ECOLOGICAL RISK ASSESSMENT: PROTECTING NORTHWEST ANADROMOUS SALMONID STOCKS

EPA Science Inventory

Ecological risk assessment is usually defined as the process that evaluates the likelihood that adverse ecological effects are occurring, or may occur, as a result of exposure to one or mare stressors. he basic concept, while straightforward, is difficult to apply. trong reaction...

The Basics of Risk Assessment to Protect Human Health and the Environment

EPA Science Inventory

Risk assessment is the evaluation to determine the chance of harmful effects to human health or ecological systems resulting from exposure to an environmental stressor. A stressor is any physical, chemical, or biological entity that can induce an adverse response. Stressors may a...

A novel method of fuzzy fault tree analysis combined with VB program to identify and assess the risk of coal dust explosions

PubMed Central

Li, Jia; Wang, Deming; Huang, Zonghou

2017-01-01

Coal dust explosions (CDE) are one of the main threats to the occupational safety of coal miners. Aiming to identify and assess the risk of CDE, this paper proposes a novel method of fuzzy fault tree analysis combined with the Visual Basic (VB) program. In this methodology, various potential causes of the CDE are identified and a CDE fault tree is constructed. To overcome drawbacks from the lack of exact probability data for the basic events, fuzzy set theory is employed and the probability data of each basic event is treated as intuitionistic trapezoidal fuzzy numbers. In addition, a new approach for calculating the weighting of each expert is also introduced in this paper to reduce the error during the expert elicitation process. Specifically, an in-depth quantitative analysis of the fuzzy fault tree, such as the importance measure of the basic events and the cut sets, and the CDE occurrence probability is given to assess the explosion risk and acquire more details of the CDE. The VB program is applied to simplify the analysis process. A case study and analysis is provided to illustrate the effectiveness of this proposed method, and some suggestions are given to take preventive measures in advance and avoid CDE accidents. PMID:28793348

A novel method of fuzzy fault tree analysis combined with VB program to identify and assess the risk of coal dust explosions.

PubMed

Wang, Hetang; Li, Jia; Wang, Deming; Huang, Zonghou

2017-01-01

Coal dust explosions (CDE) are one of the main threats to the occupational safety of coal miners. Aiming to identify and assess the risk of CDE, this paper proposes a novel method of fuzzy fault tree analysis combined with the Visual Basic (VB) program. In this methodology, various potential causes of the CDE are identified and a CDE fault tree is constructed. To overcome drawbacks from the lack of exact probability data for the basic events, fuzzy set theory is employed and the probability data of each basic event is treated as intuitionistic trapezoidal fuzzy numbers. In addition, a new approach for calculating the weighting of each expert is also introduced in this paper to reduce the error during the expert elicitation process. Specifically, an in-depth quantitative analysis of the fuzzy fault tree, such as the importance measure of the basic events and the cut sets, and the CDE occurrence probability is given to assess the explosion risk and acquire more details of the CDE. The VB program is applied to simplify the analysis process. A case study and analysis is provided to illustrate the effectiveness of this proposed method, and some suggestions are given to take preventive measures in advance and avoid CDE accidents.

Promoting Service User Inclusion in Risk Assessment and Management: A Pilot Project Developing a Human Rights-Based Approach

ERIC Educational Resources Information Center

Greenhill, Beth; Whitehead, Richard

2011-01-01

Recent reports highlight the extent to which many people with learning disabilities are not afforded access to their basic human rights. In addition, traditional approaches to risk management often focus on professional assessments of risks and challenging behaviour and exclude service user perspectives. In this paper, we outline what we believe…

Basic CNC Operation. Training Workbook [and] Assessment and Training Guide [and] Hands-on Assessment.

ERIC Educational Resources Information Center

Anoka-Hennepin Technical Coll., Minneapolis, MN.

This workbook is intended for students taking a course in basic computer numerical control (CNC) operation that was developed during a project to retrain defense industry workers at risk of job loss or dislocation because of conversion of the defense industry. The workbook contains daily training guides for each of the course's 13 sessions. Among…

Associating Changes in the Immune System with Clinical Diseases for Interpretation in Risk Assessment##

EPA Science Inventory

This overview is a revision to the unit originally published in 2004. While the basic tenants of immunotoxicity have not changed in the past 10 years, several publications have explored the application of immunotoxicological data to the risk assessment process. Therefore, the goa...

Basic symptoms and the prediction of first-episode psychosis.

PubMed

Schultze-Lutter, Frauke; Ruhrmann, Stephan; Fusar-Poli, Paolo; Bechdolf, Andreas; Schimmelmann, Benno G; Klosterkötter, Joachim

2012-01-01

Recent focus on early detection and intervention in psychosis has renewed interest in subtle psychopathology beyond positive and negative symptoms. Such self-experienced sub-clinical disturbances are described in detail by the basic symptom concept. This review will give an introduction into the concept of basic symptoms and describe the development of the current instruments for their assessment, the Schizophrenia Proneness Instrument, Adult (SPI-A) and Child and Youth version (SPI-CY), as well as of the two at-risk criteria: the at-risk criterion Cognitive-Perceptive Basic Symptoms (COPER) and the high-risk criterion Cognitive Disturbances (COGDIS). Further, an overview of prospective studies using both or either basic symptom criteria and transition rates related to these will be given, and the potential benefit of combining ultra-high risk criteria, particularly attenuated psychotic symptoms, and basic symptom criteria will be discussed. Finally, their prevalence in psychosis patients, i.e. the sensitivity, as well as in general population samples will be described. It is concluded that both COPER and COGDIS are able to identify subjects at a high risk of developing psychosis. Further, they appear to be sufficiently frequent prior to onset of the first psychotic episode as well as sufficiently rare in persons of general population to be considered as valuable for an early detection of psychosis.

[Geriatric assessment. Development, status quo and perspectives].

PubMed

Lüttje, D; Varwig, D; Teigel, B; Gilhaus, B

2011-08-01

Multimorbidity is typical for geriatric patients. Problems not identified in time may lead to increased hospitalisation or prolonged hospital stay. Problems of multimorbidity are not covered by most guidelines or clinical pathways. The geriatric assessment supports standard clinical and technical assessment. Geriatric identification screening is basic for general practitioners and in emergency rooms to filter those patients bearing a special risk. Geriatric basic assessment covers most of the problems relevant for people in old age, revealing even problems that had so far been hidden. It permits to structure a comprehensive and holistic therapeutic approach and to evaluate the targets of treatment relevant for independent living and well-being. This results in reduction of morbidity and mortality. Assessment tools focusing on pain, nutrition and frailty should be added to the standardized geriatric basic assessment in Germany.

Randomized Controlled Trial of a Spring Break Intervention to Reduce High-Risk Drinking

PubMed Central

Lee, Christine M.; Neighbors, Clayton; Lewis, Melissa A.; Kaysen, Debra; Mittmann, Angela; Geisner, Irene M.; Atkins, David C.; Zheng, Cheng; Garberson, Lisa A.; Kilmer, Jason R.; Larimer, Mary E.

2014-01-01

Objective While recent studies have documented high-risk drinking occurring during Spring Break (SB), particularly on SB trips with friends, published intervention studies are few. The present study evaluated the efficacy of Event Specific Prevention (ESP) strategies for reducing SB drinking among college students, compared to general prevention strategies and an assessment-only control group, as well as evaluated inclusion of peers in interventions and mode of intervention delivery (in-person vs. web). Method Participants included 783 undergraduates (56.1% women, average age 20.5) intending to go on a SB trip with friends as well as to drink heavily on at least one day of SB. Participants completed assessments prior to SB and were randomized to one of five intervention conditions: SB in-person BASICS, SB web BASICS, SB in-person BASICS with friend, SB web BASICS with friend, general BASICS, or an attention control condition. Follow-up assessment was completed one week after SB. Results While the SB web BASICS (with and without friends) and general BASICS interventions were not effective at reducing SB drinking, results indicated significant intervention effects for SB in-person BASICS in reducing SB drinking, particularly on trip days. Follow-up analyses indicated change in descriptive norms mediated treatment effect and reductions in drinking, while SB drinking intentions and positive expectancies did not. Conclusions Overall, results suggest an in-person SB-specific intervention is effective at reducing SB drinking, especially during trips. In contrast, interventions that contain non-SB related content, are web-based, or seek to involve friends may be less effective at reducing SB drinking. PMID:24491072

[The frequency of risk factors for atherosclerosis in youth aged 16 and 18 years--students of upper-secondary schools in Poland].

