment in three samples of adolescent girls and boys not identified as being at risk for problems. Found qualified evidence of a negative linear relationship between the number of parenting transitions experienced and child…

  2. Evolving Adjustments to External (Gamma) Slope Factors for CERCLA Risk and Dose Assessments - 12290

    SciTech Connect

    Walker, Stuart

    2012-07-01

    To model the external exposure pathway in risk and dose assessments of radioactive contamination at Superfund sites, the U.S. Environmental Protection Agency (EPA) uses slope factors (SFs), also known as risk coefficients, and dose conversion factors (DCFs). Without any adjustment these external radiation exposure pathways effectively assumes that an individual is exposed to a source geometry that is effectively an infinite slab. The concept of an 'infinite slab' means that the thickness of the contaminated zone and its aerial extent are so large that it behaves as if it were infinite in its physical dimensions. EPA has been making increasingly complex adjustments to account for the extent of the contamination and its corresponding radiation field to provide more accurate risk and dose assessment modeling when using its calculators. In most instances, the more accurate modeling results derived from these gamma adjustments are less conservative. The notable exception are for some radionuclides in rooms with contaminated walls, ceiling, and floors, and the receptor is in location of the room with the highest amount of radiation exposure, usually the corner of small rooms and the center of large conference rooms. (authors)

  3. A risk-adjusted approach to comparing the return on investment in health care programs.

    PubMed

    Sendi, Pedram; Al, Maiwenn J; Zimmermann, Heinz

    2004-09-01

    The league table approach to rank ordering health care programs according to the incremental cost-effectiveness ratio is a common method to guide policy makers in setting priorities for resource allocation. In the presence of uncertainty, however, ranking programs is complicated by the degree of variability associated with each program. Confidence intervals for cost-effectiveness ratios may be overlapping. Moreover, confidence intervals may include negative ratios and the interpretation of negative cost-effectiveness ratios is ambiguous. We suggest to rank mutually exclusive health care programs according to their rate of return which is defined as the net monetary benefit over the costs of the program. However, how does a program with a higher expected return but higher uncertainty compare to a program with a lower expected return but lower risk? In the present paper we propose a risk-adjusted measure to compare the return on investment in health care programs. Financing a health care program is treated as an investment in a risky asset. The risky asset is combined with a risk-free asset in order to construct a combined portfolio. The weights attributed to the risk-free and risky assets are chosen in such a manner that all programs under consideration exhibit the same degree of uncertainty. We can then compare the performance of the individual programs by constructing a risk-adjusted league table of expected returns.

  4. The public health hazards of risk avoidance associated with public reporting of risk-adjusted outcomes in coronary intervention.

    PubMed

    Resnic, Frederic S; Welt, Frederick G P

    2009-03-10

    Public reporting of risk-adjusted outcomes for percutaneous coronary intervention (PCI) procedures has been mandated in New York State for more than a decade. During that time there has been a significant decline in the unadjusted mortality after such procedures. Massachusetts joined New York in 2003 as only the second state to require case level reporting of every coronary interventional procedure performed. In this review, we explore the differences in the populations reported by the 2 states and consider possible risks of public reporting of clinical outcomes after PCI procedures, including the risk of increasing conservatism in the treatment of the sickest patients. We offer a conceptual framework to understand the potential risk-averse behavior of interventional cardiologists subject to public reporting, and offer several proposals to counteract this potential deleterious effect of reporting programs.

  5. The public health hazards of risk avoidance associated with public reporting of risk adjusted outcomes in coronary intervention

    PubMed Central

    Resnic, Frederic S.; Welt, Frederick G. P.

    2009-01-01

    Public reporting of risk adjusted outcomes for percutaneous coronary interventional (PCI) procedures has been mandated in New York State for more than a decade. Over that time there has been a significant decline in the unadjusted mortality following such procedures. Massachusetts joined New York in 2003 as only the second state to require case level reporting of every coronary interventional procedure performed. In this review, we explore the differences in the populations reported by the two states, and consider possible risks of public reporting of clinical outcomes following PCI procedures including the risk of increasing conservatism in the treatment of the sickest patients. We offer a conceptual framework to understand the potential risk-averse behavior of interventional cardiologists subject to public reporting, and offer several proposals to counteract this potential deleterious effect of reporting programs. PMID:19264236

  6. Ambient Fine Particulate Matter Exposure and Risk of Cardiovascular Mortality: Adjustment of the Meteorological Factors

    PubMed Central

    Luo, Kai; Li, Wenjing; Zhang, Ruiming; Li, Runkui; Xu, Qun; Cao, Yang

    2016-01-01

    Few studies have explicitly explored the impacts of the extensive adjustment (with a lag period of more than one week) of temperature and humidity on the association between ambient fine particulate matter (PM2.5) and cardiovascular mortality. In a time stratified case-crossover study, we used a distributed lag nonlinear model to assess the impacts of extensive adjustments of temperature and humidity for longer lag periods (for 7, 14, 21, 28 and 40 days) on effects of PM2.5 on total cardiovascular mortality and mortality of cerebrovascular and ischemic heart disease and corresponding exposure-response relationships in Beijing, China, between 2008 and 2011. Compared with results only controlled for temperature and humidity for 2 days, the estimated effects of PM2.5 were smaller and magnitudes of exposure-response curves were decreased when longer lag periods of temperature and relative humidity were included for adjustments, but these changes varied across subpopulation, with marked decreases occurring in males and the elderly who are more susceptible to PM2.5-related mortalities. Our findings suggest that the adjustment of meteorological factors using lag periods shorter than one week may lead to overestimated effects of PM2.5. The associations of PM2.5 with cardiovascular mortality in susceptible populations were more sensitive to further adjustments for temperature and relative humidity. PMID:27827945

  7. Parental reactions to children's negative emotions: prospective relations to Chinese children's psychological adjustment.

    PubMed

    Tao, Annie; Zhou, Qing; Wang, Yun

    2010-04-01

    The prospective relations between five types of parental reactions to children's negative emotions (PRCNE) and children's psychological adjustment (behavioral problems and social competence) were examined in a two-wave longitudinal study of 425 school-age children in China. Parents (mostly mothers) reported their own PRCNE. Parents, teachers, and children or peers reported on children's adjustment. Parental punitive reactions positively predicted externalizing problems (controlling for baseline), whereas emotion- and problem-focused reactions were negatively related to internalizing problems. Parental minimizing and encouragement of emotion expression were unrelated to adjustment. Concurrent relations were found between PRCNE and parents' authoritative and authoritarian parenting dimensions. However, PRCNE did not uniquely predict adjustment controlling for global parenting dimensions. The findings have implications for cultural adaptation of parent-focused interventions for families of Chinese origin.

  8. One idea of portfolio risk control for absolute return strategy risk adjustments by signals from correlation behavior

    NASA Astrophysics Data System (ADS)

    Nishiyama, N.

    2001-12-01

    Absolute return strategy provided from fund of funds (FOFs) investment schemes is the focus in Japanese Financial Community. FOFs investment mainly consists of hedge fund investment and it has two major characteristics which are low correlation against benchmark index and little impact from various external changes in the environment given maximizing return. According to the historical track record of survival hedge funds in this business world, they maintain a stable high return and low risk. However, one must keep in mind that low risk would not be equal to risk free. The failure of Long-term capital management (LTCM) that took place in the summer of 1998 was a symbolized phenomenon. The summer of 1998 exhibited a certain limitation of traditional value at risk (VaR) and some possibility that traditional VaR could be ineffectual to the nonlinear type of fluctuation in the market. In this paper, I try to bring self-organized criticality (SOC) into portfolio risk control. SOC would be well known as a model of decay in the natural world. I analyzed nonlinear type of fluctuation in the market as SOC and applied SOC to capture complicated market movement using threshold point of SOC and risk adjustments by scenario correlation as implicit signals. Threshold becomes the control parameter of risk exposure to set downside floor and forecast extreme nonlinear type of fluctuation under a certain probability. Simulation results would show synergy effect of portfolio risk control between SOC and absolute return strategy.

  9. Identifying Military and Combat-Specific Risk Factors for Child Adjustment: Comparing High and Low Risk Military Families and Civilian Families

    DTIC Science & Technology

    2013-06-01

    0034 TITLE: Identifying Military and Combat-Specific Risk Factors for Child Adjustment: Comparing High and Low Risk Military Families and...From - To) 15 May 2012- 14 May 2013 Identifying Military and Combat-Specific Risk Factors for Child Adjustment: Comparing High and Low Risk...N=200) whose spouse/partner is currently deployed and has a child between the age of 3 and 7 and comparison groups of civilain single parent

  10. Relative risk regression analysis of epidemiologic data.

    PubMed

    Prentice, R L

    1985-11-01

    Relative risk regression methods are described. These methods provide a unified approach to a range of data analysis problems in environmental risk assessment and in the study of disease risk factors more generally. Relative risk regression methods are most readily viewed as an outgrowth of Cox's regression and life model. They can also be viewed as a regression generalization of more classical epidemiologic procedures, such as that due to Mantel and Haenszel. In the context of an epidemiologic cohort study, relative risk regression methods extend conventional survival data methods and binary response (e.g., logistic) regression models by taking explicit account of the time to disease occurrence while allowing arbitrary baseline disease rates, general censorship, and time-varying risk factors. This latter feature is particularly relevant to many environmental risk assessment problems wherein one wishes to relate disease rates at a particular point in time to aspects of a preceding risk factor history. Relative risk regression methods also adapt readily to time-matched case-control studies and to certain less standard designs. The uses of relative risk regression methods are illustrated and the state of development of these procedures is discussed. It is argued that asymptotic partial likelihood estimation techniques are now well developed in the important special case in which the disease rates of interest have interpretations as counting process intensity functions. Estimation of relative risks processes corresponding to disease rates falling outside this class has, however, received limited attention. The general area of relative risk regression model criticism has, as yet, not been thoroughly studied, though a number of statistical groups are studying such features as tests of fit, residuals, diagnostics and graphical procedures. Most such studies have been restricted to exponential form relative risks as have simulation studies of relative risk estimation

  11. 75 FR 3187 - Defense Federal Acquisition Regulation Supplement: Inflation Adjustment of Acquisition-Related...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... adjustment every 5 years of statutory acquisition- related thresholds, except for Davis-Bacon Act, Service... acquisition-related thresholds, except for Davis-Bacon Act, Service Contract Act, and trade agreements... acquisition-related thresholds established by the Davis Bacon Act, the Service Contract Act, or...

  12. Anticipatory postural adjustments contribute to age-related changes in compensatory steps associated with unilateral perturbations.

    PubMed

    Hyodo, Masaki; Saito, Mayumi; Ushiba, Junichi; Tomita, Yutaka; Minami, Mihoko; Masakado, Yoshihisa

    2012-07-01

    Compensatory steps are essential for preventing falls following perturbations. This study aimed to explore age-related changes in compensatory steps to unilateral perturbations, specifically in terms of whether anticipatory postural adjustments (APAs) play a role in stabilizing lateral balance. Five young and five elderly male adults participated. The split-belt treadmill was used to provide bi- and unilateral perturbations, as forward or backward transitions, applied 10 times in random order. Backward steps evoked by unilateral forward perturbations were evaluated. We measured temporal characteristics, mediolateral (ML) center of mass (COM) motion, and ML step length of compensatory steps. Compensatory steps to unexpected perturbations showed delayed onset of foot-off (FO) and expanded lateral swing length in elderly compared to young subjects. Differences in COM motions and step width arose related to APAs. Elderly subjects showing APAs exhibited no significant differences in ML COM, ML COM velocity, or ML swing length compared to young subjects. However, elderly subjects without APAs showed significant changes toward instability in these parameters. The fact that APAs play a notable role, particularly in the elderly, in stability offers a new insight into preventing falls. However, APAs occurred in 29% of the steps of young and 35% of the steps of elderly subjects. If the occurrence of APAs in elderly people in response to compensatory steps was more frequent, fall risk would be reduced. Further studies, particularly into APA frequency, might contribute to improved intervention to prevent falls.

  13. Testing a Social Ecological Model for Relations between Political Violence and Child Adjustment in Northern Ireland

    PubMed Central

    Cummings, E. Mark; Merrilees, Christine E.; Schermerhorn, Alice C.; Goeke-Morey, Marcie C.; Shirlow, Peter; Cairns, Ed

    2013-01-01

    Relations between political violence and child adjustment are matters of international concern. Past research demonstrates the significance of community, family and child psychological processes in child adjustment, supporting study of inter-relations between multiple social ecological factors and child adjustment in contexts of political violence. Testing a social ecological model, 300 mothers and their children (M= 12.28 years, SD = 1.77) from Catholic and Protestant working class neighborhoods in Belfast, Northern Ireland completed measures of community discord, family relations, and children’s regulatory processes (i.e., emotional security) and outcomes. Historical political violence in neighborhoods based on objective records (i.e., politically motivated deaths) were related to family members’ reports of current sectarian and non-sectarian antisocial behavior. Interparental conflict and parental monitoring and children’s emotional security about both the community and family contributed to explanatory pathways for relations between sectarian antisocial behavior in communities and children’s adjustment problems. The discussion evaluates support for social ecological models for relations between political violence and child adjustment and its implications for understanding relations in other parts of the world. PMID:20423550

  14. Development and Validation of a Risk-Adjustment Tool in Acute Asthma

    PubMed Central

    Tsai, Chu-Lin; Clark, Sunday; Sullivan, Ashley F; Camargo, Carlos A

    2009-01-01

    Objective To develop and prospectively validate a risk-adjustment tool in acute asthma. Data Sources Data were obtained from two large studies on acute asthma, the Multicenter Airway Research Collaboration (MARC) and the National Emergency Department Safety Study (NEDSS) cohorts. Both studies involved >60 emergency departments (EDs) and were performed during 1996–2001 and 2003–2006, respectively. Both included patients aged 18–54 years presenting to the ED with acute asthma. Study Design Retrospective cohort studies. Data Collection Clinical information was obtained from medical record review. The risk index was derived in the MARC cohort and then was prospectively validated in the NEDSS cohort. Principle Findings There were 3,515 patients in the derivation cohort and 3,986 in the validation cohort. The risk index included nine variables (age, sex, current smoker, ever admitted for asthma, ever intubated for asthma, duration of symptoms, respiratory rate, peak expiratory flow, and number of beta-agonist treatments) and showed satisfactory discrimination (area under the receiver operating characteristic curve, 0.75) and calibration (p=.30 for Hosmer–Lemeshow test) when applied to the validation cohort. Conclusions We developed and validated a novel risk-adjustment tool in acute asthma. This tool can be used for health care provider profiling to identify outliers for quality improvement purposes. PMID:19619246

  15. Variation In Accountable Care Organization Spending And Sensitivity To Risk Adjustment: Implications For Benchmarking.

    PubMed

    Rose, Sherri; Zaslavsky, Alan M; McWilliams, J Michael

    2016-03-01

    Spending targets (or benchmarks) for accountable care organizations (ACOs) participating in the Medicare Shared Savings Program must be set carefully to encourage program participation while achieving fiscal goals and minimizing unintended consequences, such as penalizing ACOs for serving sicker patients. Recently proposed regulatory changes include measures to make benchmarks more similar for ACOs in the same area with different historical spending levels. We found that ACOs vary widely in how their spending levels compare with those of other local providers after standard case-mix adjustments. Additionally adjusting for survey measures of patient health meaningfully reduced the variation in differences between ACO spending and local average fee-for-service spending, but substantial variation remained, which suggests that differences in care efficiency between ACOs and local non-ACO providers vary widely. Accordingly, measures to equilibrate benchmarks between high- and low-spending ACOs--such as setting benchmarks to risk-adjusted average fee-for-service spending in an area--should be implemented gradually to maintain participation by ACOs with high spending. Use of survey information also could help mitigate perverse incentives for risk selection and upcoding and limit unintended consequences of new benchmarking methodologies for ACOs serving sicker patients.

  16. Testing a social ecological model for relations between political violence and child adjustment in Northern Ireland.

    PubMed

    Cummings, E Mark; Merrilees, Christine E; Schermerhorn, Alice C; Goeke-Morey, Marcie C; Shirlow, Peter; Cairns, Ed

    2010-05-01

    Relations between political violence and child adjustment are matters of international concern. Past research demonstrates the significance of community, family, and child psychological processes in child adjustment, supporting study of interrelations between multiple social ecological factors and child adjustment in contexts of political violence. Testing a social ecological model, 300 mothers and their children (M = 12.28 years, SD = 1.77) from Catholic and Protestant working class neighborhoods in Belfast, Northern Ireland, completed measures of community discord, family relations, and children's regulatory processes (i.e., emotional security) and outcomes. Historical political violence in neighborhoods based on objective records (i.e., politically motivated deaths) were related to family members' reports of current sectarian antisocial behavior and nonsectarian antisocial behavior. Interparental conflict and parental monitoring and children's emotional security about both the community and family contributed to explanatory pathways for relations between sectarian antisocial behavior in communities and children's adjustment problems. The discussion evaluates support for social ecological models for relations between political violence and child adjustment and its implications for understanding relations in other parts of the world.

  17. Classroom risks and resources: Teacher burnout, classroom quality and children's adjustment in high needs elementary schools.

    PubMed

    Hoglund, Wendy L G; Klingle, Kirsten E; Hosan, Naheed E

    2015-10-01

    The current paper presents two related sets of findings on the classroom context in high needs elementary schools. First, we investigated change over one school term in teacher burnout (emotional exhaustion, depersonalization, personal accomplishment) and classroom quality (emotional and instructional support, organization) and assessed the degree to which burnout and classroom quality co-varied over the term with each other and with aggregate externalizing behaviors (average child externalizing behaviors in the classroom). These analyses describe the classroom context in which the children are nested. Second, we examined change over one school term in children's social adjustment (relationship quality with teachers and friends) and academic adjustment (school engagement, literacy skills) and assessed how adjustment co-varied over time with child externalizing behaviors and was predicted by teacher burnout, classroom quality and aggregate externalizing behaviors. These models were tested with a sample of low-income, ethnically diverse children in kindergarten to grade 3 and their teachers. The children and teachers were assessed three times over one school term. Personal accomplishment co-varied positively with overall classroom quality. Reciprocally, classroom organization co-varied positively with overall teacher burnout. Aggregate externalizing behaviors co-varied positively with depersonalization and negatively with personal accomplishment and overall classroom quality, including emotional support and organization. In turn, teacher burnout interacted with aggregate externalizing behaviors to predict change in child social and academic adjustment. Alternatively, classroom quality interacted with aggregate and child externalizing behaviors to predict change in child social and academic adjustment.

  18. Adjustment of costly extra-group paternity according to inbreeding risk in a cooperative mammal

    PubMed Central

    Cant, Michael A.; Sanderson, Jennifer L.

    2015-01-01

    Females of many animal species seek mating opportunities with multiple males, despite being able to obtain sufficient sperm to father their offspring from a single male. In animals that live in stable social groups, females often choose to mate outside their group resulting in extra-group paternity (EGP). One reason proposed to explain female choice for extra-group males is to obtain compatible genes, for example, in order to avoid inbreeding depression in offspring. The benefits of such extra-group paternities could be substantial if they result in fitter, outbred offspring. However, avoiding inbreeding in this way could be costly for females, for example, through retaliation by cuckolded males or through receiving aggression while prospecting for extra-group mating opportunities. We investigate the costs and benefits of EGP in the banded mongoose Mungos mungo, a cooperatively breeding mammal in which within-group mates are sometimes close relatives. We find that pups born to females that mate with extra-group males are more genetically heterozygous are heavier and are more likely to survive to independence than pups born to females that mate within their group. However, extra-group matings also involve substantial costs as they occur during violent encounters that sometimes result in injury and death. This appears to lead femalebanded mongooses to adaptively adjust EGP levels according to the current risk of inbreeding associated with mating within the group. For group-living animals, the costs of intergroup interactions may help to explain variation in both inbreeding rates and EGP within and between species. PMID:26609201

  19. 12 CFR Appendix B to Part 3 - Risk-Based Capital Guidelines; Market Risk Adjustment

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... internal model may use any generally accepted measurement techniques, such as variance-covariance models, historical simulations, or Monte Carlo simulations. However, the level of sophistication and accuracy of a... from business trading units. (2) The bank's internal risk measurement model must be integrated into...

  20. 12 CFR Appendix B to Part 3 - Risk-Based Capital Guidelines; Market Risk Adjustment

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Basle Committee on Banking Supervision and endorsed by the Group of Ten Central Bank Governors. The... trading activity 2 (on a worldwide consolidated basis) equals: 2 Trading activity means the gross sum of...) The bank must have a risk control unit that reports directly to senior management and is...

  1. 12 CFR Appendix B to Part 3 - Risk-Based Capital Guidelines; Market Risk Adjustment

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... safe and sound banking practices. (3) The OCC may exclude a national bank otherwise meeting the... deems it consistent with safe and sound banking practices. (c) Scope. The capital requirements of this... maturity) if the payment would cause the issuing bank's risk-based capital ratio to fall or remain...

  2. Regression Trees Identify Relevant Interactions: Can This Improve the Predictive Performance of Risk Adjustment?

    PubMed

    Buchner, Florian; Wasem, Jürgen; Schillo, Sonja

    2017-01-01

    Risk equalization formulas have been refined since their introduction about two decades ago. Because of the complexity and the abundance of possible interactions between the variables used, hardly any interactions are considered. A regression tree is used to systematically search for interactions, a methodologically new approach in risk equalization. Analyses are based on a data set of nearly 2.9 million individuals from a major German social health insurer. A two-step approach is applied: In the first step a regression tree is built on the basis of the learning data set. Terminal nodes characterized by more than one morbidity-group-split represent interaction effects of different morbidity groups. In the second step the 'traditional' weighted least squares regression equation is expanded by adding interaction terms for all interactions detected by the tree, and regression coefficients are recalculated. The resulting risk adjustment formula shows an improvement in the adjusted R(2) from 25.43% to 25.81% on the evaluation data set. Predictive ratios are calculated for subgroups affected by the interactions. The R(2) improvement detected is only marginal. According to the sample level performance measures used, not involving a considerable number of morbidity interactions forms no relevant loss in accuracy. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Relational Victimization: The Association between Recalled Adolescent Social Experiences and Emotional Adjustment in Early Adulthood

    ERIC Educational Resources Information Center

    Dempsey, Allison G.; Storch, Eric A.

    2008-01-01

    Although the relationship between relational victimization and psychosocial adjustment in adolescence has been established, it is unknown whether it extends into early adulthood. The current retrospective study investigated the relationship between recall of adolescent relational victimization and symptoms of depression, social anxiety, and…

  4. Need for risk adjustment in adapting episode grouping software to Medicare data.

    PubMed

    MaCurdy, Thomas; Kerwin, Jason; Theobald, Nick

    2009-01-01

    Episode grouper software offers a potential framework for developing important components of a pay-for-performance system for healthcare providers. If the costs for treating health conditions can be computed, then policymakers can in principle benchmark different providers' cost distributions and reward the most efficient. This article applies two of the most prominent commercial groupers and examines the properties of the cost distributions calculated for their constructed episodes. The analysis reveals that episode cost distributions exhibit substantial variation and skewness, suggesting the need for innovative risk adjustment methods prior to utilizing groupers for the purpose of physician profiling.

  5. Psychosocial Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorder: Risk and Protective Factors

    ERIC Educational Resources Information Center

    Walton, Katherine M.; Ingersoll, Brooke R.

    2015-01-01

    This study compared sibling adjustment and relationships in siblings of children with Autism Spectrum Disorder (ASD-Sibs; n = 69) and siblings of children with typical development (TD-Sibs; n = 93). ASD-Sibs and TD-Sibs demonstrated similar emotional/behavioral adjustment. Older male ASD-Sibs were at increased risk for difficulties. Sibling…

  6. Relations of SARS-Related Stressors and Coping to Chinese College Students' Psychological Adjustment during the 2003 Beijing SARS Epidemic

    ERIC Educational Resources Information Center

    Main, Alexandra; Zhou, Qing; Ma, Yue; Luecken, Linda J.; Liu, Xin

    2011-01-01

    This study examined the main and interactive relations of stressors and coping related to severe acute respiratory syndrome (SARS) with Chinese college students' psychological adjustment (psychological symptoms, perceived general health, and life satisfaction) during the 2003 Beijing SARS epidemic. All the constructs were assessed by self-report…

  7. Longitudinal relations between sectarian and nonsectarian community violence and child adjustment in Northern Ireland.

    PubMed

    Cummings, E Mark; Merrilees, Christine E; Taylor, Laura K; Shirlow, Peter; Goeke-Morey, Marcie C; Cairns, Ed

    2013-08-01

    Although relations between political violence and child adjustment are well documented, longitudinal research is needed to adequately address the many questions remaining about the contexts and developmental trajectories underlying the effects on children in areas of political violence. The study examined the relations between sectarian and nonsectarian community violence and adolescent adjustment problems over 4 consecutive years. Participants included 999 mother-child dyads (482 boys, 517 girls), M ages = 12.18 (SD = 1.82), 13.24 (SD = 1.83), 13.61 (SD = 1.99), and 14.66 (SD = 1.96) years, respectively, living in socially deprived neighborhoods in Belfast, Northern Ireland, a context of historical and ongoing political violence. In examining trajectories of adjustment problems, including youth experience with both sectarian and nonsectarian antisocial behaviors, sectarian antisocial behavior significantly predicted more adjustment problems across the 4 years of the study. Experiencing sectarian antisocial behavior was related to increased adolescent adjustment problems, and this relationship was accentuated in neighborhoods characterized by higher crime rates. The discussion considers the implications for further validating the distinction between sectarian and nonsectarian violence, including consideration of neighborhood crime levels, from the child's perspective in a setting of political violence.

  8. Assessment and indirect adjustment for confounding by smoking in cohort studies using relative hazards models.

    PubMed

    Richardson, David B; Laurier, Dominique; Schubauer-Berigan, Mary K; Tchetgen Tchetgen, Eric; Cole, Stephen R

    2014-11-01

    Workers' smoking histories are not measured in many occupational cohort studies. Here we discuss the use of negative control outcomes to detect and adjust for confounding in analyses that lack information on smoking. We clarify the assumptions necessary to detect confounding by smoking and the additional assumptions necessary to indirectly adjust for such bias. We illustrate these methods using data from 2 studies of radiation and lung cancer: the Colorado Plateau cohort study (1950-2005) of underground uranium miners (in which smoking was measured) and a French cohort study (1950-2004) of nuclear industry workers (in which smoking was unmeasured). A cause-specific relative hazards model is proposed for estimation of indirectly adjusted associations. Among the miners, the proposed method suggests no confounding by smoking of the association between radon and lung cancer--a conclusion supported by adjustment for measured smoking. Among the nuclear workers, the proposed method suggests substantial confounding by smoking of the association between radiation and lung cancer. Indirect adjustment for confounding by smoking resulted in an 18% decrease in the adjusted estimated hazard ratio, yet this cannot be verified because smoking was unmeasured. Assumptions underlying this method are described, and a cause-specific proportional hazards model that allows easy implementation using standard software is presented.

  9. Breeds of risk-adjusted fundamentalist strategies in an order-driven market

    NASA Astrophysics Data System (ADS)

    LiCalzi, Marco; Pellizzari, Paolo

    2006-01-01

    This paper studies an order-driven stock market where agents have heterogeneous estimates of the fundamental value of the risky asset. The agents are budget-constrained and follow a value-based trading strategy which buys or sells depending on whether the price of the asset is below or above its risk-adjusted fundamental value. This environment generates returns that are remarkably leptokurtic and fat-tailed. By extending the study over a grid of different parameters for the fundamentalist trading strategy, we exhibit the existence of monotone relationships between the bid-ask spread demanded by the agents and several statistics of the returns. We conjecture that this effect, coupled with positive dependence of the risk premium on the volatility, generates positive feedbacks that might explain volatility bursts.

  10. CKD increases the risk of age-related macular degeneration.

    PubMed

    Liew, Gerald; Mitchell, Paul; Wong, Tien Yin; Iyengar, Sudha K; Wang, Jie Jin

    2008-04-01

    Age-related macular degeneration is the leading cause of irreversible blindness in the United States and often coexists with chronic kidney disease. Both conditions share common genetic and environmental risk factors. A total of 1183 participants aged 54+ were examined in the population-based, prospective cohort Blue Mountains Eye Study (Australia) to determine if chronic kidney disease increases the risk of age-related macular degeneration. Moderate chronic kidney disease (estimated glomerular filtration rate < 60 ml/min per 1.73 m(2) based on the Cockcroft-Gault equation) was present in 24% of the population (286 of 1183). The 5-yr incidence of early age-related macular degeneration was 3.9% in participants with no/mild chronic kidney disease (35 of 897) and 17.5% in those with moderate chronic kidney disease (50 of 286). After adjusting for age, sex, cigarette smoking, hypertension, complement factor H polymorphism, and other risk factors, persons with moderate chronic kidney disease were 3 times more likely to develop early age-related macular degeneration than persons with no/mild chronic kidney disease (odds ratio = 3.2; 95% confidence interval, 1.8 to 5.7, P < 0.0001). Each SD (14.8 ml/min per 1.73 m(2)) decrease in Cockcroft-Gault estimated glomerular filtration rate was associated with a doubling of the adjusted risk for early age-related macular degeneration (odds ratio = 2.0; 95% confidence interval, 1.5 to 2.8, P < 0.0001). In conclusion, persons with chronic kidney disease have a higher risk of early age-related macular degeneration, suggesting the possibility of shared pathophysiologic mechanisms between the two conditions.

  11. A Bayesian adaptive blinded sample size adjustment method for risk differences.

    PubMed

    Hartley, Andrew Montgomery

    2015-01-01

    Adaptive sample size adjustment (SSA) for clinical trials consists of examining early subsets of on trial data to adjust estimates of sample size requirements. Blinded SSA is often preferred over unblinded SSA because it obviates many logistical complications of the latter and generally introduces less bias. On the other hand, current blinded SSA methods for binary data offer little to no new information about the treatment effect, ignore uncertainties associated with the population treatment proportions, and/or depend on enhanced randomization schemes that risk partial unblinding. I propose an innovative blinded SSA method for use when the primary analysis is a non-inferiority or superiority test regarding a risk difference. The method incorporates evidence about the treatment effect via the likelihood function of a mixture distribution. I compare the new method with an established one and with the fixed sample size study design, in terms of maximization of an expected utility function. The new method maximizes the expected utility better than do the comparators, under a range of assumptions. I illustrate the use of the proposed method with an example that incorporates a Bayesian hierarchical model. Lastly, I suggest topics for future study regarding the proposed methods.

  12. International note: Maternal warmth, behavioral control, and psychological control: Relations to adjustment of Ghanaian early adolescents.

    PubMed

    Salaam, Braima; Mounts, Nina S

    2016-06-01

    This investigation addressed the relation between maternal warmth, behavioral control, psychological control, and psychological adjustment in a sample of 119 Ghanaian adolescents (42% boys) living in an urban area (mean age = 14.19). Adolescents in the sample reported clinically elevated levels of depression and anxiety. Significant associations were found between warmth, behavioral control, and psychological control and adolescents' anxiety, physical aggression, relational aggression, positive friendship quality, and conflict with friends. Warmth moderated the effect of behavioral control on anxiety, physical aggression, and relational aggression such that higher levels of warmth in combination with higher levels of behavioral control were related to more positive adjustment. Higher levels of warmth in conjunction with higher psychological control were related to higher levels of anxiety. Boys who reported lower levels of warmth in combination with higher behavioral control reported higher levels of physical aggression. For boys reporting higher levels of warmth, higher behavioral control was associated with lower physical aggression.

  13. Relational aggression in middle childhood predicting adolescent social-psychological adjustment: the role of friendship quality.

    PubMed

    Kamper, Kimberly E; Ostrov, Jamie M

    2013-01-01

    The present longitudinal study examined the indirect effect of 6th-grade negative friendship quality on the associations between 5th-grade relational aggression and age 15 social-psychological adjustment (i.e., depressive symptoms and risky behavior). The study consisted of a secondary analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development using 776 children (M = 10.42 years in 5th grade; 50.4% boys) from the original sample. Using teacher and self-report ratings, relational and physical aggression, friendship quality, depressive symptoms, and risky behavior were measured. Bootstrapping mediation analyses were conducted. Negative friendship quality was found to mediate the association between relational aggression and depressive symptoms as well as between relational aggression and risky behavior, when controlling for physical aggression, gender and age. This longitudinal study identifies possible developmental pathways by which relational aggression and future social psychological adjustment may be linked.

  14. Negative Cognitive Errors and Positive Illusions: Moderators of Relations between Divorce Events and Children's Psychological Adjustment.

    ERIC Educational Resources Information Center

    Mazur, Elizabeth; Wolchik, Sharlene

    Building on prior literature on adults' and children's appraisals of stressors, this study investigated relations among negative and positive appraisal biases, negative divorce events, and children's post-divorce adjustment. Subjects were 79 custodial nonremarried mothers and their children ages 9 to 13 who had experienced parental divorce within…

  15. Acculturation and Social Support in Relation to Psychosocial Adjustment of Adolescent Refugees Resettled in Australia

    ERIC Educational Resources Information Center

    Kovacev, Lydia; Shute, Rosalyn

    2004-01-01

    This study examined how different modes of acculturation and perceived social support are related to adolescent refugee psychosocial adjustment, as measured by global self-worth and peer social acceptance. The 83 participants, aged between 12 and 19 and now resident in Australia, were from the former Republic of Yugoslavia. Those who had the most…

  16. Individual Skill Predictors of the School- and Career-Related Adjustment of Adolescents with Disabilities

    ERIC Educational Resources Information Center

    Pinkney, Christopher J.; Murray, Christopher J.; Lind, John R.

    2012-01-01

    In this investigation, the authors examine the relationship between individual skills (i.e., career locus of control [LOC], social skills [SOC], and social problem-solving skills [SPSS]) and the school- and perceived career-related adjustment of 211 students with disabilities. Data pertaining to individual skills were gathered from student…

  17. Children's Responses to Daily Social Stressors: Relations with Parenting, Children's Effortful Control, and Adjustment

    ERIC Educational Resources Information Center

    Valiente, Carlos; Lemery-Chalfant, Kathryn; Swanson, Jodi

    2009-01-01

    Background: We examined children's coping and involuntary stress responses as mediators of the relations between parenting or children's effortful control (EC) and adjustment. Method: Two hundred and forty primarily Mexican American 7- to 12-year-old children reported on their EC, coping, involuntary stress responses, and problem behaviors.…

  18. Social Cognition and Its Relation to Psychosocial Adjustment in Children with Nonverbal Learning Disabilities

    ERIC Educational Resources Information Center

    Galway, Tanya M.; Metsala, Jamie L.

    2011-01-01

    The current study examined social cognitive skills in children with nonverbal learning disabilities (NLD) compared to normally achieving (NA) children. The relation between social cognitive skills and psychosocial adjustment was also investigated. There were no group differences on children's ability to represent orally presented social vignettes.…

  19. Peer and School Problems in the Lives of Urban Adolescents: Frequency, Difficulty, and Relation to Adjustment

    ERIC Educational Resources Information Center

    Farrell, Albert D.; Sullivan, Terri N.; Kliewer, Wendy; Allison, Kevin W.; Erwin, Elizabeth H.; Meyer, Aleta L.; Esposito, Layla

    2006-01-01

    This study examined the occurrence of problem situations in the peer and school domains and their relation to adjustment among urban adolescents. Students from three urban middle schools ("N"=176) serving a predominantly African American population rated 61 problem situations identified in a previous qualitative study and completed measures of…

  20. Relations between political violence and child adjustment: a four-wave test of the role of emotional insecurity about community.

    PubMed

    Cummings, E Mark; Taylor, Laura K; Merrilees, Christine E; Goeke-Morey, Marcie C; Shirlow, Peter; Cairns, Ed

    2013-12-01

    This study further explored the impact of sectarian violence and children's emotional insecurity about community on child maladjustment using a 4-wave longitudinal design. The study included 999 mother-child dyads in Belfast, Northern Ireland (482 boys, 517 girls). Across the 4 waves, child mean age was 12.19 (SD = 1.82), 13.24 (SD = 1.83), 13.61 (SD = 1.99), and 14.66 years (SD = 1.96), respectively. Building on previous studies of the role of emotional insecurity in child adjustment, the current study examines within-person change in emotional insecurity using latent growth curve analyses. The results showed that children's trajectories of emotional insecurity about community were related to risk for developing conduct and emotion problems. These findings controlled for earlier adjustment problems, age, and gender, and took into account the time-varying nature of experience with sectarian violence. Discussion considers the implications for children's emotional insecurity about community for relations between political violence and children's adjustment, including the significance of trajectories of emotional insecurity over time.

  1. Relations between Political Violence and Child Adjustment: A Four-Wave Test of the Role of Emotional Insecurity about Community

    PubMed Central

    Cummings, E. Mark; Taylor, Laura K.; Merrilees, Christine E.; Goeke-Morey, Marcie C.; Shirlow, Peter; Cairns, Ed

    2015-01-01

    This study further explored the impact of sectarian violence and children’s emotional insecurity about community on child maladjustment using a four-wave longitudinal design. The study included 999 mother-child dyads in Belfast, Northern Ireland (482 boys, 517 girls). Across the four-waves, child mean age was 12.19 (SD = 1.82), 13.24 (SD = 1.83), 13.61 (SD = 1.99), and 14.66 years (SD = 1.96), respectively. Building on previous studies of the role of emotional insecurity in child adjustment, the current study examines within-person change in emotional insecurity using latent growth curve analyses. The results showed that children’s trajectories of emotional insecurity about community were related to risk for developing conduct and emotion problems. These findings controlled for earlier adjustment problems, age and gender, and took into account the time-varying nature of experience with sectarian violence. Discussion considers the implications for children’s emotional insecurity about community for relations between political violence and children’s adjustment, including the significance of trajectories of emotional insecurity over time. PMID:23527495

  2. Relative Hazard and Risk Measure Calculation Methodology

    SciTech Connect

    Stenner, Robert D.; Strenge, Dennis L.; Elder, Matthew S.

    2004-03-20

    The relative hazard (RH) and risk measure (RM) methodology and computer code is a health risk-based tool designed to allow managers and environmental decision makers the opportunity to readily consider human health risks (i.e., public and worker risks) in their screening-level analysis of alternative cleanup strategies. Environmental management decisions involve consideration of costs, schedules, regulatory requirements, health hazards, and risks. The RH-RM tool is a risk-based environmental management decision tool that allows managers the ability to predict and track health hazards and risks over time as they change in relation to mitigation and cleanup actions. Analysis of the hazards and risks associated with planned mitigation and cleanup actions provides a baseline against which alternative strategies can be compared. This new tool allows managers to explore “what if scenarios,” to better understand the impact of alternative mitigation and cleanup actions (i.e., alternatives to the planned actions) on health hazards and risks. This new tool allows managers to screen alternatives on the basis of human health risk and compare the results with cost and other factors pertinent to the decision. Once an alternative or a narrow set of alternatives are selected, it will then be more cost-effective to perform the detailed risk analysis necessary for programmatic and regulatory acceptance of the selected alternative. The RH-RM code has been integrated into the PNNL developed Framework for Risk Analysis In Multimedia Environmental Systems (FRAMES) to allow the input and output data of the RH-RM code to be readily shared with the more comprehensive risk analysis models, such as the PNNL developed Multimedia Environmental Pollutant Assessment System (MEPAS) model.

  3. Relating space radiation environments to risk estimates

    SciTech Connect

    Curtis, S.B.

    1991-10-01

    This lecture will provide a bridge from the physical energy or LET spectra as might be calculated in an organ to the risk of carcinogenesis, a particular concern for extended missions to the moon or beyond to Mars. Topics covered will include (1) LET spectra expected from galactic cosmic rays, (2) probabilities that individual cell nuclei in the body will be hit by heavy galactic cosmic ray particles, (3) the conventional methods of calculating risks from a mixed environment of high and low LET radiation, (4) an alternate method which provides certain advantages using fluence-related risk coefficients (risk cross sections), and (5) directions for future research and development of these ideas.

  4. Autonomy, Self-Realization, and Self-Advocacy and the School- and Career-Related Adjustment of Adolescent Girls with Disabilities

    ERIC Educational Resources Information Center

    Doren, Bonnie; Kang, Hyun Ju

    2016-01-01

    The purpose of the current study was to identify component elements of self-determination that may promote positive or buffer negative school- and career-related adjustment of adolescent girls with disabilities or with multiple risk factors. Autonomy, self-realization, and self-advocacy were examined together to ascertain both their cumulative and…

  5. Bidirectional Relations Between Temperament and Parenting Predicting Preschool-Age Children's Adjustment.

    PubMed

    Klein, Melanie R; Lengua, Liliana J; Thompson, Stephanie F; Moran, Lyndsey; Ruberry, Erika J; Kiff, Cara; Zalewski, Maureen

    2016-07-11

    Bidirectional associations between child temperament (fear, frustration, positive affect, effortful control) and parenting behaviors (warmth, negativity, limit setting, scaffolding, responsiveness) were examined as predictors of preschool-age children's adjustment problems and social competence. Participants were a community sample of children (N = 306; 50% female, 64% European American) and their mothers. Observational measures of child temperament and parenting were obtained using laboratory tasks at two time points (children's ages 36 and 54 months). Teacher-reported adjustment measures were collected at the first and third time points (children's ages 36 and 63 months). Cross-lagged analyses were performed to examine whether child temperament and parenting predict changes in one another, whether they each contribute independently to children's adjustment, and whether these transactional relations account for adjustment outcomes. Maternal negativity at 36 months predicted increases in child frustration at 54 months. Maternal negativity and child effortful control predicted decreases in each other from 36 to 54 months. Maternal warmth predicted increases in child effortful control over time. Child frustration, child effortful control, maternal warmth, and maternal negativity at 54 months each independently predicted child adjustment problems at 63 months, controlling for problems at 36 months. Child executive control at 54 months predicted increases in child social competence at 63 months. The findings suggest that temperament and parenting have independent and additive effects on preschool-age child adjustment, with some support for a bidirectional relation.

  6. Assessing the Relative Risk of Aerocapture Using Probabalistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Percy, Thomas K.; Bright, Ellanee; Torres, Abel O.

    2005-01-01

    A recent study performed for the Aerocapture Technology Area in the In-Space Propulsion Technology Projects Office at the Marshall Space Flight Center investigated the relative risk of various capture techniques for Mars missions. Aerocapture has been proposed as a possible capture technique for future Mars missions but has been perceived by many in the community as a higher risk option as compared to aerobraking and propulsive capture. By performing a probabilistic risk assessment on aerocapture, aerobraking and propulsive capture, a comparison was made to uncover the projected relative risks of these three maneuvers. For mission planners, this knowledge will allow them to decide if the mass savings provided by aerocapture warrant any incremental risk exposure. The study focuses on a Mars Sample Return mission currently under investigation at the Jet Propulsion Laboratory (JPL). In each case (propulsive, aerobraking and aerocapture), the Earth return vehicle is inserted into Martian orbit by one of the three techniques being investigated. A baseline spacecraft was established through initial sizing exercises performed by JPL's Team X. While Team X design results provided the baseline and common thread between the spacecraft, in each case the Team X results were supplemented by historical data as needed. Propulsion, thermal protection, guidance, navigation and control, software, solar arrays, navigation and targeting and atmospheric prediction were investigated. A qualitative assessment of human reliability was also included. Results show that different risk drivers contribute significantly to each capture technique. For aerocapture, the significant drivers include propulsion system failures and atmospheric prediction errors. Software and guidance hardware contribute the most to aerobraking risk. Propulsive capture risk is mainly driven by anomalous solar array degradation and propulsion system failures. While each subsystem contributes differently to the risk of

  7. Changes over calendar time in the risk of specific first AIDS-defining events following HIV seroconversion, adjusting for competing risks

    PubMed Central

    Babiker, Abdel; Darbyshire, Janet; Pezzotti, Patrizio; Porter, Kholoud; Rezza, Giovanni; Walker, Sarah A; Beral, Valerie; Coutinho, Roel; Del Amo, Julia; Gill, Noël; Lee, Christine; Meyer, Laurence; Tyrer, Freya; Dabis, François; Thiébaut, Rodolphe; Lawson-Aye, Sylvie; Boufassa, Faroudy; Hamouda, Osamah; Fischer, Klaus; Pezzotti, Patrizio; Touloumi, Giota; Hatzakis, Angelos; Karafoulidou, Anastasia; Katsarou, Olga; Brettle, Ray; Del Romero, Jorge; Prins, Maria; Van Benthem, Birgit; Kirk, Ole; Pederson, Court; Hernández Aguado, Idelfonso; Pérez-Hoyos, Santiago; Eskild, Anne; Bruun, Johan N; Sannes, Mette; Sabin, Caroline; Johnson, Anne M; Phillips, Andrew N; Francioli, Patrick; Vanhems, Philippe; Egger, Mathias; Rickenbach, Martin; Cooper, David; Kaldor, John; Ashton, Lesley; Vizzard, Jeanette; Muga, Roberto; Day, Nicholas E; De Angelis, Daniela

    2002-01-01

    Background Although studies have reported large reductions in the risks of AIDS and death since the introduction of potent anti-retroviral therapies, few have evaluated whether this has been similar for all AIDS-defining diseases. We wished to evaluate changes over time in the risk of specific AIDS-defining diseases, as first events, using data from individuals with known dates of HIV seroconversion. Methods Using a competing risks proportional hazards model on pooled data from 20 cohorts (CASCADE), we evaluated time from HIV seroconversion to each first AIDS-defining disease (16 groups) and to death without AIDS for four calendar periods, adjusting for exposure category, age, sex, acute infection, and stratifying by cohort. We compared results to those obtained from a cause-specific hazards model. Results Of 6941, 2021 (29%) developed AIDS and 437 (6%) died without AIDS. The risk of AIDS or death remained constant to 1996 then reduced; relative hazard = 0.89 (95% CI: 0.77–1.03); 0.90 (95% CI: 0.81–1.01); and 0.32 (95% CI: 0.28–0.37) for 1979–1990, 1991–1993, and 1997–2001, respectively, compared to 1994–1996. Significant risk reductions in 1997–2001 were observed in all but two AIDS-defining groups and death without AIDS in a competing risks model (with similar results from a cause-specific model). There was significant heterogeneity in the risk reduction across events; from 96% for cryptosporidiosis, to 17% for death without AIDS (P < 0.0001). Conclusion These findings suggest that studies reporting a stable trend for particular AIDS diseases over the period 1979–2001 may not have accounted for the competing risks among other events or lack the power to detect smaller trends. PMID:12435766

  8. Relative risk regression models with inverse polynomials.

    PubMed

    Ning, Yang; Woodward, Mark

    2013-08-30

    The proportional hazards model assumes that the log hazard ratio is a linear function of parameters. In the current paper, we model the log relative risk as an inverse polynomial, which is particularly suitable for modeling bounded and asymmetric functions. The parameters estimated by maximizing the partial likelihood are consistent and asymptotically normal. The advantages of the inverse polynomial model over the ordinary polynomial model and the fractional polynomial model for fitting various asymmetric log relative risk functions are shown by simulation. The utility of the method is further supported by analyzing two real data sets, addressing the specific question of the location of the minimum risk threshold.

  9. Quantifying Geographic Variation in Health Care Outcomes in the United States before and after Risk-Adjustment

    PubMed Central

    Matheson, David H. M.; Ringel, Michael; VonAchen, Paige; Lesser, Richard I.; Li, Yue; Dimick, Justin B.; Gawande, Atul A.; Larsson, Stefan H.; Moses, Hamilton

    2016-01-01

    Background Despite numerous studies of geographic variation in healthcare cost and utilization at the local, regional, and state levels across the U.S., a comprehensive characterization of geographic variation in outcomes has not been published. Our objective was to quantify variation in US health outcomes in an all-payer population before and after risk-adjustment. Methods and Findings We used information from 16 independent data sources, including 22 million all-payer inpatient admissions from the Healthcare Cost and Utilization Project (which covers regions where 50% of the U.S. population lives) to analyze 24 inpatient mortality, inpatient safety, and prevention outcomes. We compared outcome variation at state, hospital referral region, hospital service area, county, and hospital levels. Risk-adjusted outcomes were calculated after adjusting for population factors, co-morbidities, and health system factors. Even after risk-adjustment, there exists large geographical variation in outcomes. The variation in healthcare outcomes exceeds the well publicized variation in US healthcare costs. On average, we observed a 2.1-fold difference in risk-adjusted mortality outcomes between top- and bottom-decile hospitals. For example, we observed a 2.3-fold difference for risk-adjusted acute myocardial infarction inpatient mortality. On average a 10.2-fold difference in risk-adjusted patient safety outcomes exists between top and bottom-decile hospitals, including an 18.3-fold difference for risk-adjusted Central Venous Catheter Bloodstream Infection rates. A 3.0-fold difference in prevention outcomes exists between top- and bottom-decile counties on average; including a 2.2-fold difference for risk-adjusted congestive heart failure admission rates. The population, co-morbidity, and health system factors accounted for a range of R2 between 18–64% of variability in mortality outcomes, 3–39% of variability in patient safety outcomes, and 22–70% of variability in

  10. Increased Risk of Dementia Among Sleep-Related Movement Disorders

    PubMed Central

    Lin, Chun-Chieh; Chou, Chung-Hsing; Fan, Yu-Ming; Yin, Jiu-Haw; Chung, Chi-Hsiang; Chien, Wu-Chien; Sung, Yueh-Feng; Tsai, Chia-Kuang; Lin, Guan-Yu; Lin, Yu-Kai; Lee, Jiunn-Tay

    2015-01-01

    Abstract Sleep-related movement disorders (SRMD) are sleep disorders. As poor sleep quality is associated with cognitive impairment, we hypothesized that SRMD patients were exposed to a great risk for developing dementia. The present study was aimed to retrospectively examine the association of SRMD and dementia risk. A retrospective longitudinal study was conducted using the data obtained from the Longitudinal Health Insurance Database (LHID) in Taiwan. The study cohort enrolled 604 patients with SRMD who were initially diagnosed and 2416 patients who were randomly selected and age/gender matched with the study group. SRMD, dementia, and other confounding factors were defined according to International Classification of Diseases Clinical Modification Codes. Cox proportional-hazards regressions were employed to examine adjusted hazard ratios (HR) after adjusting with confounding factors. Our data revealed that patients with SRMD had a 3.952 times (95% CI = 1.124–4.767) higher risk to develop all-cause dementia compared with individuals without SRMD. The results showed that SRMD patients aged 45 to 64 exhibited highest risk of developing all-cause dementia (HR: 5.320, 95% CI = 1.770–5.991), followed by patients age ≥65 (HR: 4.123, 95% CI = 2.066–6.972) and <45 (HR: 3.170, 95% CI = 1.050–4.128), respectively. Females with SRMD were at greater risk to develop all-cause dementia (HR: 4.372, 95% CI = 1.175–5.624). The impact of SRMD on dementia risk was progressively increased by various follow-up time intervals (<1 year, 1–2 years, and ≥2 years). The results suggest that SRMD is linked to an increased risk for dementia with gender-dependent and time-dependent characteristics. PMID:26705224

  11. Longitudinal Relations between Sectarian and non-Sectarian Community Violence and Child Adjustment in Northern Ireland

    PubMed Central

    Cummings, E. Mark; Merrilees, Christine E.; Taylor, Laura K.; Shirlow, Peter; Goeke-Morey, Marcie C.; Cairns, Ed

    2015-01-01

    Although relations between political violence and child adjustment are well-documented, long-term longitudinal research is needed to adequately address the many questions remaining about the contexts and developmental trajectories underlying the effects on children in areas of political violence. The present study examined relations between sectarian and non-sectarian community violence and adolescent adjustment problems over four consecutive years for mother-child dyads (total N = 1015, 485 boys, 517 girls) living in socially deprived neighborhoods in a context of historical and ongoing political violence, that is, Belfast, Northern Ireland. Both sectarian and non-sectarian community violence predicted youth adjustment across four years, consistent with the hypothesis that both of these elements of the social ecology merit consideration with regard to children's well-being in contexts of political violence. The impact of sectarian community violence on adolescent adjustment was further accentuated in neighborhoods characterized by higher crime rates. Discussion considers the implications for evaluating social ecologies pertinent to the impact of political violence on children. PMID:23880380

  12. Acute anticoagulation adjustment in patients with atrial fibrillation at risk for stroke: approaches, strategies, risks and benefits.

    PubMed

    Olshansky, Brian; Guo, Hongsheng

    2005-07-01

    The acute management of anticoagulation in patients with atrial fibrillation to prevent stroke and other thromboembolic complications includes the use of individualized strategies tailored to the patient and based on the situation (cardioversion, surgeries, dental procedures, cardiac interventions, other invasive procedures and initiation of, or adjustment to, warfarin dosing). The vast range of choices can cause confusion and few randomized controlled clinical trials in this area provide adequate guidance. Chronic anticoagulation management is more straightforward since clinical evidence is ample, randomized clinical trial data provides cogent informaiton and guidelines have been established. Acute management of anticoagulation in patients with atrial fibrillation to prevent thromboembolic complications is often unrecognized but is emerging as a crucial, but challenging, and increasingly complex aspect of the care of patients with atrial fibrillation. This review addresses issues regarding such patients who may be at risk for stroke and require acute adjustments of anticoagulation (in light of, or in lieu of, chronic anticoagulation). Several promising new strategies are considered in light of established medical care. This analysis provides practical recommendations based on available data and presents results from recent investigations that may provide insight into future strategies.

  13. Characterization of the human kinetic adjustment factor for the health risk assessment of environmental contaminants.

    PubMed

    Valcke, Mathieu; Krishnan, Kannan

    2014-03-01

    A default uncertainty factor of 3.16 (√10) is applied to account for interindividual variability in toxicokinetics when performing non-cancer risk assessments. Using relevant human data for specific chemicals, as WHO/IPCS suggests, it is possible to evaluate, and replace when appropriate, this default factor by quantifying chemical-specific adjustment factors for interindividual variability in toxicokinetics (also referred to as the human kinetic adjustment factor, HKAF). The HKAF has been determined based on the distributions of pharmacokinetic parameters (e.g., half-life, area under the curve, maximum blood concentration) in relevant populations. This article focuses on the current state of knowledge of the use of physiologically based algorithms and models in characterizing the HKAF for environmental contaminants. The recent modeling efforts on the computation of HKAF as a function of the characteristics of the population, chemical and its mode of action (dose metrics), as well as exposure scenario of relevance to the assessment are reviewed here. The results of these studies, taken together, suggest the HKAF varies as a function of the sensitive subpopulation and dose metrics of interest, exposure conditions considered (route, duration, and intensity), metabolic pathways involved and theoretical model underlying its computation. The HKAF seldom exceeded the default value of 3.16, except in very young children (i.e., <≈ 3 months) and when the parent compound is the toxic moiety. Overall, from a public health perspective, the current state of knowledge generally suggest that the default uncertainty factor is sufficient to account for human variability in non-cancer risk assessments of environmental contaminants.

  14. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... July 15, 2011 Part III Department of Health and Human Services 45 CFR Part 153 Patient Protection and... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment AGENCY: Department of Health and...

  15. Emotional adjustment and distressed interpersonal relations among low-income African American mothers: moderating effects of demanding kin relations.

    PubMed

    Taylor, Ronald D; Budescu, Mia

    2013-01-01

    Association of mothers' emotional adjustment and negative kin relations with distressed interpersonal relations was examined. Among 115 low-income African American mothers, relationship of depressive symptoms, self-esteem, and demanding kin relations with psychological control and stressful interpersonal relations was assessed. Depressive symptoms and demanding kin relations were positively associated with mothers' use of psychological control in parenting. Interaction of self-esteem with demanding kin relations revealed that self-esteem was negatively associated with psychological control for mothers with high-demanding kin relations but not for mothers with low-demanding kin relations. Mothers' depressive symptoms and demanding kin relations were positively associated with their stressful interpersonal relations. Findings were discussed in terms of the need for research on the beneficial and detrimental aspects of families' social network.

  16. Are Chinese consumers at risk due to exposure to metals in crayfish? A bioaccessibility-adjusted probabilistic risk assessment.

    PubMed

    Peng, Qian; Nunes, Luís M; Greenfield, Ben K; Dang, Fei; Zhong, Huan

    2016-03-01

    Freshwater crayfish, the world's third largest crustacean species, has been reported to accumulate high levels of metals, while the current knowledge of potential risk associated with crayfish consumption lags behind that of finfish. We provide the first estimate of human health risk associated with crayfish (Procambarus clarkii) consumption in China, the world's largest producer and consumer of crayfish. We performed Monte Carlo Simulation on a standard risk model parameterized with local data on metal concentrations, bioaccessibility (φ), crayfish consumption rate, and consumer body mass. Bioaccessibility of metals in crayfish was found to be variable (68-95%) and metal-specific, suggesting a potential influence of metal bioaccessibility on effective metal intake. However, sensitivity analysis suggested risk of metals via crayfish consumption was predominantly explained by consumption rate (explaining >92% of total risk estimate variability), rather than metals concentration, bioaccessibility, or body mass. Mean metal concentrations (As, Cd, Cu, Ni, Pb, Se and Zn) in surveyed crayfish samples from 12 provinces in China conformed to national safety standards. However, risk calculation of φ-modified hazard quotient (HQ) and hazard index (HI) suggested that crayfish metals may pose a health risk for very high rate consumers, with a HI of over 24 for the highest rate consumers. Additionally, the φ-modified increased lifetime risk (ILTR) for carcinogenic effects due to the presence of As was above the acceptable level (10(-5)) for both the median (ILTR=2.5×10(-5)) and 90th percentile (ILTR=1.8×10(-4)), highlighting the relatively high risk of As in crayfish. Our results suggest a need to consider crayfish when assessing human dietary exposure to metals and associated health risks, especially for high crayfish-consuming populations, such as in China, USA and Sweden.

  17. Contextual, Ecological and Organizational Variations in Risk-Adjusted COPD and Asthma Hospitalization Rates of Rural Medicare Beneficiaries.

    PubMed

    Wan, Thomas T H; Lin, Yi-Ling; Ortiz, Judith

    2016-01-01

    The purpose of this study is to examine what factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method. A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling. A generalized estimating equation (GEE) method was used to identify the relevance of selected predictors in accounting for the variability in risk-adjusted admission rates for COPD and asthma. Both adjusted and unadjusted rates of COPD admission showed a slight decline from 2010 to 2013. The growth curve modeling showed the annual rates of change were gradually accentuated through time. GEE revealed that a moderate amount of variance (marginal R(2) = 0.66) in the risk-adjusted hospital admission rates for COPD and asthma was accounted for by contextual, ecological, and organizational variables. The contextual, ecological, and organizational factors are those associated with RHCs, not hospitals. We cannot infer how the variability in hospital practices in RHC service areas may have contributed to the disparities in admissions. Identification of RHCs with substantially higher rates than an average rate can portray the need for further enhancement of needed ambulatory or primary care services for the specific groups of RHCs. Because the risk-adjusted rates of hospitalization do not very by classification of rural area, future research should address the variation in a specific COPD and asthma condition of RHC patients. Risk-adjusted admission rates for COPD and asthma are influenced by the synergism of multiple contextual, ecological, and organizational factors

  18. Reduced relative risk of fractures among users of lithium.

    PubMed

    Vestergaard, P; Rejnmark, L; Mosekilde, L

    2005-07-01

    Lithium has been shown to inhibit bone resorption and to interact with W nt signaling, potentially pointing to bone anabolic properties. We, therefore, studied the effects of lithium on fracture risk using a case-control study design. Cases were all subjects including children with any fracture sustained during the year 2000 (n=124,655). For each case, three controls (n=373,962) matched according to age and gender was randomly drawn from the background population. Adjustments were made for use of other psychotropic drugs (neuroleptics, antidepressants, and anxiolytics/sedatives), psychiatric disease (manic depressive states, schizophrenia, and other psychoses), and other confounders. The effect of dose was examined by stratifying for cumulated dose (DDD, defined daily dose). In the crude analysis, there was a decreasing relative risk of any fracture with increasing accumulated dose of lithium. After adjustment for psychotropic drug use, the risk of any fracture was decreased (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.60--0.92 for 250--849 DDD, and OR 0.67, 95% CI 0.55--0.81 for >or= 850 DDD of lithium). For Colles' fractures and spine fractures, a significant decrease was seen with >or= 850 DDD (OR 0.57, 95% CI 0.35--0.94 for Colles' fracture and OR 0.32, 95% CI 0.11--0.95 for spine fractures). For hip fractures, a nonsignificant trend toward a decrease was seen; however, without a dose-response relationship. Adjustment for further confounders did not change the results. Lithium treatment was associated with a decreased risk of fractures potentially pointing at bone anabolic properties.

  19. Self-discrepancies in work-related upper extremity pain: relation to emotions and flexible-goal adjustment.

    PubMed

    Goossens, Mariëlle E; Kindermans, Hanne P; Morley, Stephen J; Roelofs, Jeffrey; Verbunt, Jeanine; Vlaeyen, Johan W

    2010-08-01

    Recurrent pain not only has an impact on disability, but on the long term it may become a threat to one's sense of self. This paper presents a cross-sectional study of patients with work-related upper extremity pain and focuses on: (1) the role of self-discrepancies in this group, (2) the associations between self-discrepancies, pain, emotions and (3) the interaction between self-discrepancies and flexible-goal adjustment. Eighty-nine participants completed standardized self-report measures of pain intensity, pain duration, anxiety, depression and flexible-goal adjustment. A Selves Questionnaire was used to generate self-discrepancies. A series of hierarchical regression analyses showed relationships between actual-ought other, actual-ought self, actual-feared self-discrepancies and depression as well as a significant association between actual-ought other self-discrepancy and anxiety. Furthermore, significant interactions were found between actual-ought other self-discrepancies and flexibility, indicating that less flexible participants with large self-discrepancies score higher on depression. This study showed that self-discrepancies are related to negative emotions and that flexible-goal adjustment served as a moderator in this relationship. The view of self in pain and flexible-goal adjustment should be considered as important variables in the process of chronic pain.

  20. Acculturative stress, social support, and coping: relations to psychological adjustment among Mexican American college students.

    PubMed

    Crockett, Lisa J; Iturbide, Maria I; Torres Stone, Rosalie A; McGinley, Meredith; Raffaelli, Marcela; Carlo, Gustavo

    2007-10-01

    This study examined the relations between acculturative stress and psychological functioning, as well as the protective role of social support and coping style, in a sample of 148 Mexican American college students (67% female, 33% male; mean age = 23.05 years, SD = 3.33). In bivariate analyses, acculturative stress was associated with higher levels of anxiety and depressive symptoms. Moreover, active coping was associated with better adjustment (lower depression), whereas avoidant coping predicted poorer adjustment (higher levels of depression and anxiety). Tests of interaction effects indicated that parental support and active coping buffered the effects of high acculturative stress on anxiety symptoms and depressive symptoms. In addition, peer support moderated the relation between acculturative stress and anxiety symptoms. Implications for reducing the effects of acculturative stress among Mexican American college students are discussed.

  1. [Colombian healthcare reform: a proposal for adjusting healthcare-related insurance and financing].

    PubMed

    García-Ubaque, Juan C; García-Ubaque, César A; Benítez, Luisa F C

    2012-10-01

    Colombian healthcare system reform (incorporated over fifteen years ago) has been the frequent object of analysis and the system currently seems to be facing one of its most serious crises. This has led to large-scale change being suggested from many social, professional and academic spaces, ranging from varied adjustments to the healthcare-related insurance model's total elimination. Research over the last ten years has suggested a balance of what may have been central to the current problem and has suggested that, although adjustment must be made from a wide national consensus, it is reasonable to maintain a healthcare-related insurance model as long as this reflects the learning achieved to date. Precautions and the necessary control measures must be taken to impede a fresh wave of frustration regarding the aim of ensuring a healthcare system which would be more equitable for all.

  2. Cancer risks related to electricity production.

    PubMed

    Boffetta, P; Cardis, E; Vainio, H; Coleman, M P; Kogevinas, M; Nordberg, G; Parkin, D M; Partensky, C; Shuker, D; Tomatis, L

    1991-01-01

    The International Agency for Research on Cancer has previously evaluated the cancer risks associated with fossil fuel-based industrial processes such as coal gastification and coke production, substances and mixtures such as coal tars, coal tar pitch and mineral oils, and a number of substances emitted from fossil-fuelled plants such as benzo[a]pyrene and other polycyclic aromatic hydrocarbons, arsenic, beryllium, cadmium, chromium, nickel, lead and formaldehyde. Based on these evaluations and other evidence from the literature, the carcinogenic risks to the general population and occupational groups from the fossil fuel cycle, the nuclear fuel cycle and renewable cycles are reviewed. Cancer risks from waste disposal, accidents and misuses, and electricity distribution are also considered. No cycle appears to be totally free from cancer risk, but the quantification of the effects of such exposures (in particular of those involving potential exposure to large amounts of carcinogens, such as coal, oil and nuclear) requires the application of methods which are subject to considerable margins of error. Uncertainties due to inadequate data and unconfirmed assumptions are discussed. Cancer risks related to the operation of renewable energy sources are negligible, although there may be some risks from construction of such installations. The elements of knowledge at our disposal do not encourage any attempt toward a quantitative comparative risk assessment. However, even in the absence of an accurate quantification of risk, qualitative indication of carcinogenic hazards should lead to preventive measures.

  3. Population-Adjusted Street Connectivity, Urbanicity and Risk of Obesity in the U.S

    PubMed Central

    Wang, Fahui; Wen, Ming; Xu, Yanqing

    2013-01-01

    Street connectivity, defined as the number of (3-way or more) intersections per area unit, is an important index of built environments as a proxy for walkability in a neighborhood. This paper examines its geographic variations across the rural-urban continuum (urbanicity), major racial-ethnic groups and various poverty levels. The population-adjusted street connectivity index is proposed as a better measure than the regular index for a large area such as county due to likely concentration of population in limited space within the large area. Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS), this paper uses multilevel modeling to analyze its association with physical activity and obesity while controlling for various individual and county-level variables. Analysis of data subsets indicates that the influences of individual and county-level variables on obesity risk vary across areas of different urbanization levels. The positive influence of street connectivity on obesity control is limited to the more but not the mostly urbanized areas. This demonstrates the value of obesogenic environment research in different geographic settings, helps us reconcile and synthesize some seemingly contradictory results reported in different studies, and also promotes that effective policies need to be highly sensitive to the diversity of demographic groups and geographically adaptable. PMID:23667278

  4. Maternal Adjustment and Infant Outcome in Medically Defined High-Risk Pregnancy.

    ERIC Educational Resources Information Center

    Levy-Shiff, Rachel; Lerman, Maya; Har-Even, Dov; Hod, Moshe

    2002-01-01

    Explored relation of biological and psychosocial risk factors to infant development among pregnant women who had pregestational diabetes, gestational diabetes, or were nondiabetic. Found that infants of diabetic mothers scored lower on the Bayley Scales at 1 year and revealed fewer positive and more negative behaviors than infants of nondiabetic…

  5. Traumatization, Marital Adjustment, and Parenting among Veterans and Their Spouses: A Longitudinal Study of Reciprocal Relations.

    PubMed

    Levin, Yafit; Bachem, Rahel; Solomon, Zahava

    2016-10-26

    Despite considerable research on secondary traumatization, the ramifications of veterans' and their wives' posttraumatic stress symptoms (PTSS) for the family system remain largely uninvestigated. Beginning to fill this gap, the current study aims to investigate the reciprocal relations between both spouses' PTSS and marital adjustment, and the implications these bear for their parental functioning. Two hundred and twenty-five Israeli veterans (mean age = 58.62, SD = 7.6) from the 1973 Yom Kippur War and their wives (mean age = 58.28, SD = 5.79) were examined at two points in time: 30 (T1) and 35-37 years after the war (T2). Analysis included longitudinal actor-partner interdependence modeling and sequential mediation analyses. The results show that higher PTSS among the wives at T1 predicted higher PTSS among husbands at T2, and vice versa, and predicted their husbands' marital adjustment at T2. Moreover, wives' PTSS at T1 had a significant effect on parental overinvolvement of both parents at T2, but neither their PTSS nor their husbands' PTSS had an impact on positive parenting. In the intrapersonal domain, better marital adjustment at T1 predicted positive parenting among both spouses in subsequent measurement. Interpersonally, wives' lower marital adjustment at T1 predicted husbands' higher parental functioning, but not vice versa. Furthermore, marital adjustment mediated the association between PTSS and positive parenting for both spouses. The results emphasize the detrimental ramifications of war trauma on the interpersonal domains in veterans' families. Hence, both marital and parental consequences of trauma should be considered in clinical family interventions.

  6. The Effect of Complementary and Alternative Medicine Claims on Risk Adjustment

    PubMed Central

    Lind, Bonnie K.; Abrams, Chad; Lafferty, William E.; Kiehr, Paula K.; Grembowski, David E.

    2006-01-01

    Objective To assess how the inclusion of diagnoses from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients. Methods Claims data from Washington State were used to create two versions of a case-mix index. One version included claims from all provider types; the second version omitted claims from CAM providers who are covered under commercial insurance. Expected resource use was also calculated. The distribution of expected and actual resource use was then compared for the two indices. Results Inclusion of CAM providers shifts many patients into higher morbidity categories; 54% of 61,914 CAM users had higher risk scores in the index which included CAM providers. When expected resource use categories were defined based on all providers, CAM users in the highest morbidity category had average (± s.d.) annual expenditures of $6661 (± $13,863). This was less than those in the highest morbidity category when CAM providers were not included in the index ($8562 ± $16,354), and was also lower than the highest morbidity patients who did not use any CAM services ($8419 ± $18,885). Conclusions Inclusion of services from CAM providers under third party payment increases risk scores for their patients but expectations of costs for this group are lower than expected had costs been estimated based only on services from traditional providers. Additional work is needed to validate risk adjustment indices when adding services from provider groups not included in the development of the index. PMID:17122711

  7. Geographic mobility, family, and maternal variables as related to the psychosocial adjustment of military children.

    PubMed

    Kelley, Michelle L; Finkel, Lisa B; Ashby, Jayne

    2003-12-01

    The present study examined maternal and family factors and family mobility as related to mothers' and children's reports of the psychological adjustment of children in military families. Participants were 86 mother-child dyads in U.S. traditional military families. Children's reports of loneliness, peer relationships, fear of negative evaluations, and self-esteem were predicted by family cohesiveness, children's reports of their relationships with their mothers, and the length of time they had lived in their current residence, but not their rate of mobility (i.e., number of moves in the child's lifetime divided by the child's age). In contrast, maternal depressive symptoms predicted children's depressive and anxious behaviors, and both maternal depressive symptoms and children's perception of their relationship with their mothers predicted children's aggression and noncompliance. Results suggest that moving may not be as important as other aspects of maternal functioning and family relationships for the psychosocial adjustment of children in military families.

  8. An uncertainty relation in terms of generalized metric adjusted skew information and correlation measure

    NASA Astrophysics Data System (ADS)

    Fan, Ya-Jing; Cao, Huai-Xin; Meng, Hui-Xian; Chen, Liang

    2016-12-01

    The uncertainty principle in quantum mechanics is a fundamental relation with different forms, including Heisenberg's uncertainty relation and Schrödinger's uncertainty relation. In this paper, we prove a Schrödinger-type uncertainty relation in terms of generalized metric adjusted skew information and correlation measure by using operator monotone functions, which reads, U_ρ ^{(g,f)}(A)U_ρ ^{(g,f)}(B)≥ f(0)^2l/k| Corr_ρ ^{s(g,f)}(A,B)| ^2 for some operator monotone functions f and g, all n-dimensional observables A, B and a non-singular density matrix ρ . As applications, we derive some new uncertainty relations for Wigner-Yanase skew information and Wigner-Yanase-Dyson skew information.

  9. Adjusting for risk selection in state health insurance exchanges will be critically important and feasible, but not easy.

    PubMed

    Weiner, Jonathan P; Trish, Erin; Abrams, Chad; Lemke, Klaus

    2012-02-01

    The Affordable Care Act calls for the establishment of state-level health insurance exchanges. The viability and success of these exchanges will require effective risk-adjustment strategies to compensate for differences in enrollees' health status across health plans. This article describes why the Affordable Care Act could lead to favorable or adverse risk selection across plans. It reviews provisions in the act and recent proposed regulations intended to mitigate the problem of risk selection. We performed a simulation that showed that under the premium rating restrictions in the law, large incentives for insurers to attract healthier enrollees will be likely to persist-resulting in substantial overpayment to plans with very healthy enrollees and underpayment to plans with very sick members. We conclude that risk adjustment based on patients' diagnoses, such as will be in place from 2014 on, will yield payments to insurers that will be more accurate than what will come solely from the age-adjusted and other rating allowed by the act. We also describe additional challenges of implementing risk adjustment.

  10. Psychological adjustment to familial genetic risk assessment: differences in two longitudinal samples.

    PubMed

    Ritvo, P; Robinson, G; Irvine, J; Brown, L; Matthew, A; Murphy, K J; Stewart, D S; Styra, R; Wang, C; Mullen, M; Cole, D; Rosen, B

    2000-05-01

    Heritable cancer risk assessment is an increasingly common method of deriving valuable information relevant to deciding on appropriate screening regimens and preventive treatments. Assessments of heritable risk typically include familial-genetic evaluation, where analyses relate family pedigree to cancer risk, and DNA testing, where analyses indicate genetic mutations associated with cancer risk (e.g., BRCA1/BRCA2 mutations) or their absence. In this paper we report on the psychological responses of women given familial-genetic evaluations for ovarian cancer risk. The baseline and 6 to 12 follow-up assessments of an initial clinic-attending cohort of 65 women are compared with the baseline and 9 to 12 follow-up assessments of a second clinic-attending cohort of 60 women. Sizeable differences were found in the prevalence of clinically significant depression in these two physician or self-referred populations, as assessed by the Center for Epidemiological Studies Depression scale and in the mean scores. Hypotheses accounting for these differences are discussed.

  11. 77 FR 73456 - Update to the TR-12 Fuel Related Rate Adjustment Policy (SDDC Fuel Surcharge Policy)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... Department of the Army Update to the TR-12 Fuel Related Rate Adjustment Policy (SDDC Fuel Surcharge Policy...: Reference: TR-12 Fuel Related Rate Adjustment Policy. Background: The following FRA policy applies to... increases in diesel fuel prices. Miscellaneous: A copy of the TR-12 FRA Policy can be accessed via the...

  12. Temperament as a moderator of the relation between neighborhood and children's adjustment.

    PubMed

    Bush, Nicole R; Lengua, Liliana J; Colder, Craig R

    2010-09-01

    Although proposed by bioecological models, there has been minimal empirical examination of whether children's individual differences moderate neighborhood effects on development. We used an urban community sample (8-12 years, N = 316) to examine interactions among neighborhood characteristics (problems and social organization) and children's temperament (fear, irritability and impulsivity) in predicting psychosocial adjustment. The main effects of neighborhood and temperament on outcomes were consistent with previous research. Findings show that development is challenging in disadvantaged neighborhoods whatever one's temperament, however, some effects of neighborhood were conditioned by temperament, particularly children's fear and irritability. Neighborhood problems were more strongly related to lower social competence for fearful and for less irritable children. Neighborhood problems were more strongly related to higher internalizing problems for low-fear children. Neighborhood social organization was more strongly related to greater social competence for low-fear children. Findings are discussed in relation to "diathesis-stress" and "differential responsiveness" models of temperament.

  13. Anticipatory postural adjustments during cutting manoeuvres in football and their consequences for knee injury risk.

    PubMed

    Mornieux, Guillaume; Gehring, Dominic; Fürst, Patrick; Gollhofer, Albert

    2014-01-01

    Anticipatory postural adjustments (APAs), i.e. preparatory positioning of the head, the trunk and the foot, are essential to initiate cutting manoeuvres during football games. The aim of the present study was to determine how APA strategies during cutting manoeuvres are influenced by a reduction of the time available to prepare the movement. Thirteen football players performed different cutting tasks, with directions of cutting either known prior to the task or indicated by a light signal occurring 850, 600 or 500 ms before ground contact. With less time available to prepare the cutting manoeuvre, the head was less orientated towards the cutting direction (P = 0.033) and the trunk was even more rotated in the opposite direction (P = 0.002), while the foot placement was not significantly influenced. Moreover, the induced higher lateral trunk flexion correlated with the increased knee abduction moment (r = 0.41; P = 0.009). Increasing lateral trunk flexion is the main strategy used to successfully perform a cutting manoeuvre when less time is available to prepare the movement. However, higher lateral trunk flexion was associated with an increased knee abduction moment and therefore an increased knee injury risk. Reducing lateral trunk flexion during cutting manoeuvres should be part of training programs seeking the optimisation of APAs.

  14. A Proportional Hazards Regression Model for the Sub-distribution with Covariates Adjusted Censoring Weight for Competing Risks Data

    PubMed Central

    HE, PENG; ERIKSSON, FRANK; SCHEIKE, THOMAS H.; ZHANG, MEI-JIE

    2015-01-01

    With competing risks data, one often needs to assess the treatment and covariate effects on the cumulative incidence function. Fine and Gray proposed a proportional hazards regression model for the subdistribution of a competing risk with the assumption that the censoring distribution and the covariates are independent. Covariate-dependent censoring sometimes occurs in medical studies. In this paper, we study the proportional hazards regression model for the subdistribution of a competing risk with proper adjustments for covariate-dependent censoring. We consider a covariate-adjusted weight function by fitting the Cox model for the censoring distribution and using the predictive probability for each individual. Our simulation study shows that the covariate-adjusted weight estimator is basically unbiased when the censoring time depends on the covariates, and the covariate-adjusted weight approach works well for the variance estimator as well. We illustrate our methods with bone marrow transplant data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Here cancer relapse and death in complete remission are two competing risks. PMID:27034534

  15. Risk assessment of diesel exhaust and lung cancer: combining human and animal studies after adjustment for biases in epidemiological studies

    PubMed Central

    2011-01-01

    Background Risk assessment requires dose-response data for the evaluation of the relationship between exposure to an environmental stressor and the probability of developing an adverse health effect. Information from human studies is usually limited and additional results from animal studies are often needed for the assessment of risks in humans. Combination of risk estimates requires an assessment and correction of the important biases in the two types of studies. In this paper we aim to illustrate a quantitative approach to combining data from human and animal studies after adjusting for bias in human studies. For our purpose we use the example of the association between exposure to diesel exhaust and occurrence of lung cancer. Methods Firstly, we identify and adjust for the main sources of systematic error in selected human studies of the association between occupational exposure to diesel exhaust and occurrence of lung cancer. Evidence from selected animal studies is also accounted for by extrapolating to average ambient, occupational exposure concentrations of diesel exhaust. In a second stage, the bias adjusted effect estimates are combined in a common effect measure through meta-analysis. Results The random-effects pooled estimate (RR) for exposure to diesel exhaust vs. non-exposure was found 1.37 (95% C.I.: 1.08-1.65) in animal studies and 1.59 (95% C.I.: 1.09-2.10) in human studies, whilst the overall was found equal to 1.49 (95% C.I.: 1.21-1.78) with a greater contribution from human studies. Without bias adjustment in human studies, the pooled effect estimate was 1.59 (95% C.I.: 1.28-1.89). Conclusions Adjustment for the main sources of uncertainty produced lower risk estimates showing that ignoring bias leads to risk estimates potentially biased upwards. PMID:21481231

  16. Cancer risk assessment on trihalomethanes and haloacetic acids in drinking water of China using disability-adjusted life years.

    PubMed

    Pan, Shenling; An, Wei; Li, Hongyan; Su, Ming; Zhang, Jinliang; Yang, Min

    2014-09-15

    The cancer risks from exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) through multiple pathways were assessed based on the result of a water quality survey in 35 major cities of China. To express the risks in disability-adjusted life years (DALYs), the excess cancer incidence estimates were combined with a two-stage disease model for calculation. The median total cancer risk of THMs and HAAs was calculated as 7.34 × 10(-7) DALYs per person-year (ppy), lower than the reference level of risk (10(-6)DALYsppy) set by WHO. The risk from ingestion and inhalation exposures contributed 93.6% and 6.3% of the total risk respectively, while dermal contact made a negligible contribution. The median risk of trichloroacetic acid (TCAA) (2.12 × 10(-7)DALYsppy) was highest among the disinfection by-products (DBPs) considered. The risk ratio of total HAAs (THAA) to total THMs (TTHM) was 1.12. The risk was highest in northeast China while lowest in northwest China. As for the 35 cities, Tianjin had the highest risk while Yinchuan had the lowest. This study attempted to use DALYs for the risk assessment of DBPs, which will provide useful information for risk comparison and prioritization of hazards in drinking water.

  17. Zoom lens calibration with zoom- and focus-related intrinsic parameters applied to bundle adjustment

    NASA Astrophysics Data System (ADS)

    Zheng, Shunyi; Wang, Zheng; Huang, Rongyong

    2015-04-01

    A zoom lens is more flexible for photogrammetric measurements under diverse environments than a fixed lens. However, challenges in calibration of zoom-lens cameras preclude the wide use of zoom lenses in the field of close-range photogrammetry. Thus, a novel zoom lens calibration method is proposed in this study. In this method, instead of conducting modeling after monofocal calibrations, we summarize the empirical zoom/focus models of intrinsic parameters first and then incorporate these parameters into traditional collinearity equations to construct the fundamental mathematical model, i.e., collinearity equations with zoom- and focus-related intrinsic parameters. Similar to monofocal calibration, images taken at several combinations of zoom and focus settings are processed in a single self-calibration bundle adjustment. In the self-calibration bundle adjustment, three types of unknowns, namely, exterior orientation parameters, unknown space point coordinates, and model coefficients of the intrinsic parameters, are solved simultaneously. Experiments on three different digital cameras with zoom lenses support the feasibility of the proposed method, and their relative accuracies range from 1:4000 to 1:15,100. Furthermore, the nominal focal length written in the exchangeable image file header is found to lack reliability in experiments. Thereafter, the joint influence of zoom lens instability and zoom recording errors is further analyzed quantitatively. The analysis result is consistent with the experimental result and explains the reason why zoom lens calibration can never have the same accuracy as monofocal self-calibration.

  18. Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing

    PubMed Central

    2011-01-01

    Background Automated adverse outcome surveillance tools and methods have potential utility in quality improvement and medical product surveillance activities. Their use for assessing hospital performance on the basis of patient outcomes has received little attention. We compared risk-adjusted sequential probability ratio testing (RA-SPRT) implemented in an automated tool to Massachusetts public reports of 30-day mortality after isolated coronary artery bypass graft surgery. Methods A total of 23,020 isolated adult coronary artery bypass surgery admissions performed in Massachusetts hospitals between January 1, 2002 and September 30, 2007 were retrospectively re-evaluated. The RA-SPRT method was implemented within an automated surveillance tool to identify hospital outliers in yearly increments. We used an overall type I error rate of 0.05, an overall type II error rate of 0.10, and a threshold that signaled if the odds of dying 30-days after surgery was at least twice than expected. Annual hospital outlier status, based on the state-reported classification, was considered the gold standard. An event was defined as at least one occurrence of a higher-than-expected hospital mortality rate during a given year. Results We examined a total of 83 hospital-year observations. The RA-SPRT method alerted 6 events among three hospitals for 30-day mortality compared with 5 events among two hospitals using the state public reports, yielding a sensitivity of 100% (5/5) and specificity of 98.8% (79/80). Conclusions The automated RA-SPRT method performed well, detecting all of the true institutional outliers with a small false positive alerting rate. Such a system could provide confidential automated notification to local institutions in advance of public reporting providing opportunities for earlier quality improvement interventions. PMID:22168892

  19. 77 FR 49354 - Revision of Patent Term Adjustment Provisions Relating to Appellate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ... Patent and Trademark Office 37 CFR Part 1 RIN 0651-AC63 Revision of Patent Term Adjustment Provisions... adjustment provisions of the rules of practice in patent cases to better reflect the period of appellate review. The patent term adjustment provisions of the American Inventors Protection Act of 1999...

  20. Age-Related Reversal of Postural Adjustment Characteristics During Motor Imagery

    PubMed Central

    2016-01-01

    Physical and imagined movements show similar behavioral constraints and neurophysiological activation patterns. An inhibition mechanism is thought to suppress overt movement during motor imagery, but it does not effectively suppress autonomic or postural adjustments. Inhibitory processes and postural stability both deteriorate with age. Thus, older people’s balance is potentially vulnerable to interference from postural adjustments induced by thoughts about past or future actions. Here, young and older adults stood upright and executed or imagined manual reaching movements. Reported arm movement time (MT) of all participants increased with target distance. Older participants reported longer MT than young participants when executing arm movements, but not when imagining them. Older adults’ anteroposterior (AP) and mediolateral (ML) postural sway was higher than young adults’ at baseline, but their AP sway fell below their baseline level during manual imagery. In contrast, young adults’ AP sway increased during imagery relative to their baseline. A similar tendency to reduce sway in the ML direction was also observed in older adults during imagery in a challenging stance. These results suggest that postural response during manual motor imagery reverses direction with age. Motor imagery and action planning are ubiquitous tasks, and older people are likely to spend more time engaged in them. The shift toward restricting body sway during these tasks is akin to a postural threat response, with the potential to interfere with balance during activities of daily living. PMID:27808526

  1. Adolescent RSA responses during an anger discussion task: Relations to emotion regulation and adjustment.

    PubMed

    Cui, Lixian; Morris, Amanda Sheffield; Harrist, Amanda W; Larzelere, Robert E; Criss, Michael M; Houltberg, Benjamin J

    2015-06-01

    The current study examined associations between adolescent respiratory sinus arrhythmia (RSA) during an angry event discussion task and adolescents' emotion regulation and adjustment. Data were collected from 206 adolescents (10-18 years of age, M age = 13.37). Electrocardiogram (ECG) and respiration data were collected from adolescents, and RSA values and respiration rates were computed. Adolescents reported on their own emotion regulation, prosocial behavior, and aggressive behavior. Multilevel latent growth modeling was employed to capture RSA responses across time (i.e., linear and quadratic changes; time course approach), and adolescent emotion regulation and adjustment variables were included in the model to test their links to RSA responses. Results indicated that high RSA baseline was associated with more adolescent prosocial behavior. A pattern of initial RSA decreases (RSA suppression) in response to angry event recall and subsequent RSA increases (RSA rebound) were related to better anger and sadness regulation and more prosocial behavior. However, RSA was not significantly linked to adolescent aggressive behavior. We also compared the time course approach with the conventional linear approach and found that the time course approach provided more meaningful and rich information. The implications of adaptive RSA change patterns are discussed.

  2. Age-related gestation length adjustment in a large iteroparous mammal at northern latitude.

    PubMed

    Mysterud, Atle; Røed, Knut H; Holand, Øystein; Yoccoz, Nigel G; Nieminen, Mauri

    2009-09-01

    1. There is considerable interest in patterns of age-dependent reproductive effort and reproductive timing of large iteroparous mammals living in strongly seasonal environments. Due to lack of data on both timing of mating and birth, there is generally little insight into whether variation in gestation length play a role for life-history patterns observed for large mammals at northern latitudes. 2. Based on data on both timing of mating and birth of 88 female reindeer (and paternity confirmed with DNA fingerprinting), we explore the view that adjustment of gestation length plays a role in the reproductive tactic. 3. Observed gestation lengths of reindeer varied between 211 and 229 days (mean of 221 days). Consistent with a dynamic view of gestation length, variation could be predicted from life-history traits. Gestation length was longer for male than female offspring, which is expected in polygynous species where males benefit more from extra allocation of maternal resources. Gestation length increased with maternal age both due to direct effects and indirect effects linked to earlier mating of older, heavier females. Early mating females increased gestation length. A relatively small effect of female age on birth mass operated through variation in gestation length. 4. Our analysis supports the view that adjustment of gestation length is a part of the reproductive tactic of large mammals in northern environments.

  3. Occupation-related risks for colorectal cancer.

    PubMed

    Spiegelman, D; Wegman, D H

    1985-11-01

    Several population data bases were used to generate hypotheses about associations between colorectal cancer and workplace exposures. The Third National Cancer Survey interview sample was used to select 343 male and 208 female cases and 626 male and 1,235 female cancer controls. Potential work exposures were assigned with the use of data from the National Institute for Occupational Safety and Health National Occupational Hazard Survey. Dietary factors were modeled from the National Health and Nutrition Examination Survey data. Work-related stress was considered with the use of a model based on the U.S. Department of Labor's Quality of Employment Survey. Other risk factors included age, race, ponderosity, and menopausal status. Logistic analysis yielded hypotheses for colon cancer risk in males with potentially high exposure to solvents, abrasives, and fuel oil and in those in jobs with high demand and low control (high "stress"). Hypotheses emerged for females with potentially high exposure to dyes, solvents, and grinding wheel dust.

  4. The importance of calculating absolute rather than relative fracture risk.

    PubMed

    Tucker, Graeme; Metcalfe, Andrew; Pearce, Charles; Need, Allan G; Dick, Ian M; Prince, Richard L; Nordin, B E Christopher

    2007-12-01

    The relation between fracture risk and bone mineral density (BMD) is commonly expressed as a multiplicative factor which is said to represent the increase in risk for each standard deviation fall in BMD. This practice assumes that risk increases multiplicatively with each unit fall in bone density, which is not correct. Although odds increase multiplicatively, absolute risk, which lies between 0 and 1, cannot do so though it can be derived from odds by the term Odds/(1+Odds). This concept is illustrated in a prospective study of 1098 women over age 69 followed for 6 years in a calcium trial in which hip BMD was measured in the second year. 304 Women (27.6%) had prevalent fractures and 198 (18.1%) incident fractures with a significant association between them (P 0.005). Age-adjusted hip BMD and T-score were significantly lower in those with prevalent fractures than in those without (P 0.003) and significantly lower in those with incident fractures than in those without (P 0.001). When the data were analysed by univariate logistic regression, the fracture odds at zero T-score were 0.130 and the rise in odds for each unit fall in hip T-score was 1.55. When these odds were converted to risks, there was a progressive divergence between odds and risk at T-scores below zero. Multiple logistic regression yielded significant odds ratios of 1.47 for each 5-year increase in age, 1.47 for prevalent fracture and 1.49 for each unit fall in hip T-score. Calcium therapy was not significant. Poisson regression, logistic regression and Cox's proportional hazards yielded very similar outcomes when converted into absolute risks. A nomogram was constructed to enable clinicians to estimate the approximate 6-year fracture risk from hip T-score, age and prevalent fracture which can probably be applied (with appropriate correction) to men as well as to women. We conclude that multiplicative factors can be applied to odds but not to risk and that multipliers of risk tend to overstate the

  5. Parent-Adolescent Discrepancies Regarding Adolescents' Peer-Related Loneliness: Associations with Adolescent Adjustment.

    PubMed

    Spithoven, Annette W M; Vanhalst, Janne; Lodder, Gerine; Bijttebier, Patricia; Goossens, Luc

    2017-05-01

    Because loneliness is a subjective experience, it is often examined using self-reports. Yet, researchers have started to use other-reports to examine loneliness. As previous research suggests that discrepancies between self- and other views might have important implications for adolescents' mental health, the current study examines discrepancies in multi-informant reports on adolescents' loneliness in relation with prosocial behavior, aggression, and adolescents' parent-related loneliness. The sample consisted of 374 mother-adolescent dyads and 318 father-adolescent dyads (41.80% male, M age  = 15.67 years, SD = 1.25). Results indicated that informants used different reference points to assess adolescents' peer-related loneliness, but were otherwise comparable. Moreover, informant discrepancies were associated with greater adolescents' reported parent-related loneliness. The current study did not provide evidence that discrepancies were related to prosocial or aggressive behavior. The current study adds to the notion that other-reports on loneliness show substantial convergence with self-reports. In addition, this study indicates that the discrepancy between other- and self-reports on loneliness holds valuable information for adolescent socio-emotional adjustment.

  6. Is low IQ related to risk of death by homicide? Testing a hypothesis using data from the Vietnam Experience Study.

    PubMed

    Batty, George David; Mortensen, Laust H; Gale, Catharine R; Deary, Ian J

    2008-10-30

    Lower IQ test scores are related to an increased risk of violent assault. We tested the relation between IQ and death by homicide. In a prospective cohort study of 14,537 men (21 homicides), the association between lower IQ and an increased risk of homicide was lost after multiple adjustment.

  7. Toward the Development of Integrative Risk-Adjusted Measures of Quality Using Large Clinical Data Bases: The Case of Anesthesia Services.

    ERIC Educational Resources Information Center

    Fleming, Steven T.

    1992-01-01

    The concept of risk-adjusted measures of quality is discussed, and a methodology is proposed for risk-adjusting and integrating multiple adverse outcomes of anesthesia services into measures for quality assurance and quality improvement programs. Although designed for a new anesthesiology database, the methods should apply to other health…

  8. Parental dysphoria and children's adjustment: marital conflict styles, children's emotional security, and parenting as mediators of risk.

    PubMed

    Du Rocher Schudlich, Tina D; Cummings, E Mark

    2007-08-01

    Dimensions of martial conflict, children's emotional security regarding interparental conflict, and parenting style were examined as mediators between parental dysphoria and child adjustment. A community sample of 262 children, ages 8-16, participated with their parents. Behavioral observations were made of parents' interactions during marital conflict resolution tasks, which children later observed to assess their emotional security. Questionnaires assessed parents' dysphoria, parenting, and children's adjustment. Structural equation modeling indicated that parental dysphoria was linked with child adjustment through specific and distinct mediating family processes, including marital conflict and parenting. Children's emotional security in the context of particular marital conflict styles also mediated relations between parental dysphoria and child adjustment problems, with similar pathways found for mothers and fathers. These pathways remained significant even after significant parenting contributions were considered.

  9. Anticipatory postural adjustments modify the movement-related potentials of upper extremity voluntary movement.

    PubMed

    Yoshida, S; Nakazawa, K; Shimizu, E; Shimoyama, I

    2008-01-01

    To elucidate the effect on movement-related potentials (MRPs) of anticipatory postural adjustments (APAs) accompanied by voluntary focal movement, we examined the MRPs of shoulder flexion movement under standing and sitting postural conditions in 12 normal subjects. MRPs were evaluated based on three components: readiness potential (RP), motor potential (MP), and movement-monitoring potential. APAs were observed in the activities of postural muscles including the biceps femoris and erector spinae muscles only under standing conditions. The amplitudes of the three MRP components were larger under standing conditions than under sitting conditions for all recorded electrode positions, and the RP and MP amplitudes at the vertex position, which lies over the supplementary motor area (SMA), showed a prominent increase under standing conditions with the highest statistical significance. These results suggest that a recruited neural process of the cortical area including the SMA may be necessary to generate voluntary movement accompanied by APA.

  10. Heterogeneity of variation of relative risk by age at exposure in the Japanese atomic bomb survivors.

    PubMed

    Little, Mark P

    2009-08-01

    General reductions in cancer relative risk with increasing age at exposure are observed in the Japanese atomic bomb survivors and in other groups. However, there has been little evidence of heterogeneity in such trends by cancer type within the Japanese cohort, nor for cancer-type variations in other factors (sex, attained age) that modify relative risk. A recent report on the Japanese atomic bomb survivors published by Preston et al. in 2007 suggests that solid cancer relative risk exhibits a U-shaped relationship with age at exposure, and is initially decreasing and then increasing at older exposure ages. In this report, we reanalyse the latest Japanese atomic bomb survivor solid cancer mortality and incidence data analysed by Preston and co-workers, stratifying by cancer subtype where possible, the stratification being both in relation to the baseline and the radiation-associated excess. We find highly statistically significant (P < 0.001) variations of relative risk by cancer type, and statistically significant variations by cancer type in the adjustments for sex (P = 0.010) and age at exposure (P = 0.013) to the relative risk. There is no statistically significant (P > 0.2) variation by cancer type in the adjustment of relative risk for attained age. Although, for all incident solid cancers, there is marginally statistically significant (P = 0.033) variation of relative risk with a quadratic log-linear function of age at exposure, there is much weaker variation in the relative risk of solid cancer mortality (P > 0.1). However, the manner in which relative risk varies with age at exposure is qualitatively similar for incidence and mortality, so one should not make too much of these differences between the two datasets. Stratification by solid cancer type slightly weakens the evidence for quadratic variation in relative risk by age at exposure (P = 0.060).

  11. Narrative story stems with high risk six year-olds: differential associations with mother- and teacher-reported psycho-social adjustment.

    PubMed

    Page, Timothy; Boris, Neil W; Heller, Sherryl; Robinson, Lara; Hawkins, Shantice; Norwood, Rhonda

    2011-07-01

    Children's responses on a Narrative Story Stem Technique (NSST) were coded using scales reflecting essential attachment constructs, specifically, attachment, exploratory, sociability, and caregiving behavioral systems, as originally conceived by Bowlby ( 1973 , 1982 ) and elaborated upon by his followers (Cassidy, 2008 ). NSST responses were examined in relation to both mother- and teacher-reported psycho-social adjustment and risk using the MacArthur Health & Behavior Questionnaire (HBQ). Forty-six children participated (average age 6 years 10 months), 19 of whom had high-risk backgrounds, and the rest demographically matched. Findings indicate that NSST scales were associated with behavior on certain HBQ scales, in expected directions. NSST responses appeared to differentiate socially competent children from children with the specific psycho-social risks of externalizing behavior problems and social isolation, according to mother-reports, on the one hand, and peer vulnerability and internalizing problems, according to teacher-reports, on the other. Implications for clinical applications are discussed.

  12. GPS and Relative Sea-level Constraints on Glacial Isostatic Adjustment in North America

    NASA Astrophysics Data System (ADS)

    James, T. S.; Simon, K.; Henton, J. A.; Craymer, M.

    2015-12-01

    Recently, new GIA models have been developed for the Innuitian Ice Sheet and for the north-central portion of the Laurentide Ice Sheet (Simon, 2014; Simon et al., 2015). This new combined model, herein called Innu-Laur15, was developed from the ICE-5G model and load adjustments were made to improve the fit to relative sea-level observations and to GPS-constrained vertical crustal motion in the Canadian Arctic Archipelago and around Hudson Bay. Here, the predictions of Innu-Laur15 are compared to observations and other GIA models over an extended region comprising much of North America east of the Rocky Mountains. GIA predictions are made using compressible Maxwell Earth models with gravitationally self-consistent ocean loading, changing coastlines, and ocean-water inundation where marine ice retreats or floats. For this study, GPS time series are the NA12 solution (Blewitt et al., 2013) downloaded from http://geodesy.unr.edu/NGLStationPages/GlobalStationList and fit with a linear trend, annual and semi-annual terms, and offsets as indicated by station logs and by inspection of the time series. For example, a comparison of GPS observations of vertical crustal motion from the NA12 solution at 360 sites gives root-mean-square (RMS) residuals of 3.2 mm/yr (null hypothesis), 1.8 mm/yr (Innu-Laur15), and 2.9 mm/yr (ICE-5G) for the VM5a Earth model. Preliminary comparisons with other Earth models give similar patterns where Innu-Laur15 provides a better fit than ICE-5G. Further adjustments to the Innu-Laur15 ice sheet history could improve the fit to GPS rates in other regions of North America.

  13. Interpersonal Circumplex Descriptions of Psychosocial Risk Factors for Physical Illness: Application to Hostility, Neuroticism, and Marital Adjustment

    PubMed Central

    Smith, Timothy W.; Traupman, Emily K.; Uchino, Bert N.; Berg, Cynthia A.

    2016-01-01

    Personality risk factors for physical illness are typically studied individually and apart from risk factors reflecting the social environment, potentially fostering a piecemeal understanding of psychosocial influences on health. Because it can be used to describe both personality and social relationship processes, the interpersonal circumplex (IPC) provides an integrative approach to psychosocial risk. In 301 married couples we examined IPC correlates of three risk factor domains: anger, hostility, and aggressiveness; neuroticism; and marital adjustment. Risk factors displayed IPC locations ranging from hostile dominance (e.g., verbal aggressiveness, marital conflict) to hostility (e.g., anger) to hostile submissiveness (e.g., anxiety, depression); protective factors (marital satisfaction and support) reflected warmth or friendliness in the IPC. Similar descriptions were found using self-reports and spouse ratings of IPC dimensions, indicating that interpersonal styles associated with risk factors do not simply reflect common method variance. Findings identify interpersonal processes reflecting low affiliation or high hostility as a common component of risk and indicate distinctions among risk factors along the dominance dimension. PMID:20573134

  14. Interpersonal circumplex descriptions of psychosocial risk factors for physical illness: application to hostility, neuroticism, and marital adjustment.

    PubMed

    Smith, Timothy W; Traupman, Emily K; Uchino, Bert N; Berg, Cynthia A

    2010-06-01

    Personality risk factors for physical illness are typically studied individually and apart from risk factors reflecting the social environment, potentially fostering a piecemeal understanding of psychosocial influences on health. Because it can be used to describe both personality and social relationship processes, the interpersonal circumplex (IPC) provides an integrative approach to psychosocial risk. In 301 married couples we examined IPC correlates of 3 risk factor domains: anger, hostility, and aggressiveness; neuroticism; and marital adjustment. Risk factors displayed IPC locations ranging from hostile dominance (e.g., verbal aggressiveness, marital conflict) to hostility (e.g., anger) to hostile submissiveness (e.g., anxiety, depression); protective factors (marital satisfaction and support) reflected warmth or friendliness in the IPC. Similar descriptions were found using self-reports and spouse ratings of IPC dimensions, indicating that interpersonal styles associated with risk factors do not simply reflect common method variance. Findings identify interpersonal processes reflecting low affiliation or high hostility as a common component of risk and indicate distinctions among risk factors along the dominance dimension.

  15. Evaluating the Investment Benefit of Multinational Enterprises' International Projects Based on Risk Adjustment: Evidence from China

    ERIC Educational Resources Information Center

    Chen, Chong

    2016-01-01

    This study examines the international risks faced by multinational enterprises to understand their impact on the evaluation of investment projects. Moreover, it establishes a 'three-dimensional' theoretical framework of risk identification to analyse the composition of international risk indicators of multinational enterprises based on the theory…

  16. [Lifestyle-related disease and fracture risk].

    PubMed

    Fujiwara, Saeko

    2011-05-01

    Meta analysis of fracture risk in diabetes indicates that the risk of proximal femoral fracture in type-2 diabetes is increased 1.4-1.7 times. It is well known that increased fracture risk is observed in serious kidney disease. However, it has recently been reported that increased fracture risk is also observed in the early stages of chronic kidney disease (CKD) . The risk of proximal femoral fracture increases in early stages after stroke, but gradually decreases in subsequent stages. Some reports indicate decreased fracture risk in metabolic syndrome and hyperlipidemia and increased fracture risk in hypertension, arterial calcification and ischemic heart disease, while other reports indicate contradictory results.

  17. Cortical delta activity reflects reward prediction error and related behavioral adjustments, but at different times.

    PubMed

    Cavanagh, James F

    2015-04-15

    Recent work has suggested that reward prediction errors elicit a positive voltage deflection in the scalp-recorded electroencephalogram (EEG); an event sometimes termed a reward positivity. However, a strong test of this proposed relationship remains to be defined. Other important questions remain unaddressed: such as the role of the reward positivity in predicting future behavioral adjustments that maximize reward. To answer these questions, a three-armed bandit task was used to investigate the role of positive prediction errors during trial-by-trial exploration and task-set based exploitation. The feedback-locked reward positivity was characterized by delta band activities, and these related EEG features scaled with the degree of a computationally derived positive prediction error. However, these phenomena were also dissociated: the computational model predicted exploitative action selection and related response time speeding whereas the feedback-locked EEG features did not. Compellingly, delta band dynamics time-locked to the subsequent bandit (the P3) successfully predicted these behaviors. These bandit-locked findings included an enhanced parietal to motor cortex delta phase lag that correlated with the degree of response time speeding, suggesting a mechanistic role for delta band activities in motivating action selection. This dissociation in feedback vs. bandit locked EEG signals is interpreted as a differentiation in hierarchically distinct types of prediction error, yielding novel predictions about these dissociable delta band phenomena during reinforcement learning and decision making.

  18. Affect and Acceptability: Exploring Teachers' Technology-Related Risk Perceptions

    ERIC Educational Resources Information Center

    Howard, Sarah K.

    2011-01-01

    Educational change, such as technology integration, involves risk. Teachers are encouraged to "take risks", but what risks they are asked to take and how do they perceive these risks? Developing an understanding of teachers' technology-related risk perceptions can help explain their choices and behaviours. This paper presents a way to…

  19. A toolbox for health risk related decisions

    SciTech Connect

    Easterly, C.E.; Jones, T.D.

    1996-10-01

    Development efforts since the late 1970s have resulted in a generalized method for ranking health hazards. This method provides the basis for a wide range of applications where decisions are needed for allocating resources on the basis of health risk considerations. It has been used for more than a decade to solve real problems, and it is supported by 23 publications in the open literature. The diversity of this generalized methodology allows us to provide support in a great number of problem areas. we give four examples in this manuscript: the relative toxicities of petroleum mixtures; a method to derive Emergency Response Planning Guides; an estimate of the possible carcinogenic potency of tungsten, an alternative material to depleted uranium for heavy armor penetrators; and an approach to low dose extrapolation. Our experience suggests that many more applications of the original concept and variations on it can be of utility in military situations. Some potentially fruitful areas may be in the: development of a health-risk-ranking system for alternative solutions to manufacturing, waste management, and remediation; provision of a basis for identifying levels of hazardous agents which are below health concerns, or which should be of concern; development of a framework for evaluating chemicals and radioactive materials on the same basis, and in the development of a battery of in vitro bioassays which could take the place of long-term whole animal tests.

  20. Pathways of Parenting Style on Adolescents' College Adjustment, Academic Achievement, and Alcohol Risk

    ERIC Educational Resources Information Center

    Kenney, Shannon R.; Lac, Andrew; Hummer, Justin F.; Grimaldi, Elizabeth M.; LaBrie, Joseph W.

    2015-01-01

    This study examined the pathways of parenting style (permissive, authoritarian, and authoritative) to alcohol consumption and consequences through the mediators of college adjustment and academic achievement (grade point average [GPA]). Participants were 289 students from a private, mid-size, West Coast university (mean age 19.01 years, 58.8%…

  1. Disability and risk of school related injury

    PubMed Central

    Ramirez, M; Peek-Asa, C; Kraus, J

    2004-01-01

    Objective: Approximately six million children with disabilities attend school in the United States. Cognitive and physical limitations may compromise their ability to handle environmental hazards and hence increase their risk for injury. The objective of this study was to describe the epidemiology of school related injury among children enrolled in 17 special education schools in one large, urban school district. Design: Altogether 6769 schoolchildren with disabilities were followed up from 1994–98. Injury and population data were collected from pupil accident reports and existing school records. Associations were estimated through generalized estimating equations. Results: A total of 697 injuries were reported for a rate of 4.7/100 students per year. Children with multiple disabilities had a 70% increased odds of injury compared with the developmentally disabled (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.3 to 2.3). The physically disabled (OR 1.4, 95% CI 1.0 to 1.9) had a modest increased odds of injury. Cuts, bruises, and abrasions composed almost three fourths of all injuries; almost half of these injuries were to the face. Falls (34%) and insults by other students (31%) were the most common external causes. More than a fourth of injuries were sports related, and 21% occurred on the playground/athletic field. Injury patterns differed across disabilities. Conclusions: Although limited to one school district, the population studied is the largest cohort thus far of schoolchildren with disabilities. With this large study base, potentially high risk groups were identified and circumstances of injury described. This information is imperative for developing and improving school based injury prevention measures. PMID:14760022

  2. WBGT clothing adjustments for four clothing ensembles under three relative humidity levels.

    PubMed

    Bernard, Thomas E; Luecke, Christina L; Schwartz, Skai W; Kirkland, K Scott; Ashley, Candi D

    2005-05-01

    Threshold limit values for heat stress and strain are based on an upper limit wet bulb globe temperature (WBGT) for ordinary work clothes, with clothing adjustment factors (CAF) for other clothing ensembles. The purpose of this study was to determine the CAF for four clothing ensembles (Cotton Coveralls, Tyvek 1424 Coveralls, NexGen Coveralls, and Tychem QC Coveralls) against a baseline of cotton work clothes and to determine what effect relative humidity may have. A climatic chamber was used to slowly increase the level of heat stress by increasing air temperature at three levels of relative humidity (20%, 50%, and 70%). Study participants wore one of the five ensembles while walking on a treadmill at a moderate metabolic rate of 155 W m-2 (about 300 W). Physiological data and environmental data were collected. When the participant's core temperature reached a steady state, the dry bulb temperature was increased at constant relative humidity. The point at which the core temperature began to increase was defined as the inflection point. The environmental temperature recorded 5 min before the inflection point was used to calculate the critical WBGT for each ensemble. A three-way analysis of variance with ensemble by humidity protocol interactions and a multiple comparison test were used to make comparisons among the mean values. Only the vapor-barrier ensemble (Tychem QC) demonstrated an interaction with humidity level. The following CAFs are proposed: Cotton Coveralls (0 degrees C-WBGT), Tyvek 1424 Coveralls (+1), NexGen Coveralls (+2), and Tychem QC Coveralls (+10).