PubMed

Jodkowska, Maria; Oblacińska, Anna; Mikiel-Kostyra, Krystyna; Tabak, Izabela

2012-01-01

1. To examine the prevalence of selected risk factors for atherosclerosis: overweight, tobacco smoking, low physical activity, psychological distress and type A personality (characterized by tenseness, impatience, competitiveness, and aggressiveness) in adolescents and to assess the frequency the coexistence of risk factors (≥3) in relation to gender, age and school type. A cross-sectional study was carried out in a representative sample of youth aged 16 and 18 years (N=2983) in 8 voivodeships in Poland. The frequency of five atherosclerosis risk factors and their coexistence (≥3) was examined using self-reported questionnaires, in relation to gender, age and school type. Logistic regression analyses were used to assess the influence of the variables (gender, age and school type) on odds ratios of risk factor coexistence. Low physical activity was the most common risk factor, statistically more frequent in students from Basic Vocational Schools than in other school types (p<0.05). In Basic Vocational Schools there was also the highest percentage of cigarette smokers (p<0.001). Psychological distress and type A behaviour were observed most frequently in students from General Upper Secondary Schools. The highest risk factor accumulation (≥3) was observed among students from Basic Vocational Schools (40%), significantly more frequent in girls than boys (47.5% and 37.5% respectively). Multivariable analyses show that students from Basic Vocational Schools had twice the odds (OR=2.25, p<0.001) to have the coexistence of risk factors for atherosclerosis as compared with students from General Upper Secondary Schools, girls had almost twice as many occurrences (OR=1.83, p<0.001) as boys and 18-year-olds 1.5 more than 16-year-olds (OR=1.46, p<0.001). 1. A significant difference in the prevalence of risk factors for atherosclerosis in youth from different school types requires precise definition of priority health promotion activities depending on school type. 2. Students from Basic Vocational Schools should be the target group for intervention aimed at reducing atherosclerosis risk factors.

Basic overview towards the assessment of landslide and subsidence risks along a geothermal pipeline network

NASA Astrophysics Data System (ADS)

Astisiasari; Van Westen, Cees; Jetten, Victor; van der Meer, Freek; Rahmawati Hizbaron, Dyah

2017-12-01

An operating geothermal power plant consists of installation units that work systematically in a network. The pipeline network connects various engineering structures, e.g. well pads, separator, scrubber, and power station, in the process of transferring geothermal fluids to generate electricity. Besides, a pipeline infrastructure also delivers the brine back to earth, through the injection well-pads. Despite of its important functions, a geothermal pipeline may bear a threat to its vicinity through a pipeline failure. The pipeline can be impacted by perilous events like landslides, earthquakes, and subsidence. The pipeline failure itself may relate to physical deterioration over time, e.g. due to corrosion and fatigue. The geothermal reservoirs are usually located in mountainous areas that are associated with steep slopes, complex geology, and weathered soil. Geothermal areas record a noteworthy number of disasters, especially due to landslide and subsidence. Therefore, a proper multi-risk assessment along the geothermal pipeline is required, particularly for these two types of hazard. This is also to mention that the impact on human fatality and injury is not presently discussed here. This paper aims to give a basic overview on the existing approaches for the assessment of multi-risk assessment along geothermal pipelines. It delivers basic principles on the analysis of risks and its contributing variables, in order to model the loss consequences. By considering the loss consequences, as well as the alternatives for mitigation measures, the environmental safety in geothermal working area could be enforced.

The WHO Green Page - Assessment of the Environmental Health Risks in Children.

PubMed

Kurpas, Donata; Church, Joseph; Mroczek, Bożena; Hans-Wytrychowska, Anna; Rudkowski, Zbigniew

2014-01-01

The objective of this study was to assess the possibility of implementation of the WHO Green Page as a tool to supplement basic medical interviews with environmental health risk factors for children. The WHO Green Page questionnaire was tested on parents of children who visited family practice doctors. A total of 159 parents took part in the study. It was noted that 24.3% of caregivers expressed concern about their children's environment without naming the risk factors. It was also found that 23.7% of the parents demonstrated knowledge and awareness of existing real environmental risks, and 7.0% of them stated that their children had sustained injuries in connection with road traffic prior to the questionnaire study. The WHO Green Page will provide additional information to the basic medical interview and, if regularly updated, will allow for monitoring of changing environmental conditions of children.

The WHO Green Page – Assessment of the Environmental Health Risks in Children

PubMed Central

Kurpas, Donata; Church, Joseph; Mroczek, Bożena; Hans-Wytrychowska, Anna; Rudkowski, Zbigniew

2013-01-01

Background: The objective of this study was to assess the possibility of implementation of the WHO Green Page as a tool to supplement basic medical interviews with environmental health risk factors for children. Methods: The WHO Green Page questionnaire was tested on parents of children who visited family practice doctors. Results: A total of 159 parents took part in the study. It was noted that 24.3% of caregivers expressed concern about their children’s environment without naming the risk factors. It was also found that 23.7% of the parents demonstrated knowledge and awareness of existing real environmental risks, and 7.0% of them stated that their children had sustained injuries in connection with road traffic prior to the questionnaire study. Conclusions: The WHO Green Page will provide additional information to the basic medical interview and, if regularly updated, will allow for monitoring of changing environmental conditions of children. PMID:25648271

Essentials of Risk Management. Strategic Decisions. Board Basics.

ERIC Educational Resources Information Center

Sonenstein, Burton; Kumin, Laura A.

1998-01-01

This booklet, intended for trustees of institutions of higher education, offers some instruction on the principles of risk management. Introductory information provides a definition of risk management, which is seen as a planning and strategic function, not solely as a financial or safety assessment. Individual sections then address the following…

Using risk assessment in periodontics.

PubMed

Woodman, Alan J

2014-08-01

Risk assessment has become a regular feature in both dental practice and society as a whole, and principles used to assess risk in society are similar to those used in a clinical setting. Although the concept of risk assessment as a prognostic indicator for periodontal disease incidence and activity is well established in the management of periodontitis, the use of risk assessment to manage the practical treatment of periodontitis and its sequelae appears to have less foundation. A simple system of initial risk assessment - building on the use of the Basic Periodontal Examination (BPE), clinical, medical and social factors - is described, linked to protocols for delivering care suited to general dental practice and stressing the role of long-term supportive care. The risks of not treating the patient are considered, together with the possible causes of failure, and the problems of successful treatment are illustrated by the practical management of post-treatment recession.

Analysis of Alternatives for Risk Assessment Methodologies and Tools

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

Nachtigal, Noel M.; Fruetel, Julia A.; Gleason, Nathaniel J.

The purpose of this document is to provide a basic overview and understanding of risk assessment methodologies and tools from the literature and to assess the suitability of these methodologies and tools for cyber risk assessment. Sandia National Laboratories (SNL) performed this review in support of risk modeling activities performed for the Stakeholder Engagement and Cyber Infrastructure Resilience (SECIR) division of the Department of Homeland Security (DHS) Office of Cybersecurity and Communications (CS&C). The set of methodologies and tools covered in this document is not intended to be exhaustive; instead, it focuses on those that are commonly used in themore » risk assessment community. The classification of methodologies and tools was performed by a group of analysts with experience in risk analysis and cybersecurity, and the resulting analysis of alternatives has been tailored to address the needs of a cyber risk assessment.« less

Nuclear detecting systems at LNL and LNS: foreseen experiments to provide basic data for heavy-ion risk assessment.

PubMed

Moroni, A; Abbondanno, U; Agodi, C; Alba, R; Ballarini, F; Bellia, G; Biaggi, M; Bruno, M; Casini, G; Cavallaro, S; Cherubini, R; Chiari, M; Colonna, N; Coniglione, R; D'Agostino, M; Del Zoppo, A; Giussani, A; Gramegna, F; Maiolino, C; Margagliotti, G V; Mastinu, P F; Migneco, E; Milazzo, P M; Nannini, A; Ordine, A; Ottolenghi, A; Piattelli, P; Santonocito, D; Sapienza, P; Vannini, G; Vannucci, L; Vardaci, E

2001-01-01

The use of existing detecting systems developed for nuclear physics studies allows collecting data on particle and ion production cross-sections in reactions induced by Oxygen and Carbon beams, of interest for hadrontherapy and heavy-ion risk assessment. The MULTICS and GARFIELD apparatus, together with the foreseen experiments, are reviewed.

Basic Information about EPA ExpoBox

EPA Pesticide Factsheets

EPA ExpoBox is a toolbox for exposure assessors. Its purpose is to provide a compendium of exposure assessment and risk characterization tools that will present comprehensive step-by-step guidance and links to relevant exposure assessment data bases,

Basic need satisfaction and suicidal ideation: a self-determination perspective on interpersonal suicide risk and suicidal thinking.

PubMed

Tucker, Raymond P; Wingate, LaRicka R

2014-01-01

This study investigated the relationship between the basic psychological needs, as outlined by self-determination theory, and the interpersonal predictors of suicidal desire, as outlined by the interpersonal-psychological theory of suicidal behavior. It was hypothesized that basic need satisfaction (collective feeling of autonomy, relatedness, and competence) would be related to suicidal ideation through thwarted belongingness and perceived burdensomeness. Mediation analyses demonstrated that thwarted belongingness and perceived burdensomeness both individually mediated the relationship between basic need satisfaction and suicidal ideation. Relatedness also predicted variance of the interaction of thwarted belongingness by perceived burdensomeness while controlling for depression. The clinical utility of assessing need satisfaction as an indication of suicide risk is discussed. Future research to investigate the temporal relationship of the study variables is recommended.

Information and problem report usage in system saftey engineering division

NASA Technical Reports Server (NTRS)

Morrissey, Stephen J.