  3. Exposure to Conflict and Violence across Contexts: Relations to Adjustment among Palestinian Children

    PubMed Central

    Dubow, Eric F.; Boxer, Paul; Huesmann, L. Rowell; Shikaki, Khalil; Landau, Simha; Gvirsman, Shira Dvir; Ginges, Jeremy

    2009-01-01

    Despite extensive literatures on the impact on children of exposure to violence in families, neighborhoods, and peer groups, there has been relatively little effort evaluating their cumulative impact. There also has been less attention to the effects of exposure to political conflict and violence. We collected data from a representative sample of 600 Palestinian youths (three age cohorts: 8, 11, and 14 years old) to evaluate the relation of exposure to political conflict and violence, and violence in the family, community, and school, to post-traumatic stress symptoms (PTS) and aggressive behavior. Results highlight the additive effects of exposure to political conflict and violence, suggesting that interventionists should consider the full spectrum of sources of environmental risk for PTS symptoms and aggressive behavior. PMID:20390802

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

    PubMed

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

    2016-10-24

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

  5. Nonlinear relative-proportion-based route adjustment process for day-to-day traffic dynamics: modeling, equilibrium and stability analysis

    NASA Astrophysics Data System (ADS)

    Zhu, Wenlong; Ma, Shoufeng; Tian, Junfang; Li, Geng

    2016-11-01

    Travelers' route adjustment behaviors in a congested road traffic network are acknowledged as a dynamic game process between them. Existing Proportional-Switch Adjustment Process (PSAP) models have been extensively investigated to characterize travelers' route choice behaviors; PSAP has concise structure and intuitive behavior rule. Unfortunately most of which have some limitations, i.e., the flow over adjustment problem for the discrete PSAP model, the absolute cost differences route adjustment problem, etc. This paper proposes a relative-Proportion-based Route Adjustment Process (rePRAP) maintains the advantages of PSAP and overcomes these limitations. The rePRAP describes the situation that travelers on higher cost route switch to those with lower cost at the rate that is unilaterally depended on the relative cost differences between higher cost route and its alternatives. It is verified to be consistent with the principle of the rational behavior adjustment process. The equivalence among user equilibrium, stationary path flow pattern and stationary link flow pattern is established, which can be applied to judge whether a given network traffic flow has reached UE or not by detecting the stationary or non-stationary state of link flow pattern. The stability theorem is proved by the Lyapunov function approach. A simple example is tested to demonstrate the effectiveness of the rePRAP model.

  6. Almost efficient estimation of relative risk regression

    PubMed Central

    Fitzmaurice, Garrett M.; Lipsitz, Stuart R.; Arriaga, Alex; Sinha, Debajyoti; Greenberg, Caprice; Gawande, Atul A.

    2014-01-01

    Relative risks (RRs) are often considered the preferred measures of association in prospective studies, especially when the binary outcome of interest is common. In particular, many researchers regard RRs to be more intuitively interpretable than odds ratios. Although RR regression is a special case of generalized linear models, specifically with a log link function for the binomial (or Bernoulli) outcome, the resulting log-binomial regression does not respect the natural parameter constraints. Because log-binomial regression does not ensure that predicted probabilities are mapped to the [0,1] range, maximum likelihood (ML) estimation is often subject to numerical instability that leads to convergence problems. To circumvent these problems, a number of alternative approaches for estimating RR regression parameters have been proposed. One approach that has been widely studied is the use of Poisson regression estimating equations. The estimating equations for Poisson regression yield consistent, albeit inefficient, estimators of the RR regression parameters. We consider the relative efficiency of the Poisson regression estimator and develop an alternative, almost efficient estimator for the RR regression parameters. The proposed method uses near-optimal weights based on a Maclaurin series (Taylor series expanded around zero) approximation to the true Bernoulli or binomial weight function. This yields an almost efficient estimator while avoiding convergence problems. We examine the asymptotic relative efficiency of the proposed estimator for an increase in the number of terms in the series. Using simulations, we demonstrate the potential for convergence problems with standard ML estimation of the log-binomial regression model and illustrate how this is overcome using the proposed estimator. We apply the proposed estimator to a study of predictors of pre-operative use of beta blockers among patients undergoing colorectal surgery after diagnosis of colon cancer. PMID

  7. Why and when is ethnic harassment a risk for immigrant adolescents' school adjustment? understanding the processes and conditions.

    PubMed

    Bayram Özdemir, Sevgi; Stattin, Håkan

    2014-08-01

    Ethnically harassed immigrant youth are at risk for experiencing a wide range of school adjustment problems. However, it is still unclear why and under what conditions experiencing ethnic harassment leads to school adjustment difficulties. To address this limitation in the literature, we examined two important questions. First, we investigated whether self-esteem and/or depressive symptoms would mediate the associations between ethnic harassment and poor school adjustment among immigrant youth. Second, we examined whether immigrant youths' perception of school context would play a buffering role in the pathways between ethnic harassment and school adjustment difficulties. The sample (n = 330; M age = 14.07, SD = .90; 49% girls at T1) was drawn from a longitudinal study in Sweden. The results revealed that experiencing ethnic harassment led to a decrease in immigrant youths' self-esteem over time, and that youths' expectations of academic failure increased. Further, youths' relationships with their teachers and their perceptions of school democracy moderated the mediation processes. Specifically, when youth had poor relationships with their teachers or perceived their school context as less democratic, being exposed to ethnic harassment led to a decrease in their self-esteem. In turn, they reported low school satisfaction and perceived themselves as being unsuccessful in school. Such indirect effects were not observed when youth had high positive relationships with their teachers or perceived their school as offering a democratic environment. These findings highlight the importance of understanding underlying processes and conditions in the examination of the effects of ethnic devaluation experiences in order to reach a more comprehensive understanding of immigrant youths' school adjustment.

  8. Aspiration-related organizing pneumonia complicating laparoscopic adjustable gastric banding: A lung cancer mimicker

    PubMed Central

    Aljohaney, Ahmed A.; Ajlan, Amr M.; Alghamdi, Fahad A.

    2016-01-01

    There are several described pulmonary complications due to laparoscopic adjustable gastric banding. We report a rare case of a 32-year-old male who presented with pulmonary symptoms and a solitary lung mass 12 years after laparoscopic adjustable gastric banding. A bronchoscopic lung biopsy showed organizing pneumonia that was induced by aspiration pneumonia. The atypical radiological appearance of the aspiration pneumonia may pose a diagnostic challenge, and clinicians' awareness regarding such an entity is needed to avoid unnecessary intervention. PMID:27803757

  9. Aspiration-related organizing pneumonia complicating laparoscopic adjustable gastric banding: A lung cancer mimicker.

    PubMed

    Aljohaney, Ahmed A; Ajlan, Amr M; Alghamdi, Fahad A

    2016-01-01

    There are several described pulmonary complications due to laparoscopic adjustable gastric banding. We report a rare case of a 32-year-old male who presented with pulmonary symptoms and a solitary lung mass 12 years after laparoscopic adjustable gastric banding. A bronchoscopic lung biopsy showed organizing pneumonia that was induced by aspiration pneumonia. The atypical radiological appearance of the aspiration pneumonia may pose a diagnostic challenge, and clinicians' awareness regarding such an entity is needed to avoid unnecessary intervention.

  10. Tea and Risk of Age-Related Cataracts: A Cross-Sectional Study in Zhejiang Province, China

    PubMed Central

    Sheng, Yan; He, Fan; Lin, Jun-Fen; Shen, Wei; Qiu, Yin-Wei

    2016-01-01

    Background The antioxidant properties of tea extracts are considered to be effective in protecting against cataracts. However, there is still insufficient epidemiological knowledge about the protective effects of different types of tea on age-related cataracts. Methods The data was derived from the Zhejiang Major Public Health Surveillance (ZJMPHS) Program on health and related factors in the elderly. The relationships between consumption of different types of tea and risk of age-related cataracts were assessed after adjusting for related covariates. Results The prevalence of age-related cataracts in this study population was 4.4% (409/9343). After adjustment for potential confounders, tea drinking was associated with reduced risk of age-related cataracts (adjusted odds ratio [OR] 0.65; 95% confidence interval [CI], 0.47–0.91). Compared to nondrinkers, green tea drinkers had a significantly reduced risk of cataracts (adjusted OR 0.58; 95% CI, 0.40–0.85). Average tea consumption of 14–27 cups (adjusted OR 0.55; 95% CI, 0.33–0.93) and over 28 cups (adjusted OR 0.58; 95% CI, 0.34–0.99) per week had a protective effect against cataracts in comparison to no consumption. In addition, ingesting a moderate concentration of tea significantly decreased the risk of cataract compared to no consumption (adjusted OR 0.43; 95% CI, 0.27–0.71). Conclusions Tea ingestion was associated with reduced risk of age-related cataracts. In light of these findings, we suggest that reasonable tea consumption (ie, favoring green tea and consuming an average of over 500 mL per day at moderate concentration) should offer protection against age-related cataracts. PMID:27180932

  11. Association Between Sitting Time and Cardiometabolic Risk Factors After Adjustment for Cardiorespiratory Fitness, Cooper Center Longitudinal Study, 2010–2013

    PubMed Central

    Shuval, Kerem; Balasubramanian, Bijal A.; Kendzor, Darla E.; Radford, Nina B.; DeFina, Laura F.; Gabriel, Kelley Pettee

    2016-01-01

    Introduction Objective estimates, based on waist-worn accelerometers, indicate that adults spend over half their day (55%) in sedentary behaviors. Our study examined the association between sitting time and cardiometabolic risk factors after adjustment for cardiorespiratory fitness (CRF). Methods A cross-sectional analysis was conducted with 4,486 men and 1,845 women who reported daily estimated sitting time, had measures for adiposity, blood lipids, glucose, and blood pressure, and underwent maximal stress testing. We used a modeling strategy using logistic regression analysis to assess CRF as a potential effect modifier and to control for potential confounding effects of CRF. Results Men who sat almost all of the time (about 100%) were more likely to be obese whether defined by waist girth (OR, 2.61; 95% CI, 1.25–5.47) or percentage of body fat (OR, 3.33; 95% CI, 1.35–8.20) than were men who sat almost none of the time (about 0%). Sitting time was not significantly associated with other cardiometabolic risk factors after adjustment for CRF level. For women, no significant associations between sitting time and cardiometabolic risk factors were observed after adjustment for CRF and other covariates. Conclusion As health professionals struggle to find ways to combat obesity and its health effects, reducing sitting time can be an initial step in a total physical activity plan that includes strategies to reduce sedentary time through increases in physical activity among men. In addition, further research is needed to elucidate the relationships between sitting time and CRF for women as well as the underlying mechanisms involved in these relationships. PMID:28033088

  12. 78 FR 32255 - HHS-Operated Risk Adjustment Data Validation Stakeholder Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... information that we obtain through this meeting may aid future policy-making for the HHS-operated risk... knives), and dogs or other animals (except service animals). Once cleared for entry to the...

  13. 75 FR 10973 - Hazardous Materials: Risk-Based Adjustment of Transportation Security Plan Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ... Transportation Pipeline and Hazardous Materials Safety Administration 49 CFR Part 172 Hazardous Materials: Risk... security plan requirements applicable to the commercial transportation of hazardous materials by air, rail... Requirements The federal hazardous materials transportation law (federal hazmat law, 49......

  14. Parent birds assess nest predation risk and adjust their reproductive strategies

    USGS Publications Warehouse

    Fontaine, J.J.; Martin, T.E.

    2006-01-01

    Avian life history theory has long assumed that nest predation plays a minor role in shaping reproductive strategies. Yet, this assumption remains conspicuously untested by broad experiments that alter environmental risk of nest predation, despite the fact that nest predation is a major source of reproductive failure. Here, we examined whether parents can assess experimentally reduced nest predation risk and alter their reproductive strategies. We experimentally reduced nest predation risk and show that in safer environments parents increased investment in young through increased egg size, clutch mass, and the rate they fed nestlings. Parents also increased investment in female condition by increasing the rates that males fed incubating females at the nest, and decreasing the time that females spent incubating. These results demonstrate that birds can assess nest predation risk at large and that nest predation plays a key role in the expression of avian reproductive strategies. ?? 2006 Blackwell Publishing Ltd/CNRS.

  15. Socially anxious mothers' narratives to their children and their relation to child representations and adjustment.

    PubMed

    Murray, Lynne; Pella, Jeff E; De Pascalis, Leonardo; Arteche, Adriane; Pass, Laura; Percy, Ray; Creswell, Catharine; Cooper, Peter J

    2014-11-01

    Anxious mothers' parenting, particularly transfer of threat information, has been considered important in their children's risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their preschool 4- to 5-year-old children, via a picture book about starting school, were assessed in socially anxious (N = 73), and nonanxious (N = 63) mothers. Child representations of school were assessed via doll play (DP). After one school term, mothers (Child Behavior Checklist [CBCL]) and teachers (Teacher Report Form) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution) and less supportive (lower encouragement) narratives than controls, and their children's DP representations SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, Teacher Report Form scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations and CBCL scores. Maternal narratives are affected by social anxiety and contribute to adverse child outcome.

  16. Applying risk adjusted cost-effectiveness (RAC-E) analysis to hospitals: estimating the costs and consequences of variation in clinical practice.

    PubMed

    Karnon, Jonathan; Caffrey, Orla; Pham, Clarabelle; Grieve, Richard; Ben-Tovim, David; Hakendorf, Paul; Crotty, Maria

    2013-06-01

    Cost-effectiveness analysis is well established for pharmaceuticals and medical technologies but not for evaluating variations in clinical practice. This paper describes a novel methodology--risk adjusted cost-effectiveness (RAC-E)--that facilitates the comparative evaluation of applied clinical practice processes. In this application, risk adjustment is undertaken with a multivariate matching algorithm that balances the baseline characteristics of patients attending different settings (e.g., hospitals). Linked, routinely collected data are used to analyse patient-level costs and outcomes over a 2-year period, as well as to extrapolate costs and survival over patient lifetimes. The study reports the relative cost-effectiveness of alternative forms of clinical practice, including a full representation of the statistical uncertainty around the mean estimates. The methodology is illustrated by a case study that evaluates the relative cost-effectiveness of services for patients presenting with acute chest pain across the four main public hospitals in South Australia. The evaluation finds that services provided at two hospitals were dominated, and of the remaining services, the more effective hospital gained life years at a low mean additional cost and had an 80% probability of being the most cost-effective hospital at realistic cost-effectiveness thresholds. Potential determinants of the estimated variation in costs and effects were identified, although more detailed analyses to identify specific areas of variation in clinical practice are required to inform improvements at the less cost-effective institutions.

  17. Medicare determinations and income-related monthly adjustment amounts to Medicare Part B premiums; conforming changes to regulations. Final rule.

    PubMed

    2014-03-03

    This final rule adopts, without change, the interim final rule with request for comments we published in the Federal Register on September 18, 2013. The interim final rule modified our rules regarding Medicare Part B income-related monthly adjustment amounts to conform to changes made to the Social Security Act (Act) and Internal Revenue Code by the Affordable Care Act. We also removed provisions that phased in income-related monthly adjustment amounts between 2007 and 2009 and updated a citation to reflect the transfer of authority for hearing appeals under title XVIII of the Act from the Social Security Administration to the Department of Health and Human Services.

  18. Risk-adjusted impact of administrative costs on the distribution of terminal wealth for long-term investment.

    PubMed

    Guillén, Montserrat; Jarner, Søren Fiig; Nielsen, Jens Perch; Pérez-Marín, Ana M

    2014-01-01

    The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs.

  19. The adjustment of children with divorced parents: a risk and resiliency perspective.

    PubMed

    Hetherington, E M; Stanley-Hagan, M

    1999-01-01

    This review addresses major questions about divorce, around which much contemporary research is oriented. These involve questions of the consequences of divorce for the adjustment of children and the vulnerability and resiliency of children in coping with divorce, whether children are better off in a conflictual intact family situation or a divorced family, and how mothers, fathers, and clinical or educational interventions can moderate the effects of divorce. Although research in the past decade has yielded considerable information about these questions, issues that need further investigation are also presented.

  20. Effortful Control, Behavior Problems and Peer Relations: What Predicts Academic Adjustment in Kindergarteners from Low-income Families?

    PubMed Central

    Morris, Amanda Sheffield; John, Aesha; Halliburton, Amy L.; Morris, Michael D. S.; Robinson, Lara R.; Myers, Sonya S.; Aucoin, Katherine J.; Keyes, Angela W.; Terranova, Andrew

    2013-01-01

    This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children’s effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children’s effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children’s effortful control primarily account for variation in children’s academic adjustment. The associations between children’s effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children’s internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed. PMID:24163572

  1. Effortful Control, Behavior Problems and Peer Relations: What Predicts Academic Adjustment in Kindergarteners from Low-income Families?

    PubMed

    Morris, Amanda Sheffield; John, Aesha; Halliburton, Amy L; Morris, Michael D S; Robinson, Lara R; Myers, Sonya S; Aucoin, Katherine J; Keyes, Angela W; Terranova, Andrew

    2013-01-01

    This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children's effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children's effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children's effortful control primarily account for variation in children's academic adjustment. The associations between children's effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children's internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed.

  2. Critical review of methods for risk ranking of food related hazards, based on risks for human health.

    PubMed

    van der Fels-Klerx, H J; van Asselt, E D; Raley, M; Poulsen, M; Korsgaard, H; Bredsdorff, L; Nauta, M; D'Agostino, M; Coles, D; Marvin, H J P; Frewer, L J

    2016-02-08

    This study aimed to critically review methods for ranking risks related to food safety and dietary hazards on the basis of their anticipated human health impacts. A literature review was performed to identify and characterize methods for risk ranking from the fields of food, environmental science and socio-economic sciences. The review used a predefined search protocol, and covered the bibliographic databases Scopus, CAB Abstracts, Web of Sciences, and PubMed over the period 1993-2013. All references deemed relevant, on the basis of of predefined evaluation criteria, were included in the review, and the risk ranking method characterized. The methods were then clustered - based on their characteristics - into eleven method categories. These categories included: risk assessment, comparative risk assessment, risk ratio method, scoring method, cost of illness, health adjusted life years, multi-criteria decision analysis, risk matrix, flow charts/decision trees, stated preference techniques and expert synthesis. Method categories were described by their characteristics, weaknesses and strengths, data resources, and fields of applications. It was concluded there is no single best method for risk ranking. The method to be used should be selected on the basis of risk manager/assessor requirements, data availability, and the characteristics of the method. Recommendations for future use and application are provided.

  3. The Relation of Marital Adjustment and Family Functions With Quality of Life in Women

    PubMed Central

    Basharpoor, Sajjad; Sheykholeslami, Ali

    2015-01-01

    Given the immense importance of marital relationships in the quality of life, this research was conducted in order to investigate the relationships between marital adjustment and family functions with quality of life in women. The design of the current study was correlational. Seven hundred and thirty women were selected randomly among all women living in the province of Western Azerbaijan (Iran) and participated in this study. The sample responded to the Family Assessment Device, Dyadic Adjustment scale and Quality of Life questionnaire, individually in their homes. Collected data were analyzed by Pearson’s correlation and multiple regression tests. The results showed that all dimensions of family functions and dyadic adjustment were positively correlated with quality of life in women. Results of multiple regression also revealed that 33 percent of total quality of life can be explained by family functions and 24 percent of this variable can be explained by dyadic adjustment. Our study demonstrated that women’s quality of life was affected by family functions and marital adjustment in family. PMID:27247668

  4. Behavioral adjustments of African herbivores to predation risk by lions: spatiotemporal variations influence habitat use.

    PubMed

    Valeix, M; Loveridge, A J; Chamaillé-Jammes, S; Davidson, Z; Murindagomo, F; Fritz, H; Macdonald, D W

    2009-01-01

    Predators may influence their prey populations not only through direct lethal effects, but also through indirect behavioral changes. Here, we combined spatiotemporal fine-scale data from GPS radio collars on lions with habitat use information on 11 African herbivores in Hwange National Park (Zimbabwe) to test whether the risk of predation by lions influenced the distribution of herbivores in the landscape. Effects of long-term risk of predation (likelihood of lion presence calculated over four months) and short-term risk of predation (actual presence of lions in the vicinity in the preceding 24 hours) were contrasted. The long-term risk of predation by lions appeared to influence the distributions of all browsers across the landscape, but not of grazers. This result strongly suggests that browsers and grazers, which face different ecological constraints, are influenced at different spatial and temporal scales in the variation of the risk of predation by lions. The results also show that all herbivores tend to use more open habitats preferentially when lions are in their vicinity, probably an effective anti-predator behavior against such an ambush predator. Behaviorally induced effects of lions may therefore contribute significantly to structuring African herbivore communities, and hence possibly their effects on savanna ecosystems.

  5. Shyness-sensitivity and unsociability in rural Chinese children: relations with social, school, and psychological adjustment.

    PubMed

    Chen, Xinyin; Wang, Li; Cao, Ruixin

    2011-01-01

    The purpose of this study was to examine how shyness-sensitivity and unsociability were associated with social, school, and psychological adjustment in rural Chinese children. Participants were third- to fifth-grade students (N = 820; M age = 10 years) in rural schools in P. R. China. Data on shyness-sensitivity, unsociability, and adjustment were obtained from multiple sources including peer assessments, sociometric nominations, teacher ratings, self-reports, and school records. It was found that unsociability was associated with social, school, and psychological problems, whereas shyness was generally associated with indexes of adjustment such as social status, teacher-rated competence, and academic achievement. The results indicate that rural Chinese context may play an important role in defining the functional meanings of children's social behaviors.

  6. Parental warmth, control, and indulgence and their relations to adjustment in Chinese children: a longitudinal study.

    PubMed

    Chen, X; Liu, M; Li, D

    2000-09-01

    A sample of children, initially 12 years old, in the People's Republic of China participated in this 2-year longitudinal study. Data on parental warmth, control, and indulgence were collected from children's self-reports. Information concerning social, academic, and psychological adjustment was obtained from multiple sources. The results indicated that parenting styles might be a function of child gender and change with age. Regression analyses revealed that parenting styles of fathers and mothers predicted different outcomes. Whereas maternal warmth had significant contributions to the prediction of emotional adjustment, paternal warmth significantly predicted later social and school achievement. It was also found that paternal, but not maternal, indulgence significantly predicted children's adjustment difficulties. The contributions of the parenting variables might be moderated by the child's initial conditions.

  7. Relation of physical activity to cardiovascular disease mortality and the influence of cardiometabolic risk factors.

    PubMed

    Reddigan, Jacinta I; Ardern, Chris I; Riddell, Michael C; Kuk, Jennifer L

    2011-11-15

    Physical activity can improve several metabolic risk factors associated with cardiovascular disease (CVD) and is associated with a lower risk of CVD mortality. We sought to evaluate the extent to which metabolic risk factors mediate the association between physical activity and CVD mortality and whether physical activity provides protective effects against CVD mortality in healthy adults and those with metabolic risk factors. A sample of 10,261 adults from the Third National Health and Nutrition Examination Survey with public-access mortality data linkage (follow-up 13.4 ± 3.9 years) was used. Physical activity was assessed by questionnaire and classified into inactive, light, and moderate/vigorous activity categories. Metabolic risk factors (dyslipidemia, type 2 diabetes mellitus, obesity, hypertension, inflammation, and insulin resistance) were categorized using clinical thresholds. After adjusting for basic confounders, engaging in light or moderate/vigorous physical activity was associated with a lower risk of CVD mortality (p < 0.05). Adjustment for each risk-factor set only slightly attenuated this relation. When all risk-factor sets were added to the model simultaneously, light (hazard ratio 0.72, 0.62 to 0.84) and moderate/vigorous (hazard ratio 0.72, 0.62 to 0.85) activity remained at lower risk of CVD mortality. In addition, physical activity provided protective effects for CVD mortality in healthy subjects and those with metabolic risk factors in isolation or in clusters. In conclusion, physical activity was associated with a lower risk of CVD mortality independent of traditional and inflammatory risk factors. Taken together these results suggest that physical activity may protect against CVD mortality regardless of the presence of metabolic risk factors.

  8. Generic Considerations in Adjusting Curriculum and Instruction for At Risk Students.

    ERIC Educational Resources Information Center

    Klumb, Kelly

    This document presents 28 accepted principles for modifying instruction to better meet needs of handicapped and at risk students. The principles include, among others: get to know the individual student in an informal manner; examine the patterns of children's errors; sequence skills to reduce error rates; vary response, testing, and grading…

  9. Socioenvironmental Risk and Adjustment in Latino Youth: The Mediating Effects of Family Processes and Social Competence

    ERIC Educational Resources Information Center

    Prelow, Hazel M.; Loukas, Alexandra; Jordan-Green, Lisa

    2007-01-01

    The direct and mediated effects of socioenvironmental risk on internalizing and externalizing problems among Latino youth aged 10-14 were examined using prospective analyses. Participants in this study were 464 Latino mother and child dyads surveyed as part of the "Welfare, Children & Families: A Three City Study." It was hypothesized that…

  10. Medicare program: request for public comments on implementation of risk adjusted payment for the Medicare+Choice program and announcement of public meeting--HCFA. Solicitation of comments; announcement of meeting.

    PubMed

    1998-09-08

    This notice solicits further public comments on issues related to the implementation of risk adjusted payment of Medicare+Choice organizations. Section 1853(a)(3) of the Social Security Act (the Act) requires the Secretary to implement a risk adjustment methodology that accounts for variation in per capita costs based on health status and demographic factors for payments no later than January 1, 2000. The methodology is to apply uniformly to all Medicare+Choice plans. This notice outlines our proposed approach to implementing risk adjusted payment. In order to carry out risk adjustment, section 1853(a)(3) of the Act also requires Medicare+Choice organizations, as well as other organizations with risk sharing contracts, to submit encounter data. Inpatient hospital data are required for discharges on or after July 1, 1997. Other data, as the Secretary deems necessary, may be required beginning July 1998. The Medicare+Choice interim final rule published on June 26, 1998 (63 FR 34968) describes the general process for the collection of encounter data. We also included a schedule for the collection of additional encounter data. Physician, outpatient hospital, skilled nursing facility, and home health data will be collected no earlier than October 1, 1999, and all other data we deem necessary no earlier than October 1, 2000. Given any start date, comprehensive risk adjustment will be made about three years after the year of initial collection of outpatient hospital and physician encounter data. Comments on the process for encounter data collection are requested in that interim final rule. We intend to consider comments received in response to this solicitation as we develop the final methodology for implementation of risk adjustment. This notice also informs the public of a meeting on September 17, 1998, to discuss risk adjustment and the collection of encounter data. The meeting will be held at the Health Care Financing Administration headquarters, located at 7500

  11. An Examination of Predictive Factors Related to School Adjustment for Children with Disabilities Transitioning into Formal School Settings

    ERIC Educational Resources Information Center

    Baughan, Cynthia Coss

    2012-01-01

    Data related to the adjustment to school of 86 children with disabilities who transitioned into formal school settings in the fall of 2011 were obtained through 31 parent surveys (Transition to School Parent Survey) and 64 teacher surveys ("Transition to School Teacher Survey"). Data from the subscales of these surveys were used to…

  12. Attitudes about Help-Seeking Mediate the Relation between Parent Attachment and Academic Adjustment in First-Year College Students

    ERIC Educational Resources Information Center

    Holt, Laura J.

    2014-01-01

    Although numerous studies have documented an association between parent attachment and college student adjustment, less is known about the mechanisms that underlie this relation. Accordingly, this short-term longitudinal study examined first-year college students' attitudes about academic help-seeking as one possible mechanism. As predicted,…

  13. The Psychosocial Adjustment of African American Youth from Single Mother Homes: The Relative Contribution of Parents and Peers

    ERIC Educational Resources Information Center

    Chester, Charlene; Jones, Deborah J.; Zalot, Alecia; Sterrett, Emma

    2007-01-01

    This study examined the relative roles of parents and peers in the psychosocial adjustment of African American youth (7-15 years old) from single mother homes (N = 242). Main effects of both positive parenting and peer relationship quality were found for youth depressive symptoms. In addition, a main effect of peer relationship quality and an…

  14. Enforcement Related to Minimum Risk Pesticides

    EPA Pesticide Factsheets

    If a product does not meet all the requirements of the minimum risk exemption, it must be registered unless eligible for some other exemption. Learn about enforcement actions EPA can take where unregistered products make pesticidal claims.

  15. Emotional and organizational supports for preschoolers' emotion regulation: Relations with school adjustment.

    PubMed

    Bailey, Craig S; Denham, Susanne A; Curby, Timothy W; Bassett, Hideko H

    2016-03-01

    Preschool teachers, like parents, support children in ways that promote the regulation capacities that drive school adjustment, especially for children struggling to succeed in the classroom. The purpose of this study was to explore the emotionally and organizationally supportive classroom processes that contribute to the development of children's emotion regulation and executive control. Emotion regulation and executive control were assessed in 312 3-, 4- and 5-year-old children. The 44 teachers of these children completed questionnaires asking about 3 components of children's school adjustment: Positive/Engaged, Independent/Motivated, and Prosocial/Connected. Observations of classroom emotional and organizational supports were conducted. Results of multilevel models indicated emotion regulation was significantly associated with the Positive/Engaged school adjustment component, but only when teachers' emotional and organizational supports were taken into account. Children with lower levels of emotion regulation, who were also in less supportive classrooms, had the lowest scores on the Positive/Engaged component. Children's executive control was associated with the Independent/Motivated and Prosocial/Connected components independently of teacher effects. In general, moderate support was found for the notion that teachers' supports can be particularly helpful for children struggling to regulate their emotions to be better adjusted to school. Children's emotionally salient classroom behaviors, and teachers' emotion scaffolding, are discussed.

  16. The Mediational Role of Adolescents' Friends in Relations between Activity Breadth and Adjustment

    ERIC Educational Resources Information Center

    Simpkins, Sandra D.; Eccles, Jacquelynne S.; Becnel, Jennifer N.

    2008-01-01

    This investigation addresses the mediational role of friends' characteristics between adolescents' activity breadth (i.e., variety in activity participation) and their later adjustment. Data were drawn from 2 longitudinal studies: the Childhood and Beyond (CAB; N = 925) study and the Maryland Adolescent Development in Context Study (MADICS; N =…

  17. Age-Adjustment and Related Epidemiology Rates in Education and Research

    ERIC Educational Resources Information Center

    Baker, John D.; Kruckman, Laurence; George, Joyce

    2006-01-01

    A quick review of introductory textbooks reveals that while gerontology authors and instructors introduce some aspect of demography and epidemiology data, there is limited focus on age adjustment or other important epidemiology rates. The goal of this paper is to reintroduce a variety of basic epidemiology strategies such as incidence, prevalence,…

  18. "Try Walking in Our Shoes": Teaching Acculturation and Related Cultural Adjustment Processes through Role-Play

    ERIC Educational Resources Information Center

    Zamboanga, Byron L.; Ham, Lindsay S.; Tomaso, Cara C.; Audley, Shannon; Pole, Nnamdi

    2016-01-01

    In this article, we describe several role-playing exercises on acculturation and relevant cultural adjustment processes that we incorporated into Tomcho and Foel's classroom activity on acculturation, and we report data that examine subsequent changes in students' responses on pretest and posttest measures shortly after the activity and present…

  19. Relation between Assertiveness, Academic Self-Efficacy, and Psychosocial Adjustment among International Graduate Students.

    ERIC Educational Resources Information Center

    Poyrazli, Senel; Arbona, Consuelo; Nora, Amaury; McPherson, Robert; Pisecco, Stewart

    2002-01-01

    Rathus Assertiveness Schedule, Academic Self-Efficacy Scale, The Inventory for Student Adjustment Strain, and UCLA Loneliness Scale were used to examine a total of 122 graduate international students. Findings indicate that English proficiency, assertiveness, and academic self-efficacy contributed uniquely to the variance in students' general…

  20. Preschoolers' Self-Regulation Moderates Relations between Mothers' Representations and Children's Adjustment to School

    ERIC Educational Resources Information Center

    Sher-Censor, Efrat; Khafi, Tamar Y.; Yates, Tuppett M.

    2016-01-01

    Consistent with models of environmental sensitivity (Pluess, 2015), research suggests that the effects of parents' behaviors on child adjustment are stronger among children who struggle to regulate their thoughts, feelings, and behaviors compared with children with better self-regulation. This study extended prior research by assessing maternal…

  1. Peer Relations and Social Adjustment of Latino and Chinese Children in Head Start Classrooms

    ERIC Educational Resources Information Center

    Lee, Linda S.

    2016-01-01

    Research Findings: The present study investigated the role of ethnic similarity in the peer preferences and play quality of Latino and Chinese children enrolled in Head Start classrooms and the relationship between peer acceptance and social adjustment in these groups. Participants were 244 children (M = 4.6 years old) from Head Start preschools…

  2. Calculating disability-adjusted life years (DALY) as a measure of excess cancer risk following radiation exposure.

    PubMed

    Shimada, K; Kai, M

    2015-12-01

    This paper has proposed that disability-adjusted life year (DALY) can be used as a measure of radiation health risk. DALY is calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). This multidimensional concept can be expressed as a risk index without a probability measure to avoid the misuse of the current radiation detriment at low doses. In this study, we calculated YLL and YLD using Japanese population data by gender. DALY for all cancers in Japan per 1 Gy per person was 0.84 year in men and 1.34 year in women. The DALY for all cancers in the Japanese baseline was 4.8 in men and 3.5 in women. When we calculated the ICRP detriment from the same data, DALYs for the cancer sites were similar to the radiation detriment in the cancer sites, excluding leukemia, breast and thyroid cancer. These results suggested that the ICRP detriment overestimate the weighting fraction of leukemia risk and underestimate the weighting fraction of breast and thyroid cancer. A big advantage over the ICRP detriment is that DALY can calculate the risk components for non-fatal diseases without the data of lethality. This study showed that DALY is a practical tool that can compare many types of diseases encountered in public health.

  3. Adjusting for Risk Associated with Pediatric and Congenital Cardiac Catheterization: A Report from the NCDR® IMPACT™ Registry

    PubMed Central

    Jayaram, Natalie; Beekman, Robert H.; Benson, Lee; Holzer, Ralf; Jenkins, Kathy; Kennedy, Kevin F.; Martin, Gerard R.; Moore, John W.; Ringel, Richard; Rome, Jonathan; Spertus, John A.; Vincent, Robert; Bergersen, Lisa

    2016-01-01

    Background As US healthcare increasingly focuses upon outcomes as a means for quantifying quality, there is a growing demand for risk models that can account for the variability of patients treated at different hospitals so that equitable comparisons between institutions can be made. We sought to apply aspects of prior risk-standardization methodology in order to begin development of a risk-standardization tool for the NCDR® IMPACT™ (Improving Pediatric and Adult Congenital Treatment) Registry. Methods and Results Using IMPACT, all patients undergoing diagnostic or interventional cardiac catheterization between January 2011 and March 2013 were identified. Multivariable hierarchical logistic regression was used to identify patient and procedural characteristics predictive of experiencing a major adverse event following cardiac catheterization. A total of 19,608 cardiac catheterizations were performed between January 2011 and March 2013. Amongst all cases, a major adverse event occurred in 378 (1.9%) of all cases. After multivariable adjustment, eight variables were identified as critical for risk-standardization: patient age, renal insufficiency, single-ventricle physiology, procedure-type risk group, low systemic saturation, low mixed venous saturation, elevated systemic ventricular end diastolic pressure, and elevated main pulmonary artery pressures. The model had good discrimination (C-statistic of 0.70), confirmed by bootstrap validation (validation C-statistic of 0.69). Conclusions Using prior risk-standardization efforts as a foundation, we developed and internally validated a model to predict the occurrence of a major adverse event following cardiac catheterization for congenital heart disease. Future efforts should be directed towards further refinement of the model variables within this large, multicenter dataset. PMID:26481778

  4. The Relation Between Marital Adjustment and Posttraumatic Growth in Infertile Couples: The Mediatory Role of Religious Coping Strategies

    PubMed Central

    Ghafouri, Seyyedeh Fatemeh; Ghanbari, Saeed; Fallahzadeh, Hajar; Shokri, Omid

    2016-01-01

    Background: Infertility as a crisis can both lead to negative reactions and stress in infertile couples and bring about positive reactions and growth, to which henceforth posttraumatic growth is referred. This study was conducted to model the relation between martial adjustment and posttraumatic growth through the mediation of religious coping strategies in infertile couples. Methods: This correlation-based study was performed on 250 couples at the infertility center of Shariati hospital, Tehran, Iran, selected via convenience sampling. They answered to the Marital Adjustment Scale, the Posttraumatic Growth Inventory, and the Religious Coping Strategies Inventory. This study used Structural Equation Modeling. Results: The results showed significant positive relationships between marital adjustment and both positive religious coping strategies and posttraumatic growth. A significant positive relationship between positive religious coping strategies and posttraumatic growth was also detected. Positive religious coping strategies were observed to play a mediatory role between marital adjustment and posttraumatic growth. This was the case while attributing such a mediatory role to negative coping strategies was not possible. Conclusion: Based on the results, this study can be seen as further evidence showing the necessity of focusing on the role of positive religious coping strategies in marital adjustment and posttraumatic growth in infertile couples. PMID:27921001

  5. A pilot study of risk adjustment for benchmarking antibiotic use between hospitals in Sweden.

    PubMed

    Norberg, Signe; Struwe, Johan; Grunewald, Maria; Ternhag, Anders

    2014-03-01

    There is no established standard for comparing overall antibiotic use between hospitals taking patient characteristics into account. The objective of this study was to investigate whether there is a correlation between surrogate markers for patient morbidity, namely case mix index (CMI), mean length of hospital stay (LoS) and mean cost per admission, and antibiotic use in a sample of Swedish hospitals. All primary and secondary hospitals in three counties with high and three counties with low consumption of antibiotics were selected. Data from 16 hospitals were included. A regression analysis was used to evaluate whether there was a linear trend between defined daily doses (DDD) of antibiotics per 100 bed-days and the surrogate markers for morbidity. No correlation could be found between any of the measures of morbidity and total antibiotic consumption. However, a correlation was found between CMI and the proportion of narrow-spectrum antibiotics: the higher the CMI, the lower the proportional use of β-lactamase-sensitive penicillins. In conclusion, it was found that CMI, mean LoS and mean cost per admission did not appears to be useful factors to adjust for when comparing antibiotic use in this subset of primary and secondary care hospitals. Based on this limited study, we suggest that DDD/100 bed-days can still be used as an appropriate metric to benchmark antibiotic use in primary and secondary hospitals until a better marker for variation of patients and activities is identified.

  6. Body talk and body-related co-rumination: associations with body image, eating attitudes, and psychological adjustment.

    PubMed

    Rudiger, Jonathan A; Winstead, Barbara A

    2013-09-01

    Talk about physical appearance and body image is common among young women. We investigated how body talk (negative, positive/self-accepting, and co-ruminative) is related to body image, body-related cognitive distortions, disordered eating, psychological adjustment, and friendship quality via hierarchical regression analyses (controlling for social desirability and body mass index). In a sample of young adult women (N=203), negative body talk was, as predicted, negatively related to body satisfaction and self-esteem and positively related to appearance investment, body-related cognitive distortions, disordered eating, and depression, but not friendship quality. Self-accepting/positive body talk was negatively related to body-related cognitive distortions and positively related to body satisfaction, self-esteem, and friendship quality. Body-related co-rumination demonstrated adjustment trade-offs, being related to body-related cognitive distortions, disordered eating, and higher friendship quality. Results indicated no advantage to negative body talk, both individual and relationship benefits from positive/self-accepting body talk, and mixed outcomes for body-related co-rumination.

  7. Betaine deficiency in maize: Metabolic basis and relation to osmotic adjustment

    SciTech Connect

    Rhodes, D. ); Hanson, A.D. ); Lerma, C.; Bolanos, J.

    1990-05-01

    A single recessive gene causes betaine deficiency in certain maize inbred lines. As betaine may act as a cytosolic osmolyte, deficiency might be expected to reduce osmotic adjustment. Two near-isogenic maize lines differing for betaine, as well as groups of diverse betaine-containing and deficient inbreds, were tested under field water-stress conditions. The betaine-deficient isogenic line, and the group of deficient inbreds as a whole, showed significantly (P<0.05) less osmotic adjustment than their respective betaine-containing counterparts. When leaves from field-grown plants of the isogenic lines were supplied with ({sup 14}C)choline, the betaine-containing line produced ({sup 14}C)betaine whereas the deficient line did not.

  8. Risk Factors for Violence and Relational Aggression in Adolescence

    ERIC Educational Resources Information Center

    Herrenkohl, Todd I.; McMorris, Barbara J.; Catalano, Richard F.; Abbott, Robert D.; Hemphill, Sheryl A.; Toumbourou, John W.

    2007-01-01

    Analyses examined risk factors for seventh- and ninth-grade youth categorized as nonoffenders, physically violent, relationally aggressive, and both violent and relationally aggressive. Bivariate and multivariate results showed that relationally aggressive youth were elevated on most risks above levels for nonoffenders but lower than those for…

  9. Capture-recapture-adjusted prevalence rates of type 2 diabetes are related to social deprivation.

    PubMed

    Ismail, A A; Beeching, N J; Gill, G V; Bellis, M A

    1999-12-01

    We examined the prevalence of type 2 diabetes and social deprivation in one urban district in Liverpool from October 1995 to September 1996 inclusive. This area has a stable Caucasian population of 176, 682. Lists were made of all known diabetics attending six different medical points of contact during the year, and were condensed and aggregated to eliminate duplicates. From postcode data, each patient was assigned to residence in one of the 14 electoral wards in the district, for which demographic structure and standardized measures of social deprivation were known (Townsend index). The crude period prevalences of type 1 and type 2 diabetes were estimated for each ward. Crude prevalence data were then corrected by applying capture-recapture (CR) techniques to the different patient datasets to allow for undercount. The crude period prevalence (95%CI) of diabetes was 1.5% (1.4-1.5%), or 2585/176, 682. The mean age of people with diabetes was not significantly different between electoral wards. The crude period prevalence of type 2 diabetes within individual wards ranged from 0.4% (0.3-0.6%) in the least deprived area to 4.1% (3.6-4.6%) in the most deprived area. The corresponding range of CR-adjusted period prevalence rates of type 2 diabetes was from 3.2% (2.8-3.6%) to 6.7% (6.1-7.4%), and there was strong correlation between both crude and CR-adjusted prevalence and social deprivation in each ward (r=0.76, p<0.001 for crude; and r=0. 49, p<0.005 for CR-adjusted prevalence). There was no correlation between the crude or CR-adjusted period prevalence rates of type 1 diabetes and Townsend index (r=0.14, p=NS). This strong correlation between the prevalence of type 2 diabetes and social deprivation has important implications for the planning of health-care delivery.

  10. Risk of vocal chord dysplasia in relation to smoking, alcohol intake and occupation.

    PubMed

    Grasl, M C; Neuwirth-Riedl, K; Vutuc, C; Horak, F; Vorbeck, F; Banyai, M

    1990-03-01

    The significance of tobacco smoking, alcohol consumption and occupation as risk factors for the development of vocal chord dysplasia was evaluated in a case-control study. Twenty-seven male patients with dysplasia of the vocal chords were chosen from the I. ENT-University Clinic in Vienna (1985-1988) and compared with 54 controls. The main results are: The relative risk (RR) of a smoker compared to that of a non-smoker for vocal chord dysplasia is 7.27 (6.81-7.73); the RR adjusted for occupation is 3.58 (2.31-4.84). The most important risk factor, however, is occupational exposure. The relative risk of a blue collar worker compared to that of a white collar worker is 11.04 (10.61-11.46), which is reduced only to 10.02 (10.61-11.46) after stratification according to smoking habits.

  11. Theta and Alpha Band Modulations Reflect Error-Related Adjustments in the Auditory Condensation Task

    PubMed Central

    Novikov, Nikita A.; Bryzgalov, Dmitri V.; Chernyshev, Boris V.

    2015-01-01

    Error commission leads to adaptive adjustments in a number of brain networks that subserve goal-directed behavior, resulting in either enhanced stimulus processing or increased motor threshold depending on the nature of errors committed. Here, we studied these adjustments by analyzing post-error modulations of alpha and theta band activity in the auditory version of the two-choice condensation task, which is highly demanding for sustained attention while involves no inhibition of prepotent responses. Errors were followed by increased frontal midline theta (FMT) activity, as well as by enhanced alpha band suppression in the parietal and the left central regions; parietal alpha suppression correlated with the task performance, left central alpha suppression correlated with the post-error slowing, and FMT increase correlated with both behavioral measures. On post-error correct trials, left-central alpha band suppression started earlier before the response, and the response was followed by weaker FMT activity, as well as by enhanced alpha band suppression distributed over the entire scalp. These findings indicate that several separate neuronal networks are involved in post-error adjustments, including the midfrontal performance monitoring network, the parietal attentional network, and the sensorimotor network. Supposedly, activity within these networks is rapidly modulated after errors, resulting in optimization of their functional state on the subsequent trials, with corresponding changes in behavioral measures. PMID:26733266

  12. Effect of time-activity adjustment on exposure assessment for traffic-related ultrafine particles.

    PubMed

    Lane, Kevin J; Levy, Jonathan I; Scammell, Madeleine Kangsen; Patton, Allison P; Durant, John L; Mwamburi, Mkaya; Zamore, Wig; Brugge, Doug

    2015-01-01

    Exposures to ultrafine particles (<100 nm, estimated as particle number concentration, PNC) differ from ambient concentrations because of the spatial and temporal variability of both PNC and people. Our goal was to evaluate the influence of time-activity adjustment on exposure assignment and associations with blood biomarkers for a near-highway population. A regression model based on mobile monitoring and spatial and temporal variables was used to generate hourly ambient residential PNC for a full year for a subset of participants (n=140) in the Community Assessment of Freeway Exposure and Health study. We modified the ambient estimates for each hour using personal estimates of hourly time spent in five micro-environments (inside home, outside home, at work, commuting, other) as well as particle infiltration. Time-activity adjusted (TAA)-PNC values differed from residential ambient annual average (RAA)-PNC, with lower exposures predicted for participants who spent more time away from home. Employment status and distance to highway had a differential effect on TAA-PNC. We found associations of RAA-PNC with high sensitivity C-reactive protein and Interleukin-6, although exposure-response functions were non-monotonic. TAA-PNC associations had larger effect estimates and linear exposure-response functions. Our findings suggest that time-activity adjustment improves exposure assessment for air pollutants that vary greatly in space and time.

  13. Effect of time-activity adjustment on exposure assessment for traffic-related ultrafine particles

    PubMed Central

    Lane, Kevin J; Levy, Jonathan I; Scammell, Madeleine Kangsen; Patton, Allison P; Durant, John L; Mwamburi, Mkaya; Zamore, Wig; Brugge, Doug

    2015-01-01

    Exposures to ultrafine particles (<100 nm, estimated as particle number concentration, PNC) differ from ambient concentrations because of the spatial and temporal variability of both PNC and people. Our goal was to evaluate the influence of time-activity adjustment on exposure assignment and associations with blood biomarkers for a near-highway population. A regression model based on mobile monitoring and spatial and temporal variables was used to generate hourly ambient residential PNC for a full year for a subset of participants (n=140) in the Community Assessment of Freeway Exposure and Health study. We modified the ambient estimates for each hour using personal estimates of hourly time spent in five micro-environments (inside home, outside home, at work, commuting, other) as well as particle infiltration. Time-activity adjusted (TAA)-PNC values differed from residential ambient annual average (RAA)-PNC, with lower exposures predicted for participants who spent more time away from home. Employment status and distance to highway had a differential effect on TAA-PNC. We found associations of RAA-PNC with high sensitivity C-reactive protein and Interleukin-6, although exposure-response functions were non-monotonic. TAA-PNC associations had larger effect estimates and linear exposure-response functions. Our findings suggest that time-activity adjustment improves exposure assessment for air pollutants that vary greatly in space and time. PMID:25827314

  14. Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease.

    PubMed

    Forstmeier, Simon; Maercker, Andreas; Maier, Wolfgang; van den Bussche, Hendrik; Riedel-Heller, Steffi; Kaduszkiewicz, Hanna; Pentzek, Michael; Weyerer, Siegfried; Bickel, Horst; Tebarth, Franziska; Luppa, Melanie; Wollny, Anja; Wiese, Birgitt; Wagner, Michael

    2012-06-01

    Midlife motivational abilities, that is, skills to initiate and persevere in the implementation of goals, have been related to mental and physical health, but their association with risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) has not yet been directly investigated. This relation was examined with data from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). A total of 3,327 nondemented participants (50.3% of a randomly selected sample) aged 75-89 years were recruited in primary care and followed up twice (after 1.5 and 3 years). Motivation-related occupational abilities were estimated on the basis of the main occupation (assessed at follow-up II) using the Occupational Information Network (O* NET) database, which provides detailed information on worker characteristics and abilities. Cox proportional hazards models were used to evaluate the relative risk of developing MCI and AD in relation to motivation-related occupational abilities, adjusting for various covariates. Over the 3 years of follow-up, 15.2% participants developed MCI and 3.0% developed AD. In a fully adjusted model, motivation-related occupational abilities were found to be associated with a reduced risk of MCI (HR: 0.77; 95% CI: 0.64-0.92). Motivation-related occupational abilities were associated with reduced risk of AD in ApoE ε4 carriers (HR: 0.48; CI: 0.25-0.91), but not in noncarriers (HR: 0.99; CI: 0.65-1.53). These results suggest that midlife motivational abilities are associated with reduced risk of MCI in general and with reduced risk of AD in ApoE ε4 carriers. Revealing the mechanisms underlying this association may inform novel prevention strategies for decelerating cognitive decline in old age.

  15. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders

    PubMed Central

    Fevery, Davina; Peeters, Bob; Lenders, Sonia; Spanoghe, Pieter

    2015-01-01

    Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq) is used in environmental policy in Flanders (Belgium). The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN). The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders. PMID:26046655

  16. Adjustments of the Pesticide Risk Index Used in Environmental Policy in Flanders.

    PubMed

    Fevery, Davina; Peeters, Bob; Lenders, Sonia; Spanoghe, Pieter

    2015-01-01

    Indicators are used to quantify the pressure of pesticides on the environment. Pesticide risk indicators typically require weighting environmental exposure by a no effect concentration. An indicator based on spread equivalents (ΣSeq) is used in environmental policy in Flanders (Belgium). The pesticide risk for aquatic life is estimated by weighting active ingredient usage by the ratio of their maximum allowable concentration and their soil halflife. Accurate estimates of total pesticide usage in the region are essential in such calculations. Up to 2012, the environmental impact of pesticides was estimated on sales figures provided by the Federal Government. Since 2013, pesticide use is calculated based on results from the Farm Accountancy Data Network (FADN). The estimation of pesticide use was supplemented with data for non-agricultural use based on sales figures of amateur use provided by industry and data obtained from public services. The Seq-indicator was modified to better reflect reality. This method was applied for the period 2009-2012 and showed differences between estimated use and sales figures of pesticides. The estimated use of pesticides based on accountancy data is more accurate compared to sales figures. This approach resulted in a better view on pesticide use and its respective environmental impact in Flanders.

  17. Understanding relative risk, odds ratio, and related terms: as simple as it can get.

    PubMed

    Andrade, Chittaranjan

    2015-07-01

    Risk, and related measures of effect size (for categorical outcomes) such as relative risks and odds ratios, are frequently presented in research articles. Not all readers know how these statistics are derived and interpreted, nor are all readers aware of their strengths and limitations. This article examines several measures, including absolute risk, attributable risk, attributable risk percent, population attributable risk percent, relative risk, odds, odds ratio, and others. The concept and method of calculation are explained for each of these in simple terms and with the help of examples. The interpretation of each is presented in plain English rather than in technical language. Clinically useful notes are provided, wherever necessary.

  18. Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences

    PubMed Central

    2014-01-01

    Background This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Methods Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject’s self-evaluation, and through lottery games. Results Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when “out of pocket” payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. Conclusions WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning. PMID:24989615

  19. The quantitative estimation of IT-related risk probabilities.

    PubMed

    Herrmann, Andrea

    2013-08-01

    How well can people estimate IT-related risk? Although estimating risk is a fundamental activity in software management and risk is the basis for many decisions, little is known about how well IT-related risk can be estimated at all. Therefore, we executed a risk estimation experiment with 36 participants. They estimated the probabilities of IT-related risks and we investigated the effect of the following factors on the quality of the risk estimation: the estimator's age, work experience in computing, (self-reported) safety awareness and previous experience with this risk, the absolute value of the risk's probability, and the effect of knowing the estimates of the other participants (see: Delphi method). Our main findings are: risk probabilities are difficult to estimate. Younger and inexperienced estimators were not significantly worse than older and more experienced estimators, but the older and more experienced subjects better used the knowledge gained by knowing the other estimators' results. Persons with higher safety awareness tend to overestimate risk probabilities, but can better estimate ordinal ranks of risk probabilities. Previous own experience with a risk leads to an overestimation of its probability (unlike in other fields like medicine or disasters, where experience with a disease leads to more realistic probability estimates and nonexperience to an underestimation).

  20. Relating space radiation environments to risk estimates

    NASA Technical Reports Server (NTRS)

    Curtis, Stanley B.

    1993-01-01

    A number of considerations must go into the process of determining the risk of deleterious effects of space radiation to travelers. Among them are (1) determination of the components of the radiation environment (particle species, fluxes and energy spectra) which will encounter, (2) determination of the effects of shielding provided by the spacecraft and the bodies of the travelers which modify the incident particle spectra and mix of particles, and (3) determination of relevant biological effects of the radiation in the organs of interest. The latter can then lead to an estimation of risk from a given space scenario. Clearly, the process spans many scientific disciplines from solar and cosmic ray physics to radiation transport theeory to the multistage problem of the induction by radiation of initial lesions in living material and their evolution via physical, chemical, and biological processes at the molecular, cellular, and tissue levels to produce the end point of importance.

  1. Adding Laboratory Data to Hospital Claims Data to Improve Risk Adjustment of Inpatient/30-Day Postdischarge Outcomes.

    PubMed

    Pine, Michael; Fry, Donald E; Hannan, Edward L; Naessens, James M; Whitman, Kay; Reband, Agnes; Qian, Feng; Schindler, Joseph; Sonneborn, Mark; Roland, Jaclyn; Hyde, Linda; Dennison, Barbara A

    Numerical laboratory data at admission have been proposed for enhancement of inpatient predictive modeling from administrative claims. In this study, predictive models for inpatient/30-day postdischarge mortality and for risk-adjusted prolonged length of stay, as a surrogate for severe inpatient complications of care, were designed with administrative data only and with administrative data plus numerical laboratory variables. A comparison of resulting inpatient models for acute myocardial infarction, congestive heart failure, coronary artery bypass grafting, and percutaneous cardiac interventions demonstrated improved discrimination and calibration with administrative data plus laboratory values compared to administrative data only for both mortality and prolonged length of stay. Improved goodness of fit was most apparent in acute myocardial infarction and percutaneous cardiac intervention. The emergence of electronic medical records should make the addition of laboratory variables to administrative data an efficient and practical method to clinically enhance predictive modeling of inpatient outcomes of care.