1990-01-01

Five basic problems or question areas are examined. They are as follows: (1) Evaluate adequacy of current problem/performance data base; (2) Evaluate methods of performing trend analysis; (3) Methods and sources of data for probabilistic risk assessment; and (4) How is risk assessment documentation upgraded and/or updated. The fifth problem was to provide recommendations for each of the above four areas.

Essentials of finance for occupational physicians.

PubMed

Miller, K; Fallon, L F

2001-01-01

Comprehending the principles of finance is paramount to understanding the way an organization chooses to generate and use its financial resources. Financial principles may be employed in the same way a physician reviews fundamental systems to gauge a person s health. Just as basic anatomical and physiological components are used to assess the health of an individual, basic financial elements exist to ascertain the health of an organization. This chapter explains risk assessment, accounts receivable management, inventory, depreciation, capital formation, ratio analysis, and more.

Supplementary health insurance as a tool for risk-selection in mandatory basic health insurance markets.

PubMed

Paolucci, Francesco; Schut, Erik; Beck, Konstantin; Gress, Stefan; Van de Voorde, Carine; Zmora, Irit

2007-04-01

As the share of supplementary health insurance (SI) in health care finance is likely to grow, SI may become an increasingly attractive tool for risk-selection in basic health insurance (BI). In this paper, we develop a conceptual framework to assess the probability that insurers will use SI for favourable risk-selection in BI. We apply our framework to five countries in which risk-selection via SI is feasible: Belgium, Germany, Israel, the Netherlands, and Switzerland. For each country, we review the available evidence of SI being used as selection device. We find that the probability that SI is and will be used for risk-selection substantially varies across countries. Finally, we discuss several strategies for policy makers to reduce the chance that SI will be used for risk-selection in BI markets.

Risk perception and communication: lessons for the food and food packaging industry.

PubMed

Renn, O

2005-10-01

Health risks are front-page news. Be it bovine spongiform encephalitis (BSE), surface ozone, or radiation from transmitter stations or mobile phones, the popular press puts out a constant stream of risk warnings and sensational reports about potential health threats. This paper examines how the general public perceives and assesses such information when it comes to food and food packaging risks. In the first part, the basic components of food risks are discussed and then compared with the perceptions of these risks. The main emphasis is on the risks from food packaging. The term 'perception' as used in cognitive psychology applies to the mental processes through which a person takes in, deals with and assesses information from the environment (physical and communicative) via the senses. The last part of the paper deals with the consequences of risk assessment and risk perception for risk management and risk communication.

Comparison of two occurrence risk assessment methods for collapse gully erosion ——A case study in Guangdong province

NASA Astrophysics Data System (ADS)

Sun, K.; Cheng, D. B.; He, J. J.; Zhao, Y. L.

2018-02-01

Collapse gully erosion is a specific type of soil erosion in the red soil region of southern China, and early warning and prevention of the occurrence of collapse gully erosion is very important. Based on the idea of risk assessment, this research, taking Guangdong province as an example, adopt the information acquisition analysis and the logistic regression analysis, to discuss the feasibility for collapse gully erosion risk assessment in regional scale, and compare the applicability of the different risk assessment methods. The results show that in the Guangdong province, the risk degree of collapse gully erosion occurrence is high in northeastern and western area, and relatively low in southwestern and central part. The comparing analysis of the different risk assessment methods on collapse gully also indicated that the risk distribution patterns from the different methods were basically consistent. However, the accuracy of risk map from the information acquisition analysis method was slightly better than that from the logistic regression analysis method.

Final Report for the ZERT Project: Basic Science of Retention Issues, Risk Assessment & Measurement, Monitoring and Verification for Geologic Sequestration

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

Spangler, Lee; Cunningham, Alfred; Lageson, David

2011-03-31

ZERT has made major contributions to five main areas of sequestration science: improvement of computational tools; measurement and monitoring techniques to verify storage and track migration of CO{sub 2}; development of a comprehensive performance and risk assessment framework; fundamental geophysical, geochemical and hydrological investigations of CO{sub 2} storage; and investigate innovative, bio-based mitigation strategies.

Analytic concepts for assessing risk as applied to human space flight

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

Garrick, B J

Quantitative risk assessment (QRA) principles provide an effective framework for quantifying individual elements of risk, including the risk to astronauts and spacecraft of the radiation environment of space flight. The concept of QRA is based on a structured set of scenarios that could lead to different damage states initiated by either hardware failure, human error, or external events. In the context of a spacecraft risk assessment, radiation may be considered as an external event and analyzed in the same basic way as any other contributor to risk. It is possible to turn up the microscope on any particular contributor tomore » risk and ask more detailed questions than might be necessary to simply assess safety. The methods of QRA allow for as much fine structure in the analysis as is desired. For the purpose of developing a basis for comprehensive risk management and considering the tendency to {open_quotes}fear anything nuclear,{close_quotes} radiation risk is a prime candidate for examination beyond that necessary to answer the basic question of risk. Thus, rather than considering only the customary damage states of fatalities or loss of a spacecraft, it is suggested that the full range of damage be analyzed to quantify radiation risk. Radiation dose levels in the form of a risk curve accomplish such a result. If the risk curve is the complementary cumulative distribution function, then it answers the extended question of what is the likelihood of receiving a specific dose of radiation or greater. Such results can be converted to specific health effects as desired. Knowing the full range of the radiation risk of a space mission and the contributors to that risk provides the information necessary to take risk management actions [operational, design, scheduling of missions around solar particle events (SPE), etc.] that clearly control radiation exposure.« less

Left ventricular mass, blood pressure, and lowered cognitive performance in the Framingham offspring.

PubMed

Elias, Merrill F; Sullivan, Lisa M; Elias, Penelope K; D'Agostino, Ralph B; Wolf, Philip A; Seshadri, Sudha; Au, Rhoda; Benjamin, Emelia J; Vasan, Ramachandran S

2007-03-01

The purpose of this study was to determine whether echocardiographic left ventricular mass is related to cognitive performance beyond casual blood pressure adjusting for the influence of other vascular risk factors. We used multivariable regression analyses to relate left ventricular mass assessed at a routine examination (1995-1998) to measures of cognitive ability obtained routinely (1998-2001) in 1673 Framingham Offspring Study participants (56% women; mean age: 57 years) free from stroke, transient ischemic attack, and dementia. We adjusted for the following covariates hierarchically: (1) age, education, sex, body weight, height, interval between left ventricular mass measurement and neuropsychological testing (basic model); (2) basic model+blood pressure+treatment for hypertension; and (3) basic model+blood pressure+treatment for hypertension+vascular risk factors and prevalent cardiovascular disease. For the basic model, left ventricular mass was inversely associated with abstract reasoning (similarities), visual-spatial memory and organization, and verbal memory. For the basic model+blood pressure+treatment for hypertension, left ventricular mass was inversely associated with similarities and visual-spatial memory and organization. For the basic+blood pressure+treatment for hypertension+risk factors+cardiovascular disease model, no significant associations were observed. Echocardiographic left ventricular mass is associated with cognitive performance beyond casual and time-averaged systolic blood pressure, but this association is attenuated and rendered nonsignificant with additional adjustment for cardiovascular risk factors and cardiovascular disease, thus suggesting that these variables play an important role in mediating the association between left ventricular mass and cognition.

The Utility of the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) in Predicting Reading Achievement

ERIC Educational Resources Information Center

Echols, Julie M. Young

2010-01-01

Reading proficiency is the goal of many local and national reading initiatives. A key component of these initiatives is accurate and reliable reading assessment. In this high-stakes testing arena, the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) has emerged as a preferred measure for identification of students at risk for reading…

Understanding Interrater Reliability and Validity of Risk Assessment Tools Used to Predict Adverse Clinical Events.

PubMed

Siedlecki, Sandra L; Albert, Nancy M

This article will describe how to assess interrater reliability and validity of risk assessment tools, using easy-to-follow formulas, and to provide calculations that demonstrate principles discussed. Clinical nurse specialists should be able to identify risk assessment tools that provide high-quality interrater reliability and the highest validity for predicting true events of importance to clinical settings. Making best practice recommendations for assessment tool use is critical to high-quality patient care and safe practices that impact patient outcomes and nursing resources. Optimal risk assessment tool selection requires knowledge about interrater reliability and tool validity. The clinical nurse specialist will understand the reliability and validity issues associated with risk assessment tools, and be able to evaluate tools using basic calculations. Risk assessment tools are developed to objectively predict quality and safety events and ultimately reduce the risk of event occurrence through preventive interventions. To ensure high-quality tool use, clinical nurse specialists must critically assess tool properties. The better the tool's ability to predict adverse events, the more likely that event risk is mediated. Interrater reliability and validity assessment is relatively an easy skill to master and will result in better decisions when selecting or making recommendations for risk assessment tool use.

[Basic symptoms in schizophrenia, their clinical study and relevance in research].