  2. Ethnic identity, achievement, and psychological adjustment: Examining risk and resilience among youth from immigrant Chinese families in Canada.

    PubMed

    Costigan, Catherine L; Koryzma, Céline M; Hua, Josephine M; Chance, Lauren J

    2010-04-01

    Ethnic identity, achievement, and psychological adjustment were examined among 95 youth from immigrant Chinese families in Canada (mean age 12 years). Utilizing cross-sectional data, promotive effects of ethnic identity were observed; higher ethnic identity was associated with above average achievement and self-esteem and below average levels of depressive symptoms. Vulnerability effects of ethnic identity were fewer; lower ethnic identity was associated with above average depressive symptoms and, for males only, below average self-esteem. Findings also suggested that higher ethnic identity might buffer the stress of poor achievement, indicating a possible protective effect of ethnic identity. Although requiring replication, these preliminary findings illustrate the utility of adopting a risk and resilience framework and suggest the value of promoting strong ethnic identities.

  3. Knee injuries account for the sports-related increased risk of knee osteoarthritis.

    PubMed

    Thelin, N; Holmberg, S; Thelin, A

    2006-10-01

    Increased risk of osteoarthritis has been found among athletes active in different kinds of sports. Knee injury is an established risk factor for knee osteoarthritis. In this population-based case-control study we investigated the risk of knee osteoarthritis with respect to sports activity and previous knee injuries. A total of 825 cases with x-ray-verified femorotibial osteoarthritis were identified at six hospitals in southern Sweden. The cases were matched (age, sex and residential area) with 825 controls from the general population. Mailed questionnaire data on sports activity for more than 1 year after the age of 16, knee injuries and confounding variables (weight, height, heredity, smoking and occupation) were collected and analyzed using logistic regression models. The response frequency was 89%. Among men knee osteoarthritis was related to soccer (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.1-2.2), ice hockey (OR 1.9, 95% CI 1.2-3.0) and tennis (OR 2.0, 95% CI 1.1-3.8) but not to track and field sports, cross-country skiing, and orienteering. After adjustment for confounding variables soccer and ice hockey remained significantly related to knee osteoarthritis, but after adjustment for knee injuries no significant relation remained. The sports-related increased risk for knee osteoarthritis was explained by knee injuries.

  4. Illness-related stigma, mood and adjustment to illness in persons with hepatitis C.

    PubMed

    Golden, Jeannette; Conroy, Ronán Michael; O'Dwyer, Ann Marie; Golden, Daniel; Hardouin, Jean-Benoit

    2006-12-01

    We examined stigma in persons with hepatitis C and its relationship with mood and adjustment to illness. We studied 87 persons awaiting interferon treatment for hepatitis C at St James's Hospital, Dublin. Stigma was assessed using Fife's Experience of Illness scale. A structured clinical interview was used to establish DSM-IV diagnosis. The Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI) were also used as measures of mood. Factor analysis and clustering around latent variables analysis were used to assess scale structure and reliability. The stigma scale had an overall reliability of 0.94. A strong dimension of fear of disclosure emerged, from item analysis, together with dimensions of social isolation and social rejection. Stigma was higher in those in manual occupations and the unemployed than in those in non-manual occupation. There were high levels in those with disease associated with injecting drug use and iatrogenic disease caused by transfusion or anti-D blood products, and low levels in those who had been treated for haemophilia with contaminated products or whose hepatitis was of unknown origin. Adjusted for confounders, a 1-decile increase in stigma score had an odds ratio of 1.4 for DSM-IV depression and similar associations with depression on the HADS and BDI. Stigma was also associated with poorer work and social adjustment, lower acceptance of illness, higher subjective levels of symptoms and greater subjective impairment of memory and concentration. These associations were replicated in the non-depressed subsample. The results underline the strong link between stigma and well-being in hepatitis C. However, they also suggest that stigma is a complex construct that will require further research to elucidate.

  5. Reference data file for neutron spectrum adjustment and related radiation damage calculations

    SciTech Connect

    Zsolnay, E.M. ); Nolthenius, H.J.; Greenwood, L.R.; Szondi, E.J. )

    1990-08-01

    The REAL-88 interlaboratory exercise organized by IAEA resulted in a neutron metrology file. (NMF-90) comprising problem dependent data for benchmark neutron fields, furthermore, nuclear data and computer programs for neutron spectrum adjustment and radiation damage parameter calculations for the service life assessment of nuclear facilities. Calculation results of some experienced laboratories are also present. This paper describes and analyses the content of the neutron metrology file and outlines the most important problems and tasks to be solved in the field of radiation damage parameter calculations. 14 refs., 2 figs., 1 tab.

  6. 48 CFR 215.404-71-3 - Contract type risk and working capital adjustment.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... money. (3) Multiply (1) by (2). (4) Only complete this block when the prospective contract is a fixed...) Efforts where there is minimal cost history; (ii) Long-term contracts without provisions protecting the... with extensive cost history; (ii) Relative short-term contracts; (iii) Contractual provisions...

  7. Risk and Protective Factors in Young Children's Adjustment to Parental Divorce: A Review of the Research.

    ERIC Educational Resources Information Center

    Leon, Kim

    2003-01-01

    Reviews the literature on parental divorce and early childhood development, using developmental psychopathology as an organizing framework. Because this review is unique in its focus on divorce-related issues specific to young children, limitations of existing research are noted and directions for future research are suggested. (Contains 63…

  8. The New Friends Vignettes: Measuring Parental Psychological Control that Confers Risk for Anxious Adjustment in Preschoolers

    ERIC Educational Resources Information Center

    McShane, Kelly E.; Hastings, Paul D.

    2009-01-01

    This investigation examined the links between preschoolers' internalizing problems and anxiety-related social difficulties and two aspects of maternal and paternal psychological control: overprotection and critical control. Some 115 mothers and 92 fathers completed the New Friends Vignettes (NFV), a new measure of psychological control and…

  9. Adjustment Disorders as a Stress-Related Disorder: A Longitudinal Study of the Associations among Stress, Resources, and Mental Health

    PubMed Central

    Kocalevent, Rüya-Daniela; Mierke, Annett; Danzer, Gerhard; Klapp, Burghard F.

    2014-01-01

    Objective Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design. Methods The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients’ presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time. Results Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β = −0.23, R2corr = 0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df = 15.26; RMSEA = 0.21). Conclusions Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress. PMID:24825165

  10. The relations of temperament reactivity and effortful control to children's adjustment problems in China and the United States.

    PubMed

    Zhou, Qing; Lengua, Liliana J; Wang, Yun

    2009-05-01

    The relations of parents' and teachers' reports of temperament anger-irritability, positive emotionality, and effortful control (attention focusing and inhibitory control) to children's externalizing and internalizing problems were examined in Chinese (N = 382) and U.S. (N = 322) samples of school-age children. Results suggested that in both cultures, low effortful control and high anger-irritability were associated with high externalizing problems, although the relations were stronger in the Chinese sample than in the U.S. sample. Low positive emotionality was associated with high internalizing problems in both cultures. However, high positive emotionality was associated with noncomorbid externalizing problems (teachers' reports) in the Chinese sample but not in the U.S. sample. These findings suggest that there are considerable cross-cultural similarities in the temperament-adjustment associations, although some cross-cultural differences might exist. Implications of the findings for the detection and intervention of adjustment problems in Chinese children are discussed.

  11. Risk Analysis Related to Quality Management Principles

    NASA Astrophysics Data System (ADS)

    Vykydal, David; Halfarová, Petra; Nenadál, Jaroslav; Plura, Jiří; Hekelová, Edita

    2012-12-01

    Efficient and effective implementation of quality management principles asks for a responsible approach from top managers' perspectives. A study of the current state of affairs in Czech organizations discovers a lot of shortcomings in this field that can be changed to vary managerial risks. The article identifies and analyses some of them and gives short guidance for appropriate treatment. Text of the article reflects the authors' experience as well as knowledge obtained from the systematic analysis of industrial companies' environments.

  12. Sports-related workload and injury risk: simply knowing the risks will not prevent injuries.

    PubMed

    Drew, Michael K; Cook, Jill; Finch, Caroline F

    2016-05-10

    Training loads contribute to sports injury risk but their mitigation has rarely been considered in a sports injury prevention framework. A key concept behind monitoring training loads for injury prevention is to screen for those at increased risk of injury so that workloads can be adjusted to minimise these risks. This review describes how advances in management of workload can be applied as a preventive measure. Primary prevention involves screening for preparticipation load risk factors, such as low training loads, prior to a training period or competition. Secondary prevention involves screening for workloads that are known to precede an injury developing so that modification can be undertaken to mitigate this risk. Tertiary prevention involves rehabilitation practices that include a graded return to training programme to reduce the risk of sustaining a subsequent injury. The association of training loads with injury incidence is now established. Prevention measures such as rule changes that affect the workload of an athlete are universal whereas those that address risk factors of an asymptomatic subgroup are more selective. Prevention measures, when implemented for asymptomatic individuals exhibiting possible injury risk factors, are indicated for an athlete at risk of developing a sports injury. Seven key indicated risks and associated prevention measures are proposed.

  13. Parental Expressivity and Parenting Styles in Chinese Families: Prospective and Unique Relations to Children’s Psychological Adjustment

    PubMed Central

    Chen, Stephen H.; Zhou, Qing; Eisenberg, Nancy; Valiente, Carlos; Wang, Yun

    2012-01-01

    SYNOPSIS Objectives Parents from different cultures differ in how frequently they express emotions. However, the generalizability of the relations between parental expressivity and child adjustment in non-Western cultures has not been extensively studied. The goal of the present study was to investigate prospective relations between parental expressivity within the family (positive, negative dominant, and negative submissive expressivity) and Chinese children’s psychological adjustment, above and beyond parenting styles. Design The study used two waves (3.8 years apart) of longitudinal data from a sample (n= 425) of children in Beijing (mean ages = 7.7 years at T1 and 11.6 years at T2). Parental expressivity and parenting styles were self-reported. To reduce the potential measurement overlap, items that tap parental expression of emotions toward the child were removed from the parenting style measure. Children’s adjustment was measured with parents’, teachers’, and peers’ or children’s reports. Results Consistent with findings with European American samples, parental negative dominant expressivity uniquely and positively predicted Chinese children’s externalizing problems controlling for prior externalizing problems, parenting styles, and family SES. Neither parental expressivity nor parenting styles uniquely predicted social competence. Conclusions Despite previously reported cultural differences in the mean levels of parental expressivity, some of the socialization functions of parental expressivity found in Western countries can be generalized to Chinese families. Although parental expressivity and parenting styles are related constructs, their unique relations to child’s adjustment suggest that they should be examined as distinct processes. PMID:23226715

  14. Prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients with age-related macular degeneration in Germany

    PubMed Central

    Jacob, Louis; Spiess, Alexandra; Kostev, Karel

    2017-01-01

    Aims: The purpose of this study was to analyze the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders in patients diagnosed with age-related macular degeneration (AMD) in Germany. Methods: This study included 7,580 patients between the ages of 40 and 90 diagnosed with AMD between January 2011 and December 2014 in 1,072 primary care practices (index date). The last follow-up was in July 2016. We also included 7,580 controls without AMD, which were matched (1:1) to the AMD cases by age, sex, type of health insurance (private or statutory), physician, and Charlson comorbidity score as a generic marker of comorbidity. The outcome of the study was the prevalence of depression, anxiety, adjustment disorders, and somatoform disorders recorded in the database between the index date and the end of follow-up. Results: The mean age among subjects was 75.7 years (SD=10.1 years), 34.0% were men, and 7.8% had private health insurance coverage. The Charlson comorbidity index was 2.0 (SD=1.8). Depression was the most frequent disease (33.7% in AMD patients versus 27.3% in controls), followed by somatoform disorders (19.6% and 16.7%), adjustment disorders (14.8% and 10.5%), and anxiety disorders (11.7% and 8.2%). Depression (OR=1.37, 95% CI: 1.27–1.47), anxiety (OR=1.50, 95% CI: 1.35–1.67), adjustment disorders (OR=1.50, 95% CI: 1.36–1.65), and somatoform disorders (OR=1.22, 95% CI: 1.12–1.32) were all positively associated with AMD. Conclusion: Overall, a significant association was found between AMD and depression, anxiety, adjustment disorders, and somatoform disorders. PMID:28243189

  15. Quantifying the relative risk of sex offenders: risk ratios for static-99R.

    PubMed

    Hanson, R Karl; Babchishin, Kelly M; Helmus, Leslie; Thornton, David

    2013-10-01

    Given the widespread use of empirical actuarial risk tools in corrections and forensic mental health, it is important that evaluators and decision makers understand how scores relate to recidivism risk. In the current study, we found strong evidence for a relative risk interpretation of Static-99R scores using 8 samples from Canada, United Kingdom, and Western Europe (N = 4,037 sex offenders). Each increase in Static-99R score was associated with a stable and consistent increase in relative risk (as measured by an odds ratio or hazard ratio of approximately 1.4). Hazard ratios from Cox regression were used to calculate risk ratios that can be reported for Static-99R. We recommend that evaluators consider risk ratios as a useful, nonarbitrary metric for quantifying and communicating risk information. To avoid misinterpretation, however, risk ratios should be presented with recidivism base rates.

  16. Overt and Relational Victimization: A Meta-Analytic Review of Their Overlap and Associations With Social-Psychological Adjustment.

    PubMed

    Casper, Deborah M; Card, Noel A

    2017-03-01

    This meta-analytic review includes 135 studies, representing 17 countries, of child and adolescent (ages 4-17) samples of overt and relational peer victimization and examines the magnitude of overlap between forms of victimization and associations with five social-psychological adjustment indices. Results indicate a strong intercorrelation between forms of victimization (r¯ = .72). No gender difference with regard to relational victimization was found, but boys were slightly higher in overt victimization. Overt victimization is more strongly associated with overt aggression; relational victimization is more strongly related to internalizing problems, lower levels of received prosocial behavior from peers, and relational aggression. Both forms are related to externalizing problems. Age and method of assessment were explored as potential sources of variability in effect sizes.

  17. Determining the Relative Criticality of Diverse Exploration Risks in NASA's Human Research Program

    NASA Technical Reports Server (NTRS)

    Kundrot, Craig E.; Edwards, J. Michelle; Anton, Wilma; Robotham, Kwesi

    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, primarily in the context of Continuous Risk Management. Each risk is evaluated in terms of two missions (a six month stay on the Moon and a thirty month round trip to Mars) and three types of consequences (in-mission crew health, post-mission crew health, and in-mission performance). The lack of a common metric between the three consequence scales, such as financial costs or quality adjusted life years lost, makes it difficult to compare the relative criticality of the risks. We are, therefore, exploring the use of a ternary scale of criticality based on the common metric of influencing an operational decision. The three levels correspond to the level of concern the risk generates for a "go/no-go" decision to launch a mission: 1) no-go; 2) go with significant reservations; 3) go. The criticality of each of the 27 risks is scored for the three types of consequence in both types of mission. The scores are combined to produce an overall criticality rating for each risk. The overall criticality rating can then be used to guide the prioritization of resources to affect the greatest amount of risk reduction.

  18. Suicidal Behavior in Relatives or Associates Moderates the Strength of Common Risk Factors for Suicide.

    PubMed

    Tong, Yongsheng; Phillips, Michael R; Duberstein, Paul; Zhan, Weihai

    2015-08-01

    The prevalence and odds ratios of different suicide risk factors were compared in three pairs of decedents: 80 suicides and 25 injury decedents with blood relatives with suicidal behavior history (biologically exposed); 259 suicides and 126 injury decedents with unrelated acquaintances with suicidal behavior history (socially exposed); and 471 suicides and 523 injury decedents with neither relatives nor acquaintances with suicidal behavior history (unexposed). Negative life events and high psychological stress were more common in socially exposed suicides than in other suicides. The adjusted odds ratios of most established suicide risk factors were higher in unexposed decedents than in biologically or socially exposed decedents, suggesting that the predictive value of established risk factors wanes in individuals who have been exposed to suicidal behavior in family or friends.

  19. Humorous Relations: Attentiveness, Pleasure and Risk

    ERIC Educational Resources Information Center

    Mayo, Cris

    2014-01-01

    This article focuses on the structures of humor and joke telling that require particular kinds of attentiveness and particular relationships between speaker and audience, or more specifically, between classmates. First, I will analyze the pedagogical and relational preconditions that are necessary for humor to work. If humor is to work well, the…

  20. A Longitudinal Study of Relational Aggression, Physical Aggression, and Children's Social-Psychological Adjustment

    ERIC Educational Resources Information Center

    Crick, Nicki R.; Ostrov, Jamie M.; Werner, Nicole E.

    2006-01-01

    Although great strides have recently been made in our understanding of relational aggression and its consequences, one significant limitation has been the lack of prospective studies. The present research addressed this issue by identifying and assessing groups of relationally aggressive, physically aggressive, relationally plus physically…

  1. Association of Variants in Estrogen-Related Pathway Genes with Prostate Cancer Risk

    PubMed Central

    Holt, Sarah K.; Kwon, Erika M.; Fu, Rong; Kolb, Suzanne; Feng, Ziding; Ostrander, Elaine A.; Stanford, Janet L.

    2012-01-01

    Background Through mediation of estrogen receptors, estradiol has been shown to have both carcinogenic and anti-carcinogenic effects on the prostate. We performed a population-based case-control study to investigate variants in estrogen-related genes ESR1, ESR2, CYP19A1, CYP1A1, and CYP1B1 and the potential association with risk of prostate cancer. Materials and Methods We evaluated prostate cancer risk conferred by 73 single nucleotide polymorphisms in 1,304 incident prostate cancer cases and 1,266 age-matched controls. Analysis included stratification by clinical features and assessment of environmental modifiers. Results There was evidence of altered risk of developing prostate cancer for variants in ESR1, CYP1A1, and CYP1B1, however, only CYP1B1 rs1056836 retained significance after adjustment for multiple comparisons. An association with risk for more aggressive prostate cancer was observed for variants in ESR1, ESR2, and CYP19A1, but none was significant after adjustment for multiple comparisons. There was no effect modification by obesity. Conclusions Germline genetic variation of these estrogen pathway genes may contribute to risk of prostate cancer. Additional studies to validate these results and examine the functional consequence of validated variants are warranted. PMID:22549291

  2. Family Members' Unique Perspectives of the Family: Examining their Scope, Size, and Relations to Individual Adjustment

    PubMed Central

    Jager, Justin; Bornstein, Marc H.; Diane, L. Putnick; Hendricks, Charlene

    2012-01-01

    Using the Family Assessment Device (FAD; Epstein, Baldwin, & Bishop, 1983) and incorporating the perspectives of adolescent, mother, and father, this study examined each family member's “unique perspective” or non-shared, idiosyncratic view of the family. To do so we used a modified multitrait-multimethod confirmatory factor analysis that (1) isolated for each family member's six reports of family dysfunction the non-shared variance (a combination of variance idiosyncratic to the individual and measurement error) from variance shared by one or more family members and (2) extracted common variance across each family member's set of non-shared variances. The sample included 128 families from a U.S. East Coast metropolitan area. Each family member's unique perspective generalized across his or her different reports of family dysfunction and accounted for a sizable proportion of his or her own variance in reports of family dysfunction. Additionally, after holding level of dysfunction constant across families and controlling for a family's shared variance (agreement regarding family dysfunction), each family member's unique perspective was associated with his or her own adjustment. Future applications and competing alternatives for what these “unique perspectives” reflect about the family are discussed. PMID:22545933

  3. High-Harmonic Geoid Signatures Related to Glacial Isostatic Adjustment and Their Detectability by GOCE

    NASA Astrophysics Data System (ADS)

    Vermeersen, B. L.; Schotman, H. H.

    2006-12-01

    The Earth's asthenosphere and lower continental crust can regionally have viscosities that are one to several orders of magnitude smaller than typical mantle viscosities. As a consequence, such shallow low-viscosity layers could induce high-harmonic (spherical harmonics 50 - 200) gravity and geoid anomalies due to remaining isostasy deviations following Late-Pleistocene glacial isostatic adjustment (GIA). Such high- harmonic geoid and gravity signatures would depend also on the detailed ice and meltwater loading distribution and history. ESA's GOCE satellite mission, planned for launch Summer 2007, is designed to map the quasi-static geoid with centimeter accuracy and gravity anomalies with milligal accuracy at a resolution of 100 kilometers or better. This might offer the possibility of detecting gravity and geoid effects of low-viscosity shallow earth layers and differences of the effects of various Pleistocene ice decay scenarios. For example, our predictions show that for a typical low-viscosity crustal zone GOCE should be able to discern differences between ice-load histories down to length scales of about 150 km. One of the major challenges in interpreting such high-harmonic, regional-scale, geoid signatures in GOCE solutions will be to discriminate GIA-signatures from various other solid-earth contributions. It might be of help here that the high-harmonic geoid and gravity signatures form quite characteristic 2-D patterns, depending on both ice load and low-viscosity zone model parameters.

  4. HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends.

    PubMed

    Coatsworth, Ashley M; Scheidell, Joy D; Wohl, David A; Whitehead, Nicole E; Golin, Carol E; Judon-Monk, Selena; Khan, Maria R

    2017-02-01

    We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (risk in the 6 months before incarceration. Low levels of social support from significant others, family, or friends were associated with poverty and homelessness, mental disorders, and substance use. Adjusting for age, poverty, and other sources of support, perceiving low support from significant others was strongly associated with multiple partnerships (fully adjusted odds ratio (OR) 2.64, 95% confidence interval (CI) 1.29-5.42). Low significant other support also was strongly associated with sex trade involvement when adjusting for age and poverty status (adjusted OR 3.51, 95% CI 1.25-9.85) but further adjustment for low family and friend support weakened the association (fully adjusted OR 2.81, 95% CI 0.92-8.55). Significant other support was not associated with other sex risk outcomes including concurrent partnerships, anal sex, or sex with an STI/HIV-infected partner. Low family support was associated with multiple partnerships in analyses adjusting for age and poverty (adjusted OR 1.98, 95% CI 1.05-3.76) but the association weakened and was no longer significant after adjusting for other sources of support (fully adjusted OR 1.40, 95% CI 0.65-3.00); family support was not correlated with other risk behaviors. Friend support was not significantly associated with sex risk outcomes. Indicators of overall support from any source were not associated with sex risk outcomes. Helping inmates

  5. Evaluating the effects of variation in clinical practice: a risk adjusted cost-effectiveness (RAC-E) analysis of acute stroke services

    PubMed Central

    2012-01-01

    Background Methods for the cost-effectiveness analysis of health technologies are now well established, but such methods may also have a useful role in the context of evaluating the effects of variation in applied clinical practice. This study illustrates a general methodology for the comparative analysis of applied clinical practice at alternative institutions – risk adjusted cost-effectiveness (RAC-E) analysis – with an application that compares acute hospital services for stroke patients admitted to the main public hospitals in South Australia. Methods Using linked, routinely collected data on all South Australian hospital separations from July 2001 to June 2008, an analysis of the RAC-E of services provided at four metropolitan hospitals was undertaken using a decision analytic framework. Observed (plus extrapolated) and expected lifetime costs and survival were compared across patient populations, from which the relative cost-effectiveness of services provided at the different hospitals was estimated. Results Unadjusted results showed that at one hospital patients incurred fewer costs and gained more life years than at the other hospitals (i.e. it was the dominant hospital). After risk adjustment, the cost minimizing hospital incurred the lowest costs, but with fewer life-years gained than one other hospital. The mean incremental cost per life-year gained of services provided at the most effective hospital was under $20,000, with an associated 65% probability of being cost-effective at a $50,000 per life year monetary threshold. Conclusions RAC-E analyses can be used to identify important variation in the costs and outcomes associated with clinical practice at alternative institutions. Such data provides an impetus for further investigation to identify specific areas of variation, which may then inform the dissemination of best practice service delivery and organisation. PMID:22905669

  6. Evaluation of cluster recovery for small area relative risk models.

    PubMed

    Rotejanaprasert, Chawarat

    2014-12-01

    The analysis of disease risk is often considered via relative risk. The comparison of relative risk estimation methods with "true risk" scenarios has been considered on various occasions. However, there has been little examination of how well competing methods perform when the focus is clustering of risk. In this paper, a simulated evaluation of a range of potential spatial risk models and a range of measures that can be used for (a) cluster goodness of fit, (b) cluster diagnostics are considered. Results suggest that exceedence probability is a poor measure of hot spot clustering because of model dependence, whereas residual-based methods are less model dependent and perform better. Local deviance information criteria measures perform well, but conditional predictive ordinate measures yield a high false positive rate.

  7. Joint effect of hypertension and lifestyle-related risk factors on the risk of brain microbleeds in healthy individuals.

    PubMed

    Hara, Megumi; Yakushiji, Yusuke; Nannri, Hinako; Sasaki, Satoshi; Noguchi, Tomoyuki; Nishiyama, Masanori; Hirotsu, Tatsumi; Nakajima, Junko; Hara, Hideo

    2013-09-01

    Brain microbleeds (MBs) are potential risk factors for future stroke, and hypertension is an established risk factor for MBs. However, data on other lifestyle-related risk factors and their joint effects with hypertension are limited. We enrolled 860 adults who underwent 1.5-T brain magnetic resonance imaging and had no history of stroke. Information on clinical risk factors was obtained from health-screening tests, and dietary history was assessed using a validated, brief, self-administered dietary questionnaire. Subjects were divided into three groups (no MBs, deep MBs and lobar MBs), which were compared for the potential risk factors; their joint effects with hypertension were assessed by logistic regression. Biologic interaction was estimated with the synergy index. After adjustment for possible confounders, age and systolic and diastolic blood pressures were found to be associated with the presence of MBs in a dose-dependent manner, especially in the case of deep MBs. With regard to lifestyle-related factors, current smoking status was significantly associated with deep MBs, and the odds ratio was 2.73 (95% confidence interval (CI) 1.15-6.48). We found that hypertension and current smoking status, higher alcohol consumption or lower calcium intake had joint effects on the risk of MBs and that hypertension and current smoking status had synergistic additive action (synergy index, 6.30; 95% CI 1.07-37.13). These results suggest that approaches combining lowering blood pressure and smoking cessation may greatly reduce the risk of MBs and contribute to preventing stroke.

  8. Parenting and Children's Adjustment Problems: The Mediating Role of Self-Esteem and Peer Relations

    ERIC Educational Resources Information Center

    Georgiou, Nicos A.; Stavrinides, Panayiotis; Georgiou, Stelios

    2016-01-01

    The aim of this study was to investigate the impact of parental and personal characteristics on children's internalizing/externalizing problems. Further, this study aimed to examine personal characteristics (self-esteem, peer relations) as mediators in the relation between parenting and internalizing/externalizing problems. In order to address…

  9. Predicting economic and medical outcomes based on risk adjustment for congenital heart surgery classification of pediatric cardiovascular surgical admissions.

    PubMed

    Raucci, Frank J; Hoke, Tracey R; Gutgesell, Howard P

    2014-12-01

    The Risk Adjustment for Congenital Heart Surgery (RACHS-1) classification is an established method for predicting mortality for congenital heart disease surgery. It is unknown if this extends to the cost of hospitalization or if differences in economic and medical outcomes exist in certain subpopulations. Using data obtained from the University HealthSystem Consortium, we examined inpatient resource use by patients with International Classification of Diseases, Ninth Revision, procedure codes representative of RACHS-1 classifications 1 through 5 and 6 from 2006 to 2012. A total of 15,453 pediatric congenital heart disease surgical admissions were analyzed, with overall mortality of 4.5% (n = 689). As RACHS-1 classification increased, the total cost of hospitalization, hospital charges, total length of stay, length of intensive care unit stay, and mortality increased. Even when controlled for RACHS-1 classification, black patients (n = 2034) had higher total costs ($96,884 ± $3,392, p = 0.003), higher charges ($318,313 ± $12,018, p <0.001), and longer length of stay (20.4 ± 0.7 days, p <0.001) compared with white patients ($85,396 ± $1,382, $285,622 ± $5,090, and 18.0 ± 0.3 days, respectively). Hispanic patients had similarly disparate outcomes ($104,292 ± $2,759, $351,371 ± $10,627, and 23.0 ± 0.6 days, respectively) and also spent longer in the intensive care unit (14.9 ± 0.5 days, p <0.001). In conclusion, medical and economic measures increased predictably with increased procedure risk, and admissions for black and Hispanic patients were longer and more expensive than those of their white counterparts but without increased mortality.

  10. Study finds increases in risk of leukemias related to treatment

    Cancer.gov

    A new study describes the pattern of risk for chemotherapy-related acute myeloid leukemia among adult cancer survivors over the past three decades who have previously been treated with chemotherapy for other cancers. These patterns coincide with major shi

  11. The Effectiveness of Functional Family Therapy in Reducing Adolescent Mental Health Risk and Family Adjustment Difficulties in an Irish Context.

    PubMed

    Hartnett, Dan; Carr, Alan; Sexton, Thomas

    2016-06-01

    To evaluate the effectiveness of Functional Family Therapy (FFT) 42 cases were randomized to FFT and 55 to a waiting-list control group. Minimization procedures controlled the effects of potentially confounding baseline variables. Cases were treated by a team of five therapists who implemented FFT with a moderate degree of fidelity. Rates of clinical recovery were significantly higher in the FFT group than in the control group. Compared to the comparison group, parents in the FFT group reported significantly greater improvement in adolescent problems on the Strengths and Difficulties Questionnaire (SDQ) and both parents and adolescents reported improvements in family adjustment on the Systemic Clinical Outcomes and Routine Evaluation (SCORE). In addition, 93% of youth and families in the treatment condition completed FFT. Improvements shown immediately after treatment were sustained at 3-month follow-up. Results provide a current demonstration of FFT's effectiveness for youth with behavior problems in community-based settings, expand our understanding of the range of positive outcomes of FFT to include mental health risk and family-defined problem severity and impact, and suggests that it is an effective intervention when implemented in an Irish context.

  12. Parental knowledge and adolescent adjustment: substance use and health-related quality of life.

    PubMed

    Jiménez-Iglesias, Antonia; Moreno, Carmen; Granado-Alcón, M Carmen; López, Ana

    2012-03-01

    This study analyses two models (maternal and paternal) in which parental care and sources of parental knowledge moderated the relationship between parents' knowledge about their adolescents' lives and adolescents' substance use and health-related quality of life. The sample was made up of 15942 Spanish adolescents who participated in the 2006 edition of Health Behavior in School-aged Children Study. Results showed that increased parents' knowledge about their adolescents' lives reduced adolescents' substance use and increased their quality of life. With respect to the moderation relationship, a limited effect was found. However, parental care and sources of parental knowledge used by both parents generally had main effects on adolescents' substance use and health-related quality of life, with care being the most relevant variable in the health-related quality of life, while knowledge was the most relevant one for substance use.

  13. Risk communication related to animal products derived from biotechnology.

    PubMed

    McCrea, D

    2005-04-01

    Previous chapters of this review have dealt with the key considerations related to the application of biotechnology in veterinary science and animal production. This article explores the theory and practice of risk communication and sets out the basic principles for good risk communication when dealing with new technologies, uncertainty, and cautious and sceptical consumers. After failure to communicate with consumers and stakeholders about the risk to human health from bovine spongiform encephalopathy (BSE) in the 1990s, Government Agencies in the United Kingdom have made significant improvements in risk communication. The official inquiry that followed the BSE crisis concluded that a policy of openness was the correct approach, and this article emphasises the importance of consultation, consistency and transparency. There are, however, many different factors that affect public perception of risk (religious, political, social, cultural, etc.) and developing effective risk communication strategies must take all of these complex issues into consideration.

  14. Exposure to Conflict and Violence across Contexts: Relations to Adjustment among Palestinian Children

    ERIC Educational Resources Information Center

    Dubow, Eric F.; Boxer, Paul; Huesmann, L. Rowell; Shikaki, Khalil; Landau, Simha; Gvirsman, Shira Dvir; Ginges, Jeremy

    2010-01-01

    Despite extensive literatures on the impact on children of exposure to violence in families, neighborhoods, and peer groups, there has been relatively little effort evaluating their cumulative impact. There also has been less attention to the effects of exposure to political conflict and violence. We collected data from a representative sample of…

  15. Parenting Styles as They Relate to Self-Esteem and Adjustment.

    ERIC Educational Resources Information Center

    Sigward, Timothy M.; And Others

    This study was conducted to examine the relationships between parental styles and the components of self-esteem that correspond to Damon and Hart's conceptualization of the self. Specifically, high levels of both parental control and parent acceptance were hypothesized to be positively related to self-esteem. Undergraduate students (N=225) rated…

  16. Psychosocial Adjustment in Siblings of Children with War-Related Injuries

    ERIC Educational Resources Information Center

    Khamis, Vivian

    2013-01-01

    The study assessed the prevalence and predictors of post-traumatic symptomatology and emotional and behavioral difficulties in siblings of children who incurred war-related injuries. It was predicted that injury severity, gender and attributional style would account for a significant amount of the variance in post-traumatic stress symptoms and…

  17. Relations of Maternal Socialization and Toddlers' Effortful Control to Children's Adjustment and Social Competence

    ERIC Educational Resources Information Center

    Spinrad, Tracy L.; Eisenberg, Nancy; Gaertner, Bridget; Popp, Tierney; Smith, Cynthia L.; Kupfer, Anne; Greving, Karissa; Liew, Jeffrey; Hofer, Claire

    2007-01-01

    The authors examined the relations of maternal supportive parenting to effortful control and internalizing problems (i.e., separation distress, inhibition to novelty), externalizing problems, and social competence when toddlers were 18 months old (n = 256) and a year later (n = 230). Mothers completed the Coping With Toddlers' Negative Emotions…

  18. Children's Positive Adjustment to First Grade in Risk-Filled Communities: A Case Study of the Role of School Ecologies in South Africa and Finland

    ERIC Educational Resources Information Center

    Kumpulainen, Kristiina; Theron, Linda; Kahl, Carlien; Bezuidenhout, Carla; Mikkola, Anna; Salmi, Saara; Khumalo, Tumi; Uusitalo-Malmivaara, Lotta

    2016-01-01

    This article presents a comparative case study on the ways in which children's school ecologies facilitate their adjusting positively to first grade in risk-filled contexts in South Africa and Finland. The insights of two children (one South African, one Finnish) from socio-economically disadvantaged communities, their teachers, parents and…

  19. Risk for work-related fatigue among the employees on semiconductor manufacturing lines.

    PubMed

    Lin, Yu-Cheng; Chen, Yen-Cheng; Hsieh, Hui-I; Chen, Pau-Chung

    2015-03-01

    To examine the potential risk factors for work-related fatigue (WRF) among workers in modern industries, the authors analyzed the records of need-for-recovery questionnaires and health checkup results for 1545 employees. Compared with regular daytime workers, and after adjusting for confounders, the workers adapting to day-and-night rotating shift work (RSW) had a 4.0-fold (95% confidence interval [CI] = 2.7-5.9) increased risk for WRF, higher than the 2.2-fold risk (95% CI = 1.5-3.3) for persistent shift workers. Based on highest education level, the male employees with university degrees had the highest adjusted odds ratio (a-OR) 2.8 (95% CI = 1.0-7.8) for complaining of WRF versus compulsory education group. For female workers, currently married/cohabiting status was inversely associated with WRF (a-OR = 0.5; 95% CI = 0.2-0.9), and child-rearing responsibility moderately increased WRF risk (a-OR = 1.9; 95% CI = 1.0-3.7). Day-and-night RSW and the adaptation, educational levels of males, and domestic factors for females contributed to WRF among semiconductor manufacturing employees.

  20. Contributions of pain-related adjustment and perceptions of control to coping strategy use among cervical sprain patients.

    PubMed

    LaChapelle, D L; Hadjistavropoulos, H D; McCreary, D R; Asmundson, G J

    2001-01-01

    Coping is a cyclical process in which an individual evaluates stressful events, chooses and implements coping strategies, re-evaluates the outcome of the coping effort and modifies the strategy if necessary. The intent of the present study was to evaluate the extent to which pain-related adjustment (i.e. pain severity, pain interference, negative affect) and perceptions of control are associated with the implementation of particular coping strategies. Participants were 136 patients assessed at an interdisciplinary pain clinic for cervical sprain injuries. As part of a routine assessment, participants completed a questionnaire package regarding background, pain severity, pain interference, negative affect, perceived control and use of particular coping strategies. Results of hierarchical multiple regression analyses revealed that pain interference, after controlling for all other variables, was associated with greater use of less physically demanding strategies (i.e. resting, guarding, asking for assistance, seeking social support and coping self-statements). Negative affect, on the other hand, after controlling for other variables, was associated with reduced use of task persistence. Finally, perceived control, independent of other variables, was associated with greater use of cognitive and social coping strategies (i.e. asking for assistance, seeking social support and coping self-statements). The results of the study shed light on the complex relationship between use of particular coping strategies and situational variables of pain-related adjustment and perceived control. Implications for clinicians who assist patients via implementation or modification of particular coping techniques are discussed.

  1. The Relations of Temperament Reactivity and Effortful Control to Children’s Adjustment Problems in China and the United States

    PubMed Central

    Zhou, Qing; Lengua, Liliana J.; Wang, Yun

    2014-01-01

    The relations of parents’ and teachers’ reports of temperament anger-irritability, positive emotionality, and effortful control (attention focusing and inhibitory control) to children’s externalizing and internalizing problems were examined in Chinese (N = 382) and U.S. (N = 322) samples of school-age children. Results suggested that in both cultures, low effortful control and high anger–irritability were associated with high externalizing problems, although the relations were stronger in the Chinese sample than in the U.S. sample. Low positive emotionality was associated with high internalizing problems in both cultures. However, high positive emotionality was associated with noncomorbid externalizing problems (teachers’ reports) in the Chinese sample but not in the U.S. sample. These findings suggest that there are considerable cross-cultural similarities in the temperament-adjustment associations, although some cross-cultural differences might exist. Implications of the findings for the detection and intervention of adjustment problems in Chinese children are discussed. PMID:19413428

  2. Social Support: Main and Moderating Effects on the Relation between Financial Stress and Adjustment among College Students with Disabilities

    ERIC Educational Resources Information Center

    Murray, Christopher; Lombardi, Allison; Bender, Franklin; Gerdes, Hillary

    2013-01-01

    Students with disabilities are underrepresented in 4-year colleges and universities in the United States and those that do attend are at an increased risk of performing poorly in these settings. These difficulties for college students with disabilities may be compounded by additional stress related to financial concerns. The current study was…

  3. Risk of hypospadias in relation to maternal occupational exposure to potential endocrine disrupting chemicals

    PubMed Central

    Vrijheid, M; Armstrong, B; Dolk, H; van Tongeren, M; Botting, B

    2003-01-01

    Background: Reported rises in the prevalence of hypospadias and other abnormalities of the male reproductive system may be a result of exposure to endocrine disrupting chemicals. Aims: To analyse the relation between risk of hypospadias and maternal occupation, particularly with regard to exposure to potential endocrine disrupting chemicals (EDCs). Methods: Data (1980–96) from the National Congenital Anomaly System (NCAS) were used to analyse the proportion of all congenital anomaly cases (n = 35 962) which were notified with hypospadias (n = 3471) by occupational codes (348 individual job titles) and by categories of exposure to potential EDCs from a job exposure matrix. Results: Five individual occupations (of 348) showed nominally statistically significant excesses, none of which had possible or probable exposure to potential EDCs. Odds ratios for "possible" or "probable" compared to "unlikely" exposure to potential EDCs did not show statistically significant increases in any of the EDC categories after adjustment for social class of the mother and father, nor was there evidence of an upward trend in risk with likelihood of exposure. In the 1992–96 time period odds ratios were increased for hairdressers (the largest group exposed to potential EDCs) and for probable exposure to phthalates (of which hairdressers form the largest group) before social class adjustment. Conclusions: There was little evidence for a relation between risk of hypospadias and maternal occupation or occupational exposure to potential EDCs, but as the exposure classification was necessarily crude, these findings should be interpreted with caution. PMID:12883014

  4. Risk and Resilience Factors for Combat-Related Posttraumatic Psychopathology and Post Combat Adjustment

    DTIC Science & Technology

    2011-06-01

    and 24 indicated high preparedness, high unit support, and high post‐deployment support,  respec,vely.  0.0 5.0 10.0 15.0 20.0 25.0 HLH HHH LHH...support,  respec,vely.  0.0 5.0 10.0 15.0 20.0 25.0 HLH HHH LHH LLH HHL HLL LHL LLL P er ce nt 33  5/24/11  12  0.0 0.2 0.4 0.6 0.8 1.0

  5. Estimating the Roles of Genetic Risk, Perinatal Risk, and Marital Hostility on Early Childhood Adjustment: Medical Records and Self-Reports.

    PubMed

    Neiderhiser, Jenae M; Marceau, Kristine; De Araujo-Greecher, Marielena; Ganiban, Jody M; Mayes, Linda C; Shaw, Daniel S; Reiss, David; Leve, Leslie D

    2016-05-01

    A wide variety of perinatal risk factors have been linked to later developmental outcomes in children. Much of this work has relied on either birth/medical records or mothers' self-reports collected after delivery, and there has been an ongoing debate about which strategy provides the most accurate and reliable data. This report uses a parent-offspring adoption design (N = 561 families) to (1) examine the correspondence between medical record data and self-report data, (2) examine how perinatal risk factors may influence child internalizing and externalizing behavior at age 4.5 years, and (3) explore interactions among genetic, perinatal risk, and rearing environment on child internalizing and externalizing behavior during early childhood. The agreement of self-reports and medical records data was relatively high (51-100 %), although there was some variation based on the construct. There were few main effects of perinatal risk on child outcomes; however, there were several 2- and 3-way interactions suggesting that the combined influences of genetic, perinatal, and rearing environmental risks are important, particularly for predicting whether children exhibit internalizing versus externalizing symptoms at age 4.5 years.

  6. Relation of filial responsibility to the personal and social adjustment of Latino adolescents from immigrant families.

    PubMed

    Kuperminc, Gabriel P; Jurkovic, Gregory J; Casey, Sean

    2009-02-01

    A multidimensional model of filial responsibility encompassing caregiving activities in the home and perceptions of fairness was examined in relation to multiple self- and teacher-reported indices of competence and distress in a sample of Latino adolescents from immigrant families (N = 129, mean age = 16.8, 64% girls). Whereas most research of Latino adolescents has focused on felt familial obligations and attitudes, this study found that reports of actual caregiving activities were associated with higher competence for the sample as a whole and fewer acting out problems among boys. Perceived fairness was associated with lower levels of distress and moderated the curvilinear association of caregiving with behavioral restraint. High levels of filial caregiving predicted high levels of restraint, but only when the balance of give-and-take at home was perceived as fair. These results are consistent with a model that views filial responsibilities as a source of both personal distress and competence.

  7. Child Temperamental Flexibility Moderates the Relation between Positive Parenting and Adolescent Adjustment

    PubMed Central

    Rabinowitz, Jill A.; Drabick, Deborah A.G.; Reynolds, Maureen D.; Clark, Duncan B.; Olino, Thomas M.

    2016-01-01

    Temperamental flexibility and lower positive parenting are associated with internalizing and externalizing problems; however, youth varying in flexibility may be differentially affected by positive parenting in the prediction of symptoms. We examined whether children's flexibility moderated prospective relations between maternal and paternal positive parenting and youth internalizing and externalizing symptoms during adolescence. Participants (N =775, 71% male) and their caregivers completed measures when youth were 10-12 and 12-14 years old. Father positive parenting interacted with child flexibility to predict father-reported internalizing and externalizing problems. Consistent with the diathesis-stress model, children lower in flexibility experienced greater symptoms than children higher in flexibility in lower positive parenting contexts. Among children lower in flexibility, lower paternal positive parenting was associated with greater internalizing and externalizing symptoms compared to higher paternal positive parenting. However, among youth higher in flexibility, symptom levels were similar regardless of whether youth experienced lower or higher paternal positive parenting. PMID:26834305

  8. Relational Psychotherapy Mothers' Group: a developmentally informed intervention for at-risk mothers.

    PubMed

    Luthar, S S; Suchman, N E

    2000-01-01

    The Relational Psychotherapy Mothers' Group (RPMG), a developmentally informed, supportive psychotherapy designed to serve heroin-addicted mothers with children up to 16 years of age, aims at addressing psychosocial vulnerabilities, and facilitating optimal parenting, among at-risk mothers. We present preliminary evidence on the efficacy of RPMG as an "add on" treatment in comparison with standard methadone counseling alone. At the end of the 24-week treatment period, mothers receiving RPMG plus standard methadone counseling demonstrated lower levels of risk for child maltreatment, greater involvement with their children, and more positive psychosocial adjustment than women who received methadone counseling alone. Children of RPMG participants also reflected fewer problems in multiple areas. At 6 months posttreatment, RPMG recipients continued to be at a relative advantage, although the magnitude of group differences was often attenuated. Notably, urinalyses indicated that RPMG mothers showed greater improvements in levels of opioid use over time than comparison mothers.

  9. Regulations regarding income-related monthly adjustment amounts to Medicare beneficiaries' prescription drug coverage premiums. Interim final rule with request for comments.

    PubMed

    2010-12-07

    We are adding a new subpart to our regulations, which contains the rules we will apply to determine the income-related monthly adjustment amount for Medicare prescription drug coverage premiums. This new subpart implements changes made to the Social Security Act (Act) by the Affordable Care Act. These rules parallel the rules in subpart B of this part, which describes the rules we apply when we determine the income-related monthly adjustment amount for certain Medicare Part B (medical insurance) beneficiaries. These rules describe the new subpart; what information we will use to determine whether you will pay an income-related monthly adjustment amount and the amount of the adjustment when applicable; when we will consider a major life-changing event that results in a significant reduction in your modified adjusted gross income; and how you can appeal our determination about your income-related monthly adjustment amount. These rules will allow us to implement the provisions of the Affordable Care Act on time that relate to the income-related monthly adjustment amount for Medicare prescription drug coverage premiums, when they go into effect on January 1, 2011.

  10. Injury related risk behavior--a study of Australian skydivers.

    PubMed

    Green, M; Turner, C; Purdie, D M; McClure, R

    2003-06-01

    Risk taking behaviour has been identified as an important host-related determinant of injury in young adults. The aim of this study is to clarify the relationship between the two key elements of risk taking behaviour--ie, risk assessment and risk acceptance--in participants of a high risk sporting activity. Skydivers registered with the Australian Parachute Federation were sampled at several jump meetings held at three 'drop-zones' in North Eastern Australia. A cross sectional survey of 215 skydivers ascertained each subject's risk assessment of each of nine hypothetical sky diving scenes and whether or not they would jump in the described conditions. Variables which independently predicted an individual's risk assessment were age group (p < 0.05). gender (p < 0.05) and scene details (p < 0.001). Risk assessment was found to be a statistically significant predictor of the decision to jump, with a 22% decrease in the odds of jumping with every unit increase in risk assessment (OR = 0.78: 95% CI: 0.76, 0.80). Gender was also found to be a statistically significant predictor of the decision to jump, with males being 19% more likely to jump than females, after controlling for age, experience, currency and risk assessment (OR = 1. 19: 95% CI; 1.04, 1.38). The importance of these results is that, by quantifying the relationship between two key elements of risk taking behaviour and several important host factor determinants, they facilitate more informed discussion about the possible role of risk taking behaviour in the causation of injury.

  11. Automated Brightness and Contrast Adjustment of Color Fundus Photographs for the Grading of Age-Related Macular Degeneration

    PubMed Central

    Tsikata, Edem; Laíns, Inês; Gil, João; Marques, Marco; Brown, Kelsey; Mesquita, Tânia; Melo, Pedro; da Luz Cachulo, Maria; Kim, Ivana K.; Vavvas, Demetrios; Murta, Joaquim N.; Miller, John B.; Silva, Rufino; Miller, Joan W.; Chen, Teresa C.; Husain, Deeba

    2017-01-01

    Purpose The purpose of this study was to develop an algorithm to automatically standardize the brightness, contrast, and color balance of digital color fundus photographs used to grade AMD and to validate this algorithm by determining the effects of the standardization on image quality and disease grading. Methods Seven-field color photographs of patients (>50 years) with any stage of AMD and a control group were acquired at two study sites, with either the Topcon TRC-50DX or Zeiss FF-450 Plus cameras. Field 2 photographs were analyzed. Pixel brightness values in the red, green, and blue (RGB) color channels were adjusted in custom-built software to make the mean brightness and contrast of the images equal to optimal values determined by the Age-Related Eye Disease Study (AREDS) 2 group. Results Color photographs of 370 eyes were analyzed. We found a wide range of brightness and contrast values in the images at baseline, even for those taken with the same camera. After processing, image brightness variability (brightest image–dimmest image in a color channel) was reduced 69-fold, 62-fold, and 96-fold for the RGB channels. Contrast variability was reduced 6-fold, 8-fold, and 13-fold, respectively, after adjustment. Of the 23% images considered nongradable before adjustment, only 5.7% remained nongradable. Conclusions This automated software enables rapid and accurate standardization of color photographs for AMD grading. Translational Relevance This work offers the potential to be the future of assessing and grading AMD from photos for clinical research and teleimaging. PMID:28316876

  12. The relation of vasectomy to the risk of cancer.

    PubMed

    Rosenberg, L; Palmer, J R; Zauber, A G; Warshauer, M E; Strom, B L; Harlap, S; Shapiro, S

    1994-09-01

    We previously reported a strong positive association between vasectomy and the risk of prostatic cancer that arose in multiple comparisons made within data collected from 1976 to 1988 in an ongoing hospital-based surveillance study of many exposures and diseases. We have reassessed this association with data collected in the surveillance study during 1988-1992 from a new set of patients (355 cases of prostatic cancer and 2,048 controls with nonmalignant conditions). Because some studies have reported increased relative risks of lung cancer and testicular cancer in vasectomized men, we also used the surveillance database (4,126 men with various cancers, 7,027 men with nonmalignant conditions) to assess the relation of vasectomy to the risk of these and other cancers. In the newly collected data, the multivariate relative risk estimate for prostatic cancer in vasectomized men was 1.2 (95% confidence interval (CI) 0.6-2.7). For lung cancer and testicular cancer, the relative risk estimates were 1.3 (95% CI 0.8-2.1) and 0.8 (95% CI 0.4-1.9), respectively; for lung cancer occurring > or = 15 years after vasectomy, the relative risk estimate was 1.9 but it was not statistically significant (95% CI 0.7-5.0). For pancreatic cancer, the relative risk estimate was 1.8 (95% CI 1.0-3.1). For each of the other cancers considered--malignant melanoma, large bowel cancer, bladder cancer, kidney cancer, lymphoma, leukemia, and other cancers--the relative risk estimate was 1.3 or less and compatible with a value of 1.0. The present data provide little support for an association of vasectomy with the risk of prostatic cancer or other cancers. In addition, the data from two sets of cases of prostatic cancer and controls interviewed consecutively illustrate that increased relative risks detected in screening for statistically significant associations may tend to have an upward bias and to be lower in subsequent data.

  13. Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs.

    PubMed

    Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der

    2016-12-01

    This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010.

  14. Neuroanatomy accounts for age-related changes in risk preferences

    PubMed Central

    Grubb, Michael A.; Tymula, Agnieszka; Gilaie-Dotan, Sharon; Glimcher, Paul W.; Levy, Ifat

    2016-01-01

    Many decisions involve uncertainty, or ‘risk', regarding potential outcomes, and substantial empirical evidence has demonstrated that human aging is associated with diminished tolerance for risky rewards. Grey matter volume in a region of right posterior parietal cortex (rPPC) is predictive of preferences for risky rewards in young adults, with less grey matter volume indicating decreased tolerance for risk. That grey matter loss in parietal regions is a part of healthy aging suggests that diminished rPPC grey matter volume may have a role in modulating risk preferences in older adults. Here we report evidence for this hypothesis and show that age-related declines in rPPC grey matter volume better account for age-related changes in risk preferences than does age per se. These results provide a basis for understanding the neural mechanisms that mediate risky choice and a glimpse into the neurodevelopmental dynamics that impact decision-making in an aging population. PMID:27959326

  15. [Science, technique, and culture: relations between risk and health practices].

    PubMed

    Czeresnia, Dina

    2004-01-01

    This article discusses the cultural consequences of discourses and practices aimed at training subjects for a rational, informed choice in relation to risks, calculated on the basis of scientific knowledge. The epidemiological risk concept is a central element in this process, especially in the context of health practices. The article begins by briefly characterizing the epidemiological risk concept, emphasizing that as an abstract model, it reduces the complexity of the phenomena it studies. Grasping reality through this abstraction generates values and meanings. Canguilhem's reflection on the relations between science, technique, and life is further discussed from the perspective of deepening an understanding of the cultural consequences of this process, contributing to the transformation of classical concepts of individuality, autonomy, and sociability. Such vital themes as individuality, alterity, and the relationship with death are present (albeit disguised) in issues that involve the central nature of risk in the contemporary world.