PubMed

Miret, Salvador; Fatjó-Vilas, Mar; Peralta, Víctor; Fañanás, Lourdes

2016-01-01

Basic symptoms consist of subtle sub-clinical disturbances subjectively experienced by schizophrenia patients. These are mainly related to drive, affect, thinking and language, perception, memory, motor action, central vegetative functions, control of cognitive processes, and stress tolerance. Initially described by Huber, from a phenomenological approach, basic symptoms are part of the earliest features of schizophrenia, and they can evolve along the course of the disorder. Their assessment during the prodromal phase of the disease (together with ultra-high risk criteria) is one of the 2 main approaches that allow the definition of states of clinical risk for the development of psychosis. The present review provides an updated view of the concept of basic symptoms, highlighting its potential value in establishing neurobiological correlates of interest in aetiopathogenic research. Copyright © 2015 SEP y SEPB. Published by Elsevier España. All rights reserved.

Regulatory risk assessment approaches for synthetic mineral fibres.

PubMed

Harrison, Paul; Holmes, Philip; Bevan, Ruth; Kamps, Klaus; Levy, Leonard; Greim, Helmut

2015-10-01

Exposure to synthetic mineral fibres (SMF) may occur in a number of workplace scenarios. To protect worker health, a number of different organisations worldwide have assessed the health risk of these materials and established workplace exposure limits. This paper outlines the basic principles of risk assessment and the scientific methods used to derive valid (justifiable) occupational exposure limits (OELs) and goes on to show how, for SMF, and particularly for refractory ceramic fibre (otherwise known as aluminosilicate wool, RCF/ASW), the methods used and the associated outcomes differ widely. It is argued that the resulting differences in established OELs prevent consistent and appropriate risk management of SMF worldwide, and that development of a transparent and harmonised approach to fibre risk assessment and limit-setting is required. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

A risk assessment methodology to evaluate the risk failure of managed aquifer recharge in the Mediterranean Basin

NASA Astrophysics Data System (ADS)

Rodríguez-Escales, Paula; Canelles, Arnau; Sanchez-Vila, Xavier; Folch, Albert; Kurtzman, Daniel; Rossetto, Rudy; Fernández-Escalante, Enrique; Lobo-Ferreira, João-Paulo; Sapiano, Manuel; San-Sebastián, Jon; Schüth, Christoph

2018-06-01

Managed aquifer recharge (MAR) can be affected by many risks. Those risks are related to different technical and non-technical aspects of recharge, like water availability, water quality, legislation, social issues, etc. Many other works have acknowledged risks of this nature theoretically; however, their quantification and definition has not been developed. In this study, the risk definition and quantification has been performed by means of fault trees and probabilistic risk assessment (PRA). We defined a fault tree with 65 basic events applicable to the operation phase. After that, we have applied this methodology to six different managed aquifer recharge sites located in the Mediterranean Basin (Portugal, Spain, Italy, Malta, and Israel). The probabilities of the basic events were defined by expert criteria, based on the knowledge of the different managers of the facilities. From that, we conclude that in all sites, the perception of the expert criteria of the non-technical aspects were as much or even more important than the technical aspects. Regarding the risk results, we observe that the total risk in three of the six sites was equal to or above 0.90. That would mean that the MAR facilities have a risk of failure equal to or higher than 90 % in the period of 2-6 years. The other three sites presented lower risks (75, 29, and 18 % for Malta, Menashe, and Serchio, respectively).

Study on the Application of the Kent Index Method on the Risk Assessment of Disastrous Accidents in Subway Engineering

PubMed Central

Lu, Hao; Wang, Mingyang; Yang, Baohuai; Rong, Xiaoli

2013-01-01

With the development of subway engineering, according to uncertain factors and serious accidents involved in the construction of subways, implementing risk assessment is necessary and may bring a number of benefits for construction safety. The Kent index method extensively used in pipeline construction is improved to make risk assessment much more practical for the risk assessment of disastrous accidents in subway engineering. In the improved method, the indexes are divided into four categories, namely, basic, design, construction, and consequence indexes. In this study, a risk assessment model containing four kinds of indexes is provided. Three kinds of risk occurrence modes are listed. The probability index model which considers the relativity of the indexes is established according to the risk occurrence modes. The model provides the risk assessment process through the fault tree method and has been applied in the risk assessment of Nanjing subway's river-crossing tunnel construction. Based on the assessment results, the builders were informed of what risks should be noticed and what they should do to avoid the risks. The need for further research is discussed. Overall, this method may provide a tool for the builders, and improve the safety of the construction. PMID:23710136

Basic concepts and techniques of dental implants.

PubMed

Tagliareni, Jonathan M; Clarkson, Earl

2015-04-01

Dental implants provide completely edentulous and partial edentulous patients the function and esthetics they had with natural dentition. It is critical to understand and apply predictable surgical principles when treatment planning and surgically restoring edentulous spaces with implants. This article defines basic implant concepts that should be meticulously followed for predictable results when treating patients and restoring dental implants. Topics include biological and functional considerations, biomechanical considerations, preoperative assessments, medical history and risk assessments, oral examinations, radiographic examinations, contraindications, and general treatment planning options. Copyright © 2015 Elsevier Inc. All rights reserved.

Preventive care delivered within Public Dental Service after caries risk assessment of young adults.

PubMed

Hänsel Petersson, G; Ericson, E; Twetman, S

2016-08-01

To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P < 0.05). Professional tooth cleaning and additional fluorides were most frequently employed in the 'low-risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Basic symptoms, temperament and character in adolescent psychiatric disorders.

PubMed

Poustka, L; Parzer, P; Brunner, R; Resch, F

2007-01-01

Basic symptoms are early subtle changes in thinking, feeling and perception that are subjectively experienced and precede the onset of a psychotic illness. In adult samples, high basic symptom scores are regarded as specific risk factors for the development of schizophrenia. The aim of this study was to explore the relevance of basic symptoms of psychiatric disorders in adolescent patients with special focus on early detection of psychosis. Furthermore, the association between basic symptoms and personality traits has been investigated. From 89 adolescents, who were consecutive inpatients with different psychiatric disorders in 1995 and 1997, 54 were followed up 4.7 years later. Patients were examined with the Bonn Scale for the Assessment of Basic Symptoms at the time of the first presentation and follow-up. Additionally, personality traits were assessed at follow-up using the Junior Temperament and Character Inventory. None of the subjects made the transition to schizophrenia, despite high baseline scores of basic symptoms at the initial assessment. Indirect minus symptoms were found to be the most valid predictor of a persisting psychiatric diagnosis. In addition, this specific category was strongly associated with the personality traits harm avoidance and self-directedness. In adolescents, basic symptoms in association with personality traits present as a nonspecific indicator of psychopathology rather than as an indicator of vulnerability to schizophrenia. Copyright (c) 2007 S. Karger AG, Basel.

Risk Assessment Overview

NASA Technical Reports Server (NTRS)

Prassinos, Peter G.; Lyver, John W., IV; Bui, Chinh T.

2011-01-01

Risk assessment is used in many industries to identify and manage risks. Initially developed for use on aeronautical and nuclear systems, risk assessment has been applied to transportation, chemical, computer, financial, and security systems among others. It is used to gain an understanding of the weaknesses or vulnerabilities in a system so modification can be made to increase operability, efficiency, and safety and to reduce failure and down-time. Risk assessment results are primary inputs to risk-informed decision making; where risk information including uncertainty is used along with other pertinent information to assist management in the decision-making process. Therefore, to be useful, a risk assessment must be directed at specific objectives. As the world embraces the globalization of trade and manufacturing, understanding the associated risk become important to decision making. Applying risk assessment techniques to a global system of development, manufacturing, and transportation can provide insight into how the system can fail, the likelihood of system failure and the consequences of system failure. The risk assessment can identify those elements that contribute most to risk and identify measures to prevent and mitigate failures, disruptions, and damaging outcomes. In addition, risk associated with public and environment impact can be identified. The risk insights gained can be applied to making decisions concerning suitable development and manufacturing locations, supply chains, and transportation strategies. While risk assessment has been mostly applied to mechanical and electrical systems, the concepts and techniques can be applied across other systems and activities. This paper provides a basic overview of the development of a risk assessment.

24 CFR 92.207 - Eligible administrative and planning costs.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., inspections, lead-based paint evaluations (visual assessments, inspections, and risk assessments) and other... amount of HOME funds that is not more than ten percent of the sum of the Fiscal Year HOME basic formula... and maintenance (but not purchase) of office space; and (5) Costs of administering tenant-based rental...

Science Advisory Committee on Chemicals Basic Information

EPA Pesticide Factsheets

The SACC will provide independent scientific advice and recommendations to the EPA on the scientific basis for risk assessments, methodologies, and pollution prevention measures and approaches for chemicals regulated under the TSCA.