  16. Nighttime parenting strategies and sleep-related risks to infants.

    PubMed

    Volpe, Lane E; Ball, Helen L; McKenna, James J

    2013-02-01

    A large social science and public health literature addresses infant sleep safety, with implications for infant mortality in the context of accidental deaths and Sudden Infant Death Syndrome (SIDS). As part of risk reduction campaigns in the USA, parents are encouraged to place infants supine and to alter infant bedding and elements of the sleep environment, and are discouraged from allowing infants to sleep unsupervised, from bed-sharing either at all or under specific circumstances, or from sofa-sharing. These recommendations are based on findings from large-scale epidemiological studies that generate odds ratios or relative risk statistics for various practices; however, detailed behavioural data on nighttime parenting and infant sleep environments are limited. To address this issue, this paper presents and discusses the implications of four case studies based on overnight observations conducted with first-time mothers and their four-month old infants. These case studies were collected at the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame USA between September 2002 and June 2004. Each case study provides a detailed description based on video analysis of sleep-related risks observed while mother-infant dyads spent the night in a sleep lab. The case studies provide examples of mothers engaged in the strategic management of nighttime parenting for whom sleep-related risks to infants arose as a result of these strategies. Although risk reduction guidelines focus on eliminating potentially risky infant sleep practices as if the probability of death from each were equal, the majority of instances in which these occur are unlikely to result in infant mortality. Therefore, we hypothesise that mothers assess potential costs and benefits within margins of risk which are not acknowledged by risk-reduction campaigns. Exploring why mothers might choose to manage sleep and nighttime parenting in ways that appear to increase potential risks to infants may

  17. Families at risk for destructive parent-child relations in adolescence.

    PubMed

    Garbarino, J; Sebes, J; Schellenbach, C

    1984-02-01

    This paper examines the parental, adolescent, and family system characteristics that place a family at risk for destructive parent-child relations in adolescence. It is based on a study of 62 families, all of which contained a youth (age 10-16) and 2 parents and were referred because of the adjustment problems of the adolescent. A 3-member team visited the family at home to administer a 3 1/2-hour battery of questionnaire, interview, and observation instruments. These included a measure of risk for destructive parent-child relations (the Adolescent-Abuse Inventory); the Achenbach Child Behavior Checklist; a measure of the family as an interactional system (FACES); the Cornell Parent Behavior Description; and assessments of adolescent physical maturation, interparental conflict, cognitive functioning, life events (A-FILE), and demographic and socioeconomic factors. The results permit identification of families as high risk for destructive parent-child relations using the parental scores on the Adolescent-Abuse Inventory. The high-risk group tends to be "chaotic" and "enmeshed" (FACES), to include more stepparents, to be more punishing and less supportive (Cornell Parent Behavior Description), and to be more stressed by life changes (A-FILE). Adolescents in the high-risk families are characterized by significantly more developmental problems (both internalizing and externalizing), and the number of such problems correlates significantly with the risk for destructive parent-child relations. The development of adolescent psychopathology appears to interact with the evolution of a high-risk family system to produce destructive relationships between parents and their adolescent offspring. Stepfamilies appear especially vulnerable to this dysfunctional evolution.

  18. A note on calculating asymptotic confidence intervals for the adjusted risk difference and number needed to treat in the Cox regression model.

    PubMed

    Laubender, Ruediger P; Bender, Ralf

    2014-02-28

    Recently, Laubender and Bender (Stat. Med. 2010; 29: 851-859) applied the average risk difference (RD) approach to estimate adjusted RD and corresponding number needed to treat measures in the Cox proportional hazards model. We calculated standard errors and confidence intervals by using bootstrap techniques. In this paper, we develop asymptotic variance estimates of the adjusted RD measures and corresponding asymptotic confidence intervals within the counting process theory and evaluated them in a simulation study. We illustrate the use of the asymptotic confidence intervals by means of data of the Düsseldorf Obesity Mortality Study.

  19. Discrimination and adjustment for Mexican American adolescents: A prospective examination of the benefits of culturally-related values

    PubMed Central

    Berkel, Cady; Knight, George P.; Zeiders, Katharine H.; Tein, Jenn-Yun; Roosa, Mark W.; Gonzales, Nancy A.; Saenz, Delia

    2009-01-01

    Mexican American adolescents face disparities in mental health and academic achievement, perhaps in part because of discrimination experiences. However, culturally-related values, fostered by ethnic pride and socialization, may serve to mitigate the negative impact of discrimination. Guided by the Stress Process Model, the current study examined risk and protective processes using a 2-wave multi-informant study with 750 Mexican American families. Specifically, we examined two possible mechanisms by which Mexican American values may support positive outcomes in the context of discrimination; as a protective factor (moderator) or risk reducer (mediator). Analyses supported the role of Mexican American values as a risk reducer. This study underscores the importance of examining multiple mechanisms of protective processes in understanding Mexican American adolescent resilience. PMID:21359093

  20. Epidemiology of endocrine-related risk factors for breast cancer.

    PubMed

    Bernstein, Leslie

    2002-01-01

    Ovarian and other hormones are major determinants of breast cancer risk. Particularly important is the accumulative exposure of the breast to circulating levels of the ovarian hormones estradiol and progesterone. A number of breast cancer risk factors can be understood in light of how they affect women's hormone profiles. Age is a marker for the onset and cessation of ovarian activity. Racial differences in hormone profiles correlate with breast cancer incidence patterns. Age at menarche not only serves as the chronological indicator of the onset of ovarian activity, but as a predictor of ovulatory frequency during adolescence and hormone levels in young adults, and has a long-lasting influence on risk. Age at menopause, another established breast cancer risk factor, marks the cessation of ovarian activity. Pregnancy history and lactation experience also are hormonal markers of breast cancer risk. Postmenopausal obesity, which is associated with higher levels of estrogen following cessation of ovarian activity, increases breast cancer risk, whereas physical activity, which can limit menstrual function, reduces risk. A relatively recent area of investigation is prenatal exposures like preeclampsia and low birth weight; both may be associated with lower in utero exposure to estrogen and also may predict lower breast cancer risk as an adult. Improved understanding of these exposures and their potential interactions with breast cancer susceptibility genes may, in the future, improve our prospects for breast cancer prevention.

  1. Relation of physical activity to prevalence of nonalcoholic Fatty liver disease independent of cardiometabolic risk.

    PubMed

    Oni, Ebenezer T; Kalathiya, Rohan; Aneni, Ehimen C; Martin, Seth S; Blaha, Michael J; Feldman, Theodore; Agatston, Arthur S; Blumenthal, Roger S; Conceiçao, Raquel D; Carvalho, Jose A M; Santos, Raul D; Nasir, Khurram

    2015-01-01

    Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and insulin resistance and has been linked with increased cardiovascular risk. Although physical activity (PA) and lifestyle modification are often recommended in patients at cardiovascular risk, the benefit across the cardiometabolic risk spectrum is unclear. We aimed to evaluate the relation of PA and NAFLD independent of metabolic syndrome (MS) or obesity. We evaluated 5,743 healthy Brazilian subjects (43 ± 10 years, 79% men) without clinical coronary heart disease from December 2008 to December 2010. NAFLD was diagnosed using ultrasounds, and self-reported PA was assessed using the International Physical Activity Questionnaire scale. In a multivariate logistic regression adjusted for cardiometabolic risk factors, we evaluated for an independent association of NAFLD and PA. In the total study population, NAFLD prevalence was 36% (n = 2,075), obesity 23% (1,300), and MS 20% (1,152). NAFLD was more prevalent in subjects with MS (74%) than those without (26%) and in those obese (73%) than in those nonobese (25%). Overall, 1,305 (23%) subjects reported low activity, 1,990 (35%) moderate activity, and 2,448 (42%) high activity. NAFLD prevalence was lower at higher levels of reported PA (low 45%, moderate 38%, and high 30%, p <0.001). After adjusting for risk factors, subjects with high activity had lower odds of having NAFLD. The favorable association was independent of obesity or MS. In conclusion, PA presents a dose-response association with NAFLD independent of the MS or obesity. Our results are compatible with the idea that benefits of PA are relevant to everyone regardless of cardiometabolic risk.

  2. Association between ABO blood group and HCV-related hepatocellular carcinoma risk in China

    PubMed Central

    Li, Xu; Xu, Hongqin; Ding, Zhongyang; Jin, Qinglong; Gao, Pujun

    2016-01-01

    Abstract The ABO blood group has previously been reported to be associated with risk for certain malignancies; however, data about the risks for hepatocellular carcinoma (HCC) according to blood type are limited. Thus, we conducted a retrospective case–control study to investigate whether the ABO blood group contributes to hepatitis C virus (HCV) infection–induced HCC. From January 2010 to June 2016, 447 consecutive patients with chronic HCV infection were recruited. Of these patients, 217 had HCV-related HCC, and 230 had chronic hepatitis C (CHC) without HCC. We performed multivariate logistic regression to probe the association between the ABO blood group and HCC risk. Compared with subjects with blood type O, patients with blood type A had an adjusted odds ratio (AOR) of 3.301 (95% confidence interval [CI], 1.927–5.653) for HCC after adjusting for age and gender. We found statistically significant associations between blood type A and HCC risk for both men (AOR [95% CI] = 4.192 [1.959–8.973]) and women (AOR [95% CI] = 2.594 [1.231–5.466]), and for patients aged below 70 years (<60 years: AOR [95% CI] = 3.418 [1.338–8.734]; 60–69 years: AOR [95% CI] = 3.917 [1.730–8.867]). Thus, HCC risk is associated with ABO blood type in Chinese CHC patients, and CHC patients with blood type A are more susceptible to HCV-related HCC than patients with other blood types. PMID:27930575

  3. Are all risks equal? Early experiences of poverty-related risk and children's functioning.

    PubMed

    Roy, Amanda L; Raver, C Cybele

    2014-06-01

    Using cumulative risk and latent class analysis (LCA) models, we examined how exposure to deep poverty (income-to-needs ratio <0.50) and 4 poverty-related risks (i.e., single-parent household, residential crowding, caregiver depression, and multiple life stressors) in preschool is related to children's future difficulty in school in a longitudinal sample of 602 Head Start-enrolled, low-income families. Results from the LCA revealed 4 risk profiles: low risk, deep poverty and single, single and stressed, and deep poverty and crowded household. Tests of measurement invariance across racial/ethnic groups established that, although patterns of risk are similar across groups (i.e., risks covary in the same way), the prevalence of risk profiles differs. African American families were overrepresented in the "deep poverty and single" profile while Latino and White families were overrepresented in the "deep poverty and crowded" profile. Finally, children's third grade functioning in 3 domains (i.e., academic performance, behavior problems, and self-regulatory skills) was predicted using a cumulative risk index and LCA-identified risk profiles. Both approaches demonstrated that children who experienced higher levels of risk in preschool had worse school performance than children with low levels of risk. However, LCA also revealed that children who experienced "single and stressed" family settings had more behavior problems than low-risk children while children who experienced "deep poverty and crowded" family settings had worse academic performance. The results indicate that all risks are not equal for children's development and highlight the utility of LCA for tailoring intervention efforts to best meet the needs of target populations.

  4. Adverse Vascular Risk is Related to Cognitive Decline in Older Adults

    PubMed Central

    Jefferson, Angela L.; Hohman, Timothy J.; Liu, Dandan; Haj-Hassan, Shereen; Gifford, Katherine A.; Benson, Elleena M.; Skinner, Jeannine S.; Lu, Zengqi; Sparling, Jamie; Sumner, Emily C.; Bell, Susan; Ruberg, Frederick L.

    2014-01-01

    Background Cardiovascular disease (CVD) and related risk factors are associated with Alzheimer’s disease (AD). This association is less well-defined in normal cognition (NC) or prodromal AD (mild cognitive impairment (MCI)). Objective Cross-sectionally and longitudinally relate a vascular risk index to cognitive outcomes among elders free of clinical dementia. Methods 3117 MCI (74±8 years, 56% female) and 6603 NC participants (72±8 years, 68% female) were drawn from the National Alzheimer’s Coordinating Center. A composite measure of vascular risk was defined using the Framingham Stroke Risk Profile (FSRP) score (i.e., age, systolic blood pressure, anti-hypertensive medication, diabetes, cigarette smoking, CVD history, atrial fibrillation). Ordinary linear regressions and generalized linear mixed models related baseline FSRP to cross-sectional and longitudinal cognitive outcomes, separately for NC and MCI, adjusting for age, sex, race, education, and follow-up time (in longitudinal models). Results In NC participants, increasing FSRP was related to worse baseline global cognition, information processing speed, and sequencing abilities (p-values<0.0001) and a worse longitudinal trajectory on all cognitive measures (p-values<0.0001). In MCI, increasing FSRP correlated with worse longitudinal delayed memory (p=0.004). In secondary models using an age-excluded FSRP score, associations persisted in NC participants for global cognition, naming, information processing speed, and sequencing abilities. Conclusions An adverse vascular risk profile is associated with worse cognitive trajectory, especially global cognition, naming, and information processing speed, among NC elders. Future studies are needed to understand how effective management of CVD and related risk factors can modify cognitive decline to identify the ideal timeframe for primary prevention implementation. PMID:25471188

  5. Relative risk assessment of cruise ships biosolids disposal alternatives.

    PubMed

    Avellaneda, Pedro M; Englehardt, James D; Olascoaga, Josefina; Babcock, Elizabeth A; Brand, Larry; Lirman, Diego; Rogge, Wolfgang F; Solo-Gabriele, Helena; Tchobanoglous, George

    2011-10-01

    A relative risk assessment of biosolids disposal alternatives for cruise ships is presented in this paper. The area of study encompasses islands and marine waters of the Caribbean Sea. The objective was to evaluate relative human health and ecological risks of (a) dewatering/incineration, (b) landing the solids for disposal, considering that in some countries land-disposed solids might be discharged in the near-shore environment untreated, and (c) deep ocean disposal. Input to the Bayesian assessment consisted of professional judgment based on available literature and modeling information, data on constituent concentrations in cruise ship biosolids, and simulations of constituent concentrations in Caribbean waters assuming ocean disposal. Results indicate that human health and ecological risks associated with land disposal and shallow ocean disposal are higher than those of the deep ocean disposal and incineration. For incineration, predicted ecological impacts were lower relative to deep ocean disposal before considering potential impacts of carbon emissions.

  6. Time perspective and perceived risk as related to mammography screening.

    PubMed

    Griva, Fay; Anagnostopoulos, Fotios; Potamianos, Gregory

    2013-01-01

    The present study explored the relation of time perspective to perceived risk for breast cancer and mammography screening. Women free from breast cancer (N = 194), eligible for mammography screening in terms of age, completed the Zimbardo Time Perspective Inventory (Zimbardo & Boyd, 1999) and measures of perceived risk, attitude toward performing mammography screening, intention to get a mammogram, and mammography screening behavior. Hierarchical multiple regression analysis revealed that perceived risk of breast cancer (β= .18, p < .01) and intention to be screened (β = .35, p < .01) were significantly associated with mammography screening, after controlling for the effects of sociodemographic (e.g., age, education, and economic level) and health-related variables (e.g., family history of breast cancer and previous benign breast disease). Path analyses including the main psychological variables indicated that perceived risk was indirectly related to intention via attitude (β = .17, p < .01), and to mammography screening through attitude and intention (β = .06, p < .01). Attitude was indirectly related to mammography screening via intention (β = .20, p < .01). Also, a significant indirect association was observed between future orientation and mammography screening, via perceived risk (β = .10, p < .01). Theoretical implications of study findings and suggestions for future research on use of mammography are presented.

  7. Incidence and relative risk of hearing disorders in professional musicians

    PubMed Central

    Schink, Tania; Kreutz, Gunter; Busch, Veronika; Pigeot, Iris; Ahrens, Wolfgang

    2014-01-01

    Background Hearing disorders have been associated with occupational exposure to music. Musicians may benefit from non-amplified and low-intensity music, but may also have high risks of music-induced hearing loss. Aims To compare the incidence of hearing loss (HL) and its subentities in professional musicians with that in the general population. Methods We performed a historical cohort study among insurants between 19 and 66 years who were employed subject to social insurance contributions. The study was conducted with data from three German statutory health insurance providers covering the years 2004–2008 with about 7 million insurants. Incidence rates with 95% CIs of HL and the subentities noise-induced hearing loss (NIHL), conductive HL, sensorineural HL, conductive and sensorineural HL, as well as tinnitus were estimated stratified by age, sex and federal state. A Cox regression analysis was conducted to estimate adjusted HRs and two-sided 95% CIs for HL and its subentities. Results More than 3 million insurants were eligible, of whom 2227 were identified as professional musicians (0.07%). During the 4-year observation period, 283 697cases of HL were seen, 238 of them among professional musicians (0.08%), leading to an unadjusted incidence rate ratio of 1.27. The adjusted hazard ratio of musicians was 1.45 (95% CI 1.28 to 1.65) for HL and 3.61 (95% CI 1.81 to 7.20) for NIHL. Conclusions Professional musicians have a high risk of contracting hearing disorders. Use of already available prevention measures should reduce the incidence of HL in professional musicians. PMID:24790053

  8. A Probabilistic Risk Assessment of Groundwater-Related Risks at Excavation Sites

    NASA Astrophysics Data System (ADS)

    Jurado, A.; de Gaspari, F.; Vilarrasa, V.; Sanchez-Vila, X.; Fernandez-Garcia, D.; Tartakovsky, D. M.; Bolster, D.

    2010-12-01

    Excavation sites such as those associated with the construction of subway lines, railways and highway tunnels are hazardous places, posing risks to workers, machinery and surrounding buildings. Many of these risks can be groundwater related. In this work we develop a general framework based on a probabilistic risk assessment (PRA) to quantify such risks. This approach is compatible with standard PRA practices and it employs many well-developed risk analysis tools, such as fault trees. The novelty and computational challenges of the proposed approach stem from the reliance on stochastic differential equations, rather than reliability databases, to compute the probabilities of basic events. The general framework is applied to a specific case study in Spain. It is used to estimate and minimize risks for a potential construction site of an underground station for the new subway line in the Barcelona metropolitan area.

  9. The Development of Emotional and Behavioral Control in Early Childhood: Heterotypic Continuity and Relations to Early School Adjustment

    PubMed Central

    Chang, Hyein; Shaw, Daniel S; Cheong, JeeWon

    2015-01-01

    We examined heterotypic continuity of emotional and behavioral control (EBC) across early childhood and related early manifestations of EBC to children’s school adjustment in 310 low-income, ethnically diverse boys. Multiple informants and methods were used to measure different indicators of EBC at 18, 24, 42, and 60 months, which were chosen to reflect salient regulatory challenges children face across development. Teachers rated boys’ externalizing and internalizing behaviors, and social skills at 72 months. Results indicated a modest degree of heterotypic continuity of EBC, with different constructs of EBC associated between adjacent time points and, in some instances, across more distant time points. Further, children who had struggled with early EBC demonstrated higher externalizing problems and lower social skills in school. Findings suggest that early deficits in EBC may be a target for early identification and prevention, as they may forecast continued difficulty in later-developing EBC skills and socioemotional problems. PMID:26550611

  10. Relationships between the history of thermal stress and the relative risk of diseases of Caribbean corals.

    PubMed

    Randall, C J; Jordan-Garza, A G; Muller, E M; Van Woesik, R

    2014-07-01

    The putative increase in coral diseases in the Caribbean has led to extensive declines in coral populations. Coral diseases are a consequence of the complex interactions among the coral hosts, the pathogens, and the environment. Yet, the relative influence that each of these components has on the prevalence of coral diseases is unclear. Also unknown is the extent to which historical thermal-stress events have influenced the prevalence of contemporary coral diseases and the potential adjustment of coral populations to thermal stress. We used a Bayesian approach to test the hypothesis that in 2012 the relative risk of four signs of coral disease (white signs, dark spots, black bands, and yellow signs) differed at reef locations with different thermal histories. We undertook an extensive spatial study of coral diseases at four locations in the Caribbean region (10(3) km), two with and two without a history of frequent thermal anomalies (approximately 4-6 years) over the last 143 years (1870-2012). Locations that historically experienced frequent thermal anomalies had a significantly higher risk of corals displaying white signs, and had a lower risk of corals displaying dark spots, than locations that did not historically experience frequent thermal anomalies. By contrast, there was no relationship between the history of thermal stress and the relative risk of corals displaying black bands and yellow signs, at least at the spatial scale of our observations.

  11. Perfectionism dimensions and dependency in relation to personality vulnerability and psychosocial adjustment in patients with coronary artery disease.

    PubMed

    Dunkley, David M; Schwartzman, Deborah; Looper, Karl J; Sigal, John J; Pierre, Andrena; Kotowycz, Mark A

    2012-06-01

    The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.

  12. Historic Rio Grande Channel Change: Relating Channel Adjustments Measured from Aerial Photography to Human and Climate Induced Changes in Hydrology

    NASA Astrophysics Data System (ADS)

    Meyer, G. A.; Swanson, B. J.; Coonrod, J.

    2008-12-01

    Over the last century, flow regulation, changes in land and water use, and climate change, including severe droughts, have altered geomorphic processes along the Middle Rio Grande. In association with the USACE Urban Flood Demonstration Program, we investigated changes in channel and island widths and areas as measured on 1972-2006 aerial photographs in relation to average and peak flows in the Rio Grande through Bernalillo County, NM (Albuquerque). We employed all recent (1992-2006) photographs, which were often taken annually or biannually. Digitized and georeferenced photographs were analyzed using a GIS, with particular attention paid to quantifying potential measurement error and its propagation through estimates of channel areas and bank erosion rates. Average total channel widths decreased from 169 m in 1972 to 130 m in 2006. Narrowing was concentrated in the upper and lower sections of the study reach where tributary sediment inputs and degradation related to dam operations constrict the active channel. Decreases in channel width and area coincide with periods of low flows, although the area changes are associated with large errors. Vegetated island areas have greatly increased since 1972, although islands per se were also lost during the later study period by bank attachment. Bank erosion estimates also have large associated errors. Nonetheless, erosion rates appear to be generally decreasing over time, but accelerated during the 2005 high flows. Additional research will compare geomorphic change along the Rio Grande study reach to channel adjustments along the Rio Chama, both below and above El Vado Dam, to better understand regional channel responses to dam operations and drought cycles. Initial investigations reveal that channel responses to these perturbations along the Rio Chama, a major Rio Grande tributary, are similar to the adjustments observed along the Rio Grande through Albuquerque, but the magnitude of the change is not as dramatic.

  13. [Protective and family risk factors related to adolescent drug use].

    PubMed

    Cid-Monckton, Patricia; Pedrão, Luiz Jorge

    2011-06-01

    This cross-sectional and quantitative study aimed to verify the family's protective and risk factors related to drugs use in adolescents, considering the interaction patterns developed in the family, their degree of adaptability and vulnerability. Participants in this study were 80 female adolescents, from the 1st to 4th grade of high school, who answered a questionnaire. The most relevant risk and protective factors that would influence the situation were established, such as patterns of interaction, degree of adaptability, way of coping with problems, family resources and values. The major risk factors that emerged were the way people confront problems and, within these, lack of religious support and professional support, besides communication difficulties within families. The lowest risks were values, such as personal effort. The results highlight that nurses should assume psychosocial interventions as part of their role, especially among school-age children as, thus, they would be acting as agents in the prevention of drugs use.

  14. Non-parametric estimation of spatial variation in relative risk.

    PubMed

    Kelsall, J E; Diggle, P J

    We consider the problem of estimating the spatial variation in relative risks of two diseases, say, over a geographical region. Using an underlying Poisson point process model, we approach the problem as one of density ratio estimation implemented with a non-parametric kernel smoothing method. In order to assess the significance of any local peaks or troughs in the estimated risk surface, we introduce pointwise tolerance contours which can enhance a greyscale image plot of the estimate. We also propose a Monte Carlo test of the null hypothesis of constant risk over the whole region, to avoid possible over-interpretation of the estimated risk surface. We illustrate the capabilities of the methodology with two epidemiological examples.

  15. HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?

    PubMed

    Bennett, David S; Hersh, Jill; Herres, Joanna; Foster, Jill

    2016-08-01

    Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.

  16. Estimating relative risk of a log-transformed exposure measured in pools.

    PubMed

    Mitchell, Emily M; Plowden, Torie C; Schisterman, Enrique F

    2016-12-20

    Pooling biospecimens prior to performing laboratory assays is a useful tool to reduce costs, achieve minimum volume requirements and mitigate assay measurement error. When estimating the risk of a continuous, pooled exposure on a binary outcome, specialized statistical techniques are required. Current methods include a regression calibration approach, where the expectation of the individual-level exposure is calculated by adjusting the observed pooled measurement with additional covariate data. While this method employs a linear regression calibration model, we propose an alternative model that can accommodate log-linear relationships between the exposure and predictive covariates. The proposed model permits direct estimation of the relative risk associated with a log-transformation of an exposure measured in pools. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  17. Influence of exposure to perinatal risk factors and parental mental health related hospital admission on adolescent deliberate self-harm risk.

    PubMed

    Hu, Nan; Li, Jianghong; Glauert, Rebecca A; Taylor, Catherine L

    2017-02-03

    Adolescent deliberate self-harm (DSH) has been found to be associated with a range of bio-psycho-social factors. Simultaneous investigations of these factors enable more robust estimation of the independent effect of a specific risk factor by adjusting for a more complete set of covariates. However, few studies have had the ability to examine all of these factors together. This study used the linkage of population-level de-identified data collections from government agencies to investigate a range of biological, psychological, and social risk factors and their effects on adolescent risk of DSH (with or without suicidal intent). The investigation was undertaken by progressively adjusting for plausible covariates, including fetal growth status and birth order, early familial social factors, parental hospital admissions due to psychiatric disorders or DSH, and parental all-cause death. Conditional logistic regression was used for data analysis. Children's psychiatric history was analysed to examine the extent to which it may account for the link between the risk factors and adolescent DSH risk. This study identified significant biological and perinatal social risk factors for adolescent DSH risk, including overdue birth, high birth order (≥2), single or teen/young motherhood, high neighbourhood socioeconomic disadvantage, and parental psychiatric and/or DSH-related hospital admissions. Further, parental psychiatric and/or DSH-related admissions, and children's psychiatric admissions in particular, largely attenuated the effects of the perinatal social risk factors but not the biological factors on adolescent DSH risk. These results highlight the importance of taking joint actions involving both health and social services in the prevention of adolescent DSH.

  18. Height-related risk factors for prostate cancer.

    PubMed

    Norrish, A E; McRae, C U; Holdaway, I M; Jackson, R T

    2000-01-01

    Previous studies have reported that adult height is positively associated with the risk of prostate cancer. The authors carried out a population-based case-control study involving 317 prostate cancer cases and 480 controls to further investigate the possibility that height is more strongly associated with advanced, compared with localized forms of this disease. Since the inherited endocrine factors, which in part determine height attained during the growing years, may influence the risk of familial prostate cancer later in life, the relationship with height was also investigated for familial versus sporadic prostate cancers. Adult height was not related to the risk of localized prostate cancer, but there was a moderate positive association between increasing height and the risk of advanced cancer (relative risk (RR) = 1.62; 95% confidence interval (CI) 0.97-2.73, upper versus lowest quartile, P-trend = 0.07). Height was more strongly associated with the risk of prostate cancer in men with a positive family history compared with those reporting a negative family history. The RR of advanced prostate cancer for men in the upper height quartile with a positive family history was 7.41 (95% CI 1.68-32.67, P-trend = 0.02) compared with a reference group comprised of men in the shortest height quartile with a negative family history. Serum insulin-like growth factor-1 levels did not correlate with height amongst men with familial or sporadic prostate cancers. These findings provide evidence for the existence of growth-related risk factors for prostate cancer, particularly for advanced and familial forms of this disease. The possible existence of inherited mechanisms affecting both somatic and tumour growth deserves further investigation.

  19. Cancer-related fatigue: Mechanisms, risk factors, and treatments

    PubMed Central

    Bower, Julienne E.

    2015-01-01

    Fatigue is one of the most common and distressing side effects of cancer and its treatment, and may persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and may be a risk factor for reduced survival. The prevalence and course of fatigue in cancer patients has been well characterized, and there is growing understanding of underlying biological mechanisms. Inflammation has emerged as a key biological pathway for cancer-related fatigue, with studies documenting links between markers of inflammation and fatigue before, during, and particularly after treatment. There is considerable variability in the experience of cancer-related fatigue that is not explained by disease- or treatment-related characteristics, suggesting that host factors may play an important role in the development and persistence of this symptom. Indeed, longitudinal studies have begun to identify genetic, biological, psychosocial, and behavioral risk factors for cancer-related fatigue. Given the multi-factorial nature of cancer-related fatigue, a variety of intervention approaches have been examined in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. Although there is currently no gold standard for treating fatigue, several of these approaches have shown beneficial effects and can be recommended to patients. This report provides a state of the science review of mechanisms, risk factors, and interventions for cancer-related fatigue, with a focus on recent longitudinal studies and randomized trials that have targeted fatigued patients. PMID:25113839

  20. [Occupational risk related to optical radiation exposure in construction workers].

    PubMed

    Gobba, F; Modenese, A

    2012-01-01

    Optical Radiation is a relevant occupational risk in construction workers, mainly as a consequence of the exposure to the ultraviolet (UV) component of solar radiation (SR). Available data show that UV occupational limits are frequently exceeded in these workers, resulting in an increased occupational risk of various acute and chronic effects, mainly to skin and to the eye. One of the foremost is the carcinogenic effect: SR is indeed included in Group 1 IARC (carcinogenic to humans). UV exposure is related to an increase of the incidence of basal cell carcinoma, squamous cell carcinoma of the skin and cutaneous malignant melanoma (CMM). The incidence of these tumors, especially CMM, is constantly increasing in Caucasians in the last 50 years. As a conclusion, an adequate evaluation of the occupational risk related to SR, and adequate preventive measures are essential in construction workers. The role of occupational physicians in prevention is fundamental.

  1. Urinary Melatonin in Relation to Postmenopausal Breast Cancer Risk According to Melatonin 1 Receptor Status.

    PubMed

    Devore, Elizabeth E; Warner, Erica T; Eliassen, A Heather; Brown, Susan B; Beck, Andrew H; Hankinson, Susan E; Schernhammer, Eva S

    2017-03-01

    Background: Urinary melatonin levels have been associated with a reduced risk of breast cancer in postmenopausal women, but this association might vary according to tumor melatonin 1 receptor (MT1R) expression.Methods: We conducted a nested case-control study among 1,354 postmenopausal women in the Nurses' Health Study, who were cancer free when they provided first-morning spot urine samples in 2000 to 2002; urine samples were assayed for 6-sulfatoxymelatonin (aMT6s, a major metabolite of melatonin). Five-hundred fifty-five of these women developed breast cancer before May 31, 2012, and were matched to 799 control subjects. In a subset of cases, immunohistochemistry was used to determine MT1R status of tumor tissue. We used multivariable-adjusted conditional logistic regression to estimate the relative risk (RR) of breast cancer [with 95% confidence intervals (CI)] across quartiles of creatinine-standardized urinary aMT6s level, including by MT1R subtype.Results: Higher urinary melatonin levels were suggestively associated with a lower overall risk of breast cancer (multivariable-adjusted RR = 0.78; 95% CI = 0.61-0.99, comparing quartile 4 vs. quartile 1; Ptrend = 0.08); this association was similar for invasive vs. in situ tumors (Pheterogeneity = 0.12). There was no evidence that associations differed according to MT1R status of the tumor (e.g., Pheterogeneity for overall breast cancer = 0.88).Conclusions: Higher urinary melatonin levels were associated with reduced breast cancer risk in this cohort of postmenopausal women, and the association was not modified by MT1R subtype.Impact: Urinary melatonin levels appear to predict the risk of breast cancer in postmenopausal women. However, future research should evaluate these associations with longer-term follow-up and among premenopausal women. Cancer Epidemiol Biomarkers Prev; 26(3); 413-9. ©2016 AACR.

  2. Dehydration and osmotic adjustment in apple stem tissue during winter as it relates to the frost resistance of buds.

    PubMed

    Pramsohler, Manuel; Neuner, Gilbert

    2013-08-01

    In deciduous trees, measurement of stem water potential can be difficult during the leafless period in winter. By using thermocouple psychrometry, osmotic water potentials (Ψo; actual Ψo: Ψo(act); Ψo at full saturation: Ψo(sat)) of expressed sap of bark and bud tissue were measured in order to test if the severity of winter desiccation in apple stems could be sufficiently assessed with Ψo. Water potentials were related to frost resistance and freezing behaviour of buds. The determination of Ψo reliably allowed winter desiccation and osmotic adjustments in apple stem tissue to be assessed. In winter in bark tissue, a pronounced decrease in Ψo(act) and Ψo(sat) was found. Decreased Ψo(sat) indicates active osmotic adjustment in the bark as observed earlier in the leaves of evergreen woody plants. In terminal bud meristems, no significant osmotic adjustments occurred and dehydration during winter was much less. Osmotic water potentials, Ψo(act) and Ψo(sat), of bud tissue were always less negative than in the bark. To prevent water movement and dehydration of the bud tissue via this osmotic gradient, it must be compensated for either by a sufficiently high turgor pressure (Ψp) in bark tissue or by the isolation of the bud tissue from the bark during midwinter. During freezing of apple buds, freeze dehydration and extra-organ freezing could be demonstrated by significantly reduced Ψo(act) values of bud meristems that had been excised in the frozen state. Infrared video thermography was used to monitor freezing patterns in apple twigs. During extracellular freezing of intact and longitudinally dissected stems, infrared differential thermal analysis (IDTA) images showed that the bud meristem remains ice free. Even if cooled to temperatures below the frost-killing temperature, no freezing event could be detected in bud meristems during winter. In contrast, after bud break, terminal buds showed a second freezing at the frost-killing temperature that indicates

  3. Spatial Relative Risk Patterns of Autism Spectrum Disorders in Utah

    ERIC Educational Resources Information Center

    Bakian, Amanda V.; Bilder, Deborah A.; Coon, Hilary; McMahon, William M.

    2015-01-01

    Heightened areas of spatial relative risk for autism spectrum disorders (ASD), or ASD hotspots, in Utah were identified using adaptive kernel density functions. Children ages four, six, and eight with ASD from multiple birth cohorts were identified by the Utah Registry of Autism and Developmental Disabilities. Each ASD case was gender-matched to…

  4. Explanatory risk factors in the relations between schizotypy and indicators of suicide risk.

    PubMed

    Jahn, Danielle R; DeVylder, Jordan E; Hilimire, Matthew R

    2016-04-30

    Schizotypy has been linked to suicide risk, but it is not known whether established suicide-related risk factors mediate this relation. The aim of this study was to assess the mediating effects of depressive symptoms, social anxiety, self-esteem, and intimate disclosure in peer relationships in the relation between interpersonal schizotypy and suicide ideation or lifetime suicide attempts. This aim was tested in 590 young adults using a nonparametric bootstrapping procedure. After inclusion of the mediators, interpersonal schizotypy was no longer directly associated with either suicide ideation or lifetime suicide attempts. Depression and self-esteem mediated the relation between interpersonal schizotypy and suicide ideation. No variables mediated the relation between interpersonal schizotypy and lifetime suicide attempts, and there were no significant direct relations when mediators were included. Schizotypy appears to be a distal risk factor for suicidal behavior; assessing depressive symptoms and self-esteem may provide more proximal information about suicide risk, and may be targets for mitigating suicide risk in individuals with schizotypy.

  5. Folate, vitamin B(6) , vitamin B(12) , methionine and alcohol intake in relation to ovarian cancer risk.

    PubMed

    Harris, Holly R; Cramer, Daniel W; Vitonis, Allison F; DePari, Mary; Terry, Kathryn L

    2012-08-15

    Folate, methionine, vitamin B(6) and vitamin B(12) may influence carcinogenesis due to their roles in the one-carbon metabolism pathway, which is critical for DNA synthesis, methylation and repair. Low intake of these nutrients has been associated with an increased risk of breast, colon and endometrial cancers. Previous studies that have examined the relation between these nutrients and ovarian cancer risk have been inconsistent and have had limited power to examine the relation by histologic subtype. We investigated the association between folate, methionine, vitamin B(6) , vitamin B(12) and alcohol among 1910 women with ovarian cancer and 1989 controls from a case-control study conducted in eastern Massachusetts and New Hampshire from 1992 to 2008. Diet was assessed via food frequency questionnaire. Participants were asked to recall diet one-year before diagnosis or interview. Logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (95% CIs). We also examined whether the associations varied by ovarian cancer histologies using polytomous logistic regression. We observed an inverse association between dietary vitamin B(6) (covariate-adjusted OR = 0.76, 95% CI 0.64-0.92; p(trend) = 0.002) and methionine intake (covariate-adjusted OR = 0.72, 95% CI = 0.60-0.87; p(trend) < 0.001) and ovarian cancer risk comparing the highest to lowest quartile. The association with dietary vitamin B(6) was strongest for serous borderline (covariate-adjusted OR = 0.49, 95% CI = 0.32-0.77; p(trend) = 0.001) and serous invasive (covariate-adjusted OR = 0.74, 95% CI = 0.58-0.94; p(trend) = 0.012) subtypes. Overall, we observed no significant association between folate and ovarian cancer risk. One-carbon metabolism related nutrients, especially vitamin B(6) and methionine, may lower ovarian cancer risk.

  6. Body mass index and smoking-related lung cancer risk in the Singapore Chinese Health Study

    PubMed Central

    Koh, W-P; Yuan, J-M; Wang, R; Lee, H-P; Yu, M C

    2009-01-01

    Background: Smokers with low body mass index (BMI) may be more susceptible to lung cancer. Methods: We prospectively examined the association between baseline BMI and lung cancer risk in the Singapore Chinese Health Study, a cohort of 63 257 Chinese enrolled between 1993 and 1998. Results: After adjustment for smoking intensity and duration, BMI was inversely associated with risk of lung cancer among current smokers (P for trend=0.0004). Current smokers at different dosage of smoking with low BMI had significantly higher risk for lung cancer than those with high BMI. Hazard ratios (95% confidence intervals) of lung cancer for heavy smokers with BMI of ⩾28, 24–<28, 20–<24, and <20 kg m−2 were 6.37 (2.10–19.30), 9.01 (5.04–16.10), 8.53 (6.35–11.5), and 11.12 (6.60–18.70), respectively, as compared with nonsmokers. BMI had no modifying effects on lung cancer risk among nonsmokers and former smokers. Conclusion: Smokers with lower BMI may experience an enhanced risk of lung cancer. The findings have significant public-health implication given the increase in smoking prevalence in developing countries, where people still have relatively low BMI. PMID:20010947

  7. Racial Discrimination and HIV-related Risk Behaviors in Southeast Louisiana

    PubMed Central

    Kaplan, Kathryn C.; Hormes, Julia M.; Wallace, Maeve; Rountree, Michele; Theall, Katherine P.

    2016-01-01

    Objectives We examined the relationship between cumulative experiences of racial discrimination and HIV-related risk taking, and whether these relationships are mediated through alcohol use among African Americans in semi-rural southeast Louisiana. Methods Participants (N = 214) reported on experiences of discrimination, HIV sexual risk-taking, history of sexually transmitted infection (STI), and health behaviors including alcohol use in the previous 90 days. Experiences of discrimination (scaled both by frequency of occurrence and situational counts) as a predictor of a sexual risk composite score as well as a history of STI was assessed using multivariate linear and logistic regression, respectively, including tests for mediation by alcohol use. Results Discrimination was common in this cohort, with respondents confirming their experience on average 7 of the 9 potential situations and on more than 34 separate occasions. After adjustment, discrimination was significantly associated with increasing sexual risk-taking and lifetime history of STI when measured either by frequency of occurrence or number of situations, although there was no evidence that these relationships were mediated through alcohol use. Conclusions Cumulative experiences of discrimination may play a significant role in sexual risk behavior and consequently increase vulnerability to HIV and other STIs. PMID:26685822

  8. Flavonoid intake and the risk of age-related cataract in China's Heilongjiang Province

    PubMed Central

    Ma, Yingna; Gao, Weiqi; Wu, Kun; Bao, Yongping

    2015-01-01

    Background/objectives Epidemiological evidence suggests that diets rich in flavonoids may reduce the risk of developing age-related cataract (ARC). Flavonoids are widely distributed in foods of plant origin, and the objective of this study was to evaluate retrospectively the association between the intakes of the five flavonoid subclasses and the risk of ARC. Subjects/methods A population-based case-control study (249 cases and 66 controls) was carried out in Heilongjiang province, which is located in the northeast of China, and where intakes and availability of fresh vegetables and fruits can be limited. Dietary data gathered by food-frequency questionnaire (FFQ) were used to calculate flavonoid intake. Adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression. Results No linear associations between risk of developing ARC and intakes of total dietary flavonoids, anthocyanidins, flavon-3-ol, flavanone, total flavones or total flavonols were found, but quercetin and isorhamnetin intake was inversely associated with ARC risk (OR 11.78, 95% CI: 1.62–85.84, p<0.05, and OR 6.99, 95% CI: 1.12–43.44, p<0.05, quartile 4 vs. quartile 1, respectively). Conclusion As quercetin is contained in many plant foods and isorhamnetin in very few foods, we concluded that higher quercetin intake may be an important dietary factor in the reduction of the risk of ARC. PMID:26652740

  9. Dairy foods and nutrients in relation to risk of ovarian cancer and major histological subtypes.

    PubMed

    Merritt, Melissa A; Cramer, Daniel W; Vitonis, Allison F; Titus, Linda J; Terry, Kathryn L

    2013-03-01

    Inconsistent results for the role of dairy food intake in relation to ovarian cancer risk may reflect the potential adverse effects of lactose, which has been hypothesized to increase gonadotropin levels, and the beneficial antiproliferative effects of calcium and vitamin D. Using data from the New England case-control study (1,909 cases and 1,989 controls), we examined dairy foods and nutrients in relation to risk of ovarian cancer overall, histological subtypes and rapidly fatal versus less aggressive disease. We used logistic regression and polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). In models that were simultaneously adjusted for total (dietary plus supplements) calcium, total vitamin D and lactose, we observed a decreased overall risk of ovarian cancer with high intake of total calcium [Quartile 4 (Q4, >1,319 mg/day) vs. Quartile 1 (Q1, <655 mg/day), OR = 0.62, 95% CI = 0.49-0.79]; the inverse association was strongest for serous borderline and mucinous tumors. High intake of total vitamin D was not associated overall with ovarian cancer risk, but was inversely associated with risk of serous borderline (Q4, >559 IU/day vs. Q1, <164 IU/day, OR = 0.51, 95% CI = 0.34-0.76) and endometrioid tumors (Q4 vs. Q1, OR = 0.55, 95% CI = 0.39-0.80). We found no evidence that lactose intake influenced ovarian cancer risk or that risk varied by tumor aggressiveness in the analyses of intake of dairy foods and nutrients. The overall inverse association with high intake of calcium and the inverse associations of calcium and vitamin D with specific histological subtypes warrant further investigation.

  10. Increased Risk Taking in Relation to Chronic Stress in Adults

    PubMed Central

    Ceccato, Smarandita; Kudielka, Brigitte M.; Schwieren, Christiane

    2016-01-01

    Chronic stress is a public health problem that affects a significant part of the population. While the physiological damage it causes is under ongoing scrutiny, its behavioral effects have been overlooked. This is one of the first studies to examine the relation between chronic stress and decision-making, using a standard lottery paradigm. We measured risk taking in the gain domain through binary choices between financially incentivized lotteries. We then measured self-reported chronic stress with the Trier Inventory for the Assessment of Chronic Stress (TICS). We additionally collected hair samples in a subsample of volunteers, in order to quantify accumulation of the stress hormone cortisol. We discovered a significant positive, though modest, correlation between self-reported chronic stress and risk taking that is stronger for women than for men. This confirms part of the findings in acute stress research that show a connection between higher stress and increased risk taking. However, unlike the biologically-based results from acute stress research, we did not identify a significant relation between hair cortisol and behavior. In line with previous literature, we found a clear gender difference in risk taking and self-reports: women generally take less risk and report slightly higher stress levels than men. We conclude that perceived chronic stress can impact behavior in risky situations. PMID:26858663

  11. Nonbenzodiazepine Sedative Hypnotics and Risk of Fall-Related Injury

    PubMed Central

    Tom, Sarah E.; Wickwire, Emerson M.; Park, Yujin; Albrecht, Jennifer S.

    2016-01-01

    Study Objectives: The objective of this study was to test the hypothesis that use of zolpidem, eszopiclone, and zaleplon would be associated with increased risk of traumatic brain injury (TBI) and hip fracture. Methods: We conducted a case-crossover study on a 5% random sample of Medicare beneficiaries age 65 y or older hospitalized with either TBI (n = 15,031) or hip fracture (n = 37,833) during 2007–2009. Use of zolpidem, eszopiclone, or zaleplon during the 30-day period prior to injury hospitalization was compared to use during four control periods at 3, 6, 9, and 12 mo prior to injury. The primary outcome was hospitalization for TBI or hip fracture. Results: Zolpidem use during the month prior to injury was associated with increased risk of TBI (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.56, 2.25); however, eszopiclone use during the same period was not associated with increased risk (OR 0.67; 95% CI 0.40, 1.13). Zolpidem use during the month prior to injury was associated with increased risk of hip fracture (OR 1.59; 95% CI 1.41, 1.79); however, eszopiclone use during the same period was not associated with increased risk (OR 1.12; 95% CI 0.83, 1.50). Analysis of zaleplon use in the month prior to injury was limited by low drug utilization but was not associated with increased risk of TBI (OR 0.85; 95% CI 0.21, 3.34) or hip fracture (OR 0.92; 95% CI 0.40, 2.13) in this study. Conclusions: For the treatment of insomnia in older adults, eszopiclone may present a safer alternative to zolpidem, in terms of fall-related injuries. Citation: Tom SE, Wickwire EM, Park Y, Albrecht JS. Nonbenzodiazepine sedative hypnotics and risk of fall-related injury. SLEEP 2016;39(5):1009–1014. PMID:26943470

  12. Genetic risk factors and age-related macular degeneration (AMD)

    PubMed Central

    Mousavi, Maryam; Armstrong, Richard A.

    2013-01-01

    Age related macular degeneration (AMD) is the leading cause of blindness in individuals older than 65 years of age. It is a multifactorial disorder and identification of risk factors enables individuals to make lifestyle choices that may reduce the risk of disease. Collaboration between geneticists, ophthalmologists, and optometrists suggests that genetic risk factors play a more significant role in AMD than previously thought. The most important genes are associated with immune system modulation and the complement system, e.g., complement factor H (CFH), factor B (CFB), factor C3, and serpin peptidase inhibitor (SERPING1). Genes associated with membrane transport, e.g., ATP-binding cassette protein (ABCR) and voltage-dependent calcium channel gamma 3 (CACNG3), the vascular system, e.g., fibroblast growth factor 2 (FGF2), fibulin-5, lysyl oxidase-like gene (LOXL1) and selectin-P (SELP), and with lipid metabolism, e.g., apolipoprotein E (APOE) and hepatic lipase (LIPC) have also been implicated. In addition, several other genes exhibit some statistical association with AMD, e.g., age-related maculopathy susceptibility protein 2 (ARMS2) and DNA excision repair protein gene (ERCC6) but more research is needed to establish their significance. Modifiable risk factors for AMD should be discussed with patients whose lifestyle and/or family history place them in an increased risk category. Furthermore, calculation of AMD risk using current models should be recommended as a tool for patient education. It is likely that AMD management in future will be increasingly influenced by assessment of genetic risk as such screening methods become more widely available.

  13. Relation Between Health-Related Quality of Life and Sleep Quality With Adjustment for Comorbidity Among the Korean Elderly: Mixed-Effects Model With a 6-Year Follow-up Study.

    PubMed

    Kwon, Amy M; Shin, Chol

    2016-04-01

    It is an important public health problem to identify risk factors of health-related quality of life (HRQoL) among the elderly. We recruited subjects from Ansan, Korea, as a subset of the Korean Genome and Epidemiology Study (KoGES), which is an ongoing population study, and followed up their sleep quality for 6 years. Mixed effect models were used to estimate the association between sleep quality and HRQoL, and we found that overall HRQoL was significantly lower to the elderly having poor sleep quality with adjustment for significant covariates although sleep quality showed a significant interaction effect with time for the mental component summary of SF-12. In particular, the elderly having lack of quality sleep appeared to have good general health, but their functional performances were significantly poor.

  14. Impacts, Perceptions and Management of Climate-Related Risks to Cage Aquaculture in the Reservoirs of Northern Thailand.

    PubMed

    Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

    2016-12-01

    Weather is suspected to influence fish growth and survival, and be a factor in mass mortality events in cage aquaculture in reservoirs. The purpose of this study was to identify the important climate-related risks faced by cage aquaculture farms; evaluate how these risks were currently being managed; and explore how farmers might adapt to the effects of climate change. Fish farmers were interviewed across the northern region of Thailand to get information on impacts, perceptions and practices. Drought or low water levels, heat waves, cold spells and periods with dense cloud cover, each caused significant financial losses. Perceptions of climate-related risks were consistent with experienced impacts. Risks are primarily managed in the short-term with techniques like aeration and reducing feed. In the mid-term farmers adjust stocking calendars, take financial measures and seek new information. Farmers also emphasize the importance of maintaining good relations with other stakeholders and reservoir management. Larger farms placed greater importance on risk management than small farms, even though types and levels of risk perceived were very similar. Most fish farms were managed by men alone, or men and women working together. Gender differences in risk perception were not detected, but women judged a few risk management practices as more important than men. Fish farmers perceived that climate is changing, but their perceptions were not strongly associated with recently having suffered impacts from extreme weather. The findings of this study provide important inputs to improving risk management under current and future climate.

  15. Impacts, Perceptions and Management of Climate-Related Risks to Cage Aquaculture in the Reservoirs of Northern Thailand

    NASA Astrophysics Data System (ADS)

    Lebel, Louis; Lebel, Phimphakan; Lebel, Boripat

    2016-12-01

    Weather is suspected to influence fish growth and survival, and be a factor in mass mortality events in cage aquaculture in reservoirs. The purpose of this study was to identify the important climate-related risks faced by cage aquaculture farms; evaluate how these risks were currently being managed; and explore how farmers might adapt to the effects of climate change. Fish farmers were interviewed across the northern region of Thailand to get information on impacts, perceptions and practices. Drought or low water levels, heat waves, cold spells and periods with dense cloud cover, each caused significant financial losses. Perceptions of climate-related risks were consistent with experienced impacts. Risks are primarily managed in the short-term with techniques like aeration and reducing feed. In the mid-term farmers adjust stocking calendars, take financial measures and seek new information. Farmers also emphasize the importance of maintaining good relations with other stakeholders and reservoir management. Larger farms placed greater importance on risk management than small farms, even though types and levels of risk perceived were very similar. Most fish farms were managed by men alone, or men and women working together. Gender differences in risk perception were not detected, but women judged a few risk management practices as more important than men. Fish farmers perceived that climate is changing, but their perceptions were not strongly associated with recently having suffered impacts from extreme weather. The findings of this study provide important inputs to improving risk management under current and future climate.

  16. Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide—An Overview

    PubMed Central

    Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

    2017-01-01

    People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools. PMID:28257103

  17. Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide-An Overview.

    PubMed

    Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

    2017-03-02

    People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools.

  18. Risk factors influencing non-use of condoms at sexual relations in populations under heightened risk.

    PubMed

    Medić, Alan; Dzelalija, Boris; Koźul, Karlo; Novosel, Iva Pem; Dijanić, Tomislav

    2014-09-01

    To determine risk factors for non-use of condoms when engaging in sexual intercourse among high-risk population groups for acquiring HIV/STIs. We collected the data obtained by interviews in the period from 2005 to 2011 in the Voluntary Counseling and Testing Center for HIV/AIDS at the Institute of Public Health of Zadar County. Four hundred ninety four respondents were divided into risk and control groups. The majority of the respondents in our population does not consistently use condoms, in the risk group as much as 89.9%, and in the control group 65.7% of them (p< 0.001). Persons consuming alcohol when having sexual relations use condoms about 5x less often compared to those not consuming alcohol at all (OR=5.00; CI=1.69-14.29). There are significant differences among women and men in the risk group regarding reasons for non-use of condoms. The main reason with women is "I trust mypartners" 33.7% while men "do not like having sex with condoms, 53.6% of them (p < 0.001). The main risk factors for non-use of condoms are alcohol consumption at sexual relations, non-use of condoms in a casual relationship. Having in mind the non-use of condoms among populations of high-risk groups of acquiring HIV there are significant differences among genders.

  19. Lifestyle and health-related risk factors and risk of cognitive aging among older veterans.

    PubMed

    Yaffe, Kristine; Hoang, Tina D; Byers, Amy L; Barnes, Deborah E; Friedl, Karl E

    2014-06-01

    Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them.

  20. Coupling mechanisms in inductive discharges with RF substrate bias driven at consecutive harmonics with adjustable relative phase

    NASA Astrophysics Data System (ADS)

    Steinberger, Thomas; Berger, Birk; Schulze, Julian; Schuengel, Edmund; Koepke, Mark

    2016-09-01

    Hybrid combinations of inductive and capacitive RF discharges are commonly used for plasma etching because the inductive coupling ensures a high plasma density, while the capacitive coupling allows the control of the ion bombardment energy at the substrate. We experimentally study the coupling mechanisms between the two driving-voltage sources in such a plasma driven inductively at 13.56 MHz and capacitively at 27.12 MHz in argon and neon at low pressure. We find that the resulting DC self-bias can be controlled via the Electrical Asymmetry Effect by adjusting the relative phase between the two driving harmonics in the E-mode. Langmuir probe measurements and Phase Resolved Optical Emission Spectroscopy (PROES) reveal that the addition of the applied RF-bias in the plasma acts as a catalyst for the transition between E- and H-mode. PROES measurements generally show that the electron power absorption dynamics are affected by the relative phase between the two driving voltage waveforms and by the ratio of the inductive to the capacitive driving powers. Finally, the ion flux-energy distribution function is measured at the RF-powered electrode and found also to be affected by coupling effects.

  1. The Predictive Relationship between Temperament, School Adjustment, and Academic Achievement: A 2-Year Longitudinal Study of Children At-Risk

    ERIC Educational Resources Information Center

    Al-Hendawi, Maha

    2010-01-01

    Individual differences in temperament can be a risk or a protective factor for a child, especially for children at-risk who possess single or multiple risk factors that may interfere with their educational success and affect their healthy development and their life-long outcomes. This research study examined the concurrent and longitudinal…

  2. Recreational physical activity and leisure-time sitting in relation to postmenopausal breast cancer risk.

    PubMed

    Hildebrand, Janet S; Gapstur, Susan M; Campbell, Peter T; Gaudet, Mia M; Patel, Alpa V

    2013-10-01

    Epidemiologic evidence supports an inverse association between physical activity and postmenopausal breast cancer. Whether associations exist for moderate activities, such as walking, and whether associations differ by estrogen receptor (ER) status, body mass index (BMI, kg/m(2)), adult weight gain, or use of postmenopausal hormones (PMH) is unclear. The relation between time spent sitting and breast cancer also is unclear. Among 73,615 postmenopausal women in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, 4,760 women were diagnosed with breast cancer between 1992 and 2009. Extended Cox regression was used to estimate multivariable-adjusted relative risks (RR) of breast cancer in relation to total recreational physical activity, walking, and leisure-time sitting. Differences in associations by ER status, BMI, weight gain, and PMH use were also evaluated. The most active women (those reporting >42 MET-hours/week physical activity) experienced 25% lower risk of breast cancer than the least active [0-<7 MET-hours/week; 95% confidence interval (CI), 0.63-0.89; Ptrend = 0.01]. Forty-seven percent of women reported walking as their only recreational activity; among these women, a 14% lower risk was observed for ≥7 hours/week relative to ≤3 hours/week of walking (95% CI, 0.75-0.98). Associations did not differ by ER status, BMI, weight gain, or PMH use. Sitting time was not associated with risk. These results support an inverse association between physical activity and postmenopausal breast cancer that does not differ by ER status, BMI, weight gain, or PMH use. The finding of a lower risk associated with ≥7 hours/week of walking may be of public health interest.