Health literacy and 30-day hospital readmission after acute myocardial infarction

PubMed Central

Bailey, Stacy Cooper; Fang, Gang; Annis, Izabela E; O'Conor, Rachel; Paasche-Orlow, Michael K; Wolf, Michael S

2015-01-01

Objective To assess the validity of a predictive model of health literacy, and to examine the relationship between derived health literacy estimates and 30-day hospital readmissions for acute myocardial infarction (AMI). Design Retrospective cohort study. Setting and participants A National Institute of Aging (NIA) study cohort of 696 adult, English-speaking primary care patients, aged 55–74 years, was used to assess the validity of derived health literacy estimates. Claims from 7733 Medicare beneficiaries hospitalised for AMI in 2008 in North Carolina and Illinois were used to investigate the association between health literacy estimates and 30-day hospital readmissions. Measures The NIA cohort was administered 3 common health literacy assessments (Newest Vital Sign, Test of Functional Health Literacy in Adults, and Rapid Estimate of Adult Literacy in Medicine). Health literacy estimates at the census block group level were derived via a predictive model. 30-day readmissions were measured from Medicare claims data using a validated algorithm. Results Fair agreement was found between derived estimates and in-person literacy assessments (Pearson Correlation coefficients: 0.38–0.51; κ scores: 0.38–0.40). Medicare enrollees with above basic literacy according to derived health literacy estimates had an 18% lower risk of a 30-day readmission (RR=0.82, 95% CI 0.73 to 0.92) and 21% lower incidence rate of 30-day readmission (IRR=0.79, 95% CI 0.68 to 0.87) than patients with basic or below basic literacy. After adjusting for demographic and clinical characteristics, the risk of 30-day readmission was 12% lower (p=0.03), and the incidence rate 16% lower (p<0.01) for patients with above basic literacy. Conclusions Health literacy, as measured by a predictive model, was found to be a significant, independent predictor of 30-day readmissions. As a modifiable risk factor with evidence-based solutions, health literacy should be considered in readmission reduction efforts. PMID:26068508

A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students.

PubMed

Turrisi, Rob; Larimer, Mary E; Mallett, Kimberly A; Kilmer, Jason R; Ray, Anne E; Mastroleo, Nadine R; Geisner, Irene Markman; Grossbard, Joel; Tollison, Sean; Lostutter, Ty W; Montoya, Heidi

2009-07-01

The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

A Randomized Clinical Trial Evaluating a Combined Alcohol Intervention for High-Risk College Students*

PubMed Central

Turrisi, Rob; Larimer, Mary E.; Mallett, Kimberly A.; Kilmer, Jason R.; Ray, Anne E.; Mastroleo, Nadine R.; Geisner, Irene Markman; Grossbard, Joel; Tollison, Sean; Lostutter, Ty W.; Montoya, Heidi

2009-01-01

Objective: The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Method: Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. Results: The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. Conclusions: The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session. PMID:19515296

Analysis of currently available data for characterising the risk of engineered nanomaterials to the environment and human health--lessons learned from four case studies.

PubMed

Aschberger, Karin; Micheletti, Christian; Sokull-Klüttgen, Birgit; Christensen, Frans M

2011-08-01

Production volumes and the use of engineered nanomaterials in many innovative products are continuously increasing, however little is known about their potential risk for the environment and human health. We have reviewed publicly available hazard and exposure data for both, the environment and human health and attempted to carry out a basic risk assessment appraisal for four types of nanomaterials: fullerenes, carbon nanotubes, metals, and metal oxides (ENRHES project 2009(1)). This paper presents a summary of the results of the basic environmental and human health risk assessments of these case studies, highlighting the cross cutting issues and conclusions about fate and behaviour, exposure, hazard and methodological considerations. The risk assessment methodology being the basis for our case studies was that of a regulatory risk assessment under REACH (ECHA, 2008(2)), with modifications to adapt to the limited available data. If possible, environmental no-effect concentrations and human no-effect levels were established from relevant studies by applying assessment factors in line with the REACH guidance and compared to available exposure data to discuss possible risks. When the data did not allow a quantitative assessment, the risk was assessed qualitatively, e.g. for the environment by evaluating the information in the literature to describe the potential to enter the environment and to reach the potential ecological targets. Results indicate that the main risk for the environment is expected from metals and metal oxides, especially for algae and Daphnia, due to exposure to both, particles and ions. The main risks for human health may arise from chronic occupational inhalation exposure, especially during the activities of high particle release and uncontrolled exposure. The information on consumer and environmental exposure of humans is too scarce to attempt a quantitative risk characterisation. It is recognised that the currently available database for both, hazard and exposure is limited and there are high uncertainties in any conclusion on a possible risk. The results should therefore not be used for any regulatory decision making. Likewise, it is recognised that the REACH guidance was developed without considering the specific behaviour and the mode of action of nanomaterials and further work in the generation of data but also in the development of methodologies is required. Copyright © 2011 Elsevier Ltd. All rights reserved.

Basic Exploratory Research versus Guideline-Compliant Studies Used for Hazard Evaluation and Risk Assessment: Bisphenol A as a Case Study

PubMed Central

Tyl, Rochelle W.

2009-01-01

Background Myers et al. [Environ Health Perspect 117:309–315 (2009)] argued that Good Laboratory Practices (GLPs) cannot be used as a criterion for selecting data for risk assessment, using bisphenol A (BPA) as a case study. They did not discuss the role(s) of guideline-compliant studies versus basic/exploratory research studies, and they criticized both GLPs and guideline-compliant studies and their roles in formal hazard evaluation and risk assessment. They also specifically criticized our published guideline-compliant dietary studies on BPA in rats and mice and 17β-estradiol (E2) in mice. Objectives As the study director/first author of the criticized E2 and BPA studies, I discuss the uses of basic research versus guideline-compliant studies, how testing guidelines are developed and revised, how new end points are validated, and the role of GLPs. I also provide an overview of the BPA guideline-compliant and exploratory research animal studies and describe BPA pharmacokinetics in rats and humans. I present responses to specific criticisms by Myers et al. Discussion and conclusions Weight-of-evidence evaluations have consistently concluded that low-level BPA oral exposures do not adversely affect human developmental or reproductive health, and I encourage increased validation efforts for “new” end points for inclusion in guideline studies, as well as performance of robust long-term studies to follow early effects (observed in small exploratory studies) to any adverse consequences. PMID:20049112

Back to basics: the role of health insurance in getting a physical exam.

PubMed

McBride, Duane C; Drumm, Rene D; Terry-McElrath, Yvonne; Chitwood, Dale D

2005-01-01

The social work profession has a long history of advocacy to improve the human condition, especially for groups of people at high risk of discrimination and marginalization. Social workers have been instrumental in identifying, assessing, treating, and preventing illicit drug use as part of this commitment to advocacy. One component of social work's endeavors on behalf of drug users and other populations- at-risk has been advocating for increased access to health care. This article examines the role that having health insurance plays in obtaining the most basic of all health care-getting a physical examination. Featuring a sample of 1,271 chronic and injecting street drug users and comparison group non-users, the analysis demonstrates that having health insurance enhances access and utilization of health care among this at-risk population. Subjects who had health insurance for even one month of the past twelve were twice as likely to participate in basic health care by having a physical exam.

Data Analysis

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

Powell, Danny H; Elwood Jr, Robert H

2011-01-01

Analysis of the material protection, control, and accountability (MPC&A) system is necessary to understand the limits and vulnerabilities of the system to internal threats. A self-appraisal helps the facility be prepared to respond to internal threats and reduce the risk of theft or diversion of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) fault tree was developed to depict the failure of the MPC&A system as a result of poor practices and random failures in the MC&A system. It can also be employed as a basis for assessing deliberate threats against a facility. MSET uses faultmore » tree analysis, which is a top-down approach to examining system failure. The analysis starts with identifying a potential undesirable event called a 'top event' and then determining the ways it can occur (e.g., 'Fail To Maintain Nuclear Materials Under The Purview Of The MC&A System'). The analysis proceeds by determining how the top event can be caused by individual or combined lower level faults or failures. These faults, which are the causes of the top event, are 'connected' through logic gates. The MSET model uses AND-gates and OR-gates and propagates the effect of event failure using Boolean algebra. To enable the fault tree analysis calculations, the basic events in the fault tree are populated with probability risk values derived by conversion of questionnaire data to numeric values. The basic events are treated as independent variables. This assumption affects the Boolean algebraic calculations used to calculate results. All the necessary calculations are built into the fault tree codes, but it is often useful to estimate the probabilities manually as a check on code functioning. The probability of failure of a given basic event is the probability that the basic event primary question fails to meet the performance metric for that question. The failure probability is related to how well the facility performs the task identified in that basic event over time (not just one performance or exercise). Fault tree calculations provide a failure probability for the top event in the fault tree. The basic fault tree calculations establish a baseline relative risk value for the system. This probability depicts relative risk, not absolute risk. Subsequent calculations are made to evaluate the change in relative risk that would occur if system performance is improved or degraded. During the development effort of MSET, the fault tree analysis program used was SAPHIRE. SAPHIRE is an acronym for 'Systems Analysis Programs for Hands-on Integrated Reliability Evaluations.' Version 1 of the SAPHIRE code was sponsored by the Nuclear Regulatory Commission in 1987 as an innovative way to draw, edit, and analyze graphical fault trees primarily for safe operation of nuclear power reactors. When the fault tree calculations are performed, the fault tree analysis program will produce several reports that can be used to analyze the MPC&A system. SAPHIRE produces reports showing risk importance factors for all basic events in the operational MC&A system. The risk importance information is used to examine the potential impacts when performance of certain basic events increases or decreases. The initial results produced by the SAPHIRE program are considered relative risk values. None of the results can be interpreted as absolute risk values since the basic event probability values represent estimates of risk associated with the performance of MPC&A tasks throughout the material balance area (MBA). The RRR for a basic event represents the decrease in total system risk that would result from improvement of that one event to a perfect performance level. Improvement of the basic event with the greatest RRR value produces a greater decrease in total system risk than improvement of any other basic event. Basic events with the greatest potential for system risk reduction are assigned performance improvement values, and new fault tree calculations show the improvement in total system risk. The operational impact or cost-effectiveness from implementing the performance improvements can then be evaluated. The improvements being evaluated can be system performance improvements, or they can be potential, or actual, upgrades to the system. The RIR for a basic event represents the increase in total system risk that would result from failure of that one event. Failure of the basic event with the greatest RIR value produces a greater increase in total system risk than failure of any other basic event. Basic events with the greatest potential for system risk increase are assigned failure performance values, and new fault tree calculations show the increase in total system risk. This evaluation shows the importance of preventing performance degradation of the basic events. SAPHIRE identifies combinations of basic events where concurrent failure of the events results in failure of the top event.« less

Establishment of the Fox Chase Network Breast Cancer Risk Registry.

DTIC Science & Technology

1998-10-01

urologists, pathologists, nurses, health educators, genetic counselors, epidemiologists, behavioral scientists, nutritionists and basic scientists. The...data can readily be translated into a family pedigree for counseling and teaching purposes. Our success in confirming diagnoses with medical records...didactic and interactive teaching covering the following topics: fundamentals of cancer genetics; cancer inheritance patterns; risk assessment and

Risk Assessment of Sexual Offenders for Extended Supervision Orders in New Zealand: Basic Principles and Current Practice

ERIC Educational Resources Information Center

Vess, James

2009-01-01

A growing number of jurisdictions in North America, the United Kingdom, and Australasia have enacted legislation allowing for special sentencing, civil commitment, and community supervision options for high risk sexual offenders. In New Zealand, one example of this concern for public protection is the Parole (Extended Supervision) Amendment Act…

Travel medicine: Part 1-The basics.

PubMed

Kamata, Kazuhiro; Birrer, Richard B; Tokuda, Yasuharu

2017-04-01

International travels for tourism and business purposes continue to increase annually, while the global terrorism and the risk of lethal viral infections are currently real concerns. It is important that primary care physicians assess travel risk and adequately prepare the prospective traveler for trips. Appropriate vaccines should be administered and an emergency self-kit recommended. Patient should be educated about safe travel habits and a posttravel follow-up process established. Further, traveling healthcare professionals may be called upon to assist an ill patient at any time during their journey. In these 2-part special articles, we provide a practical brief summary of up-to-date travel medicine basics for primary care physicians.

Risk assessment and management of radiofrequency radiation exposure

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

Dabala, Dana; Surducan, Emanoil; Surducan, Vasile

2013-11-13

Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

Risk assessment and management of radiofrequency radiation exposure

NASA Astrophysics Data System (ADS)

Dabala, Dana; Surducan, Emanoil; Surducan, Vasile; Neamtu, Camelia

2013-11-01

Radiofrequency radiation (RFR) industry managers, occupational physicians, security department, and other practitioners must be advised on the basic of biophysics and the health effects of RF electromagnetic fields so as to guide the management of exposure. Information on biophysics of RFR and biological/heath effects is derived from standard texts, literature and clinical experiences. Emergency treatment and ongoing care is outlined, with clinical approach integrating the circumstances of exposure and the patient's symptoms. Experimental risk assessment model in RFR chronic exposure is proposed. Planning for assessment and monitoring exposure, ongoing care, safety measures and work protection are outlining the proper management.

Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis "prodromal" population.

PubMed

Nelson, Barnaby; Thompson, Andrew; Yung, Alison R

2012-11-01

Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to a disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. In this study, we investigated the presence of basic self-disturbance in an "ultra high risk" (UHR) for psychosis sample compared with a healthy control sample and whether it predicted transition to psychotic disorder. Forty-nine UHR patients and 52 matched healthy control participants were recruited to the study. Participants were assessed for basic self-disturbance using the Examination of Anomalous Self-Experience (EASE) instrument. UHR participants were followed for a mean of 569 days. Levels of self-disturbance were significantly higher in the UHR sample compared with the healthy control sample (P < .001). Cox regression indicated that total EASE score significantly predicted time to transition (P < .05) when other significant predictors were controlled for. Exploratory analyses indicated that basic self-disturbance scores were higher in schizophrenia spectrum cases, irrespective of transition to psychosis, than nonschizophrenia spectrum cases. The results indicate that identifying basic self-disturbance in the UHR population may provide a means of further "closing in" on individuals truly at high risk of psychotic disorder, particularly of schizophrenia spectrum disorders. This may be of practical value by reducing inclusion of "false positive" cases in UHR samples and of theoretical value by shedding light on core phenotypic features of schizophrenia spectrum pathology.

Northwest Latinos' health promotion lifestyle profiles according to diabetes risk status.

PubMed

Sutherland, Leonie L; Weiler, Dawn M; Bond, Laura; Simonson, Shawn; Reis, Janet

2012-12-01

A sample of 225 low income and low education, middle aged Latinos with concern about diabetes and living in a mid-size Idaho city volunteered for a physical assessment for risk status for the disease. The health promoting lifestyles of Latino congregants were measured using the Health Promoting Lifestyle Profile II. Diabetes risk was measured by clinically standard glycated hemoglobin readings. From no risk for the disease to full blown diabetes as determined by glycated hemoglobin levels, the respondents reported engaging in basically the same levels of physical activity, monitoring of nutrition and use of health care services thus evidencing no apparent understanding of the role of lifestyle in disease management. The findings point to the imperative of a broad, comprehensive and especially culturally attuned educational campaign on basic disease pathophysiology, the value of prevention for individual health, and the necessity of day-to-day self-care should diabetes be diagnosed.

Obesity and Cardiovascular Disease Risk Factors in Black and White Girls: The NHLBI Growth and Health Study.

ERIC Educational Resources Information Center

American Journal of Public Health, 1992

1992-01-01

The National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study Research Group's 5-year cohort study provides basic information on the baseline cohort of 1,166 white and 1,213 African-American girls aged 9 through 10 years. Factors associated with development of obesity and cardiovascular risk factors are assessed. (SLD)

Use of Probabilistic Risk Assessment in Shuttle Decision Making Process

NASA Technical Reports Server (NTRS)

Boyer, Roger L.; Hamlin, Teri, L.

2011-01-01

This slide presentation reviews the use of Probabilistic Risk Assessment (PRA) to assist in the decision making for the shuttle design and operation. Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and disciplined approach to identifying and analyzing risk in complex systems and/or processes that seeks answers to three basic questions: (i.e., what can go wrong? what is the likelihood of these occurring? and what are the consequences that could result if these occur?) The purpose of the Shuttle PRA (SPRA) is to provide a useful risk management tool for the Space Shuttle Program (SSP) to identify strengths and possible weaknesses in the Shuttle design and operation. SPRA was initially developed to support upgrade decisions, but has evolved into a tool that supports Flight Readiness Reviews (FRR) and near real-time flight decisions. Examples of the use of PRA for the shuttle are reviewed.

Quantitative Microbial Risk Assessment Tutorial: Navigate the SDMPB and Identify an 8-digit HUC of Interest

EPA Science Inventory

This tutorial reviews some of the screens, icons, and basic functions of the SDMProjectBuilder (SDMPB) that allow a user to identify a watershed of interest that can be used to choose a pour point or 12-digit HUC (HUC-12) for a microbial assessment. It demonstrates how to identif...

Induced seismicity and carbon storage: Risk assessment and mitigation strategies

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

White, Joshua A.; Foxall, William; Bachmann, Corinne

Geologic carbon storage (GCS) is widely recognized as an important strategy to reduce atmospheric carbon dioxide (CO 2) emissions. Like all technologies, however, sequestration projects create a number of potential environmental and safety hazards that must be addressed. These include earthquakes—from microseismicity to large, damaging events—that can be triggered by altering pore-pressure conditions in the subsurface. To date, measured seismicity due to CO 2 injection has been limited to a few modest events, but the hazard exists and must be considered. There are important similarities between CO 2 injection and fluid injection from other applications that have induced significant events—e.g.more » geothermal systems, waste-fluid injection, hydrocarbon extraction, and others. There are also important distinctions among these technologies that should be considered in a discussion of seismic hazard. This report focuses on strategies for assessing and mitigating risk during each phase of a CO 2 storage project. Four key risks related to fault reactivation and induced seismicity were considered. Induced slip on faults could potentially lead to: (1) infrastructure damage, (2) a public nuisance, (3) brine-contaminated drinking water, and (4) CO 2-contaminated drinking water. These scenarios lead to different types of damage—to property, to drinking water quality, or to the public welfare. Given these four risks, this report focuses on strategies for assessing (and altering) their likelihoods of occurrence and the damage that may result. This report begins with an overview of the basic physical mechanisms behind induced seismicity. This science basis—and its gaps—is crucial because it forms the foundation for risk assessment and mitigation. Available techniques for characterizing and monitoring seismic behavior are also described. Again, this technical basis—and its limitations—must be factored into the risk assessment and mitigation approach. A phased approach to risk management is then introduced. The basic goal of the phased approach is to constantly adapt site operations to current conditions and available characterization data. The remainder of the report then focuses in detail on different components of the monitoring, risk assessment, and mitigation strategies. Issues in current seismic risk assessment methods that must be modified to address induce seismicity are highlighted. The report then concludes with several specific recommendations for operators and regulatory authorities to consider when selecting, permitting, and operating a storage project.« less

Reproductive Toxicology Testing with EDCS

EPA Science Inventory

An introduction to reproductive toxicology: the basic approaches to testing chemicals for adverse effects using multigenerational studies with rats and how the regulatory agencies used the data in risk assessments. Case studies were presented of how endocrine or genomic data were...