  3. Same-Sex Peer Relations and Romantic Relationships during Early Adolescence: Interactive Links to Emotional, Behavioral, and Academic Adjustment.

    ERIC Educational Resources Information Center

    Brendgen, Mara; Vitaro, Frank; Doyle, Anna Beth; Markiewicz, Dorothy; Bukowski, William M.

    2002-01-01

    Examined the relationship between early adolescents' involvement in romantic relationships and their emotional, behavioral, and academic adjustment, depending on same-sex peer relationships. Found a negative relationship between romantic involvement and emotional and behavioral adjustment for adolescents who were unpopular with same-sex peers.…

  4. Sleep and Adjustment in Preschool Children: Sleep Diary Reports by Mothers Relate to Behavior Reports by Teachers.

    ERIC Educational Resources Information Center

    Bates, John E.; Viken, Richard J.; Alexander, Douglas B.; Beyers, Jennifer; Stockton, Lesley

    2002-01-01

    Investigated the relationship between sleep patterns and behavioral adjustment with 4- to 5-year-old children from low-income families. Found that disrupted child sleep patterns, including variability in parentally reported amount of sleep, variability in bedtime, and lateness of bedtime, predicted less optimal adjustment in preschool, even after…

  5. Heart disease and its related risk factors in Asian Indians.

    PubMed

    Uppaluri, Chitra R

    2002-01-01

    Although Asian Indians represent the second fastest growing Asian immigrant group in the United States, we know little about their increased risk for coronary artery disease (CAD). A key word search of Medline (using key words Asian Indian, South Asian Indian, coronary artery disease, and heart disease), from 1980-2001, was used to develop a database of articles relating to coronary artery disease for Asian Indians in the United States and abroad. We describe the prevalence and other data of CAD in Asian-Indian communities abroad and in the United States. We then outline certain risk factors for coronary artery disease, specifically diet, cholesterol, and Type 2 diabetes, which contribute to the increased risk of heart disease in Asian Indians. Finally, we describe an approach to screening and potential prevention of coronary artery disease in those of Asian-indian descent in this country.

  6. Early Developmental and Psychosocial Risks and Longitudinal Behavioral Adjustment Outcomes for Preschool-Age Girls Adopted from China

    ERIC Educational Resources Information Center

    Tan, Tony Xing; Marfo, Kofi; Dedrick, Robert F.

    2010-01-01

    The central goal of this longitudinal study was to examine behavioral adjustment outcomes in a sample of preschool-age adopted Chinese girls. Research examining the effects of institutional deprivation on post-adoption behavioral outcomes for internationally adopted children has been constrained by the frequent unavailability of data on the…

  7. Psychosocial Adjustment over a Two-Year Period in Children Referred for Learning Problems: Risk, Resilience, and Adaptation.

    ERIC Educational Resources Information Center

    Sorensen, Lisa G.; Forbes, Peter W.; Bernstein, Jane H.; Weiler, Michael D.; Mitchell, William M.; Waber, Deborah P.

    2003-01-01

    A 2-year study evaluated the relationship among psychosocial adjustment, changes in academic skills, and contextual factors in 100 children (ages 7-11) with learning problems. Contextual variables were significantly associated with psychosocial adaptation, including the effectiveness of the clinical assessment, extent of academic support, and the…

  8. Parental Dysphoria and Children's Adjustment: Marital Conflict Styles, Children's Emotional Security, and Parenting as Mediators of Risk

    ERIC Educational Resources Information Center

    Du Rocher Schudlich, Tina D.; Cummings, E. Mark

    2007-01-01

    Dimensions of martial conflict, children's emotional security regarding interparental conflict, and parenting style were examined as mediators between parental dysphoria and child adjustment. A community sample of 262 children, ages 8-16, participated with their parents. Behavioral observations were made of parents' interactions during marital…

  9. Assessing Changes in Socioemotional Adjustment across Early School Transitions--New National Scales for Children at Risk

    ERIC Educational Resources Information Center

    McDermott, Paul A.; Watkins, Marley W.; Rovine, Michael J.; Rikoon, Samuel H.

    2013-01-01

    This article reports the development and evidence for validity and application of the Adjustment Scales for Early Transition in Schooling (ASETS). Based on primary analyses of data from the Head Start Impact Study, a nationally representative sample (N = 3077) of randomly selected children from low-income households is configured to inform…

  10. Relative decompression risk of dry and wet chamber air dives.

    PubMed

    Weathersby, P K; Survanshi, S S; Nishi, R Y

    1990-07-01

    The difference in risk of decompression sickness (DCS) between dry chamber subjects and wet, working divers is unknown and a direct test of the difference would be large and expensive. We used probabilistic models and maximum likelihood estimation to examine 797 dry (and generally resting and comfortable) and 244 wet (and generally working and cold) chamber dives from the Defence and Civil Institute of Environmental Medicine, supplemented with 483 wet (working, cold) dives from the Navy Experimental Diving Unit. Several analyses considered whether dry and wet data were distinguishable using several models, whether models obtained from one set of exposure conditions would correctly predict the occurrence of DCS in the other condition, and whether a single wet-dry risk difference parameter was different from zero. Although the two conditions may not produce identical risks, immersion appears to change relative risk of DCS by less than 30% and certainly involves less than a doubling of DCS risk. Uncontrolled differences in exercise and temperature stresses unavoidably complicate interpretation. Several methods are presented to extrapolate results from dry-test subjects in decompression trials to expected at-sea performance.

  11. Selected Polymorphisms in Sex Hormone-Related Genes, Circulating Sex Hormones and Risk of Endometrial Cancer

    PubMed Central

    Lundin, Eva; Wirgin, Isaac; Lukanova, Annekatrin; Afanasyeva, Yelena; Krogh, Vittorio; Axelsson, Tomas; Hemminki, Kari; Clendenen, Tess V.; Arslan, Alan A.; Ohlson, Nina; Sieri, Sabina; Roy, Nirmal; Koenig, Karen L.; Idahl, Annika; Berrino, Franco; Toniolo, Paolo; Hallmans, Göran; Försti, Asta; Muti, Paola; Lenner, Per; Shore, Roy E.; Zeleniuch-Jacquotte, Anne

    2013-01-01

    Background The role of estrogen and progesterone in the development of endometrial cancer is well documented. Few studies have examined the association of genetic variants in sex hormone-related genes with endometrial cancer risk. Methods We conducted a case-control study nested within three cohorts to examine the association of endometrial cancer risk with polymorphisms in hormone-related genes among 391 cases (92% postmenopausal at diagnosis) and 712 individually-matched controls. We also examined the association of these polymorphisms with circulating levels of sex hormones and SHBG in a cross-sectional analysis including 596 healthy postmenopausal women at blood donation (controls from this nested case-control study and from a nested case-control study of breast cancer in one of the three cohorts). Results Adjusting for endometrial cancer risk factors, the A allele of rs4775936 in CYP19 was significantly associated (ORper allele = 1.22, 95% CI = 1.01–1.47, ptrend = 0.04), while the T allele of rs10046 was marginally associated with increased risk of endometrial cancer (ORper allele = 1.20, 95% CI = 0.99 – 1.45, ptrend = 0.06). PGR rs1042838 was also marginally associated with risk (ORper allele = 1.25, 95% CI = 0.96–1.61, ptrend = 0.09). No significant association was found for the other polymorphisms, i.e. CYP1B1 rs1800440 and rs1056836, UGT1A1 rs8175347, SHBG rs6259 and ESR1 rs2234693. Rs8175347 was significantly associated with postmenopausal levels of estradiol, free estradiol and estrone and rs6259 with SHBG and estradiol. Conclusion Our findings support an association between genetic variants in CYP19, and possibly PGR, and risk of endometrial cancer. PMID:22633539

  12. The Effect of HIV-Related Immunosuppression on the Risk of Tuberculosis Transmission to Household Contacts

    PubMed Central

    Huang, Chuan-Chin; Tchetgen, Eric Tchetgen; Becerra, Mercedes C.; Cohen, Ted; Hughes, Katherine C.; Zhang, Zibiao; Calderon, Roger; Yataco, Rosa; Contreras, Carmen; Galea, Jerome; Lecca, Leonid; Murray, Megan

    2014-01-01

    Background. Coinfection with human immunodeficiency virus (HIV) may modify the risk of transmitting tuberculosis. Some previous investigations suggest that patients coinfected with HIV and tuberculosis are less likely to transmit infection, whereas others do not support this conclusion. Here, we estimated the relative risk of tuberculosis transmission from coinfected patients compared to HIV-negative patients with tuberculosis. Methods. Between September 2009 and August 2012, we identified and enrolled 4841 household contacts of 1608 patients with drug-sensitive tuberculosis in Lima, Peru. We assessed the HIV status and CD4 counts of index patients, as well as other risk factors for infection specific to the index patient, the household, and the exposed individuals. Contacts underwent tuberculin skin testing to determine tuberculosis infection status. Results. After adjusting for covariates, we found that household contacts of HIV-infected tuberculosis patients with a CD4 count ≤250 cells/µL were less likely to be infected with tuberculosis (risk ratio = 0.49 [95% confidence interval, .24–.96]) than the contacts of HIV-negative tuberculosis patients. No children younger than 15 years who were exposed to HIV-positive patients with a CD4 count ≤250 cells/µL were infected with tuberculosis, compared to 22% of those exposed to non-HIV-infected patients. There was no significant difference in the risk of infection between contacts of HIV-infected index patients with CD4 counts >250 cells/µL and contacts of index patients who were not HIV-infected. Conclusions. We found a reduced risk of tuberculosis infection among the household contacts of patients with active tuberculosis who had advanced HIV-related immunosuppression, suggesting reduced transmission from these index patients. PMID:24368620

  13. Cardiovascular Risk Factors and Age-related Macular Degeneration: The Los Angeles Latino Eye Study

    PubMed Central

    Fraser-Bell, Samantha; Wu, Joanne; Klein, Ronald; Azen, Stanley P.; Hooper, Claire; Foong, Athena W. P.; Varma, Rohit

    2008-01-01

    Purpose To assess the association of cardiovascular risk factors, ocular perfusion pressure with early and advanced age-related macular degeneration (AMD) in Latinos. Design Population-based, cross-sectional study. Methods Data were collected from a population-based sample of self-identified adult Latinos using standardized protocols for assessing blood pressure and intraocular pressure (IOP) measurement and stereoscopic macular photography. Hypertension was defined as either a history of hypertension or systolic blood pressure (SBP) >140mmHg +/− diastolic blood pressure (DBP) ≥85mmHg. Ocular perfusion pressure (OPP) was defined as the difference between mean arterial blood pressure and IOP. AMD was diagnosed from photographic grading by masked trained graders. Logistic regression was used to assess associations. Results Gradable retinal photographs were available in 5875 participants. After adjusting for age, sex, and cigarette smoking, higher DBP and uncontrolled diastolic hypertension were associated with exudative AMD (Odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1−2.8; and OR, 3.3; CI, 1.2−9.3, respectively). Higher OPP was associated with a decreased risk of GA (OR, 0.4 per 10mmHg; CI, 0.3−0.5). Low pulse pressure was associated with a lower risk of exudative AMD (OR, 0.2; CI, 0.1−0.6). Obesity was associated with increased retinal pigment (OR, 1.6; CI, 1.0−2.3). Conclusion These data suggest that in Latinos cardiovascular risk factors may play a role in advanced AMD. Given that Latinos have a high prevalence of cardiovascular risk factors, an intervention aimed at reducing these risk factors may also have a beneficial impact on the risk of having early and advanced AMD. PMID:18222193

  14. Teacher-Student Relationships among Behaviorally At-Risk African American Youth from Low-Income Backgrounds: Student Perceptions, Teacher Perceptions, and Socioemotional Adjustment Correlates

    ERIC Educational Resources Information Center

    Murray, Christopher; Zvoch, Keith

    2011-01-01

    This investigation examines teacher-student relationships among African American youth from low-income backgrounds (N = 193). Students and their teachers completed measures of teacher-student relationship quality and measures pertaining to emotional, behavioral, and school-related adjustment. Results indicated that African American youth who fell…

  15. Educational Aspiration-Expectation Discrepancies: Relation to Socioeconomic and Academic Risk-Related Factors

    ERIC Educational Resources Information Center

    Boxer, Paul; Goldstein, Sara E.; DeLorenzo, Tahlia; Savoy, Sarah; Mercado, Ignacio

    2011-01-01

    This study examines whether disconnection between educational aspirations and expectations is associated with socioeconomic status, academic performance, academic risk-related behaviors and related psychosocial factors in an ethnically and economically diverse sample of early adolescents from a public middle school (N = 761). Results suggest that…

  16. Relative Risk Appraisal, the September 11 Attacks, and Terrorism-Related Fears

    PubMed Central

    Marshall, Randall D.; Bryant, Richard A.; Amsel, Lawrence; Suh, Eun Jung; Cook, Joan M.; Neria, Yuval

    2013-01-01

    There are now replicated findings that posttraumatic stress disorder (PTSD) symptoms related to the September 11, 2001, attacks occurred in large numbers of persons who did not fit the traditional definition of exposure to a traumatic event. These data are not explained by traditional epidemiologic “bull’s eye” disaster models, which assume the psychological effects are narrowly, geographically circumscribed, or by existing models of PTSD onset. In this article, the authors develop a researchable model to explain these and other terrorism-related phenomena by synthesizing research and concepts from the cognitive science, risk appraisal, traumatic stress, and anxiety disorders literatures. They propose the new term relative risk appraisal to capture the psychological function that is the missing link between the event and subjective response in these and other terrorism-related studies to date. Relative risk appraisal highlights the core notion from cognitive science that human perception is an active, multidimensional process, such that for unpredictable societal threats, proximity to the event is only one of several factors that influence behavioral responses. Addressing distortions in relative risk appraisal effectively could reduce individual and societal vulnerability to a wide range of adverse economic and ethnopolitical consequences to terrorist attacks. The authors present ways in which these concepts and related techniques can be helpful in treating persons with September 11– or terrorism-related distress or psychopathology. PMID:17516775

  17. Building-related risk factors and work-related lower respiratory symptoms in 80 office buildings

    SciTech Connect

    Mendell, M.J.; Naco, G.M.; Wilcox, T.G.; Sieber, W.K.

    2002-01-01

    We assessed building-related risk factors for lower respiratory symptoms in office workers. The National Institute for Occupational Safety and Health in 1993 collected data during indoor environmental health investigations of workplaces. We used multivariate logistic regression analyses to assess relationships between lower respiratory symptoms in office workers and risk factors plausibly related to microbiologic contamination. Among 2,435 occupants in 80 office buildings, frequent, work-related multiple lower respiratory symptoms were strongly associated, in multivariate models, with two risk factors for microbiologic contamination: poor pan drainage under cooling coils and debris in outside air intake. Associations tended to be stronger among those with a history of physician-diagnosed asthma. These findings suggest that adverse lower respiratory health effects from indoor work environments, although unusual, may occur in relation to poorly designed or maintained ventilation systems, particularly among previously diagnosed asthmatics. These findings require confirmation in more representative buildings.

  18. Adjustment of interaural time difference in head related transfer functions based on listeners' anthropometry and its effect on sound localization

    NASA Astrophysics Data System (ADS)

    Suzuki, Yôiti; Watanabe, Kanji; Iwaya, Yukio; Gyoba, Jiro; Takane, Shouichi

    2005-04-01

    Because the transfer functions governing subjective sound localization (HRTFs) show strong individuality, sound localization systems based on synthesis of HRTFs require suitable HRTFs for individual listeners. However, it is impractical to obtain HRTFs for all listeners based on measurements. Improving sound localization by adjusting non-individualized HRTFs to a specific listener based on that listener's anthropometry might be a practical method. This study first developed a new method to estimate interaural time differences (ITDs) using HRTFs. Then correlations between ITDs and anthropometric parameters were analyzed using the canonical correlation method. Results indicated that parameters relating to head size, and shoulder and ear positions are significant. Consequently, it was attempted to express ITDs based on listener's anthropometric data. In this process, the change of ITDs as a function of azimuth angle was parameterized as a sum of sine functions. Then the parameters were analyzed using multiple regression analysis, in which the anthropometric parameters were used as explanatory variables. The predicted or individualized ITDs were installed in the nonindividualized HRTFs to evaluate sound localization performance. Results showed that individualization of ITDs improved horizontal sound localization.

  19. Prospect relativity: how choice options influence decision under risk.

    PubMed

    Stewart, Neil; Chater, Nick; Stott, Henry P; Reimers, Stian

    2003-03-01

    In many theories of decision under risk (e.g., expected utility theory, rank-dependent utility theory, and prospect theory), the utility of a prospect is independent of other options in the choice set. The experiments presented here show a large effect of the available options, suggesting instead that prospects are valued relative to one another. The judged certainty equivalent for a prospect is strongly influenced by the options available. Similarly, the selection of a preferred prospect is strongly influenced by the prospects available. Alternative theories of decision under risk (e.g., the stochastic difference model, multialternative decision field theory, and range frequency theory), where prospects are valued relative to one another, can provide an account of these context effects.

  20. Relative deprivation and risk factors for obesity in Canadian adolescents.

    PubMed

    Elgar, Frank J; Xie, Annie; Pförtner, Timo-Kolja; White, James; Pickett, Kate E

    2016-03-01

    Research on socioeconomic differences in overweight and obesity and on the ecological association between income inequality and obesity prevalence suggests that relative deprivation may contribute to lifestyle risk factors for obesity independently of absolute affluence. We tested this hypothesis using data on 25,980 adolescents (11-15 years) in the 2010 Canadian Health Behaviour in School-aged Children (HBSC) study. The Yitzhaki index of relative deprivation was applied to the HBSC Family Affluence Scale, an index of common material assets, with more affluent schoolmates representing the comparative reference group. Regression analysis tested the associations between relative deprivation and four obesity risk factors (skipping breakfasts, physical activity, and healthful and unhealthful food choices) plus dietary restraint. Relative deprivation uniquely related to skipping breakfasts, less physical activity, fewer healthful food choices (e.g., fruits, vegetables, whole grain breads), and a lower likelihood of dieting to lose weight. Consistent with Runciman's (1966) theory of relative deprivation and with psychosocial interpretations of the health consequences of income inequality, the results indicate that having mostly better off schoolmates can contribute to poorer health behaviours independently of school-level affluence and subjective social status. We discuss the implications of these findings for understanding the social origins of obesity and targeting health interventions.

  1. Elevated uric acid and obesity-related cardiovascular disease risk factors among hypertensive youth

    PubMed Central

    Reschke, Lauren D.; Miller, Edgar R.; Fadrowski, Jeffrey J.; Loeffler, Lauren F.; Holmes, Kathryn W.; Appel, Lawrence J.; Brady, Tammy M.

    2015-01-01

    Background Uric acid (UA) is associated with high blood pressure in adolescents and left ventricular hypertrophy (LVH) and cardiovascular disease (CVD) in adults. We sought to determine if UA is independently associated with CVD risk factors and left ventricular mass (LVM) over time in hypertensive youth. Methods One-year prospective observational study of hypertensive children aged 3-19 years. Cross-sectional and longitudinal associations of serum UA with CVD risk factors and LVM were explored. Results At baseline: mean age 13.8 years, mean UA 5.5 mg/dL, 24 % with elevated UA, 51 % overweight/obese, and 39 % with LVH. Measures of adiposity, low high-density lipoprotein cholesterol, high-sensitivity CRP, LVM and LVH were all significantly associated with elevated UA at baseline, but not with change over time. Each 1 mg/dL increase in baseline UA was associated with 2.5 g/m2.7 greater LVM index at follow-up (95% CI 0.64, 4.39; p=0.01); after adjustment for age, sex, race, body mass index z-score, change in UA, time, BP and medication use, this association was no longer significant. Conclusions Hypertensive children with elevated UA have a higher prevalence of obesity-related CVD risk factors. Among hypertensive children, UA may be a marker of adiposity and not an independent CVD risk factor. PMID:26135139

  2. Children's intellectual and emotional-behavioral adjustment at 4 years as a function of cocaine exposure, maternal characteristics, and environmental risk.

    PubMed

    Bennett, David S; Bendersky, Margaret; Lewis, Michael

    2002-09-01

    The authors examined 223 children at age 4 years for the effects of prenatal cocaine exposure, exposure to other substances, maternal and environmental risk factors, and neonatal medical problems on IQ, externalizing problems, and internalizing problems. Regression analyses showed that maternal verbal IQ and low environmental risk predicted child IQ. Cocaine exposure negatively predicted children's overall IQ and verbal reasoning scores, but only for boys. Cocaine exposure also predicted poorer short-term memory. Maternal harsh discipline, maternal depressive symptoms, and increased environmental risk predicted externalizing problems. In contrast, only maternal depressive symptoms predicted internalizing problems. These findings indicate that early exposure to substances is largely unrelated to subsequent IQ or adjustment, particularly for girls.

  3. Relative risk for concussions in young female soccer players.

    PubMed

    Strand, Sarah; Lechuga, David; Zachariah, Thomas; Beaulieu, Kathryn

    2015-01-01

    The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p < .001, α = .05, CI = 95%). This demonstrates that the relative risk of probable concussions in young female soccer players is significantly higher than in a control group of nonsoccer players of the same sex and age.

  4. Increased Waist-to-height Ratio May Contribute to Age-related Increase in Cardiovascular Risk Factors

    PubMed Central

    Akhlaghi, Masoumeh; Kamali, Majid; Dastsouz, Farideh; Sadeghi, Fatemeh; Amanat, Sassan

    2016-01-01

    Background: The risk of cardiovascular diseases (CVDs) increases with age. The objective was to determine whether lifestyle and dietary behaviors and anthropometric measures, which are affected by these behaviors, contribute to the increase of CVD risk factors across age categories of 20–50-year-old. Methods: In a cross-sectional design, 437 adults aged 20–50-year-old were selected from households living in Shiraz. Risk factors of CVD, including body mass index (BMI), waist-to-height ratio (WHtR), blood pressure, fasting blood glucose (FBG), serum triglycerides, total cholesterol, and low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) as well as lifestyle behaviors (physical activity and smoking), dietary habits, and food intakes were assessed across the age categories of 20–29, 30–39, and 40–50 years. Linear regression was used to examine the contribution of different variables to the age-related increase of CVD risk factors. Results: All CVD risk factors, except for HDL-C, significantly increased across age categories. Older subjects had healthier dietary habits and food intakes, but they possessed nonsignificantly lower physical activity and higher smoking rate compared to younger adults. Adjusting for physical activity, smoking, and BMI did not change the significant positive association between age and CVD risk factors but adjusting for WHtR disappeared associations for blood pressure, triglycerides, and metabolic syndrome although significant associations remained for FBG and total and LDL-C. Conclusions: Age-related increase of CVD risk factors occurred independent of lifestyle habits. WHtR, but not BMI, may partially contribute to the age-related increase in CVD risk factors. PMID:27195100

  5. Increased Risk of Pancreatic Cancer Related to Gallstones and Cholecystectomy: A Systematic Review and Meta-Analysis.

    PubMed

    Fan, Yonggang; Hu, Jie; Feng, Bing; Wang, Wei; Yao, Guoliang; Zhai, Jingming; Li, Xin

    2016-04-01

    To investigate the potential roles of gallstones and cholecystectomy in pancreatic carcinogenesis, we performed the first meta-analysis of all currently published studies by pooling relative risks (RRs) with 95% confidence intervals (95% CIs). Stratified analysis by ethnicity, study design, and common adjusted factors were also conducted. Individuals with a history of gallstones and cholecystectomy were at increased risk of pancreatic cancer (RR, 1.39; 95% CI, 1.28-1.52; P < 0.001). Gallstones and cholecystectomy were also associated with an elevated risk of pancreatic cancer, respectively (for gallstones: RR, 1.70; 95% CI, 1.30-2.21; P < 0.001; for cholecystectomy: RR, 1.31; 95% CI, 1.19-1.43; P < 0.001). The positive association is observed among not only the Asian population but also whites. The pooled findings were further confirmed by sensitivity analysis and stratified analyses in case-control and cohort studies. Stratified analyses by different adjusted factors further showed that the increased risk of pancreatic cancer was independent of confounders including diabetes, obesity, smoking, and follow-up years of postcholecystectomy. A history of gallstones and cholecystectomy is a robust risk factor for pancreatic cancer. Gallstone disease or cholecystectomy alone is also an independent risk factor for pancreatic carcinogenesis.

  6. Using risk analysis in Health Impact Assessment: the impact of different relative risks for men and women in different socio-economic groups.

    PubMed

    Nilunger, Louise; Diderichsen, Finn; Burström, Bo; Ostlin, Piroska

    2004-02-01

    The aim of this study is to contribute to the emerging field of quantification of Health Impact Assessment (HIA), by analysing how different relative risks affect the burden of disease for various socio-economic groups (SES). Risk analysis, utilising attributable and impact fraction, raises several methodological considerations. The present study illustrates this by measuring the impact of changed distribution levels of smoking on lung cancer, ischemic heart disease (IHD), chronic obstructive lung disorder (COLD) and stroke for the highest and lowest socio-economic groups measured in disability adjusted life years (DALY). The material is based on relative risks obtained from various international studies, smoking prevalence (SP) data and the number of DALY based on data available for Sweden. The results show that if smoking would have been eliminated (attributable fraction, AF), the inequality between the highest and lowest socio-economic groups may decrease by 75% or increase by 21% depending on the size of the relative risk. Assuming the same smoking prevalence for the lowest socio-economic group as for the highest (impact fraction), then the inequality may decrease by 7-26%. Consequently, the size of the relative risk used may have a significant impact, leading to substantial biases and therefore should be taken into serious consideration in HIA.

  7. Illegal pedestrian crossing at signalised intersections: incidence and relative risk.

    PubMed

    King, Mark J; Soole, David; Ghafourian, Ameneh

    2009-05-01

    Illegal pedestrian behaviour is common and is reported as a factor in many pedestrian crashes. Since walking is being promoted for its health and environmental benefits, minimisation of its associated risks is of interest. The risk associated with illegal road crossing is unclear, and better information would assist in setting a rationale for enforcement and priorities for public education. An observation survey of pedestrian behaviour was conducted at signalised intersections in the Brisbane CBD (Queensland, Australia) on typical workdays, using behavioural categories that were identifiable in police crash reports. The survey confirmed high levels of crossing against the lights, or close enough to the lights that they should legally have been used. Measures of exposure for crossing legally, against the lights, and close to the lights were generated by weighting the observation data. Relative risk ratios were calculated for these categories using crash data from the observation sites and adjacent midblocks. Crossing against the lights and crossing close to the lights both exhibited a crash risk per crossing event approximately eight times that of legal crossing at signalised intersections. The implications of these results for enforcement and education are discussed, along with the limitations of the study.

  8. Relative radiological risks derived from different TENORM wastes in Malaysia.

    PubMed

    Ismail, B; Teng, I L; Muhammad Samudi, Y

    2011-11-01

    In Malaysia technologically enhanced naturally occurring radioactive materials (TENORM) wastes are mainly the product of the oil and gas industry and mineral processing. Among these TENORM wastes are tin tailing, tin slag, gypsum and oil sludge. Mineral processing and oil and gas industries produce large volume of TENORM wastes that has become a radiological concern to the authorities. A study was carried out to assess the radiological risk related to workers working at these disposal sites and landfills as well as to the members of the public should these areas be developed for future land use. Radiological risk was assessed based on the magnitude of radiation hazard, effective dose rates and excess cancer risks. Effective dose rates and excess cancer risks were estimated using RESRAD 6.4 computer code. All data on the activity concentrations of NORM in wastes and sludges used in this study were obtained from the Atomic Energy Licensing Board, Malaysia, and they were collected over a period of between 5 and 10 y. Results obtained showed that there was a wide range in the total activity concentrations (TAC) of nuclides in the TENORM wastes. With the exception of tin slag and tin tailing-based TENORM wastes, all other TENORM wastes have TAC values comparable to that of Malaysia's soil. Occupational Effective Dose Rates estimated in all landfill areas were lower than the 20 mSv y(-1) permissible dose limit. The average Excess Cancer Risk Coefficient was estimated to be 2.77×10(-3) risk per mSv. The effective dose rates for residents living on gypsum and oil sludge-based TENORM wastes landfills were estimated to be lower than the permissible dose limit for members of the public, and was also comparable to that of the average Malaysia's ordinary soils. The average excess cancer risk coefficient was estimated to be 3.19×10(-3) risk per mSv. Results obtained suggest that gypsum and oil sludge-based TENORM wastes should be exempted from any radiological regulatory

  9. Immediate Postoperative Intraocular Pressure Adjustment Reduces Risk of Cystoid Macular Edema after Uncomplicated Micro Incision Coaxial Phacoemulsification Cataract Surgery

    PubMed Central

    Jarstad, Allison R.; Chung, Gary W.; Tester, Robert A.; Day, Linda E.

    2017-01-01

    Purpose To determine the accuracy of visual estimation of immediate postoperative intraocular pressure (IOP) following microincision cataract surgery (MICS) and the effect of immediate postoperative IOP adjustment on prevention of cystoid macular edema (CME). Setting Ambulatory surgical center. Methods Prospective, randomized analysis of 170 eyes in 135 patients with MICS, performed in a Medicare approved outpatient ambulatory surgery center. Surgical parameters included a keratome incision of 1.5 mm to 2.8 mm, topical anesthetic, case completion IOP estimation by palpation and patient visualization of light, and IOP adjustment before exiting the operating theater. IOPs were classified into three groups: low (<16 mmHg), normal (16 to 21 mmHg), and elevated (>21 to 30 mmHg). IOP measurements were repeated 1 day after surgery. Optical coherence tomography (Stratus OCT, Zeiss) was measured at 2 weeks. An increase in foveal thickness greater than 15 µm was used to indicate CME. Statistical analysis was performed using one- and two-tailed Student's t-tests. Results Mean minimal foveal thickness averaged 207.15 µm in the low pressure group, 205.14 µm in the normal IOP group, and 210.48 µm in the elevated IOP group 2 weeks following surgery. CME occurred in 14 of 170 eyes (8.2%) at 2 weeks (low IOP, 35.7%; normal IOP, 14.2%; elevated IOP, 50.0%). Change in IOP from the operating theater to 1 day after surgery was within +/−5 mmHg in 54 eyes (31.7%), elevated by 6 to 15 mmHg in 22 eyes (12.9%), and elevated more than 15 mmHg in four eyes (2.3%). IOP was reduced by 6 mmHg to 15 mmHg in 39 eyes (22.9%) and reduced by more than 15 mmHg in nine eyes (5.3%). Conclusions Immediate postoperative adjustment of IOP may prevent CME in MICS. Physicians can improve their ability to estimate postoperative IOP with experience in tonometry to verify immediate postoperative IOP. There are patient safety and economic benefits to immediate IOP adjustment in the operating theater

  10. Meat, fish and fat intake in relation to subsite-specific risk of colorectal cancer: The Fukuoka Colorectal Cancer Study.

    PubMed

    Kimura, Yasumi; Kono, Suminori; Toyomura, Kengo; Nagano, Jun; Mizoue, Tetsuya; Moore, Malcolm A; Mibu, Ryuichi; Tanaka, Masao; Kakeji, Yoshihiro; Maehara, Yoshihiko; Okamura, Takeshi; Ikejiri, Koji; Futami, Kitaroh; Yasunami, Yohichi; Maekawa, Takafumi; Takenaka, Kenji; Ichimiya, Hitoshi; Imaizumi, Nobutoshi

    2007-04-01

    High intake of red meat has been associated with increased risk of colorectal cancer in Western countries. There has been much interest in the role of n-3 polyunsaturated fatty acids (PUFA) in colorectal cancer prevention, but epidemiological findings are limited and inconsistent. The objective of our study was to examine associations of meat, fish and fat intake with risk of colorectal cancer, paying particular attention to the subsite within the colorectum. Data were from the Fukuoka Colorectal Cancer Study, a population-based case-control study, covering 782 cases and 793 controls. Diet was assessed by interview, using newly developed personal-computer software for registering semiquantitative food frequencies. The intake of beef/pork, processed meat, total fat, saturated fat or n-6 PUFA showed no clear association with the overall or subsite-specific risk of colorectal cancer. There was an almost significant inverse association between n-3 PUFA and the risk of colorectal cancer; the covariate-adjusted odds ratio for the highest (median 3.94 g/day) versus lowest (median 1.99 g/day) quintile of energy-adjusted intake was 0.74 (95% confidence interval 0.52-1.06, trend P=0.050). The consumption of fish and fish products was similarly inversely related to the risk although the association was not statistically significant. These associations were more evident for distal colon cancer; adjusted odds ratio for the highest versus lowest quintile of n-3 PUFA intake was 0.56 (95% confidence interval 0.34-0.92, trend P=0.02). Our findings do not support the hypothesis that consumption of red meat increases colorectal cancer risk but do suggest that high intake of fish may decrease the risk, particularly of distal colon cancer.

  11. How Elephant Seals (Mirounga leonina) Adjust Their Fine Scale Horizontal Movement and Diving Behaviour in Relation to Prey Encounter Rate

    PubMed Central

    Jouma’a, Joffrey; Picard, Baptiste; Guinet, Christophe

    2016-01-01

    Understanding the diving behaviour of diving predators in relation to concomitant prey distribution could have major practical applications in conservation biology by allowing the assessment of how changes in fine scale prey distribution impact foraging efficiency and ultimately population dynamics. The southern elephant seal (Mirounga leonina, hereafter SES), the largest phocid, is a major predator of the southern ocean feeding on myctophids and cephalopods. Because of its large size it can carry bio-loggers with minimal disturbance. Moreover, it has great diving abilities and a wide foraging habitat. Thus, the SES is a well suited model species to study predator diving behaviour and the distribution of ecologically important prey species in the Southern Ocean. In this study, we examined how SESs adjust their diving behaviour and horizontal movements in response to fine scale prey encounter densities using high resolution accelerometers, magnetometers, pressure sensors and GPS loggers. When high prey encounter rates were encountered, animals responded by (1) diving and returning to the surface with steeper angles, reducing the duration of transit dive phases (thus improving dive efficiency), and (2) exhibiting more horizontally and vertically sinuous bottom phases. In these cases, the distance travelled horizontally at the surface was reduced. This behaviour is likely to counteract horizontal displacement from water currents, as they try to remain within favourable prey patches. The prey encounter rate at the bottom of dives decreased with increasing diving depth, suggesting a combined effect of decreased accessibility and prey density with increasing depth. Prey encounter rate also decreased when the bottom phases of dives were spread across larger vertical extents of the water column. This result suggests that the vertical aggregation of prey can regulate prey density, and as a consequence impact the foraging success of SESs. To our knowledge, this is one of

  12. Availability of High Quality TRMM Ground Validation Data from Kwajalein, RMI: A Practical Application of the Relative Calibration Adjustment Technique

    NASA Technical Reports Server (NTRS)

    Marks, David A.; Wolff, David B.; Silberstein, David S.; Tokay, Ali; Pippitt, Jason L.; Wang, Jianxin

    2008-01-01

    Since the Tropical Rainfall Measuring Mission (TRMM) satellite launch in November 1997, the TRMM Satellite Validation Office (TSVO) at NASA Goddard Space Flight Center (GSFC) has been performing quality control and estimating rainfall from the KPOL S-band radar at Kwajalein, Republic of the Marshall Islands. Over this period, KPOL has incurred many episodes of calibration and antenna pointing angle uncertainty. To address these issues, the TSVO has applied the Relative Calibration Adjustment (RCA) technique to eight years of KPOL radar data to produce Ground Validation (GV) Version 7 products. This application has significantly improved stability in KPOL reflectivity distributions needed for Probability Matching Method (PMM) rain rate estimation and for comparisons to the TRMM Precipitation Radar (PR). In years with significant calibration and angle corrections, the statistical improvement in PMM distributions is dramatic. The intent of this paper is to show improved stability in corrected KPOL reflectivity distributions by using the PR as a stable reference. Inter-month fluctuations in mean reflectivity differences between the PR and corrected KPOL are on the order of 1-2 dB, and inter-year mean reflectivity differences fluctuate by approximately 1 dB. This represents a marked improvement in stability with confidence comparable to the established calibration and uncertainty boundaries of the PR. The practical application of the RCA method has salvaged eight years of radar data that would have otherwise been unusable, and has made possible a high-quality database of tropical ocean-based reflectivity measurements and precipitation estimates for the research community.

  13. Relative Importance and Additive Effects of Maternal and Infant Risk Factors on Childhood Asthma

    PubMed Central

    Rosas-Salazar, Christian; James, Kristina; Escobar, Gabriel; Gebretsadik, Tebeb; Li, Sherian Xu; Carroll, Kecia N.; Walsh, Eileen; Mitchel, Edward; Das, Suman; Kumar, Rajesh; Yu, Chang; Dupont, William D.; Hartert, Tina V.

    2016-01-01

    Background Environmental exposures that occur in utero and during early life may contribute to the development of childhood asthma through alteration of the human microbiome. The objectives of this study were to estimate the cumulative effect and relative importance of environmental exposures on the risk of childhood asthma. Methods We conducted a population-based birth cohort study of mother-child dyads who were born between 1995 and 2003 and were continuously enrolled in the PRIMA (Prevention of RSV: Impact on Morbidity and Asthma) cohort. The individual and cumulative impact of maternal urinary tract infections (UTI) during pregnancy, maternal colonization with group B streptococcus (GBS), mode of delivery, infant antibiotic use, and older siblings at home, on the risk of childhood asthma were estimated using logistic regression. Dose-response effect on childhood asthma risk was assessed for continuous risk factors: number of maternal UTIs during pregnancy, courses of infant antibiotics, and number of older siblings at home. We further assessed and compared the relative importance of these exposures on the asthma risk. In a subgroup of children for whom maternal antibiotic use during pregnancy information was available, the effect of maternal antibiotic use on the risk of childhood asthma was estimated. Results Among 136,098 singleton birth infants, 13.29% developed asthma. In both univariate and adjusted analyses, maternal UTI during pregnancy (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.18, 1.25; adjusted OR [AOR] 1.04, 95%CI 1.02, 1.07 for every additional UTI) and infant antibiotic use (OR 1.21, 95%CI 1.20, 1.22; AOR 1.16, 95%CI 1.15, 1.17 for every additional course) were associated with an increased risk of childhood asthma, while having older siblings at home (OR 0.92, 95%CI 0.91, 0.93; AOR 0.85, 95%CI 0.84, 0.87 for each additional sibling) was associated with a decreased risk of childhood asthma, in a dose-dependent manner. Compared with vaginal

  14. The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers

    PubMed Central

    2013-01-01

    musculoskeletal symptoms. Conclusion This study focused on structural risk factors in the working environment, such as the gender-based division of labor, shift work and labor intensity, that demonstrated a statistically significant correlation with the work-related musculoskeletal symptoms of hotel workers. Both men and women reported different prevalence rates of work-related musculoskeletal symptoms among different departments. This could indicate that a gender-based division of labor produces different ergonomic risk factors for each gender group. However, only females displayed a statistically significant correlation between shift work and labor intensity and musculoskeletal symptoms. Thus, minimizing ergonomic risk factors alone does not suffice to effectively prevent musculoskeletal diseases among hotel workers. Instead, work assignments should be based on gender, department, working hours and work intensity should be adjusted to address multi-dimensional musculoskeletal risk factors. In addition, an approach that seeks to minimize shift work is needed to reduce the incidence of musculoskeletal disorders. PMID:24472690

  15. MicroRNA related polymorphisms and breast cancer risk.

    PubMed

    Khan, Sofia; Greco, Dario; Michailidou, Kyriaki; Milne, Roger L; Muranen, Taru A; Heikkinen, Tuomas; Aaltonen, Kirsimari; Dennis, Joe; Bolla, Manjeet K; Liu, Jianjun; Hall, Per; Irwanto, Astrid; Humphreys, Keith; Li, Jingmei; Czene, Kamila; Chang-Claude, Jenny; Hein, Rebecca; Rudolph, Anja; Seibold, Petra; Flesch-Janys, Dieter; Fletcher, Olivia; Peto, Julian; dos Santos Silva, Isabel; Johnson, Nichola; Gibson, Lorna; Aitken, Zoe; Hopper, John L; Tsimiklis, Helen; Bui, Minh; Makalic, Enes; Schmidt, Daniel F; Southey, Melissa C; Apicella, Carmel; Stone, Jennifer; Waisfisz, Quinten; Meijers-Heijboer, Hanne; Adank, Muriel A; van der Luijt, Rob B; Meindl, Alfons; Schmutzler, Rita K; Müller-Myhsok, Bertram; Lichtner, Peter; Turnbull, Clare; Rahman, Nazneen; Chanock, Stephen J; Hunter, David J; Cox, Angela; Cross, Simon S; Reed, Malcolm W R; Schmidt, Marjanka K; Broeks, Annegien; Van't Veer, Laura J; Hogervorst, Frans B; Fasching, Peter A; Schrauder, Michael G; Ekici, Arif B; Beckmann, Matthias W; Bojesen, Stig E; Nordestgaard, Børge G; Nielsen, Sune F; Flyger, Henrik; Benitez, Javier; Zamora, Pilar M; Perez, Jose I A; Haiman, Christopher A; Henderson, Brian E; Schumacher, Fredrick; Le Marchand, Loic; Pharoah, Paul D P; Dunning, Alison M; Shah, Mitul; Luben, Robert; Brown, Judith; Couch, Fergus J; Wang, Xianshu; Vachon, Celine; Olson, Janet E; Lambrechts, Diether; Moisse, Matthieu; Paridaens, Robert; Christiaens, Marie-Rose; Guénel, Pascal; Truong, Thérèse; Laurent-Puig, Pierre; Mulot, Claire; Marme, Frederick; Burwinkel, Barbara; Schneeweiss, Andreas; Sohn, Christof; Sawyer, Elinor J; Tomlinson, Ian; Kerin, Michael J; Miller, Nicola; Andrulis, Irene L; Knight, Julia A; Tchatchou, Sandrine; Mulligan, Anna Marie; Dörk, Thilo; Bogdanova, Natalia V; Antonenkova, Natalia N; Anton-Culver, Hoda; Darabi, Hatef; Eriksson, Mikael; Garcia-Closas, Montserrat; Figueroa, Jonine; Lissowska, Jolanta; Brinton, Louise; Devilee, Peter; Tollenaar, Robert A E M; Seynaeve, Caroline; van Asperen, Christi J; Kristensen, Vessela N; Slager, Susan; Toland, Amanda E; Ambrosone, Christine B; Yannoukakos, Drakoulis; Lindblom, Annika; Margolin, Sara; Radice, Paolo; Peterlongo, Paolo; Barile, Monica; Mariani, Paolo; Hooning, Maartje J; Martens, John W M; Collée, J Margriet; Jager, Agnes; Jakubowska, Anna; Lubinski, Jan; Jaworska-Bieniek, Katarzyna; Durda, Katarzyna; Giles, Graham G; McLean, Catriona; Brauch, Hiltrud; Brüning, Thomas; Ko, Yon-Dschun; Brenner, Hermann; Dieffenbach, Aida Karina; Arndt, Volker; Stegmaier, Christa; Swerdlow, Anthony; Ashworth, Alan; Orr, Nick; Jones, Michael; Simard, Jacques; Goldberg, Mark S; Labrèche, France; Dumont, Martine; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M; Mannermaa, Arto; Hamann, Ute; Chenevix-Trench, Georgia; Blomqvist, Carl; Aittomäki, Kristiina; Easton, Douglas F; Nevanlinna, Heli

    2014-01-01

    Genetic variations, such as single nucleotide polymorphisms (SNPs) in microRNAs (miRNA) or in the miRNA binding sites may affect the miRNA dependent gene expression regulation, which has been implicated in various cancers, including breast cancer, and may alter individual susceptibility to cancer. We investigated associations between miRNA related SNPs and breast cancer risk. First we evaluated 2,196 SNPs in a case-control study combining nine genome wide association studies (GWAS). Second, we further investigated 42 SNPs with suggestive evidence for association using 41,785 cases and 41,880 controls from 41 studies included in the Breast Cancer Association Consortium (BCAC). Combining the GWAS and BCAC data within a meta-analysis, we estimated main effects on breast cancer risk as well as risks for estrogen receptor (ER) and age defined subgroups. Five miRNA binding site SNPs associated significantly with breast cancer risk: rs1045494 (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.88-0.96), rs1052532 (OR 0.97; 95% CI: 0.95-0.99), rs10719 (OR 0.97; 95% CI: 0.94-0.99), rs4687554 (OR 0.97; 95% CI: 0.95-0.99, and rs3134615 (OR 1.03; 95% CI: 1.01-1.05) located in the 3' UTR of CASP8, HDDC3, DROSHA, MUSTN1, and MYCL1, respectively. DROSHA belongs to miRNA machinery genes and has a central role in initial miRNA processing. The remaining genes are involved in different molecular functions, including apoptosis and gene expression regulation. Further studies are warranted to elucidate whether the miRNA binding site SNPs are the causative variants for the observed risk effects.

  16. MicroRNA Related Polymorphisms and Breast Cancer Risk

    PubMed Central

    Khan, Sofia; Greco, Dario; Michailidou, Kyriaki; Milne, Roger L.; Muranen, Taru A.; Heikkinen, Tuomas; Aaltonen, Kirsimari; Dennis, Joe; Bolla, Manjeet K.; Liu, Jianjun; Hall, Per; Irwanto, Astrid; Humphreys, Keith; Li, Jingmei; Czene, Kamila; Chang-Claude, Jenny; Hein, Rebecca; Rudolph, Anja; Seibold, Petra; Flesch-Janys, Dieter; Fletcher, Olivia; Peto, Julian; dos Santos Silva, Isabel; Johnson, Nichola; Gibson, Lorna; Aitken, Zoe; Hopper, John L.; Tsimiklis, Helen; Bui, Minh; Makalic, Enes; Schmidt, Daniel F.; Southey, Melissa C.; Apicella, Carmel; Stone, Jennifer; Waisfisz, Quinten; Meijers-Heijboer, Hanne; Adank, Muriel A.; van der Luijt, Rob B.; Meindl, Alfons; Schmutzler, Rita K.; Müller-Myhsok, Bertram; Lichtner, Peter; Turnbull, Clare; Rahman, Nazneen; Chanock, Stephen J.; Hunter, David J.; Cox, Angela; Cross, Simon S.; Reed, Malcolm W. R.; Schmidt, Marjanka K.; Broeks, Annegien; Veer, Laura J. V. a. n't.; Hogervorst, Frans B.; Fasching, Peter A.; Schrauder, Michael G.; Ekici, Arif B.; Beckmann, Matthias W.; Bojesen, Stig E.; Nordestgaard, Børge G.; Nielsen, Sune F.; Flyger, Henrik; Benitez, Javier; Zamora, Pilar M.; Perez, Jose I. A.; Haiman, Christopher A.; Henderson, Brian E.; Schumacher, Fredrick; Le Marchand, Loic; Pharoah, Paul D. P.; Dunning, Alison M.; Shah, Mitul; Luben, Robert; Brown, Judith; Couch, Fergus J.; Wang, Xianshu; Vachon, Celine; Olson, Janet E.; Lambrechts, Diether; Moisse, Matthieu; Paridaens, Robert; Christiaens, Marie-Rose; Guénel, Pascal; Truong, Thérèse; Laurent-Puig, Pierre; Mulot, Claire; Marme, Frederick; Burwinkel, Barbara; Schneeweiss, Andreas; Sohn, Christof; Sawyer, Elinor J.; Tomlinson, Ian; Kerin, Michael J.; Miller, Nicola; Andrulis, Irene L.; Knight, Julia A.; Tchatchou, Sandrine; Mulligan, Anna Marie; Dörk, Thilo; Bogdanova, Natalia V.; Antonenkova, Natalia N.; Anton-Culver, Hoda; Darabi, Hatef; Eriksson, Mikael; Garcia-Closas, Montserrat; Figueroa, Jonine; Lissowska, Jolanta; Brinton, Louise; Devilee, Peter; Tollenaar, Robert A. E. M.; Seynaeve, Caroline; van Asperen, Christi J.; Kristensen, Vessela N.; Slager, Susan; Toland, Amanda E.; Ambrosone, Christine B.; Yannoukakos, Drakoulis; Lindblom, Annika; Margolin, Sara; Radice, Paolo; Peterlongo, Paolo; Barile, Monica; Mariani, Paolo; Hooning, Maartje J.; Martens, John W. M.; Collée, J. Margriet; Jager, Agnes; Jakubowska, Anna; Lubinski, Jan; Jaworska-Bieniek, Katarzyna; Durda, Katarzyna; Giles, Graham G.; McLean, Catriona; Brauch, Hiltrud; Brüning, Thomas; Ko, Yon-Dschun; Brenner, Hermann; Dieffenbach, Aida Karina; Arndt, Volker; Stegmaier, Christa; Swerdlow, Anthony; Ashworth, Alan; Orr, Nick; Jones, Michael; Simard, Jacques; Goldberg, Mark S.; Labrèche, France; Dumont, Martine; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M.; Mannermaa, Arto; Hamann, Ute; Chenevix-Trench, Georgia; Blomqvist, Carl; Aittomäki, Kristiina; Easton, Douglas F.; Nevanlinna, Heli

    2014-01-01

    Genetic variations, such as single nucleotide polymorphisms (SNPs) in microRNAs (miRNA) or in the miRNA binding sites may affect the miRNA dependent gene expression regulation, which has been implicated in various cancers, including breast cancer, and may alter individual susceptibility to cancer. We investigated associations between miRNA related SNPs and breast cancer risk. First we evaluated 2,196 SNPs in a case-control study combining nine genome wide association studies (GWAS). Second, we further investigated 42 SNPs with suggestive evidence for association using 41,785 cases and 41,880 controls from 41 studies included in the Breast Cancer Association Consortium (BCAC). Combining the GWAS and BCAC data within a meta-analysis, we estimated main effects on breast cancer risk as well as risks for estrogen receptor (ER) and age defined subgroups. Five miRNA binding site SNPs associated significantly with breast cancer risk: rs1045494 (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.88–0.96), rs1052532 (OR 0.97; 95% CI: 0.95–0.99), rs10719 (OR 0.97; 95% CI: 0.94–0.99), rs4687554 (OR 0.97; 95% CI: 0.95–0.99, and rs3134615 (OR 1.03; 95% CI: 1.01–1.05) located in the 3′ UTR of CASP8, HDDC3, DROSHA, MUSTN1, and MYCL1, respectively. DROSHA belongs to miRNA machinery genes and has a central role in initial miRNA processing. The remaining genes are involved in different molecular functions, including apoptosis and gene expression regulation. Further studies are warranted to elucidate whether the miRNA binding site SNPs are the causative variants for the observed risk effects. PMID:25390939

  17. Prediagnostic Sex Steroid Hormones in Relation to Male Breast Cancer Risk

    PubMed Central

    Brinton, Louise A.; Key, Tim J.; Kolonel, Laurence N.; Michels, Karin B.; Sesso, Howard D.; Ursin, Giske; Van Den Eeden, Stephen K.; Wood, Shannon N.; Falk, Roni T.; Parisi, Dominick; Guillemette, Chantal; Caron, Patrick; Turcotte, Véronique; Habel, Laurel A.; Isaacs, Claudine J.; Riboli, Elio; Weiderpass, Elisabete; Cook, Michael B.

    2015-01-01

    Purpose Although previous studies have implicated a variety of hormone-related risk factors in the etiology of male breast cancers, no previous studies have examined the effects of endogenous hormones. Patients and Methods Within the Male Breast Cancer Pooling Project, an international consortium comprising 21 case-control and cohort investigations, a subset of seven prospective cohort studies were able to contribute prediagnostic serum or plasma samples for hormone quantitation. Using a nested case-control design, multivariable unconditional logistic regression analyses estimated odds ratios and 95% CIs for associations between male breast cancer risk and 11 individual estrogens and androgens, as well as selected ratios of these analytes. Results Data from 101 cases and 217 matched controls were analyzed. After adjustment for age and date of blood draw, race, and body mass index, androgens were found to be largely unrelated to risk, but circulating estradiol levels showed a significant association. Men in the highest quartile had an odds ratio of 2.47 (95% CI, 1.10 to 5.58) compared with those in the lowest quartile (trend P = .06). Assessment of estradiol as a ratio to various individual androgens or sum of androgens showed no further enhancement of risk. These relations were not significantly modified by either age or body mass index, although estradiol was slightly more strongly related to breast cancers occurring among younger (age < 67 years) than older men. Conclusion Our results support the notion of an important role for estradiol in the etiology of male breast cancers, similar to female breast cancers. PMID:25964249

  18. Adjustment of urinary concentration to urinary volume in relation to erythrocyte and plasma concentrations: an evaluation of urinary heavy metals and organic substances

    SciTech Connect

    Araki, S.; Aono, H.; Murata, K.

    1986-05-01

    The effects of urinary volume on adjusted and nonadjusted urinary excretion of 11 heavy metals and organic substances were examined in relation to plasma and erythrocyte concentrations in 19 metal workers under conditions of water restriction and loading. Blood lead concentrations in these workers ranged from 25 to 59 micrograms/dl. The results indicated that: urinary volume significantly affects not only nonadjusted urinary concentration for all substances, but also affects timed excretion and concentrations adjusted to urinary specific gravity and to urinary creatinine for most substances; the concentration adjusted to urinary volume is, on the other hand, independent of urinary volume; and urinary excretion of lead and mercury is related more closely to erythrocyte concentration than to plasma concentration. This last finding reflects complex renal excretory mechanisms for these heavy metals.

  19. Traffic-related air pollution and risk for leukaemia of an adult population.

    PubMed

    Raaschou-Nielsen, Ole; Ketzel, Matthias; Harbo Poulsen, Aslak; Sørensen, Mette

    2016-03-01

    Air pollution causes lung cancer, but associations with other cancers have not been established. We investigated whether long-term exposure to traffic-related air pollution is associated with the risk of the general population for leukaemia. We identified 1,967 people in whom leukaemia was diagnosed in 1992-2010 from a nation-wide cancer registry and selected 3,381 control people at random, matched on sex and year of birth, from the entire Danish population. Residential addresses since 1971 were traced in a population registry, and outdoor concentrations of NOx and NO2 , as indicators of traffic-related air pollution, were calculated at each address in a dispersion model. We used conditional logistic regression to estimate the risk for leukaemia after adjustment for income, educational level, cohabitation status and co-morbidity. In linear analyses, we found odds ratios for acute myeloid leukaemia of 1.20 (95% confidence interval: 1.04-1.38) per 20 µg/m(3) increase in NOx and 1.31 (1.02-1.68) per 10 µg/m(3) increase in NO2 , calculated as time-weighted average exposure at all addresses since 1971. We found no association with chronic myeloid or lymphocytic leukaemia. This study indicates an association between long-term exposure to traffic-related air pollution and acute myeloid leukaemia in the general population, but not for other subtypes of leukaemia.