BIOMARKERS OF EXPOSURE, EFFECT AND SUSCEPTIBILITY IN FISHES

EPA Science Inventory

Understanding basic mechanisms of toxicological processes is integral to assessment of risk, In aquatic toxicology, however, the mechanistic evaluation of environmental chemicals is a much younger area of investigation than in mammalian systems and only recently has received sig...

EVALUATING NANOPARTICLE INTERACTIONS WITH SKIN

EPA Science Inventory

Presently, there are minimal data available on the interaction between manufactured nanoparticles and biological tissues. The basic requirement for any risk assessment includes information on hazard (e.g. toxicity) and exposure (e.g. absorption). This proposal focuses on the h...

Anomalous subjective experience and psychosis risk in young depressed patients.

PubMed

Szily, Erika; Kéri, Szabolcs

2009-01-01

Help-seeking young people often display depressive symptoms. In some patients, these symptoms may co-exist with clinically high-risk mental states for psychosis. The aim of this study was to determine differences in subjective experience and social perception in young depressed patients with and without psychosis risk. Participants were 68 young persons with major depressive disorder. Twenty-six patients also met the criteria of attenuated or brief limited intermittent psychotic symptoms according to the Comprehensive Assessment of At Risk Mental States (CAARMS) criteria. Subjective experiences were assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS). Recognition of complex social emotions and mental states was assessed using the 'Reading the Mind in the Eyes' test. Perplexity, self-disorder, and diminished affectivity significantly predicted psychosis risk. Depressed patients without psychosis risk displayed impaired recognition performance for negative social emotions, whereas patients with psychosis risk were also impaired in the recognition of cognitive expressions. In the high-risk group, self-disorder was associated with impaired recognition of facial expressions. These results suggest that anomalous subjective experience and impaired recognition of complex emotions may differentiate between young depressed patients with and without psychosis risk. 2009 S. Karger AG, Basel.

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.

The Pollution Hazard Assessment System Version 20: Documentation and Users Manual

DTIC Science & Technology

1991-03-15

block number) FIELD GROUP SUB-ROUP Risk Assessment BASIC -- Public Health Baseline Assessments Environmental Effects Su r und 19. ABSTRACT (Continue...PHAS20 health - effects related concepts and operational instructions. Appendix A presents a glossary of terms and data identifications. Appendix B...Computerization) in the Environmental Quality Research Branch of the Health Effects Research Division. The author acknowledges the support of Jesse J. Barkley, Jr

Systematic overview and critical appraisal of meta-analyses of interventions in intensive care medicine.

PubMed

Koster, T M; Wetterslev, J; Gluud, C; Keus, F; van der Horst, I C C

2018-05-24

Meta-analysed intervention effect estimates are perceived to represent the highest level of evidence. However, such effects and the randomized clinical trials which are included in them need critical appraisal before the effects can be trusted. Critical appraisal of a predefined set of all meta-analyses on interventions in intensive care medicine to assess their quality and assessed the risks of bias in those meta-analyses having the best quality. We conducted a systematic search to select all meta-analyses of randomized clinical trials on interventions used in intensive care medicine. Selected meta-analyses were critically appraised for basic scientific criteria, (1) presence of an available protocol, (2) report of a full search strategy, and (3) use of any bias risk assessment of included trials. All meta-analyses which qualified these criteria were scrutinized by full "Risk of Bias in Systematic Reviews" ROBIS evaluation of 4 domains of risks of bias, and a "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" PRISMA evaluation. We identified 467 meta-analyses. A total of 56 meta-analyses complied with these basic scientific criteria. We scrutinized the risks of bias in the 56 meta-analyses by full ROBIS evaluation and a PRISMA evaluation. Only 4 meta-analyses scored low risk of bias in all the 4 ROBIS domains and 41 meta-analyses reported all 27 items of the PRISMA checklist. In contrast with what might be perceived as the highest level of evidence only 0.9% of all meta-analyses were judged to have overall low risk of bias. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

A Method for Dynamic Risk Assessment and Management of Rockbursts in Drill and Blast Tunnels

NASA Astrophysics Data System (ADS)

Liu, Guo-Feng; Feng, Xia-Ting; Feng, Guang-Liang; Chen, Bing-Rui; Chen, Dong-Fang; Duan, Shu-Qian

2016-08-01

Focusing on the problems caused by rockburst hazards in deep tunnels, such as casualties, damage to construction equipment and facilities, construction schedule delays, and project cost increase, this research attempts to present a methodology for dynamic risk assessment and management of rockbursts in D&B tunnels. The basic idea of dynamic risk assessment and management of rockbursts is determined, and methods associated with each step in the rockburst risk assessment and management process are given, respectively. Among them, the main parts include a microseismic method for early warning the occurrence probability of rockburst risk, an estimation method that aims to assess potential consequences of rockburst risk, an evaluation method that utilizes a new quantitative index considering both occurrence probability and consequences for determining the level of rockburst risk, and the dynamic updating. Specifically, this research briefly describes the referenced microseismic method of warning rockburst, but focuses on the analysis of consequences and associated risk assessment and management of rockburst. Using the proposed method of risk assessment and management of rockburst, the occurrence probability, potential consequences, and the level of rockburst risk can be obtained in real-time during tunnel excavation, which contributes to the dynamic optimisation of risk mitigation measures and their application. The applicability of the proposed method has been verified by those cases from the Jinping II deep headrace and water drainage tunnels at depths of 1900-2525 m (with a length of 11.6 km in total for D&B tunnels).

Health literacy and 30-day hospital readmission after acute myocardial infarction.

PubMed

Bailey, Stacy Cooper; Fang, Gang; Annis, Izabela E; O'Conor, Rachel; Paasche-Orlow, Michael K; Wolf, Michael S

2015-06-11

To assess the validity of a predictive model of health literacy, and to examine the relationship between derived health literacy estimates and 30-day hospital readmissions for acute myocardial infarction (AMI). Retrospective cohort study. A National Institute of Aging (NIA) study cohort of 696 adult, English-speaking primary care patients, aged 55-74 years, was used to assess the validity of derived health literacy estimates. Claims from 7733 Medicare beneficiaries hospitalised for AMI in 2008 in North Carolina and Illinois were used to investigate the association between health literacy estimates and 30-day hospital readmissions. The NIA cohort was administered 3 common health literacy assessments (Newest Vital Sign, Test of Functional Health Literacy in Adults, and Rapid Estimate of Adult Literacy in Medicine). Health literacy estimates at the census block group level were derived via a predictive model. 30-day readmissions were measured from Medicare claims data using a validated algorithm. Fair agreement was found between derived estimates and in-person literacy assessments (Pearson Correlation coefficients: 0.38-0.51; κ scores: 0.38-0.40). Medicare enrollees with above basic literacy according to derived health literacy estimates had an 18% lower risk of a 30-day readmission (RR=0.82, 95% CI 0.73 to 0.92) and 21% lower incidence rate of 30-day readmission (IRR=0.79, 95% CI 0.68 to 0.87) than patients with basic or below basic literacy. After adjusting for demographic and clinical characteristics, the risk of 30-day readmission was 12% lower (p=0.03), and the incidence rate 16% lower (p<0.01) for patients with above basic literacy. Health literacy, as measured by a predictive model, was found to be a significant, independent predictor of 30-day readmissions. As a modifiable risk factor with evidence-based solutions, health literacy should be considered in readmission reduction efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Forensic psychiatry. Its relations to clinical psychiatry and criminology].

PubMed

Kröber, H-L

2005-11-01

A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.

Chronic Chagas disease: from basics to laboratory medicine.

PubMed

Haberland, Annekathrin; Saravia, Silvia Gilka Munoz; Wallukat, Gerd; Ziebig, Reinhard; Schimke, Ingolf

2013-02-01

Chagas disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America and has huge potential to become a worldwide problem, due to increasing migration, and international tourism, as well as infectant transfer by blood contact and transfusion, intrauterine transfer, and organ transplantation. Nearly 30% of chronically-infected patients become symptomatic, often with a latency of 10-30 years, developing life-threatening complications. Of those, nearly 90% develop Chagas heart disease, while the others manifest gastrointestinal disease and neuronal disorders. Besides interrupting the infection cycle and chemo therapeutic infectant elimination, starting therapy early in symptomatic patients is important for counteracting the disease. This would be essentially supported by optimized patient management, involving risk assessment, early diagnosis and monitoring of the disease and its treatment. From economic and logistic viewpoints, the tools of laboratory medicine should be especially able to guarantee this. After summarizing the basics of chronic Chagas disease, such as the epidemiological data, the pathogenetic mechanisms thought to drive symptomatic Chagas disease and also treatment options, we present tools of laboratory medicine that address patient diagnosis, risk assessment for becoming symptomatic and guidance, focusing on autoantibody estimation for risk assessment and heart marker measurement for patient guidance. In addition, increases in levels of inflammation and oxidative stress markers in chronic Chagas disease are discussed.