  20. Sex differences in relations among remembered parental behavior in childhood, adults' current psychological adjustment, and career indecision.

    PubMed

    Rohner, Ronald P; Rising, David G; Sayre-Scibona, Jessica

    2009-04-01

    The goal was to assess sex differences in career indecision's association with different levels of self-reported psychological adjustment and with different remembrances of maternal and paternal acceptance and behavioral control in childhood. 126 participants responded to the Career Decision Scale, the Adult version of the Parental Acceptance-Rejection/Control Questionnaire, and the Adult version of the Personality Assessment Questionnaire. Results showed that career indecision among women but not men was significantly correlated with remembered maternal and paternal acceptance in childhood, as well as with self-reported psychological adjustment and age. Only women's self-reported psychological adjustment made a unique contribution to variance in reported career indecision. No predictor variables were significantly associated with career indecision among men.

  1. Current strategies in antiplatelet therapy--does identification of risk and adjustment of therapy contribute to more effective, personalized medicine in cardiovascular disease?

    PubMed

    Geisler, Tobias; Gawaz, Meinrad; Steinhubl, Steven R; Bhatt, Deepak L; Storey, Robert F; Flather, Marcus

    2010-08-01

    There is a wide consensus that intensified antiplatelet therapy contributes to the reduction of major atherothrombotic complications in cardiovascular (CV) disease. In the setting of PCI (percutaneous coronary intervention) and acute coronary syndromes, dual antiplatelet therapy at optimal dosing and timing has significantly lowered the risk of thrombotic complications. There is a growing body of evidence that there is variability in response to antiplatelet treatments and this represents a potentially important clinical problem. Understanding the mechanisms underlying this phenomenon is important in improving patient care, but due to the diversity of factors involved, a clear predictive model for responsiveness to antiplatelet therapy is still missing. Attempts have been made to characterize the efficacy of antiplatelet therapy using platelet function testing but based on current information, its routine use is not recommended particularly as costs and cost effectiveness have not been established and agreement between laboratory methods is lacking. Hence, it is necessary to identify risk factors for decreased efficacy of standard antiplatelet drug treatment. It may be useful to adjust antiplatelet therapy based on individual risk assessment, especially as new platelet inhibitors are being introduced or are in development including prasugrel as well as the non-thienopyridines, ticagrelor, elinogrel, the ATP analog cangrelor, and thrombin receptor antagonists. This article focuses on antiplatelet therapy in patients at high risk for cardiovascular events and discusses the options for individual risk assessment and strategies to personalize therapy in the light of the large number of recent developments.

  2. Understanding the relative importance of global dengue risk factors.

    PubMed

    Lowe, Rachel

    2015-10-01

    Dengue is a mosquito-transmitted viral infection of major international public health concern. Global environmental and socio-economic change has created ideal conditions for the global expansion of dengue transmission. Innovative modelling tools help in understanding the global determinants of dengue risk and the relative impact of environmental and socio-economic factors on dengue transmission and spread. While climatic factors may act as a limiting factor on the global scale, other processes may play a dominant role at the local level. Understanding the spatial scales at which environmental and socio-economic factors dominate can help to target appropriate dengue control and prevention strategies.

  3. Breast Cancer Risk in Relation to the Interval Between Menopause and Starting Hormone Therapy

    PubMed Central

    Reeves, Gillian; Bull, Diana; Green, Jane

    2011-01-01

    Background Although breast cancer risk is greater in users of estrogen–progestin than estrogen-only formulations of menopausal hormonal therapy, reports on their effects have been somewhat inconsistent. We investigated whether the timing of these therapies affected breast cancer incidence. Methods A total of 1 129 025 postmenopausal UK women provided prospective information on hormonal therapy use and other factors relevant for breast cancer risk. We used Cox regression to estimate adjusted relative risks (RRs) of breast cancer in hormonal therapy users vs never users and calculated standardized incidence rates. All statistical tests were two-sided. Results During 4.05 million woman-years of follow-up, 15 759 incident breast cancers occurred, with 7107 in current users of hormonal therapy. Breast cancer incidence was increased in current users of hormonal therapy, returning to that of never users a few years after use had ceased. The relative risks for breast cancer in current users were greater if hormonal therapy was begun before or soon after menopause than after a longer gap (Pheterogeneity < .001, for both estrogen-only and estrogen-progestin formulations). Among current users of estrogen-only formulations, there was little or no increase in risk if use began 5 years or more after menopause (RR = 1.05, 95% confidence interval [CI] = 0.89 to 1.24), but risk was statistically significantly increased if use began before or less than 5 years after menopause (RR = 1.43, 95% CI = 1.35 to 1.51). A similar pattern was observed among current users of estrogen–progestin formulations (RR = 1.53, 95% CI = 1.38 to 1.70, and RR = 2.04, 95% CI = 1.95 to 2.14, respectively). At 50–59 years of age, annual standardized incidence rates for breast cancer were 0.30% (95% CI = 0.29% to 0.31%) among never users of hormone therapy and 0.43% (95% CI = 0.42% to 0.45%) and 0.61% (95% CI = 0.59% to 0.64%), respectively, among current users of estrogen-only and estrogen

  4. Adjusting for reverse causation to estimate the effect of obesity on mortality after incident heart failure in the Atherosclerosis Risk in Communities (ARIC) study

    PubMed Central

    2016-01-01

    OBJECTIVES: The lower mortality rate of obese patients with heart failure (HF) has been partly attributed to reverse causation bias due to weight loss caused by disease. Using data about weight both before and after HF, this study aimed to adjust for reverse causation and examine the association of obesity both before and after HF with mortality. METHODS: Using the Atherosclerosis Risk in Communities (ARIC) study, 308 patients with data available from before and after the incidence of HF were included. Pre-morbid and post-morbid obesity were defined based on body mass index measurements at least three months before and after incident HF. The associations of pre-morbid and post-morbid obesity and weight change with survival after HF were evaluated using a Cox proportional hazard model. RESULTS: Pre-morbid obesity was associated with higher mortality (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.04 to 2.49) but post-morbid obesity was associated with increased survival (HR, 0.57; 95% CI, 0.37 to 0.88). Adjusting for weight change due to disease as a confounder of the obesity-mortality relationship resulted in the absence of any significant associations between post-morbid obesity and mortality. CONCLUSIONS: This study demonstrated that controlling for reverse causality by adjusting for the confounder of weight change may remove or reverse the protective effect of obesity on mortality among patients with incident HF. PMID:27283142

  5. Nanotechnology, risk, and oversight: learning lessons from related emerging technologies.

    PubMed

    Kuzma, Jennifer; Priest, Susanna

    2010-11-01

    Emerging technologies are defined by their novelty and thus are accompanied by significant uncertainty in determining appropriate ways to manage risks associated with them. Yet, there is a body of prior knowledge about risk management and oversight policy for other technologies that have already permeated society. Here, we describe two ways in which prospective oversight policy analysis for emerging technologies can draw upon these past experiences. One involves comparing specific products that have already been marketed to similar products of the emerging technology (cognate-product approach). The other treats the emerging technology as a body of products and methods and relates it to another technological field that has already emerged and penetrated markets (whole-technology approach). In this article, we describe our work using these approaches to inform risk and oversight policy for nanotechnology and its products. We draw parallels between biotechnology and nanotechnology as whole fields of development and also between genetically engineered organisms in the food supply and agricultural products of nanotechnology. Through these comparisons, we find that both approaches to historical learning have value and present lessons that could be applied to nanotechnology.

  6. Effects of Maternal Depression on Youth Adjustment.

    ERIC Educational Resources Information Center

    Alexander, Jennifer

    Depressive disorders are chronic illnesses affecting women and their families for extended periods of time. This paper summarizes research related to the effects of maternal depression on children's short and long term adjustment. Children of depressed mothers are at risk for internalizing and externalizing disorders. Genetics account for a small…

  7. Recreational amphetamine use and risk of HIV-related non-Hodgkin lymphoma.

    PubMed

    Chao, Chun; Jacobson, Lisa P; Tashkin, Donald; Martínez-Maza, Otoniel; Roth, Michael D; Margolick, Joseph B; Chmiel, Joan S; Holloway, Marcy N; Zhang, Zuo-Feng; Detels, Roger

    2009-07-01

    The results of many laboratory studies suggest that amphetamine use may lead to altered immune function and cytokine expression, both of which are implicated in HIV-related lymphomagenesis. We examined the hypothesis that use of amphetamines modifies risk of non-Hodgkin lymphoma (NHL) in HIV-infected men in the Multicenter AIDS Cohort Study. Data on amphetamine use were collected every six months during the follow-up period between 1984 and 2002. A total of 171 NHL cases were diagnosed from the 19,250 person-years accrued. Multivariable Cox models were used to estimate the effects of baseline exposures, time-varying recent exposures, and three years lagged exposures on risk of NHL adjusting for potential confounders such as demographics, use of other substances, and risky sexual behaviors. We found that weekly or more frequent use of amphetamines was associated with an increased risk of NHL, with hazard ratios of 1.75 (95% CI = 0.81-3.77) for use at baseline, 4.73 (1.41-15.81) for recent use, and 3.05 (1.19-7.82) for three years prior use. Similar associations were observed when we separately examined systemic NHL and diffuse large B-cell lymphoma. Given these observations, the impact of amphetamines on lymphomagenesis among HIV-infected populations should be assessed more thoroughly.

  8. Can parallel use of different running shoes decrease running-related injury risk?

    PubMed

    Malisoux, L; Ramesh, J; Mann, R; Seil, R; Urhausen, A; Theisen, D

    2015-02-01

    The aim of this study was to determine if runners who use concomitantly different pairs of running shoes are at a lower risk of running-related injury (RRI). Recreational runners (n = 264) participated in this 22-week prospective follow-up and reported all information about their running session characteristics, other sport participation and injuries on a dedicated Internet platform. A RRI was defined as a physical pain or complaint located at the lower limbs or lower back region, sustained during or as a result of running practice and impeding planned running activity for at least 1 day. One-third of the participants (n = 87) experienced at least one RRI during the observation period. The adjusted Cox regression analysis revealed that the parallel use of more than one pair of running shoes was a protective factor [hazard ratio (HR) = 0.614; 95% confidence interval (CI) = 0.389-0.969], while previous injury was a risk factor (HR = 1.722; 95%CI = 1.114-2.661). Additionally, increased mean session distance (km; HR = 0.795; 95%CI = 0.725-0.872) and increased weekly volume of other sports (h/week; HR = 0.848; 95%CI = 0.732-0.982) were associated with lower RRI risk. Multiple shoe use and participation in other sports are strategies potentially leading to a variation of the load applied to the musculoskeletal system. They could be advised to recreational runners to prevent RRI.

  9. Optimism as a Mediator of the Relation between Perceived Parental Authoritativeness and Adjustment among Adolescents: Finding the Sunny Side of the Street

    ERIC Educational Resources Information Center

    Jackson, Lynne M.; Pratt, Michael W.; Hunsberger, Bruce; Pancer, S. Mark

    2005-01-01

    Authoritative parenting has been associated with positive outcomes for children and adolescents, but less is known about the mechanisms responsible for such effects. Two longitudinal studies examined the hypothesis that the relation between authoritative parenting and adolescents' adjustment is mediated by adolescents' level of dispositional…

  10. The Role of Culture in Relational Aggression: Associations with Social-Psychological Adjustment Problems in Japanese and US School-Aged Children

    ERIC Educational Resources Information Center

    Kawabata, Yoshito; Crick, Nicki R.; Hamaguchi, Yoshikazu

    2010-01-01

    The purpose of this study was (1) to evaluate psychometric properties that assess forms of aggression (i.e., relational and physical aggression) across cultures (i.e., Japan and the United States) and (2) to investigate the role of culture in the associations between forms of aggression and social-psychological adjustment problems such as…

  11. Relation between self-reported physical activity level, fitness, and cardiometabolic risk.

    PubMed

    Minder, Camille Michael; Shaya, Gabriel E; Michos, Erin D; Keenan, Tanya E; Blumenthal, Roger S; Nasir, Khurram; Carvalho, Jose A M; Conceição, Raquel D; Santos, Raul D; Blaha, Michael J

    2014-02-15

    Physical activity and cardiorespiratory fitness are associated with improved cardiovascular health and reduced all-cause mortality. The relation between self-reported physical activity, objective physical fitness, and the association of each with cardiometabolic risk has not been fully described. We studied 2,800 healthy Brazilian subjects referred for an employer-sponsored health screening. Physical activity level was determined as "low," "moderate," or "high" with the International Physical Activity Questionnaire: Short Form (IPAQ-SF). Fitness was measured as METs achieved on a maximal, symptom-limited, treadmill stress test. Using multivariate linear regression analysis, we calculated age, gender, and smoking-adjusted correlation coefficients among IPAQ-SF, fitness, and cardiometabolic risk factors. Mean age of study participants was 43 ± 9 years; 81% were men, and 43% were highly active. Mean METs achieved was 12 ± 2. IPAQ-SF category and fitness were moderately correlated (r = 0.377). Compared with IPAQ-SF category, fitness was better correlated with cardiometabolic risk factors including anthropomorphic measurements, blood pressure, fasting blood glucose, dyslipidemia, high-sensitivity C-reactive protein, and hepatic steatosis (all p <0.01). Among these, anthropomorphic measurements, blood pressure, high-sensitivity C-reactive protein, and hepatic steatosis had the largest discrepancies in correlation, whereas lipid factors had the least discrepant correlation. When IPAQ-SF and fitness were discordant, poor fitness drove associations with elevated cardiometabolic risk. In conclusion, self-reported physical activity level and directly measured fitness are moderately correlated, and the latter is more strongly associated with a protective cardiovascular risk profile.

  12. Anxiousness, Frustration, and Effortful Control as Moderators of the Relation between Parenting and Adjustment in Middle-Childhood

    ERIC Educational Resources Information Center

    Lengua, Liliana J.

    2008-01-01

    Interactions among multiple dimensions of child temperament and parenting were tested as predictors of change in child adjustment problems using a community sample (N = 188) of children (8-12 years). Significant interactions suggested that the effect of parenting on changes in problems were dependent upon temperament and, in some cases, child sex.…

  13. 78 FR 57257 - Medicare Determinations and Income-Related Monthly Adjustment Amounts to Medicare Part B Premiums...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-18

    ...(i), 425, and 902(a)(5)); sec. 5, Pub. L. 97-455, 96 Stat. 2500 (42 U.S.C. 405 note); secs. 5, 6(c... 2019, these thresholds will resume adjustment for inflation as required by section 1839(i)(5) of the... Act (APA) rulemaking procedures specified in 5 U.S.C. 553 when we develop regulations. Generally,...

  14. Predicting School Adjustment in Early Elementary School: Impact of Teacher-Child Relationship Quality and Relational Classroom Climate

    ERIC Educational Resources Information Center

    Buyse, Evelien; Verschueren, Karine; Verachtert, Pieter; Van Damme, Jan

    2009-01-01

    This longitudinal study evaluated the impact of dyadic and classroom-level teacher-child relationship quality in first grade on children's psychosocial and academic adjustment in first (N = 3,784), second (N = 3,666), and third (N = 3,582) grade, controlling for several child features, namely, child demographics and children's initial levels of…

  15. Hemodialysis catheter-related infection: rates, risk factors and pathogens.

    PubMed

    Sahli, Farida; Feidjel, Razika; Laalaoui, Rima

    2016-07-13

    The main complication of central venous catheter (CVC) in hemodialysis is infection. Identifying CVC related infection (CVC-RI) risk factors and causative micro-organisms is important for setting prevention policies. There were no data regarding CVC-RI in hemodialysis in Algeria. To determine rates of CVC-RI in hemodialysis in Setif university hospital, risk factors and causative microorganisms, we conducted a prospective study from November 2014 to May 2015 involving patients with CVC in hemodialysis. Micro-organisms isolated from semi quantitative culture of CVC and blood culture were identified and tested for antibiotic susceptibility using the automated MicroScan system (DADE Behring, Sacramento, CA, USA). Chi-square test was performed to compare demographic and clinical variables (age, sex, comorbidities, duration of CVC, insertion site) in the groups of patients with and without CVC-RI. P<0.05 was considered statistically significant. All analyses were performed using SPSS V17 for Windows statistical package (SPSS Inc., Chicago, IL, USA). 94 patients and 152 CVC procedures were analyzed. 34 CVC-RI were documented with an incidence of 16.6 per 1000 CVC-days. Incidence of CVC related bloodstream infection (CVC-RBI) was 10.8 per 1000 CVC-days. Independent risk factors associated with CVC-RI were diabetes (P=0.01) and duration of catheterization (P= 0.01). Causative micro-organisms were: Klebsiella pneumoniae 26.5%, coagulase-negative staphylococci 23.5% and Staphylococcus aureus 23.5%. Micro-organisms were multidrug-resistant (MDR). Mortality was statistically associated to inadequate antibiotic therapy. The duration of CVC should be reduced by creation of fistulas. More compliance to hygiene measure is needed for decreasing CVC-RI and resistance rate.

  16. Quantifying the role of risk-taking behaviour in causation of serious road crash-related injury.

    PubMed

    Turner, Cathy; McClure, Rod

    2004-05-01

    This study was designed to quantify the increased risk of road crash-related injury, which can be attributed to risk-taking behaviour. A case-control study was conducted to compare motor vehicle drivers (car and bike) who had been hospitalised for injuries following crashes with population-based controls. Cases were recruited prospectively over 12 months and controls were randomly selected from license holders (car and bike) living in the same geographical location as cases. A self-administered questionnaire was used to ascertain participants' driving behaviour, general risk-taking behaviour and selected demographic characteristics. After adjusting for demographic variables, number of years of driving and total distance driven per week, logistic regression analysis showed that a high risk acceptance was associated with an eight-fold increased risk of having a crash that resulted in serious injury (OR 7.8, 95% CI 4.2-15.8). The findings of this study support the suggestion that certain host factors increase the risk of crash-related serious injury. There would appear to be a reasonable argument for persisting with injury prevention programmes, which concentrate on host as well as environment risk factor reduction.

  17. Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

    ERIC Educational Resources Information Center

    Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

    2013-01-01

    The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

  18. Acculturation and Adjustment in Latino Adolescents: How Cultural Risk Factors and Assets Influence Multiple Domains of Adolescent Mental Health

    ERIC Educational Resources Information Center

    Smokowski, Paul; Buchanan, Rachel L.; Bacallao, Martica L.

    2009-01-01

    The purpose of this study was to examine the relationships among risk factors, cultural assets, and Latino adolescent mental health outcomes. We extend past research by using a longitudinal design and evaluating direct and moderated acculturation effects across a range of internalizing, externalizing, and academic engagement outcomes. The sample…

  19. A prospective cohort study on the association between coffee drinking and risk of non-gallstone-related acute pancreatitis.

    PubMed

    Oskarsson, Viktor; Sadr-Azodi, Omid; Orsini, Nicola; Wolk, Alicja

    2016-05-28

    Only one previous study has examined the association between coffee consumption and risk of acute pancreatitis, and it found a reduced risk for alcohol-related episodes among high consumers of coffee. Therefore, we examined (1) the association between coffee consumption and risk of non-gallstone-related acute pancreatitis and (2) whether this association was modified by alcohol intake. Data were obtained from two prospective cohorts, the Cohort of Swedish Men and the Swedish Mammography Cohort, including 76 731 men and women (born 1914-1952). Coffee consumption was assessed at baseline with a FFQ, and the cohorts were followed up between 1998 and 2012 via linkage to national health registries. Hazard ratios were estimated using Cox models, with adjustment for potential confounding factors. During 1 035 881 person-years of total follow-up, 383 cases (246 in men and 137 in women) of incident non-gallstone-related acute pancreatitis were identified. Overall, and irrespective of whether a categorical or a continuous exposure model was used, we observed no association between coffee consumption and risk of non-gallstone-related acute pancreatitis (e.g. the multivariable-adjusted hazard ratio for each 1 cup/d increase in coffee consumption was 0·97; 95 % CI 0·92, 1·03). There was no evidence of effect modification by alcohol intake (P interaction=0·77). In conclusion, coffee consumption was not associated with risk of non-gallstone-related acute pancreatitis in this large prospective cohort study. Because of the limited number of epidemiological studies and their conflicting results, further research is needed to elucidate this potential association.

  20. Baseball Pitching Biomechanics in Relation to Injury Risk and Performance

    PubMed Central

    Fortenbaugh, Dave; Fleisig, Glenn S.; Andrews, James R.

    2009-01-01

    Context: Baseball pitching kinematics, kinetics, ball velocity, and injuries at the shoulder and elbow are related. Evidence Acquisition: PubMed and Sport Discus were searched for original studies published between 1994 and 2008. Relevant references in these studies were retrieved. Inferential studies that tested relationships between kinematics and kinetics were included, as were studies that tested relationships between kinematics and ball velocity. Descriptive studies that simply quantified kinematics and/or kinetics were excluded. Results: Several kinematic parameters at the instant of foot contact were associated with increased upper extremity kinetics: front foot position, front foot orientation, shoulder abduction, and shoulder horizontal adduction. The timing of shoulder external rotation, pelvis rotation, and upper trunk rotation was associated with increased kinetics and decreased ball velocity. Low braking force of the lead leg and a short stride were associated with decreased ball velocity. Decreased maximum shoulder external rotation, shoulder abduction, knee extension, and trunk tilt were also associated with decreased ball velocity. As pitchers develop, kinematic values remain similar, their variability reduces, and kinetic values gradually increase. Slight kinematic variations were seen among pitch types, although the kinetics of fastballs and curveballs were relatively the same; changeup kinetics were the lowest. As pitchers fatigued, kinetic values remained constant, but increases in arm pain were reported. Conclusions: Several kinematic parameters were related to joint kinetics and ball velocity. To enhance performance and reduce injury risk, pitchers need to learn proper fastball mechanics at an early age. A changeup is recommended as a safe secondary pitch to complement the fastball; the curveball can be added after fastball and changeup mechanics are mastered. Avoiding overuse and pitching while fatigued is necessary to minimize the risk of

  1. Apparatus and methods for installing, removing and adjusting an inner turbine shell section relative to an outer turbine shell section

    DOEpatents

    Leach, David; Bergendahl, Peter Allen; Waldo, Stuart Forrest; Smith, Robert Leroy; Phelps, Robert Kim

    2001-01-01

    A turbine includes upper and lower inner shell sections mounting the nozzles and shrouds and which inner shell is supported by pins secured to a surrounding outer shell. To disassemble the turbine for access to the inner shell sections and rotor, an alignment fixture is secured to the lower outer shell section and has pins engaging the inner shell section. To disassemble the turbine, the inner shell weight is transferred to the lower outer shell section via the alignment fixture and cradle pins. Roller assemblies are inserted through access openings vacated by support pins to permit rotation of the lower inner shell section out of and into the lower outer shell section during disassembly and assembly. The alignment fixture includes adjusting rods for adjusting the inner shell axially, vertically, laterally and about a lateral axis. A roller over-cage is provided to rotate the inner shell and a dummy shell to facilitate assembly and disassembly in the field.

  2. Free markets and the marriage market: structural adjustment, gender relations, and working conditions among Dominican women workers.

    PubMed

    Safa, H I

    1999-02-01

    The relationship between economic conditions and marriage patterns in the Dominican Republic is analyzed using data collected in 1994 on women working in a free-trade zone. The author concludes that changes associated with structural adjustment appear to have contributed to a deterioration of the job market and a greater prevalence of female-headed households. It is shown that "structural adjustment increases the need for women to work, because of cuts in government programs, declining real wages, growing inflation, and a deterioration in male employment, which weakens the man's role as principal breadwinner and increases the importance and visibility of women's contribution to the household economy. This change in the gender composition of the labor force has encouraged some women to resist marriage and/or remarriage because the ¿marriage market' of eligible men willing and able to support a family has been reduced, contributing to greater marital instability."

  3. Higher serum 25-hydroxyvitamin D concentrations are related to a reduced risk of depression.

    PubMed

    Jääskeläinen, Tuija; Knekt, Paul; Suvisaari, Jaana; Männistö, Satu; Partonen, Timo; Sääksjärvi, Katri; Kaartinen, Niina E; Kanerva, Noora; Lindfors, Olavi

    2015-05-14

    Vitamin D has been suggested to protect against depression, but epidemiological evidence is scarce. The present study investigated the relationship of serum 25-hydroxyvitamin D (25(OH)D) with the prevalence of depressive and anxiety disorders. The study population consisted of a representative sample of Finnish men and women aged 30-79 years from the Health 2000 Survey. The sample included 5371 individuals, of which 354 were diagnosed with depressive disorder and 222 with anxiety disorder. Serum 25(OH)D concentration was determined from frozen samples. In a cross-sectional study, a total of four indicators of depression and one indicator of anxiety were used as dependent variables. Serum 25(OH)D was the risk factor of interest, and logistic models used further included sociodemographic and lifestyle variables as well as indicators of metabolic health as confounding and/or effect-modifying factors. The population attributable fraction (PAF) was estimated. Individuals with higher serum 25(OH)D concentrations showed a reduced risk of depression. The relative odds between the highest and lowest quartiles was 0.65 (95% CI 0.46, 0.93; P for trend = 0.006) after adjustment for sociodemographic, lifestyle and metabolic factors. Higher serum 25(OH)D concentrations were associated with a lower prevalence of depressive disorder especially among men, younger, divorced and those who had an unhealthy lifestyle or suffered from the metabolic syndrome. The PAF was estimated to be 19% for depression when serum 25(OH)D concentration was at least 50 nmol/l. These results support the hypothesis that higher serum 25(OH)D concentrations protect against depression even after adjustment for a large number of sociodemographic, lifestyle and metabolic factors. Large-scale prospective studies are needed to confirm this finding.

  4. Chiropractic Adjustment

    MedlinePlus

    ... structural alignment and improve your body's physical function. Low back pain, neck pain and headache are the most common ... treated. Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only ...

  5. Adjustment disorder

    MedlinePlus

    ... from other people Skipped heartbeats and other physical complaints Trembling or twitching To have adjustment disorder, you ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  6. Compensatory Postural Adjustments in an Oculus Virtual Reality Environment and the Risk of Falling in Alzheimer's Disease

    PubMed Central

    Gago, Miguel F.; Yelshyna, Darya; Bicho, Estela; Silva, Hélder David; Rocha, Luís; Lurdes Rodrigues, Maria; Sousa, Nuno

    2016-01-01

    Background/Aims Alzheimer's disease (AD) patients have an impaired ability to quickly reweight central sensory dependence in response to unexpected body perturbations. Herein, we aim to study provoked compensatory postural adjustments (CPAs) in a conflicting sensory paradigm with unpredictable visual displacements using virtual reality goggles. Methods We used kinematic time-frequency analyses of two frequency bands: a low-frequency band (LB; 0.3-1.5 Hz; mechanical strategy) and a high-frequency band (HB; 1.5-3.5 Hz; cognitive strategy). We enrolled 19 healthy subjects (controls) and 21 AD patients, divided according to their previous history of falls. Results The AD faller group presented higher-power LB CPAs, reflecting their worse inherent postural stability. The AD patients had a time lag in their HB CPA reaction. Conclusion The slower reaction by CPA in AD may be a reflection of different cognitive resources including body schema self-perception, visual motion, depth perception, or a different state of fear and/or anxiety. PMID:27489559

  7. Social cohesion, social participation, and HIV related risk among female sex workers in Swaziland.

    PubMed

    Fonner, Virginia A; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR] = 2.25, 95% confidence interval [CI]: 1.30-3.90) and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36-4.03) and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13-3.51), and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33-0.91). Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland.

  8. Social Cohesion, Social Participation, and HIV Related Risk among Female Sex Workers in Swaziland

    PubMed Central

    Fonner, Virginia A.; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E.; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR]  = 2.25, 95% confidence interval [CI]: 1.30–3.90) and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36–4.03) and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13–3.51), and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33–0.91). Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland. PMID:24498125

  9. [Relative risk of pneumoconiosis in welders in metallurgy].

    PubMed

    Rabenda, Andrzej

    2003-01-01

    The values of pneumoconiosis risk in welders calculated against the dust doses that induce this pathology do not show linear relationship. In the group of electrical welders, relative risk (RR) was found statistically significant at the doses of 251-500 g; 1001-1500 g and 5501-6000 g. In the group of semi-automatic welders, similar results were observed. Odd ratio, calculated at workposts of semi-automatic welding with CO2 shield, showed that, depending on the size of a daily dose of dust, statistically significant RR was found at the doses of 1.6-2.0; 2.1-2.5; and 2.6-3.0 mg/kg/day. In the group of electric welders, statistically significant RR was observed at the doses of 2.1-2.5; 6.1-6.5; and 9.1-9.5 mg/kg/day. This may suggest that welding dust at workposts of semi-automatic welding is more aggressive. The division of welders by their dates of birth showed that in the group of welders born by 1945, the mean age at which they developed pneumoconiosis was almost 50 +/- 0.4 years, and the mean duration of occupational exposure was 25 +/- 0.3 years. In the group of welders born after 1945, these values were 36 +/- 0.6 years and 12.8 +/- 0.2 years, respectively.

  10. Educational aspiration-expectation discrepancies: relation to socioeconomic and academic risk-related factors.

    PubMed

    Boxer, Paul; Goldstein, Sara E; DeLorenzo, Tahlia; Savoy, Sarah; Mercado, Ignacio

    2011-08-01

    This study examines whether disconnection between educational aspirations and expectations is associated with socioeconomic status, academic performance, academic risk-related behaviors and related psychosocial factors in an ethnically and economically diverse sample of early adolescents from a public middle school (N = 761). Results suggest that students who aspire to achieve more than they expect to achieve also are likely to have more economically disadvantaged backgrounds and poorer academic performance. These students also show a variety of academic and social risks. Specifically, students whose aspirations exceeded their expectations reported lower levels of school bonding, higher levels of test/performance anxiety, and elevated behavioral/emotional difficulties. Results are discussed in terms of social-cognitive theory as well as applications for promoting student social and academic success.

  11. The relationship between effectiveness and costs measured by a risk-adjusted case-mix system: multicentre study of Catalonian population data bases

    PubMed Central

    Sicras-Mainar, Antoni; Navarro-Artieda, Ruth; Blanca-Tamayo, Milagrosa; Velasco-Velasco, Soledad; Escribano-Herranz, Esperanza; Llopart-López, Josep Ramon; Violan-Fors, Concepción; Vilaseca-Llobet, Josep Maria; Sánchez-Fontcuberta, Encarna; Benavent-Areu, Jaume; Flor-Serra, Ferran; Aguado-Jodar, Alba; Rodríguez-López, Daniel; Prados-Torres, Alejandra; Estelrich-Bennasar, Jose

    2009-01-01

    Background The main objective of this study is to measure the relationship between morbidity, direct health care costs and the degree of clinical effectiveness (resolution) of health centres and health professionals by the retrospective application of Adjusted Clinical Groups in a Spanish population setting. The secondary objectives are to determine the factors determining inadequate correlations and the opinion of health professionals on these instruments. Methods/Design We will carry out a multi-centre, retrospective study using patient records from 15 primary health care centres and population data bases. The main measurements will be: general variables (age and sex, centre, service [family medicine, paediatrics], and medical unit), dependent variables (mean number of visits, episodes and direct costs), co-morbidity (Johns Hopkins University Adjusted Clinical Groups Case-Mix System) and effectiveness. The totality of centres/patients will be considered as the standard for comparison. The efficiency index for visits, tests (laboratory, radiology, others), referrals, pharmaceutical prescriptions and total will be calculated as the ratio: observed variables/variables expected by indirect standardization. The model of cost/patient/year will differentiate fixed/semi-fixed (visits) costs of the variables for each patient attended/year (N = 350,000 inhabitants). The mean relative weights of the cost of care will be obtained. The effectiveness will be measured using a set of 50 indicators of process, efficiency and/or health results, and an adjusted synthetic index will be constructed (method: percentile 50). The correlation between the efficiency (relative-weights) and synthetic (by centre and physician) indices will be established using the coefficient of determination. The opinion/degree of acceptance of physicians (N = 1,000) will be measured using a structured questionnaire including various dimensions. Statistical analysis: multiple regression analysis (procedure

  12. Fear of abandonment as a mediator of the relations between divorce stressors and mother-child relationship quality and children's adjustment problems.

    PubMed

    Wolchik, Sharlene A; Tein, Jenn-Yun; Sandler, Irwin N; Doyle, Kathryn W

    2002-08-01

    This study examines whether fear of abandonment mediates the prospective relations between divorce stressors and mother-child relationship quality and adjustment problems of children of divorce. Participants were 216 children, ages 8-12, and their primary residential mothers. Children reported on divorce stressors and fear of abandonment; mothers and children reported on mother-child relationship quality and internalizing and externalizing problems. Structural equation models indicated that Time 1 fear of abandonment mediated the relation between Time 1 divorce stressors and Time 2 internalizing and externalizing problems. Time 1 fear of abandonment also mediated the relation between Time 1 mother-child relationship quality and Time 2 internalizing and externalizing problems. Implications of these results for understanding variability in children's postdivorce adjustment problems and interventions for divorced families are discussed.

  13. Cardiovascular Risks in Relation to Daidzein Metabolizing Phenotypes among Chinese Postmenopausal Women

    PubMed Central

    Liu, Zhao-min; Ho, Suzanne C.; Chen, Yu-ming; Liu, Jun; Woo, Jean

    2014-01-01

    Background Studies suggested that the inter-individual differences in metabolizing isoflavone daidzein to equol or O-desmethylangolensin (ODMA) might explain the inconsistency of the soy/isoflavones efficacy on cardiovascular health. Objectives The study aims to evaluate the relationship between equol and ODMA phenotypes and cardiovascular risks with habitual isoflavone consumption in Chinese postmenopausal women. Methods This is a cross-sectional study among 726 prehypertensive postmenopal women who were screened for a randomized controlled trial. 648 women returned a daidzein-challenged urine samples for determination of equol and O-DMA production. 595 attended clinic visits for assessment of cardiovascular risks including body composition, blood pressure (BP), serum lipids, uric acid, high sensitivity C-reactive protein (hs-CRP), fasting glucose and free fatty acid (FFA). Results The prevalences of equol and O-DMA producers were 53.2% and 60.9% respectively. Equol producers had higher fat free mass (p = 0.001), lower systolic (p = 0.01) and diastolic (p = 0.01) BP, serum triglyceride (p = 0.023), hs-CRP (p = 0.015) and FFA (p = 0.001) than non-producers. O-DMA producers had lower body fat% (p = 0.032), SBP (p = 0.02), total cholesterol (p = 0.002) than non-producers. The significant differences remained after further adjustment for potential confounders. The habitual soy isoflavones intake had little relation to cardiovascular risk factors in either equol/O-DMA producer phenotypes. Conclusion Equol/O-DMA producers had more favorable cardiovascular risk profiles than non-producers in prehypertensive postmenopausal women. PMID:24533060

  14. Risk for rheumatic disease in relation to ethnicity and admixture

    PubMed Central

    Molokhia, Mariam; McKeigue, Paul

    2000-01-01

    Risk of systemic lupus erythematosus (SLE) is high in west Africans compared with Europeans, and risk of rheumatoid arthritis (RA) is high in Native Americans compared with Europeans. These differences are not accounted for by differences in allele or haplotype frequencies in the human leucocyte antigen (HLA) region or any other loci known to influence risk of rheumatic disease. Where there has been admixture between two or more ethnic groups that differ in risk of disease, studies of the relationship of disease risk to proportionate admixture can help to distinguish between genetic and environmental explanations for ethnic differences in disease risk and to map the genes underlying these differences. PMID:11094421

  15. Association between vitamin D status and age-related macular degeneration by genetic risk

    PubMed Central

    Millen, Amy E.; Meyers, Kristin J; Liu, Zhe; Engelman, Corinne D; Wallace, Robert B; LeBlanc, Erin S; Tinker, Lesley F.; Iyengar, Sudha K; Robinson, Jennifer; Sarto, Gloria E.; Mares, Julie A

    2016-01-01

    Importance Deficient 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with increased odds of age-related macular degeneration (AMD). Objective We examined 1) whether this association is modified by genetic risk for AMD and 2) if there is an association between AMD and single nucleotide polymorphisms (SNPs) of genes involved in vitamin D transport, metabolism and genomic function. Design, Setting and Participants Women were postmenopausal and participants of the Carotenoids in Age-Related Eye Disease Study (CAREDS) (54 to <75 years) with available serum 25(OH)D concentrations (assessed from 1994–1998), genetic data, and measures of AMD (n=142) assessed at CAREDS baseline from 2001–2004 (n=913). Main Outcomes and Measures Prevalent early or late AMD was determined from graded, stereoscopic fundus photographs. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for AMD by the joint effects of 25(OH)D (<30, ≥30 to <50, ≥50 to <75, and ≥75 nmol/L) and risk genotype (noncarrier, one, or two risk alleles). The referent group was noncarriers with adequate vitamin D status (≥75 nmol/L). Joint effect ORs were adjusted for age, smoking, iris pigmentation, self-reported cardiovascular disease, self-reported diabetes status, and hormone use. Additive and multiplicative interactions were assessed using the Synergy Index (SI) and an interaction term, respectively. Results We observed a 6.7-fold increased odds of AMD (95% CI=1.6, 28.2) among women with deficient vitamin D status (25(OH)D<30 nmol/L) and two risk alleles for complement factor H (CFH) Y402H (SI for additive interaction=1.4, 95% CI=1.1, 1.7; p for multiplicative interaction=0.25,. A significant additive (SI=1.4, 95% CI=1.1, 1.7) and multiplicative interaction (p=0.02) was observed for deficient women with two high risk complement factor I (CFI) (rs10033900) alleles (OR=6.3, 95% CI=1.6, 24.2). The odds of AMD did not differ by genotype of candidate

  16. The prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction in Chinese men.

    PubMed

    Zhang, Z; Li, Z; Yu, Q; Wu, C; Lu, Z; Zhu, F; Zhang, H; Liao, M; Li, T; Chen, W; Xian, X; Tan, A; Mo, Z

    2015-11-01

    The aim of this study was to describe the prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction (ED) among southern Chinese men. Data were collected from 2790 men attending the Fangchenggang Area Male Healthy and Examination Survey from September 2009 to December 2009. The prostatitis-like symptoms were assessed by the NIH Chronic Prostatitis Symptom Index and ED was assessed using the 5-item International Index of Erectile Function. Lifestyle and demographic characteristics were obtained through a questionnaire. Prevalence of prostatitis-like symptoms was 12.4% among 2790 Chinese men aged 20-84 years. In smokers who smoked ≥20 cigarettes per day (age-adjusted OR = 1.29; 95% CI = 1.00-1.66; p = 0.04), physical inactivity (age-adjusted OR = 1.31; 95% CI = 1.03-1.66; p = 0.02) was a significant risk factor for prostatitis-like symptoms. Alcohol consumption (daily drinking) also was a risk factor for prostatitis-like symptoms, although the differences were not statistically significant (age-adjusted OR = 1.36; 95% CI = 0.96-1.92; p = 0.07). Those with diabetes may also be at higher risk for prostatitis-like symptoms (age-adjusted OR = 1.37; 95% CI = 0.85-2.21; p = 0.19). In addition, men with ED were more likely to have had prostatitis-like symptoms (age-adjusted OR = 1.86; 95% CI = 0.47-2.36; p < 0.0001), and the ORs increased with increasing severity of ED status (mild ED, mild to moderate ED, and moderate to severe ED were 1.57, 2.62, and 3.24, respectively. Test for trend, p = 0.0001). Our results show that prostatitis-like symptoms are prevalent in Southern China affecting men of all ages. Smoking, drinking, lack of physical activity, and elevated plasma glucose level were associated with an increased risk of prostatitis-like symptoms. In addition, our results reveal that ED accounted for a large proportion (61.5%) among men with prostatitis-like symptoms; we also confirm the magnitude of ED associated with

  17. Risk factors for carpal tunnel syndrome related to the work organization: a prospective surveillance study in a large working population.

    PubMed

    Petit, Audrey; Ha, Catherine; Bodin, Julie; Rigouin, Pascal; Descatha, Alexis; Brunet, René; Goldberg, Marcel; Roquelaure, Yves

    2015-03-01

    The study aimed to determine the risk factors for incident carpal tunnel syndrome (CTS) in a large working population, with a special focus on factors related to work organization. In 2002-2005, 3710 workers were assessed and, in 2007-2010, 1611 were re-examined. At baseline all completed a self-administered questionnaire about personal/medical factors and work exposure. CTS symptoms and physical examination signs were assessed by a standardized medical examination at baseline and follow-up. The risk of "symptomatic CTS" was higher for women (OR = 2.9 [1.7-5.2]) and increased linearly with age (OR = 1.04 [1.00-1.07] for 1-year increment). Two work organizational factors remained in the multivariate risk model after adjustment for the personal/medical and biomechanical factors: payment on a piecework basis (OR = 2.0, 95% CI 1.1-3.5) and work pace dependent on automatic rate (OR = 1.9, 95% CI 0.9-4.1). Several factors related to work organization were associated with incident CTS after adjustment for potential confounders.

  18. Accounting for time- and space-varying changes in the gravity field to improve the network adjustment of relative-gravity data

    NASA Astrophysics Data System (ADS)

    Kennedy, Jeffrey R.; Ferré, Ty P. A.

    2016-02-01

    The relative gravimeter is the primary terrestrial instrument for measuring spatially and temporally varying gravitational fields. The background noise of the instrument-that is, non-linear drift and random tares-typically requires some form of least-squares network adjustment to integrate data collected during a campaign that may take several days to weeks. Here, we present an approach to remove the change in the observed relative-gravity differences caused by hydrologic or other transient processes during a single campaign, so that the adjusted gravity values can be referenced to a single epoch. The conceptual approach is an example of coupled hydrogeophysical inversion, by which a hydrologic model is used to inform and constrain the geophysical forward model. The hydrologic model simulates the spatial variation of the rate of change of gravity as either a linear function of distance from an infiltration source, or using a 3-D numerical groundwater model. The linear function can be included in and solved for as part of the network adjustment. Alternatively, the groundwater model is used to predict the change of gravity at each station through time, from which the accumulated gravity change is calculated and removed from the data prior to the network adjustment. Data from a field experiment conducted at an artificial-recharge facility are used to verify our approach. Maximum gravity change due to hydrology (observed using a superconducting gravimeter) during the relative-gravity field campaigns was up to 2.6 μGal d-1, each campaign was between 4 and 6 d and one month elapsed between campaigns. The maximum absolute difference in the estimated gravity change between two campaigns, two months apart, using the standard network adjustment method and the new approach, was 5.5 μGal. The maximum gravity change between the same two campaigns was 148 μGal, and spatial variation in gravity change revealed zones of preferential infiltration and areas of relatively high

  19. Accounting for time- and space-varying changes in the gravity field to improve the network adjustment of relative-gravity data

    USGS Publications Warehouse

    Kennedy, Jeffrey R.; Ferre, Ty P.A.

    2015-01-01

    The relative gravimeter is the primary terrestrial instrument for measuring spatially and temporally varying gravitational fields. The background noise of the instrument—that is, non-linear drift and random tares—typically requires some form of least-squares network adjustment to integrate data collected during a campaign that may take several days to weeks. Here, we present an approach to remove the change in the observed relative-gravity differences caused by hydrologic or other transient processes during a single campaign, so that the adjusted gravity values can be referenced to a single epoch. The conceptual approach is an example of coupled hydrogeophysical inversion, by which a hydrologic model is used to inform and constrain the geophysical forward model. The hydrologic model simulates the spatial variation of the rate of change of gravity as either a linear function of distance from an infiltration source, or using a 3-D numerical groundwater model. The linear function can be included in and solved for as part of the network adjustment. Alternatively, the groundwater model is used to predict the change of gravity at each station through time, from which the accumulated gravity change is calculated and removed from the data prior to the network adjustment. Data from a field experiment conducted at an artificial-recharge facility are used to verify our approach. Maximum gravity change due to hydrology (observed using a superconducting gravimeter) during the relative-gravity field campaigns was up to 2.6 μGal d−1, each campaign was between 4 and 6 d and one month elapsed between campaigns. The maximum absolute difference in the estimated gravity change between two campaigns, two months apart, using the standard network adjustment method and the new approach, was 5.5 μGal. The maximum gravity change between the same two campaigns was 148 μGal, and spatial variation in gravity change revealed zones of preferential infiltration and areas of relatively

  20. Current and Proposed Regulations Related to Minimum Risk Pesticides

    EPA Pesticide Factsheets

    Minimum risk pesticides are exempted from requirements for registration with EPA but are still subject to certain criteria to qualify as minimum risk and may be further regulated by states. See links to the key regulatory citations.

  1. How social position of origin relates to intelligence and level of education when adjusting for attained social position.

    PubMed

    Sorjonen, Kimmo; Hemmingsson, Tomas; Lundin, Andreas; Melin, Bo

    2011-06-01

    Intelligence and its relationship to achievement is a classical question within psychology. In accordance with earlier British studies, the present study, based on conscription data and follow-ups for Swedish men born 1949-51 (N = 36,156), found that when adjusting for attained social position, people with a high social position of origin tend to have higher intelligence and level of education than people with a lower social position of origin. These results could be seen to contradict the claim that more merit, at least when operationalized as intelligence or education, is required from people with a low social position of origin in order to attain a certain social level.

  2. Australian Adolescents' Perceptions of Health-Related Risks.

    ERIC Educational Resources Information Center

    Moore, Susan M.; Rosenthal, Doreen A.

    1992-01-01

    Evaluates the perceptions of adolescents (n=189) of their risks and ascertains the relationship between risk perception and actual risky behavior in five areas: AIDS, STDs, serious car accidents, lung cancer, and skin cancer. Results indicated that although late-adolescent students underestimated risk behavior, they were able to make judgments…

  3. Circadian Clock-Related Genetic Risk Scores and Risk of Placental Abruption

    PubMed Central

    Qiu, Chunfang; Gelaye, Bizu; Denis, Marie; Tadesse, Mahlet G.; Fernandez, Miguel Angel Luque; Enquobahrie, Daniel A.; Ananth, Cande V.; Sanchez, Sixto E.; Williams, Michelle A.

    2016-01-01

    Introduction The circadian clock plays an important role in several aspects of female reproductive biology. Evidence linking circadian clock-related genes to pregnancy outcomes has been inconsistent. We sought to examine whether variations in single nucleotide polymorphisms (SNPs) of circadian clock genes are associated with PA risk. Methods Maternal blood samples were collected from 470 PA case and 473 controls. Genotyping was performed using the Illumina Cardio-MetaboChip platform. We examined 119 SNPs in 13 candidate genes known to control circadian rhythms (e.g., CRY2, ARNTL, and RORA). Univariate and penalized logistic regression models were fit to estimate odds ratios (ORs); and the combined effect of multiple SNPs on PA risk was estimated using a weighted genetic risk score (wGRS). Results A common SNP in the RORA gene (rs2899663) was associated with a 21% reduced odds of PA (P<0.05). The odds of PA increased with increasing wGRS (Ptrend< 0.001). The corresponding ORs were 1.00, 1.83, 2.81 and 5.13 across wGRS quartiles. Participants in the highest wGRS quartile had a 5.13-fold (95% confidence interval: 3.21–8.21) higher odds of PA compared to those in the lowest quartile. Although the test for interaction was not significant, the odds of PA was substantially elevated for preeclamptics with the highest wGRS quartile (OR=14.44, 95%CI: 6.62–31.53) compared to normotensive women in the lowest wGRS quartile. Discussion Genetic variants in circadian rhythm genes may be associated with PA risk. Larger studies are needed to corroborate these findings and to further elucidate the pathogenesis of this important obstetrical complication. PMID:26515929

  4. Binge drinking among adolescents: prevalence, risk practices and related variables.

    PubMed

    Golpe, Sandra; Isorna, Manuel; Barreiro, Carmen; Braña, Teresa; Rial, Antonio

    2017-01-12

    According to the last Survey on Drug Use among Secondary School Students (ESTUDES 2014-2015), consumption levels of alcohol and other substances have decreased in the last years in Spain. However, available data on binge drinking remain worrying, given the negative consequences related with this pattern. The aim of this paper is to analyse binge drinking among adolescents, providing updated data on prevalence in addition to information about the consequences and some predictive factors of binge drinking. A correlational method was used for this purpose, comprised of administering a survey to Compulsory Secondary School, High School and Vocational Training students. Based on a sample of 3,419 Galician adolescents aged between 12 and 18 years (M = 14.57; SD = 1.76), the results show that binge drinking is a common and global practice, with few socio-demographic differences but related with a wide range of risk practices. Furthermore, variables such as consumption expectancies, consumption by family and friends, as well as curfew time and allowance money have been identified as interesting predictive factors that should be taken into account at the preventive level.

  5. Excimer laser coronary angioplasty: relative risk analysis of clinical results

    NASA Astrophysics Data System (ADS)

    Bittl, John A.

    1992-08-01

    Reports of successful use of excimer laser coronary angioplasty for complex coronary artery disease abound, yet firm indications for its use have not been defined. We attempted to treat 858 coronary stenoses in 764 consecutive patients (mean age 61 years; range 32 - 91 years; 75% men; 76% with Class III or IV angina) with excimer laser angioplasty at 308 nm. Successful treatment was achieved in 86% of patients, as indicated by relative risk analysis. This showed that certain angiographic features, such as lesions at a vessel bifurcation (odds ratio, OR equals 0.46; 95% confidence interval 0.23, 0.88; P equals 0.017;) or in a tortuous segment (OR equals 0.54; 95% CI equals 0.34, 0.88; P equals 0.041), have decreased likelihood of clinical success. On the other hand, ostial stenoses (OR equals 1.06; 95% CI equals 0.44, 2.56, P equals 0.903) and saphenous vein graft lesions (OR equals 2.17; 95% CI equals 0.98, 4.82; P equals 0.051) have acceptable success rates. Diffuse disease (> 20 mm), total occlusions and calcified lesions were treated as successfully as all other lesion types. Successful treatment with excimer laser coronary angioplasty was also achieved in almost all patients (15/16) who had a prior unsuccessful attempt at balloon angioplasty in the lesion was crossed with a guidewire yet resists either balloon catheter passage or full dilatation. Follow-up angiography was obtained in 70% of eligible patients. Angiographic restenosis, defined by > 50% stenosis, was seen in 60% of patients. Relative risk analysis showed an increased risk of restenosis when adjunctive balloon angioplasty was not used (OR equals 1.68; 95% CI equals 1.02, 2.28; P equals 0.039). Other variables known to affect the outcome of balloon angioplasty, such as lesion length or stenosis in degenerated saphenous vein bypass graft, did not influence the

  6. [Harm related to medical device use - legal and organisational risks].

    PubMed

    Hölscher, U M

    2014-12-01

    The effectiveness of the risk management systems established by medical device manufacturers and health-care facilities is clearly mitigated by European and national legal provisions. Laws, regulations and authorities prevent the systematic exchange of much safety-relevant information. The obligation to report adverse events is suspended for many relevant risks associated with medical device use. Reporting into the vigilance system is of little avail for users. Reporting even may endanger the information provider. The federal fragmentation of the German vigilance system poses a risk for patients. Risk management in health-care facilities without risk policy is dangerously incomplete.

  7. Relative risk perception for terrorism: implications for preparedness and risk communication.

    PubMed

    Caponecchia, Carlo

    2012-09-01

    Terrorism presents a significant risk that is often approached at public policy, infrastructure, or emergency management level. Public perceptions of the likelihood of terrorist events, and how this may relate to individual preparedness, are not always extensively examined. The tendency to think that negative events are less likely to happen to oneself than to the average person is known as optimism bias. Optimism bias is relevant to perceptions of terrorism, because it is thought to be related to a reduction in precaution use. Using an online survey of 164 participants, this study aimed to determine whether Sydney residents thought they had a lower likelihood of experiencing terrorist events than other Australians. Significant optimism bias was observed for witnessing terrorist events, but not for personally experiencing terrorist events. In addition, Sydney residents tended to think that terrorist attacks were more likely to occur in Sydney than another major Australian city in the next five years. At the same time, household and workplace preparedness for terrorism was quite low, as was awareness of emergency strategies in the central business district. Perceptions of high likelihood of terrorism happening in one's own city, yet low preparedness present a challenge for risk communication and emergency management strategies. The diversity of possible terrorist targets, and the simple plans that can moderate the effects of a disaster may need to be emphasized in future anti-terrorism initiatives.

  8. Relative cancer risks of chemical contaminants in the great lakes

    NASA Astrophysics Data System (ADS)

    Bro, Kenneth M.; Sonzogni, William C.; Hanson, Mark E.

    1987-08-01

    Anyone who drinks water or eats fish from the Great Lakes consumes potentially carcinogenic chemicals. In choosing how to respond to such pollution, it is important to put the risks these contaminants pose in perspective. Based on recent measurements of carcinogens in Great Lakes fish and water, calculations of lifetime risks of cancer indicate that consumers of sport fish face cancer risks from Great Lakes contaminants that are several orders of magnitude higher than the risks posed by drinking Great Lakes water. But drinking urban groundwater and breathing urban air may be as hazardous as frequent consumption of sport fish from the Great Lakes. Making such comparisons is difficult because of variation in types and quality of information available and in the methods for estimating risk. Much uncertainty pervades the risk assessment process in such areas as estimating carcinogenic potency and human exposure to contaminants. If risk assessment is to be made more useful, it is important to quantify this uncertainty.

  9. Response bias, weighting adjustments, and design effects in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    PubMed

    Kessler, Ronald C; Heeringa, Steven G; Colpe, Lisa J; Fullerton, Carol S; Gebler, Nancy; Hwang, Irving; Naifeh, James A; Nock, Matthew K; Sampson, Nancy A; Schoenbaum, Michael; Zaslavsky, Alan M; Stein, Murray B; Ursano, Robert J

    2013-12-01

    The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi-component epidemiological and neurobiological study designed to generate actionable recommendations to reduce US Army suicides and increase knowledge about determinants of suicidality. Three Army STARRS component studies are large-scale surveys: one of new soldiers prior to beginning Basic Combat Training (BCT; n = 50,765 completed self-administered questionnaires); another of other soldiers exclusive of those in BCT (n = 35,372); and a third of three Brigade Combat Teams about to deploy to Afghanistan who are being followed multiple times after returning from deployment (n = 9421). Although the response rates in these surveys are quite good (72.0-90.8%), questions can be raised about sample biases in estimating prevalence of mental disorders and suicidality, the main outcomes of the surveys based on evidence that people in the general population with mental disorders are under-represented in community surveys. This paper presents the results of analyses designed to determine whether such bias exists in the Army STARRS surveys and, if so, to develop weights to correct for these biases. Data are also presented on sample inefficiencies introduced by weighting and sample clustering and on analyses of the trade-off between bias and efficiency in weight trimming.

  10. Response bias, weighting adjustments, and design effects in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

    PubMed Central

    Kessler, Ronald C.; Heeringa, Steven G.; Colpe, Lisa J.; Fullerton, Carol S.; Gebler, Nancy; Hwang, Irving; Naifeh, James A.; Nock, Matthew K.; Sampson, Nancy A.; Schoenbaum, Michael; Zaslavsky, Alan M.; Stein, Murray B.; Ursano, Robert J.

    2014-01-01

    The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi-component epidemiological and neurobiological study designed to generate actionable recommendations to reduce U.S. Army suicides and increase knowledge about determinants of suicidality. Three Army STARRS component studies are large-scale surveys: one of new soldiers prior to beginning Basic Combat Training (BCT; n=50,765 completed self-administered questionnaires); another of other soldiers exclusive of those in BCT (n=35,372); and a third of three Brigade Combat Teams about to deploy to Afghanistan who are being followed multiple times after returning from deployment (n= 9,421). Although the response rates in these surveys are quite good (72.0-90.8%), questions can be raised about sample biases in estimating prevalence of mental disorders and suicidality, the main outcomes of the surveys based on evidence that people in the general population with mental disorders are under-represented in community surveys. This paper presents the results of analyses designed to determine whether such bias exists in the Army STARRS surveys and, if so, to develop weights to correct for these biases. Data are also presented on sample inefficiencies introduced by weighting and sample clustering and on analyses of the trade-off between bias and efficiency in weight trimming. PMID:24318218

  11. About some aspects of weather related risks in Spanish Agriculture

    NASA Astrophysics Data System (ADS)

    Anton, J. M.; Tarquis, A. M.; Grau, J. B.; Saa, A.; Diaz, M. C.

    2009-04-01

    aggressive floods in 1500-1800 era, and actual added trends of "climate change" are towards higher temperatures, less water and higher perturbations. These long term risks are rather poorly predictable and will be handled mostly by improvements in agriculture and also by social and economic adaptations, but at shorter delays and specific areas active policies are possible and exist. An agribusiness can set his production plans lowering his global risk. Sometimes it might use prudently some financial instruments, such as "orange juice futures". When using decision making models, some utility functions may consider that severe losses have higher effects than good profits, letting ranges for business margins for insurers to be limited by concurrence at correct levels. Correct availability of credits is necessary for bad periods, and also state policies for rare bad situations, concerning agribusiness survival and also alimentary safety. Insurance products are effective aids for a growing variety of well definite natural risks, such as in cases of hailstorm, that have probabilities of occurrence measurable from previous events data, and a variety of adequate professional models are continuously made for them. Related to Universidad Politecnica de Madrid the CEIGRAM institute has started recently and is involved in agricultural insurance, being connected with insurers through ENESA and AGROMUTUA. That world is active, important, evolving, and is regulated by diverse laws.

  12. Relative risk site evaluations for Yakima Training Center

    SciTech Connect

    Smith, R.M.; Whelan, G.

    1996-11-01

    All 20 U.S. Army Yakima Training Center (YTC) sites evaluated were given a `low` relative risk. At Solid Waste Management Unit (SWMU) 22, a `minimum` soils contaminant hazard factor was assigned even though 6,700 mg/kg TPH-diesel was found in surface soil. SWMU 22 is physically located on top of and with the fence surrounding Area of Concern (AOC) 4. Because the diesel is most likely associated with AOC 4, and plans are to clean up AOC 4, any further actions regarding these contaminated soils should be addressed as part of the planned actions for AOC 4. Contaminant hazard factors of `moderate` were assigned to the soil pathway for SWMUs 4 and 7 because dieldrin and arsenic, respectively, were found in surface soil samples at concentrations exceeding standards. A `moderate` contaminant hazard factor was also assigned to the sediment pathway for AOC 1 because arsenic detected in sediments in `Larry`s Swimming Pool` exceeded the standard. All other contaminant hazard factors were rated as minimal. The receptor factor for all sites and pathways was rated `limited,` except for SWMU 54 in which the groundwater receptor factor was rated `potential.` A `potential` rating was assigned to the groundwater pathway at this site to be conservative. The site is located on the south side of the syncline axis where the unconfined aquifer may be present and there are no monitoring wells at the site to confirm or deny the presence of groundwater contamination.

  13. Sex-related alcohol expectancies and high-risk sexual behavior among drinking adults in Kampala, Uganda

    PubMed Central

    Nash, Scott D.; Katamba, Achilles; Mafigiri, David Kaawa; Mbulaiteye, Sam M.; Sethi, Ajay K

    2015-01-01

    Alcohol consumption, a risk factor for HIV transmission in sub-Saharan Africa, is considered high in Uganda. The study was conducted to determine whether sex-related expectations about the effects of alcohol help explain the association between alcohol use and risky sexual behaviors in a population-based sample of adults in Kampala. A two-stage sampling procedure was used to identify residents in one division of Kampala for a cross-sectional study. Associations between alcohol use (current and higher-risk drinking) and high-risk sexual behaviors (multiple regular partners and casual sex) were tested. Final models included a sex-related alcohol outcome expectancy (AOE) summary score. In age-sex-adjusted models, having multiple regular partners was associated with current drinking (Odds Ratio (OR)=2.76, 95% Confidence Intervals (CI)=1.15, 6.63) and higher-risk drinking (OR=3.35, 95%CI=1.28,8.71). Associations were similar but not statistically significant for having a causal sex partner. Sex-related AOE were associated with both alcohol use and high-risk sexual behavior and attenuated relationships between multiple regular partners and both current drinking (OR=1.94, 95%CI=0.57,6.73) and higher-risk drinking (OR=2.44, 95%CI=0.68,8.80). In this setting sexual behaviors related with alcohol consumption were explained, in part, by sex-related expectations about the effects of alcohol. These expectations could be an important component to target in HIV education campaigns. PMID:26315308

  14. Plasma lutein and zeaxanthin and the risk of age-related nuclear cataract among the elderly Finnish population.

    PubMed

    Karppi, Jouni; Laukkanen, Jari A; Kurl, Sudhir

    2012-07-14

    Oxidative stress plays an important role in cataractogenesis. Previous studies have shown that long-term dietary intake of antioxidants (lutein and zeaxanthin) may decrease the risk of age-related cataracts. The aim of the present study was to examine whether plasma concentrations of lutein and zeaxanthin are related to age-related nuclear cataract in the elderly population. Subjects were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study and they were classified into tertiles according to plasma concentrations of lutein and zeaxanthin. The association of plasma lutein and zeaxanthin concentrations with age-related nuclear cataract in 1689 elderly subjects (aged 61-80 years) was investigated in the present cross-sectional study by using the Cox proportional hazards model. A total of 113 cases of incident age-related cataracts were confirmed, of which 108 cases were nuclear cataracts. After adjustment for age, examination year, sex, BMI, smoking, alcohol consumption, serum LDL-cholesterol, serum HDL-cholesterol, years of education, use of oral corticosteroids, history of diabetes and history of hypertension with current use of antihypertensive medication, subjects in the highest tertiles of plasma concentrations of lutein and zeaxanthin had 42 and 41 % lower risks of nuclear cataract, respectively, compared with those in the lowest tertiles (relative risk (RR) = 0·58, 95 % CI 0·35, 0·98; P = 0·041 for lutein and RR = 0·59, 95 % CI 0·35, 0·99; P = 0·046 for zeaxanthin). In conclusion, we suggest that high plasma concentrations of lutein and zeaxanthin were associated with a decreased risk of age-related nuclear cataract in the elderly population.

  15. Improved in silico prediction of carcinogenic potency (TD50) and the risk specific dose (RSD) adjusted Threshold of Toxicological Concern (TTC) for genotoxic chemicals and pharmaceutical impurities.

    PubMed

    Contrera, Joseph F

    2011-02-01

    The Threshold of Toxicological Concern (TTC) is a level of exposure to a genotoxic impurity that is considered to represent a negligible risk to humans. The TTC was derived from the results of rodent carcinogenicity TD50 values that are a measure of carcinogenic potency. The TTC currently sets a default limit of 1.5 μg/day in food contact substances and pharmaceuticals for all genotoxic impurities without carcinogenicity data. Bercu et al. (2010) used the QSAR predicted TD50 to calculate a risk specific dose (RSD) which is a carcinogenic potency adjusted TTC for genotoxic impurities. This promising approach is currently limited by the software used, a combination of MC4PC (www.multicase.com) and a Lilly Inc. in-house software (VISDOM) that is not available to the public. In this report the TD50 and RSD were predicted using a commercially available software, SciQSAR (formally MDL-QSAR, www.scimatics.com) employing the same TD50 training data set and external validation test set that was used by Bercu et al. (2010). The results demonstrate the general applicability of QSAR predicted TD50 values to determine the RSDs for genotoxic impurities and the improved performance of SciQSAR for predicting TD50 values.

  16. Early Adolescents' Unique Perspectives of Maternal and Paternal Rejection: Examining Their Across-Dyad Generalizability and Relations with Adjustment 1 Year Later.

    PubMed

    Jager, Justin; Mahler, Alissa; An, Danming; Putnick, Diane L; Bornstein, Marc H; Lansford, Jennifer E; Dodge, Kenneth A; Skinner, Ann T; Deater-Deckard, Kirby

    2016-10-01

    Parental rejection is linked to deep and enduring adjustment problems during adolescence. This study aims to further clarify this relation by demonstrating what has long been posited by parental acceptance/rejection theory but never validated empirically-namely that adolescents' unique or subjective experience of parental rejection independently informs their future adjustment. Among a longitudinal, multi-informant sample of 161 families (early adolescents were 47 % female and 40 % European American) this study utilized a multitrait-multimethod confirmatory factor analysis to isolate for each early adolescent-parent dyad, the adolescent's distinct view of parental rejection (i.e., the adolescent unique perspective) from the portion of his or her view that overlaps with his or her parent's view. The findings indicated that adolescents' unique perspectives of maternal rejection were not differentiated from their unique perspectives of paternal rejection. Also, consistent with parental acceptance-rejection theory, early adolescents' unique perspectives of parental rejection were associated with worse adjustment (internalizing and externalizing) 1 year later. This study further demonstrates the utility and validity of the multitrait-multimethod confirmatory factor analysis approach for identifying and examining adolescent unique perspectives. Both conceptually and analytically, this study also integrates research focused on unique perspectives with a distinct but related line of research focused on discrepancies in perspectives.

  17. Phytohormone profiling in relation to osmotic adjustment in NaCl-treated plants of the halophyte tomato wild relative species Solanum chilense comparatively to the cultivated glycophyte Solanum lycopersicum.

    PubMed

    Gharbi, Emna; Martínez, Juan-Pablo; Benahmed, Hela; Hichri, Imène; Dobrev, Petre I; Motyka, Václav; Quinet, Muriel; Lutts, Stanley

    2017-05-01

    A holistic approach was used to investigate the hormonal profile in relation with osmotic adjustment under salinity in Solanum lycopersicum and its halophyte wild relative Solanum chilense. Plants were subjected to 125mM NaCl for 7days. Solanum chilense displayed a contrasting behaviour comparatively to S. lycopersicum, not only for mineral nutrition, but also regarding the modalities of osmotic adjustment and phytohormonal profiling. The extent of osmotic adjustment was higher in S. chilense than in S. lycopersicum. Ions K(+) and Na(+) were the major contributors of osmotic adjustment in S. chilense, accounting respectively for 47 and 60% of osmotic potential. In contrast the contributions of proline and soluble sugars remained marginal for the two species although salt-induced accumulation of proline was higher in S. lycopersicum than in S. chilense. Both species also differed for their hormonal status under salinity and concentrations of most hormonal compounds were higher in S. chilense than in S. lycopersicum. Interestingly, salicylic acid, ethylene and cytokinins were positively correlated with osmotic potential in S. chilense under salinity while these hormones were negatively correlated with osmotic adjustment in S. lycopersicum. Our results suggested that the capacity to use inorganic ions as osmotica may improve salt resistance in S.chilense and that phytohormones could be involved in this process.

  18. RELATIVE PROLIFERATION RISKS FOR NUCLEAR FUEL LEASING ARRANGEMENT

    SciTech Connect

    CHENG,L.Y.; YUE, M.; BARI, R.A.

    2007-10-01

    The present study demonstrates a probabilistic approach to quantify the proliferation risks of fuel leasing and recycling. A Markov model approach is applied to evaluate the probability of proliferation success by diversion or theft. Proliferation risk is calculated as a product of the probability of success and the corresponding consequences.

  19. Development of Relative Risk Model for Regional Groundwater Risk Assessment: A Case Study in the Lower Liaohe River Plain, China

    PubMed Central

    Li, Xianbo; Zuo, Rui; Teng, Yanguo; Wang, Jinsheng; Wang, Bin

    2015-01-01

    Increasing pressure on water supply worldwide, especially in arid areas, has resulted in groundwater overexploitation and contamination, and subsequent deterioration of the groundwater quality and threats to public health. Environmental risk assessment of regional groundwater is an important tool for groundwater protection. This study presents a new approach for assessing the environmental risk assessment of regional groundwater. It was carried out with a relative risk model (RRM) coupled with a series of indices, such as a groundwater vulnerability index, which includes receptor analysis, risk source analysis, risk exposure and hazard analysis, risk characterization, and management of groundwater. The risk map is a product of the probability of environmental contamination and impact. The reliability of the RRM was verified using Monte Carlo analysis. This approach was applied to the lower Liaohe River Plain (LLRP), northeastern China, which covers 23604 km2. A spatial analysis tool within GIS which was used to interpolate and manipulate the data to develop environmental risk maps of regional groundwater, divided the level of risk from high to low into five ranks (V, IV, III, II, I). The results indicate that areas of relative risk rank (RRR) V cover 2324 km2, covering 9.8% of the area; RRR IV covers 3986 km2, accounting for 16.9% of the area. It is a new and appropriate method for regional groundwater resource management and land use planning, and is a rapid and effective tool for improving strategic decision making to protect groundwater and reduce environmental risk. PMID:26020518

  20. Novelty seeking is related to individual risk preference and brain activation associated with risk prediction during decision making

    PubMed Central

    Wang, Ying; Liu, Ying; Yang, Lizhuang; Gu, Feng; Li, Xiaoming; Zha, Rujing; Wei, Zhengde; Pei, Yakun; Zhang, Peng; Zhou, Yifeng; Zhang, Xiaochu

    2015-01-01

    Novelty seeking (NS) is a personality trait reflecting excitement in response to novel stimuli. High NS is usually a predictor of risky behaviour such as drug abuse. However, the relationships between NS and risk-related cognitive processes, including individual risk preference and the brain activation associated with risk prediction, remain elusive. In this fMRI study, participants completed the Tridimensional Personality Questionnaire to measure NS and performed a probabilistic decision making task. Using a mathematical model, we estimated individual risk preference. Brain regions associated with risk prediction were determined via fMRI. The NS score showed a positive correlation with risk preference and a negative correlation with the activation elicited by risk prediction in the right posterior insula (r-PI), left anterior insula (l-AI), right striatum (r-striatum) and supplementary motor area (SMA). Within these brain regions, only the activation associated with risk prediction in the r-PI showed a correlation with NS after controlling for the effect of risk preference. Resting-state functional connectivity between the r-PI and r-striatum/l-AI was negatively correlated with NS. Our results suggest that high NS may be associated with less aversion to risk and that the r-PI plays an important role in relating risk prediction to NS. PMID:26065910

  1. Development of relative risk model for regional groundwater risk assessment: a case study in the lower Liaohe River Plain, China.

    PubMed

    Li, Xianbo; Zuo, Rui; Teng, Yanguo; Wang, Jinsheng; Wang, Bin

    2015-01-01

    Increasing pressure on water supply worldwide, especially in arid areas, has resulted in groundwater overexploitation and contamination, and subsequent deterioration of the groundwater quality and threats to public health. Environmental risk assessment of regional groundwater is an important tool for groundwater protection. This study presents a new approach for assessing the environmental risk assessment of regional groundwater. It was carried out with a relative risk model (RRM) coupled with a series of indices, such as a groundwater vulnerability index, which includes receptor analysis, risk source analysis, risk exposure and hazard analysis, risk characterization, and management of groundwater. The risk map is a product of the probability of environmental contamination and impact. The reliability of the RRM was verified using Monte Carlo analysis. This approach was applied to the lower Liaohe River Plain (LLRP), northeastern China, which covers 23604 km2. A spatial analysis tool within GIS which was used to interpolate and manipulate the data to develop environmental risk maps of regional groundwater, divided the level of risk from high to low into five ranks (V, IV, III, II, I). The results indicate that areas of relative risk rank (RRR) V cover 2324 km2, covering 9.8% of the area; RRR IV covers 3986 km2, accounting for 16.9% of the area. It is a new and appropriate method for regional groundwater resource management and land use planning, and is a rapid and effective tool for improving strategic decision making to protect groundwater and reduce environmental risk.

  2. Risk of Placental Abruption in Relation to Maternal Depressive, Anxiety and Stress Symptoms

    PubMed Central

    de Paz, Nicole C.; Sanchez, Sixto E.; Huaman, Luis E.; Chang, Guillermo Diez; Pacora, Percy N.; Garcia, Pedro J.; Ananth, Cande V.; Qiu, Chungfang; Williams, Michelle A.

    2010-01-01

    Background Little is known about the influence of psychiatric factors on the etiology of placental abruption (PA), an obstetrical condition that complicates 1-2% of pregnancies. We examined the risk of AP in relation to maternal psychiatric symptoms during pregnancy. Methods This case-control study included 373 AP cases and 368 controls delivered at five medical centers in Lima, Peru. Depressive, anxiety and stress symptoms were assessed using the Patient Health Questionnaire (PHQ-9) and the Depression Anxiety Stress Scales (DASS-21). Multivariable logistic regression models were fit to calculate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for confounders. Results Depressive symptoms of increasing severity (using the DASS depression subscale) was associated with AP (p for trend=0.02). Compared with women with no depressive symptoms, the aOR (95%CI) for AP associated with each level of severity of depression symptoms based on the DASS assessment were as follows: mild 1.84 (0.91-3.74); moderate 1.25 (0.67-2.33); and severe 4.68 (0.98-22.4). The corresponding ORs for mild, moderate, and moderately severe depressive symptoms based on the PHQ assessment were 1.10 (0.79-1.54), 3.31 (1.45-7.57), and 5.01 (1.06-23.6), respectively. A positive gradient was observed for the odds of AP with severity of anxiety (p for trend=0.002) and stress symptoms (p for trend=0.002). Limitations These cross-sectionally collected data may be subject to recall bias. Conclusions Maternal psychiatric disorders may be associated with an increased occurrence of AP. Larger studies that allow for more precise evaluations of maternal psychiatric health in relation to AP risk are warranted. PMID:20692040

  3. Shaft adjuster

    DOEpatents

    Harry, H.H.

    1988-03-11

    Abstract and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus. 3 figs.

  4. Shaft adjuster

    DOEpatents

    Harry, Herbert H.

    1989-01-01

    Apparatus and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus.

  5. 7 CFR 331.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Registration and related security risk assessments... AGENTS AND TOXINS § 331.7 Registration and related security risk assessments. (a) Unless exempted under... be approved by the Administrator or the HHS Secretary based on a security risk assessment by...

  6. 7 CFR 331.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 5 2014-01-01 2014-01-01 false Registration and related security risk assessments... AGENTS AND TOXINS § 331.7 Registration and related security risk assessments. (a) Unless exempted under... be approved by the Administrator or the HHS Secretary based on a security risk assessment by...

  7. 7 CFR 331.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 5 2013-01-01 2013-01-01 false Registration and related security risk assessments... AGENTS AND TOXINS § 331.7 Registration and related security risk assessments. (a) Unless exempted under... be approved by the Administrator or the HHS Secretary based on a security risk assessment by...

  8. A homocysteine metabolism-related dietary pattern and the risk of coronary heart disease in two independent German study populations.

    PubMed

    Weikert, Cornelia; Hoffmann, Kurt; Dierkes, Jutta; Zyriax, Birgit-Christiane; Klipstein-Grobusch, Kerstin; Schulze, Matthias B; Jung, Roman; Windler, Eberhard; Boeing, Heiner

    2005-08-01

    A biomarker profile of high folate and vitamin B-12 and low plasma homocysteine concentrations reduces the risk of coronary heart disease (CHD) and may be linked to diet. The objectives of the present study were to identify a food pattern related to these biomarkers and to examine its association with CHD risk. Dietary patterns related to biomarker plasma concentrations were constructed from data obtained in the Coronary Risk Factors for Atherosclerosis in Women (CORA) Study (200 cases; 255 controls) using the reduced rank regression statistical method. Risks for CHD with relation to the identified pattern were estimated in the CORA study and in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study with 157 cases of incident myocardial infarction among 26,795 participants. In these 2 German study populations, whole-grain bread, fresh fruit, olive oil, mushrooms, cruciferous vegetables, wine, and nuts contributed the most positively and fried potatoes the most negatively to a dietary pattern that was directly associated with both plasma folate and vitamin B-12 concentrations, but inversely with plasma homocysteine. Multivariate-adjusted relative risks for CHD across increasing quintiles of the food pattern score were 1.0, 0.55, 0.52, 0.58, 0.39 (P for trend = 0.05) in the case-control sample and 1.0, 0.95, 0.75, 0.56, 0.72 (P for trend = 0.041) in the prospective study. The combination of a high intake of whole-grain bread, fresh fruit, olive oil, mushrooms, cruciferous vegetables, wine, and nuts with a low intake of fried potatoes was associated with a favorable biomarker profile of homocysteine metabolism and reduced risk of CHD.

  9. Relation of C-reactive protein, fibrinogen, and cardiorespiratory fitness to risk of systemic hypertension in men.

    PubMed

    Jae, Sae Young; Kurl, Sudhir; Laukkanen, Jari A; Lee, Chong-Do; Choi, Yoon-Ho; Fernhall, Bo; Franklin, Barry A

    2015-06-15

    We investigated the relation between inflammation and incident hypertension, independent of obesity, and tested the associations of cardiorespiratory fitness (fitness) and indexes of inflammation for the development of hypertension in 2,475 normotensive men. Inflammatory markers were C-reactive protein (CRP) and fibrinogen. Fitness was directly measured by peak oxygen uptake during sign/symptom-limited treadmill exercise testing to volitional fatigue; 266 men (10.7%) developed hypertension during an average of 4 years follow-up. After adjusting for potential confounding variables, the relative risk (RR) and 95% confidence interval (CI) for incident hypertension in those in the upper tertile versus lower tertile were 1.55 (95% CI 1.15 to 2.09) for CRP and 1.51 (95% CI 1.10 to 2.06) for fibrinogen. Although the association between fibrinogen and incident hypertension persisted after adjusting for body mass index (p = 0.049), the relation between CRP and incident hypertension was no longer statistically significant (p = 0.08). Fit men had a 27% decreased (RR 0.73, 95% CI 0.56 to 0.94) risk of incident hypertension compared with unfit men in a multivariable adjusted model. In the joint analysis, unfit men with upper CRP had 1.81 times (95% CI 1.21 to 2.70) and unfit men with upper fibrinogen had 2.03 times (95% CI 1.33 to 3.12) greater risks of incident hypertension compared with fit men with low CRP and fibrinogen, respectively. However, these risks did not significantly increase in fit men with upper CRP (RR 1.12, 95% CI 0.76 to 1.63) and fibrinogen (RR 1.26, 95% CI 0.86 to 1.85) groups. In conclusion, these results suggest that heightened levels of fibrinogen, but not CRP, are associated with incident hypertension, independent of body weight, and that high fitness attenuates the risk of incident hypertension across upper levels of inflammatory markers in men.

  10. Quantification of diarrhea risk related to wastewater contact in Thailand.

    PubMed

    Ferrer, Aleix; Nguyen-Viet, Hung; Zinsstag, Jakob

    2012-03-01

    Wastewater reuse contributes to closing the nutrient recycling loop as a sustainable way of managing water resources. Bangkok has over a thousand man-made drainage and irrigation canals for such purposes. Its use for agricultural and recreational purposes has a long tradition in rural and peri-urban areas. However, the continuation of these practices is increasingly questioned since potential health risks are an issue if such practices are not appropriately managed. The microbial and chemical quality of canal water has considerably deteriorated over the last decade, mainly because of discharged, untreated domestic and industrial wastewater. It is important to understand the health risks of wastewater reuse and identify risky behaviors from the most highly exposed actors promote the safe use of wastewater. This study assessed diarrhea infection risks caused by the use of and contact with wastewater in Klong Luang municipality, a peri-urban setting in Northern Bangkok, using quantitative microbial risk assessment. Wastewater samples were collected from canals, sewers at household level, and vegetables grown in the canals for consumption. Samples were also collected from irrigation water from the agricultural fields. Two protozoa, Giardia lamblia and Entamoeba histolytica, were quantified and analyzed by real-time PCR, exposure assessment was conducted, and finally, the risk of infection due to contact with wastewater in different scenarios was calculated. The results showed that canal water and vegetables were heavily contaminated with G. lamblia and E. histolytica. Infection risk was high in tested scenarios and largely exceeded the acceptable risk given by WHO guidelines.

  11. Dietary protein and fat intake in relation to risk of colorectal adenoma in Korean.

    PubMed

    Yang, Sun Young; Kim, Young Sun; Lee, Jung Eun; Seol, Jueun; Song, Ji Hyun; Chung, Goh Eun; Yim, Jeong Yoon; Lim, Sun Hee; Kim, Joo Sung

    2016-12-01

    Consumption of red meat and alcohol are known risk factors for colorectal cancer, but associations for dietary fat remain unclear. We investigated the associations of dietary fat, protein, and energy intake with prevalence of colorectal adenoma.We performed a prospective cross-sectional study on asymptomatic persons who underwent a screening colonoscopy at a single center during a routine health check-up from May to December 2011. Dietary data were obtained via a validated Food Frequency Questionnaire (FFQ), assisted by a registered dietician. We also obtained information on alcohol consumption and smoking status, and measured metabolic syndrome markers including abdominal circumference, blood pressure, fasting glucose, serum triglyceride and high-density lipoprotein cholesterol. We calculated odds ratio (OR) and 95% confidence interval (CI) to evaluate the associations using the polytomous logistic regression models. As a secondary analysis, we also conducted a matched analysis, matched by age and sex (557 cases and 557 non-cases).The study sample included 557 cases (406 males and 151 females) with histopathologically confirmed colorectal adenoma, and 1157 controls (650 males and 507 females). The proportion of advanced adenoma was 28.1% of men and 18.5% of female, respectively. Although vegetable protein intake was inversely associated with the prevalence of colorectal adenoma, further adjustment for potential confounding factors attenuated the association, resulting in no significant associations. There were no significant associations between dietary fat intake and colorectal adenoma in energy-adjusted models. For vegetable protein in women, the OR for the comparison of those in the highest tertile with those in the lowest tertile was 0.47 (95% CI 0.25-0.91, P for trend = 0.07) after adjustment for total energy intake. However, after controlling for metabolic syndrome markers, body mass index, smoking status, alcohol consumption, and family history of

  12. Dietary protein and fat intake in relation to risk of colorectal adenoma in Korean

    PubMed Central

    Yang, Sun Young; Kim, Young Sun; Lee, Jung Eun; Seol, Jueun; Song, Ji Hyun; Chung, Goh Eun; Yim, Jeong Yoon; Lim, Sun Hee; Kim, Joo Sung

    2016-01-01

    Abstract Consumption of red meat and alcohol are known risk factors for colorectal cancer, but associations for dietary fat remain unclear. We investigated the associations of dietary fat, protein, and energy intake with prevalence of colorectal adenoma. We performed a prospective cross-sectional study on asymptomatic persons who underwent a screening colonoscopy at a single center during a routine health check-up from May to December 2011. Dietary data were obtained via a validated Food Frequency Questionnaire (FFQ), assisted by a registered dietician. We also obtained information on alcohol consumption and smoking status, and measured metabolic syndrome markers including abdominal circumference, blood pressure, fasting glucose, serum triglyceride and high-density lipoprotein cholesterol. We calculated odds ratio (OR) and 95% confidence interval (CI) to evaluate the associations using the polytomous logistic regression models. As a secondary analysis, we also conducted a matched analysis, matched by age and sex (557 cases and 557 non-cases). The study sample included 557 cases (406 males and 151 females) with histopathologically confirmed colorectal adenoma, and 1157 controls (650 males and 507 females). The proportion of advanced adenoma was 28.1% of men and 18.5% of female, respectively. Although vegetable protein intake was inversely associated with the prevalence of colorectal adenoma, further adjustment for potential confounding factors attenuated the association, resulting in no significant associations. There were no significant associations between dietary fat intake and colorectal adenoma in energy-adjusted models. For vegetable protein in women, the OR for the comparison of those in the highest tertile with those in the lowest tertile was 0.47 (95% CI 0.25–0.91, P for trend = 0.07) after adjustment for total energy intake. However, after controlling for metabolic syndrome markers, body mass index, smoking status, alcohol consumption, and family history

  13. Parental Knowledge as a Mediator of the Relation between Adolescent Summer Care Arrangement Configurations and Adjustment the Following School Year

    ERIC Educational Resources Information Center

    Parente, Maria E.; Sheppard, Adam; Mahoney, Joseph L.

    2012-01-01

    Through secondary data analysis of a nationally representative sample, the study explored the relations between adolescent summer arrangements and associated developmental outcomes (well-being, externalizing behavior, body mass index, and academic performance). The study also examined if these relations were mediated by parental knowledge of youth…

  14. The Role of Preschool Relational and Physical Aggression in the Transition to Kindergarten: Links with Social-Psychological Adjustment

    ERIC Educational Resources Information Center

    Gower, Amy L.; Lingras, Katherine A.; Mathieson, Lindsay C.; Kawabata, Yoshito; Crick, Nicki R.

    2014-01-01

    Research Findings: The transition to kindergarten has important ramifications for future achievement and psychosocial outcomes. Research suggests that physical aggression may be related to difficulty during school transitions, yet no studies to date have examined the role of relational aggression in these transitions. This article examines how…

  15. Adjustability of the circadian clock in the cockroaches: a comparative study of two closely related species, Blattella germanica and Blattella bisignata.

    PubMed

    Wei, Y S; Lee, H J

    2001-09-01

    A single 2h light pulse (250 lux) was given at various times to phase shift the locomotor circadian rhythm of two species of closely related cockroaches, Blattella bisignata and Blatella germanica. The phase-response curve (PRC) of both species showed a similar pattern. Phase delays and advances were induced by light pulse during the early and late subjective night, respectively, while no clear phase shifting was elicited during the subjective day. However, the magnitude of the phase delay (1.89h +/- 0.66h) and advance (0.69h +/- 0.36h) of B. bisignata was significantly larger than that of B. germanica (0.78h +/- 0.38h and 0.35h +/- 0.18h, respectively). This result indicates the superior adjustability of the circadian clock in B. bisignata. The period-response curve (PdRC) was also constructed for both species. Although both species did not show great flexibility in circadian period changes, the phase shifts were significantly correlated with the period changes in the advance zone of B. bisignata (r = 0.72, P < .1). This allowed the circadian clock of B. bisignata to display better entrainability since the phase advance adjustment was significantly more difficult than that of phase delay. The results indicate the overall adjustability of the circadian clock of B. germanica is inferior to that of B. bisignata. The significance of this finding is discussed from an ecological perspective.

  16. Prevention of stress-related ulcer bleeding at the intensive care unit: Risks and benefits of stress ulcer prophylaxis

    PubMed Central

    Buendgens, Lukas; Koch, Alexander; Tacke, Frank

    2016-01-01

    Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (ICU). It poses a risk of clinically relevant upper gastrointestinal (GI) bleeding. Therefore, stress ulcer prophylaxis (SUP) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors (PPI) and, less effectively, histamine 2 receptor antagonists (H2RA) prevent GI bleeding in critically ill patients in the ICU. However, the routine use of pharmacological SUP does not reduce overall mortality in ICU patients. Moreover, recent studies revealed that SUP in the ICU might be associated with potential harm such as an increased risk of infectious complications, especially nosocomial pneumonia and Clostridium difficile-associated diarrhea. Additionally, special populations such as patients with liver cirrhosis may even have an increased mortality rate if treated with PPI. Likewise, PPI can be toxic for both the liver and the bone marrow, and some PPI show clinically relevant interactions with important other drugs like clopidogrel. Therefore, the agent of choice, the specific balance of risks and benefits for individual patients as well as the possible dose of PPI has to be chosen carefully. Alternatives to PPI prophylaxis include H2RA and/or sucralfate. Instead of routine SUP, further trials should investigate risk-adjusted algorithms, balancing benefits and threats of SUP medication in the ICU. PMID:26855894

  17. Mapping Heat-related Risks for Community-based Adaptation Planning under Uncertainty

    NASA Astrophysics Data System (ADS)

    Bai, Yingjiu; Kaneko, Ikuyo; Kobayashi, Hikaru; Kurihara, Kazuo; Sasaki, Hidetaka; Murata, Akihiko; Takayabu, Izuru

    2016-04-01

    Climate change is leading to more frequent and intense heat waves. Recently, epidemiologic findings on heat-related health impacts have reinforced our understanding of the mortality impacts of extreme heat. This research has several aims: 1) to promote climate prediction services with spatial and temporal information on heat-related risks, using GIS (Geographical Information System), and digital mapping techniques; 2) to propose a visualization approach to articulating the evolution of local heat-health responses over time and the evaluation of new interventions for the implementation of valid community-based adaptation strategies and reliable actionable planning; and 3) to provide an appropriate and simple method of adjusting bias and quantifying the uncertainty in future outcomes, so that regional climate projections may be transcribed into useful forms for a wide variety of different users. Following the 2003 European heat wave, climatologists, medical specialists, and social scientists expedited efforts to revise and integrate risk governance frameworks for communities to take appropriate and effective actions themselves. Recently, the Coupled Model Intercomparison Project (CMIP) methodology has made projections possible for anyone wanting to openly access state-of-the-art climate model outputs and climate data to provide the backbone for decisions. Furthermore, the latest high-solution regional climate model (RCM) has been a huge increase in the volumes of data available. In this study, we used high-quality hourly projections (5-km resolution) from the Non-Hydrostatic Regional Climate Model (NHRCM-5km), following the SRES-A1B scenario developed by the Meteorological Research Institute (MRI) and observational data from the Automated Meteorological Data Acquisition System, Japan Meteorological Agency (JMA). The NHRCM-5km is a dynamic downscaling of results from the MRI-AGCM3.2S (20-km resolution), an atmospheric general circulation model (AGCM) driven by the

  18. Improving Results of Elective Abdominal Aortic Aneurysm Repair at a Low-Volume Hospital by Risk-Adjusted Selection of Treatment in the Endovascular Era

    SciTech Connect

    Wibmer, Andreas; Meyer, Bernhard; Albrecht, Thomas; Buhr, Heinz-Johannes; Kruschewski, Martin

    2009-09-15

    open repair was reduced from 8.5% to 3.7% (p = 0.414). In conclusion, by risk-adjusted selection of treatment and frequent application of EVAR, it is possible to improve perioperative outcome of elective AAA repair at a low-volume hospital. Mortality figures are similar to those of recent trials at high-volume centers, as reported in the literature.

  19. [Risk communication of the Federal Institute for Risk Assessment during a food-related outbreak].

    PubMed

    Lohmann, M; Epp, A; Röder, B; Böl, G-F

    2013-01-01

    Information about and explanation of risks as well as the initiation of behavioral changes and preventive actions are core tasks of risk communication. During the EHEC/HUS outbreak in spring 2011, the governmental agencies responsible for risk communication mainly focused on these tasks. In general, risk communication is understood as a continuous, long-term process that aims at an adequate handling of risks. In contrast, crisis communication is focused rather on an acute event and aims at timely information and behavioral measures. During the EHEC/HUS outbreak, risk communication partly changed over to crisis communication. The risk communication activities of the Federal Institute for Risk Assessment (Bundesinstitüt für Risikobewertung, BfR) during the EHEC/HUS outbreak are presented here. The results of a representative survey that was conducted in Germany shortly after the outbreak show details of the success of these risk communication activities. Finally, the necessity of communication about scientific uncertainty is addressed and new ways in risk communication with regard to new media are highlighted.

  20. Sexual risk related behaviour among youth living with HIV in central Uganda: implications for HIV prevention

    PubMed Central

    Ankunda, Racheal; Atuyambe, Lynn Muhimbuura; Kiwanuka, Noah

    2016-01-01

    Introduction As young people living with HIV grow their sexual behaviour and it's implication on HIV prevention is of concern. This study describes the sexual risk related-behaviours and factors associated with abstinence among Youth Living with HIV in central Uganda. Methods We conducted a cross-sectional study among 338 unmarried youth between 15 and 24 years accessing HIV care in central Uganda. Data was collected using interviewer administered structured questionnaires. Adjusted prevalence proportion ratios (adj. PPRs) of factors associated with sexual abstinence for at least six months were determined by multivariable log-binomial regression. Results Overall, 79% (269/338) of respondents were abstaining from sexual intercourse for atleast six months, although, 45% (150/338) had ever been sexually active. Of the 283 respondents who desired to get married in future, 40% preferred negative marriage partners. Only 31% (39/126) of respondents in boy/girl relationships had disclosed their HIV status to their partners. Among those currently sexually active (n = 69), 57% did not consistently use condoms and 30% had more than one sexual partner in the past six months. The adj.PRR of abstinence was higher among youth between 15 and 19 years compared to those between 20 and 24 years (adj. PPR = 1.26, 95% CI; 1.08-1.46). The prevalence of abstinence was significantly lower among respondent who consumed alcohol (adj. PPR = 0.31, 95% CI 0.16-0.61). Conclusion Tailored interventions promoting disclosure, consistent condoms use and discouraging alcohol consumption among sero-positive youth could reduce HIV transmission risk. PMID:27642390

  1. Behavioral economic decision making and alcohol-related sexual risk behavior.

    PubMed

    MacKillop, James; Celio, Mark A; Mastroleo, Nadine R; Kahler, Christopher W; Operario, Don; Colby, Suzanne M; Barnett, Nancy P; Monti, Peter M

    2015-03-01

    The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.

  2. Risk factors for liver-related mortality in chronic hepatitis C patients: A deceased case-living control study

    PubMed Central

    Zeng, Qing-Lei; Feng, Guo-Hua; Zhang, Ji-Yuan; Chen, Yan; Yang, Bin; Huang, Hui-Huang; Zhang, Xue-Xiu; Zhang, Zheng; Wang, Fu-Sheng

    2014-01-01

    AIM: To investigate the risk factors for liver-related mortality in chronic hepatitis C (CHC) patients. METHODS: All deceased CHC inpatient data were collected from the Beijing 302 Hospital clinical database, which includes more than 8250 CHC inpatients during the period from 2002 to 2012. The controls were matched to cases by age (± 2 years), sex and date of hospital admission (within the same year). Potential risk factors were included for the evaluation, and odds ratios (OR) and 95%CI were estimated using univariate (unadjusted) and multivariate (adjusted OR, AOR) conditional logistic regression. All statistical tests were two-sided. P values < 0.05 were considered statistically significant. RESULTS: Based on examinations of 144 CHC-related deceased cases and 576 controls, we found that antiviral therapy with interferon-α was associated with a 47% decrease in the risk of hepatic mortality (AOR = 0.53, 95%CI: 0.28-0.99, P = 0.048). Additionally, the initial diagnostic stage of the disease (AOR = 2.89, 95%CI: 1.83-4.56 and P < 0.001 for liver cirrhosis/AOR = 8.82, 95%CI: 3.99-19.53 and P < 0.001 for HCC compared with CHC), diabetes (AOR = 2.35, 95%CI: 1.40-3.95, P = 0.001), hypertension (AOR = 1.76, 95%CI: 1.09-2.82, P = 0.020), alcohol consumption (AOR = 1.73, 95%CI: 1.03-2.81, P = 0.037) and HBsAg positivity (AOR = 22.28, 95%CI: 5.58-89.07, P < 0.001) were associated with a significant increase in the risk of liver-related mortality in CHC patients. CONCLUSION: This study indicates that interferon-α treatment, the stage at the initial diagnosis of the disease and comorbidities are all independent risk factors for liver-related mortality in CHC patients. PMID:24833882

  3. Chronic and Acute Relational Risk Factors for Dating Aggression in Adolescence and Young Adulthood.

    PubMed

    Collibee, Charlene; Furman, Wyndol

    2016-04-01

    Dating aggression is a prevalent and costly public health concern. Using a relational risk framework, this study examined acute and chronic relational risk factors (negative interactions, jealousy, support, and relationship satisfaction) and their effects on physical and psychological dating aggression. The study also examined the interaction between chronic and acute risk, allowing us to assess how changes in acute risk have differing effects depending on whether the individual is typically at higher chronic risk. A sample of 200 youth (100 female) completed seven waves of data, which spanned 9 years from middle adolescence to young adulthood (M age at Wave 1 = 15.83). Using hierarchical linear modeling, analyses revealed both acute (within-person) and chronic (between-person) levels in jealousy, negative interactions, and relationship satisfaction, were associated with physical and psychological dating aggression. Significant interactions between chronic and acute risk emerged in predicting physical aggression for negative interactions, jealousy, and relationship satisfaction such that those with higher levels of chronic risk are more vulnerable to increases in acute risk. These interactions between chronic and acute risk indicate that risk is not static, and dating aggression is particularly likely to occur at certain times for youth at high risk for dating aggression. Such periods of increased risk may provide opportunities for interventions to be particularly effective in preventing dating aggression or its consequences. Taken together, these findings provide support for the role of relational risk factors for dating aggression. They also underscore the importance of considering risk dynamically.

  4. The Relations of Temperament Reactivity and Effortful Control to Children's Adjustment Problems in China and the United States

    ERIC Educational Resources Information Center

    Zhou, Qing; Lengua, Liliana J.; Wang, Yun

    2009-01-01

    The relations of parents' and teachers' reports of temperament anger-irritability, positive emotionality, and effortful control (attention focusing and inhibitory control) to children's externalizing and internalizing problems were examined in Chinese (N = 382) and U.S. (N = 322) samples of school-age children. Results suggested that in both…

  5. Discrimination and Adjustment for Mexican American Adolescents: A Prospective Examination of the Benefits of Culturally Related Values

    ERIC Educational Resources Information Center

    Berkel, Cady; Knight, George P.; Zeiders, Katharine H.; Tein, Jenn-Yun; Roosa, Mark W.; Gonzales, Nancy A.; Saenz, Delia

    2010-01-01

    Mexican American adolescents face disparities in mental health and academic achievement, perhaps in part because of discrimination experiences. However, culturally related values, fostered by ethnic pride and socialization, may serve to mitigate the negative impact of discrimination. Guided by the Stress Process Model, the current study examined…

  6. Risk factors for work-related symptoms in northern California office workers

    SciTech Connect

    Mendell, M.J.

    1991-10-01

    In most episodes of health complaints reported in office buildings in the last-twenty years, causal factors have not been identified. In order to assess risk factors for work-related symptoms in office workers, a reanalysis was performed of previous studies, and an epidemiologic study was conducted. The reanalysis of data, showed remarkable agreement among studies. Air-conditioned buildings were consistently associated with higher prevalence of headache, lethargy, and eye, nose, or throat problems. Humidification was not a necessary factor for this higher prevalence. Mechanical ventilation without air-conditioning was not associated with higher symptom prevalence. A study was conducted among 880 office workers, within 12 office buildings selected without regard to worker complaints, in northern California. A number of factors were found associated with prevalence of work-related symptoms, after adjustment in a logistic regression model for personal, psychosocial, job, workspace, and building factors. Two different ventilation types were associated with increases Ln symptom prevalence, relative to workers in naturally ventilated buildings: mechanical supply and exhaust ventilation, without air conditioning and with operable windows; and air-conditioning with sealed windows. No study buildings were humidified. In both these ventilation types, the highest odds ratios (ORs) found were for skin symptoms (ORs-5.0, 5.6) and for tight chest or difficulty breathing (ORs-3.6, 4.3). Use of carbonless copies or photocopiers, sharing a workspace, carpets, new carpets, new walls, and distance from a window were associated with symptom increases. Cloth partitions and new paint were associated with symptom decreases.

  7. The evolution of risk perceptions related to bovine spongiform encephalopathy--Canadian consumer and producer behavior.

    PubMed

    Yang, Jun; Goddard, Ellen

    2011-01-01

    In this study the dynamics of risk perceptions related to bovine spongiform encephalopathy (BSE) held by Canadian consumers and cow-calf producers were evaluated. Since the first domestic case of BSE in 2003, Canadian consumers and cow-calf producers have needed to make decisions on whether or not their purchasing/production behavior should change. Such changes in their behavior may relate to their levels of risk perceptions about BSE, risk perceptions that may be evolving over time and be affected by BSE media information available. An econometric analysis of the behavior of consumers and cow-calf producers might identify the impacts of evolving BSE risk perceptions. Risk perceptions related to BSE are evaluated through observed market behavior, an approach that differs from traditional stated preference approaches to eliciting risk perceptions at a particular point in time. BSE risk perceptions may be specified following a Social Amplification of Risk Framework (SARF) derived from sociology, psychology, and economics. Based on the SARF, various quality and quantity indices related to BSE media information are used as explanatory variables in risk perception equations. Risk perceptions are approximated using a predictive difference approach as defined by Liu et al. (1998). Results showed that Canadian consumer and cow-calf producer risk perceptions related to BSE have been amplified or attenuated by both quantity and quality of BSE media information. Government policies on risk communications need to address the different roles of BSE information in Canadian consumers' and cow-calf producers' behavior.

  8. A comparison of methods for the construction of confidence interval for relative risk in stratified matched-pair designs.

    PubMed

    Tang, Nian-Sheng; Li, Hui-Qiong; Tang, Man-Lai

    2010-01-15

    A stratified matched-pair study is often designed for adjusting a confounding effect or effect of different trails/centers/ groups in modern medical studies. The relative risk is one of the most frequently used indices in comparing efficiency of two treatments in clinical trials. In this paper, we propose seven confidence interval estimators for the common relative risk and three simultaneous confidence interval estimators for the relative risks in stratified matched-pair designs. The performance of the proposed methods is evaluated with respect to their type I error rates, powers, coverage probabilities, and expected widths. Our empirical results show that the percentile bootstrap confidence interval and bootstrap-resampling-based Bonferroni simultaneous confidence interval behave satisfactorily for small to large sample sizes in the sense that (i) their empirical coverage probabilities can be well controlled around the pre-specified nominal confidence level with reasonably shorter confidence widths; and (ii) the empirical type I error rates of their associated test statistics are generally closer to the pre-specified nominal level with larger powers. They are hence recommended. Two real examples from clinical laboratory studies are used to illustrate the proposed methodologies.

  9. National Security Implications of Climate-related Risks and a Changing Climate

    DTIC Science & Technology

    2015-07-23

    23 July 2015 1 NATIONAL SECURITY IMPLICATIONS OF CLIMATE -RELATED RISKS AND A CHANGING CLIMATE This report responds to the...COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE National Security Implications of Climate -related Risks and a Changing Climate 5a. CONTRACT...Response to Congressional Inquiry on National Security Implications of Climate -Related Risks and a Changing Climate July 2015 Elements of

  10. Epigenetics: a tool to understand diet-related cardiovascular risk?

    PubMed

    Zaina, Silvio; Lund, Gertrud

    2011-01-01

    Cardiovascular disease (CVD) is a leading cause of mortality and is projected to hold its grim record as developing countries increase their wealth. Since specific nutritional habits are important risk factors for CVD, it is imperative to understand how ingredients of risk-associated diets convert a healthy cellular transcriptional program into a pathological one. Epigenetics has enriched our view of the genome by showing that DNA-associated regulatory proteins and RNAs, together with chemical modifications of the DNA itself, determine which parts of the DNA chain are transcribed or silent in a given phase of a cell's life. This complex biological entity--the epigenome--accounts for the enormous phenotypic diversity within a multicellular organism despite its unicellular origin. Crucially, the epigenome can be modified by diet and other exogenous factors, thus suggesting that epigenetic mechanisms might underlie pathological responses to CVD risk factors. Here, we will review the current knowledge of epigenetic mechanisms in diet-gene interactions and propose ways in which epigenetics might clarify the impact of genetic variants on CVD risk.

  11. Longitudinal Relations between Parent-Child Conflict and Children’s Adjustment: The Role of Children’s Sleep

    PubMed Central

    Kelly, Ryan J.; Marks, Brian T.; El-Sheikh, Mona

    2014-01-01

    Sleep was examined as a process variable in relations between verbal and physical parent-child conflict and change in children’s internalizing and externalizing symptoms over time. Participants were 282 children at T1 (M age = 9.44 years; 48% girls), 280 children at T2 (M age = 10.41 years), and 275 children at T3 (M age = 11.35 years). Children reported on parent-child conflict, sleep was assessed with actigraphy, and parents reported on children’s internalizing and externalizing symptoms. Autoregressive effects for sleep and internalizing and externalizing symptoms were controlled to examine change over time. Supportive of intervening processes, physical parent-child conflict at T1 and increased change in internalizing and externalizing symptoms at T3 were indirectly related through their shared association with reduced sleep continuity (efficiency, long wake episodes) at T2. Findings build on a small but growing literature and highlight the importance of considering the role of sleep among relations between family conflict and child development. PMID:24634010

  12. The association between health-related behaviours and the risk of divorce in the USA.

    PubMed

    Fu, H; Goldman, N

    2000-01-01

    This study investigates the link between health-related variables and risks of divorce. The findings indicate that physical characteristics associated with poor health--namely, obesity and short stature--are not significantly related to risks of marital dissolution for either men or women. On the other hand, risk-taking behaviours--such as smoking and drug use--are strongly related to higher risks of divorce for both sexes. Overall, the results emphasize the need to accommodate health-related variables in the dominant economic and social psychological theories of marital dissolution.

  13. Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women.

    PubMed Central

    Cochran, S D; Mays, V M; Bowen, D; Gage, S; Bybee, D; Roberts, S J; Goldstein, R S; Robison, A; Rankow, E J; White, J

    2001-01-01

    OBJECTIVES: This study examined whether lesbians are at increased risk for certain cancers as a result of an accumulation of behavioral risk factors and difficulties in accessing health care. METHODS: Prevalence estimates of behavioral risk factors (nulliparity, obesity, smoking, and alcohol use), cancer screening behaviors, and self-reported breast cancer histories derived from 7 independently conducted surveys of lesbians/bisexual women (n = 11,876) were compared with national estimates for women. RESULTS: In comparison with adjusted estimates for the US female population, lesbians/bisexual women exhibited greater prevalence rates of obesity, alcohol use, and tobacco use and lower rates of parity and birth control pill use. These women were also less likely to have health insurance coverage or to have had a recent pelvic examination or mammogram. Self-reported histories of breast cancer, however, did not differ from adjusted US female population estimates. CONCLUSIONS: Lesbians and bisexual women differ from heterosexual women in patterns of health risk. These women would be expected to be at especially greater risk for chronic diseases linked to smoking and obesity. PMID:11291371

  14. Dietary compound score and risk of age-related macular degeneration in the Age-Related Eye Disease Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Purpose: Because foods provide many nutrients, which may interact with each other to modify risk for multifactorial diseases such as age-related macular degeneration (AMD), we sought to develop a composite scoring system to summarize the combined effect of multiple dietary nutrients on AMD risk. Th...

  15. [Eco-physiological responses and related adjustment mechanisms of Artemisia ordosica and Caragana korshinskii under different configuration modes to precipitation variation].

    PubMed

    Zhou, Hai-Yan; Wang, Ying-Jue; Fan, Fan; Fan, Heng-Wen

    2013-01-01

    This paper studied the community characteristics of two sand-fixing plants (Artemisia ordosica and Caragana korshinskii) under different configuration modes (1 m x 1 m and 2 m x 2 m) in the Shapotou region of Northwest China as well as the water relation, gas exchange, and their adjustment mechanisms of the plants under natural and artificial precipitation conditions. With the variation of soil water content, the physiological water consumption and growth characteristics of A. ordosica differed from those of C. korshinskii. A. ordosica presented obvious fluctuation in the stomatal conductance, water potential, transpiration rate, photosynthetic rate, and rapid growth, and had higher water consumption than C. korshinskii. However, the variations of the above-mentioned indices of C. korshinskii were relatively slow and more constant. The C. korshinskii had a lower photosynthetic rate but a very high accumulated biomass over years than A. ordosica. The response procedures and adjustment mechanisms of the two plants under water stress differed, with a water-conserving mechanism for A. ordosica and a water-saving mechanism for C. korshinskii. In extremely drought years, the C. korshinskii had stronger capabilities of water-saving and stress tolerance than A. ordosica. It was suggested that the selection of sand-fixing plants should have a view to the benefits in water saving and sand fixation, and also, to the stability of sand-fixing forest.

  16. Early Adolescents' Perceptions of Relative Risk from 10 Societal and Environmental Hazards.

    ERIC Educational Resources Information Center

    Riechard, Donald E.; McGarrity, Jean

    1994-01-01

    In this exploratory study, perceptions of relative risk held by 120 early adolescents (11-14 years) were examined for 10 hazards: wild animals, fire, nuclear energy, pollution, storms, war, car accidents, people, no food, and drugs. Dissonance was found between perceptions of risk and computed risk associated with factual data. (LZ)

  17. 42 CFR 73.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Registration and related security risk assessments... Secretary or Administrator based on a security risk assessment by the Attorney General: (i) The individual... public accredited academic institutions, are exempt from the security risk assessments for the entity...

  18. 42 CFR 73.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Registration and related security risk assessments... Secretary or Administrator based on a security risk assessment by the Attorney General: (i) The individual... public accredited academic institutions, are exempt from the security risk assessments for the entity...

  19. 42 CFR 73.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Registration and related security risk assessments... Secretary or Administrator based on a security risk assessment by the Attorney General: (i) The individual... public accredited academic institutions, are exempt from the security risk assessments for the entity...

  20. 42 CFR 73.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Registration and related security risk assessments... Secretary or Administrator based on a security risk assessment by the Attorney General: (i) The individual... public accredited academic institutions, are exempt from the security risk assessments for the entity...