Comparison study on qualitative and quantitative risk assessment methods for urban natural gas pipeline network.

PubMed

Han, Z Y; Weng, W G

2011-05-15

In this paper, a qualitative and a quantitative risk assessment methods for urban natural gas pipeline network are proposed. The qualitative method is comprised of an index system, which includes a causation index, an inherent risk index, a consequence index and their corresponding weights. The quantitative method consists of a probability assessment, a consequences analysis and a risk evaluation. The outcome of the qualitative method is a qualitative risk value, and for quantitative method the outcomes are individual risk and social risk. In comparison with previous research, the qualitative method proposed in this paper is particularly suitable for urban natural gas pipeline network, and the quantitative method takes different consequences of accidents into consideration, such as toxic gas diffusion, jet flame, fire ball combustion and UVCE. Two sample urban natural gas pipeline networks are used to demonstrate these two methods. It is indicated that both of the two methods can be applied to practical application, and the choice of the methods depends on the actual basic data of the gas pipelines and the precision requirements of risk assessment. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Improvement of cardiovascular risk prediction: time to review current knowledge, debates, and fundamentals on how to assess test characteristics.

PubMed

Romanens, Michel; Ackermann, Franz; Spence, John David; Darioli, Roger; Rodondi, Nicolas; Corti, Roberto; Noll, Georg; Schwenkglenks, Matthias; Pencina, Michael

2010-02-01

Cardiovascular risk assessment might be improved with the addition of emerging, new tests derived from atherosclerosis imaging, laboratory tests or functional tests. This article reviews relative risk, odds ratios, receiver-operating curves, posttest risk calculations based on likelihood ratios, the net reclassification improvement and integrated discrimination. This serves to determine whether a new test has an added clinical value on top of conventional risk testing and how this can be verified statistically. Two clinically meaningful examples serve to illustrate novel approaches. This work serves as a review and basic work for the development of new guidelines on cardiovascular risk prediction, taking into account emerging tests, to be proposed by members of the 'Taskforce on Vascular Risk Prediction' under the auspices of the Working Group 'Swiss Atherosclerosis' of the Swiss Society of Cardiology in the future.

Quantitative Microbial Risk Assessment Tutorial - Navigate the SDMPB and Identify an 8-digit HUC of Interest - Updated 2017

EPA Science Inventory

This tutorial reviews some of the screens, icons, and basic functions of the SDMProjectBuilder (SDMPB) that allow a user to identify an 8-digit HUC (HUC-8) of interest from which a pour point or 12-digit HUC (HUC-12) can be chosen for a microbial assessment. It demonstrates how t...

Neuropsychological basic deficits in preschoolers at risk for ADHD: a meta-analysis.

PubMed

Pauli-Pott, Ursula; Becker, Katja

2011-06-01

Widely accepted neuropsychological theories on attention deficit hyperactivity disorder (ADHD) assume that the complex symptoms of the disease arise from developmentally preceding neuropsychological basic deficits. These deficits in executive functions and delay aversion are presumed to emerge in the preschool period. The corresponding normative developmental processes include phases of relative stability and rapid change. These non-linear developmental processes might have implications for concurrent and predictive associations between basic deficits and ADHD symptoms. To derive a description of the nature and strength of these associations, a meta-analysis was conducted. It is assumed that weighted mean effect sizes differ between basic deficits and depend on age. The meta-analysis included 25 articles (n=3005 children) in which associations between assessments of basic deficits (i.e. response inhibition, interference control, delay aversion, working memory, flexibility, and vigilance/arousal) in the preschool period and concurrent or subsequent ADHD symptoms or diagnosis of ADHD had been analyzed. For response inhibition and delay aversion, mean effect sizes were of medium to large magnitude while the mean effect size for working memory was small. Meta-regression analyses revealed that effect sizes of delay aversion tasks significantly decreased with increasing age while effect sizes of interference control tasks and Continuous Performance Tests (CPTs) significantly increased. Depending on the normative maturational course of each skill, time windows might exist that allow for a more or less valid assessment of a specific deficit. In future research these time windows might help to describe early developing forms of ADHD and to identify children at risk. Copyright © 2011 Elsevier Ltd. All rights reserved.

Instability risk assessment of construction waste pile slope based on fuzzy entropy

NASA Astrophysics Data System (ADS)

Ma, Yong; Xing, Huige; Yang, Mao; Nie, Tingting

2018-05-01

Considering the nature and characteristics of construction waste piles, this paper analyzed the factors affecting the stability of the slope of construction waste piles, and established the system of the assessment indexes for the slope failure risks of construction waste piles. Based on the basic principles and methods of fuzzy mathematics, the factor set and the remark set were established. The membership grade of continuous factor indexes is determined using the "ridge row distribution" function, while that for the discrete factor indexes was determined by the Delphi Method. For the weight of factors, the subjective weight was determined by the Analytic Hierarchy Process (AHP) and objective weight by the entropy weight method. And the distance function was introduced to determine the combination coefficient. This paper established a fuzzy comprehensive assessment model of slope failure risks of construction waste piles, and assessed pile slopes in the two dimensions of hazard and vulnerability. The root mean square of the hazard assessment result and vulnerability assessment result was the final assessment result. The paper then used a certain construction waste pile slope as the example for analysis, assessed the risks of the four stages of a landfill, verified the assessment model and analyzed the slope's failure risks and preventive measures against a slide.

Nucleic acids-based tools for ballast water surveillance, monitoring, and research

EPA Science Inventory

Understanding the risks of biological invasion posed by ballast water—whether in the context of compliance testing, routine monitoring, or basic research—is fundamentally an exercise in biodiversity assessment, and as such should take advantage of the best tools avail...

Associating Changes in the Immune System with Clinical Diseases for Interpretation in Risk Assessment

PubMed Central

Germolec, Dori R.; Luebke, Robert W.; Johnson, Victor J.

2016-01-01

This overview is an update of the unit originally published in 2004. While the basic tenants of immunotoxicity have not changed in the past 10 years, several publications have explored the application of immunotoxicological data to the risk assessment process. Therefore, the goal of this unit is still to highlight relationships between xenobiotic-induced immunosuppression and risk of clinical diseases progression. In immunotoxicology, this may require development of models to equate moderate changes in markers of immune functions to potential changes in incidence or severity of infectious diseases. For most xenobiotics, exposure levels and disease incidence data are rarely available and safe exposure levels must be estimated based on observations from experimental models or human biomarker studies. Thus, it is important to establish a scientifically sound framework that allows accurate and quantitative interpretation of experimental or biomarker data in the risk assessment process. PMID:26828330

Associating Changes in the Immune System with Clinical Diseases for Interpretation in Risk Assessment.

PubMed

DeWitt, Jamie C; Germolec, Dori R; Luebke, Robert W; Johnson, Victor J

2016-02-01

This overview is an update of the unit originally published in 2004. While the basic tenets of immunotoxicity have not changed in the past 10 years, several publications have explored the application of immunotoxicological data to the risk assessment process. Therefore, the goal of this unit is still to highlight relationships between xenobiotic-induced immunosuppression and risk of clinical diseases progression. In immunotoxicology, this may require development of models to equate moderate changes in markers of immune functions to potential changes in incidence or severity of infectious diseases. For most xenobiotics, exposure levels and disease incidence data are rarely available, and safe exposure levels must be estimated based on observations from experimental models or human biomarker studies. Thus, it is important to establish a scientifically sound framework that allows accurate and quantitative interpretation of experimental or biomarker data in the risk assessment process. Copyright © 2016 John Wiley & Sons, Inc.

Climate change and forest trees in the Pacific Northwest: guide to vulnerability assessment methodology

Treesearch

W. Devine; C. Aubry; J. Miller; K. Potter; A. Bower

2012-01-01

This guide provides a step-by-step description of the methodology used to apply the Forest Tree Genetic Risk Assessment System (ForGRAS; Potter and Crane 2010) to the tree species of the Pacific Northwest in a recent climate change vulnerability assessment (Devine et al. 2012). We describe our modified version of the ForGRAS model, and we review the model’s basic...

Decision Making and Ratio Processing in Patients with Mild Cognitive Impairment.

PubMed

Pertl, Marie-Theres; Benke, Thomas; Zamarian, Laura; Delazer, Margarete

2015-01-01

Making advantageous decisions is important in everyday life. This study aimed at assessing how patients with mild cognitive impairment (MCI) make decisions under risk. Additionally, it investigated the relationship between decision making, ratio processing, basic numerical abilities, and executive functions. Patients with MCI (n = 22) were compared with healthy controls (n = 29) on a complex task of decision making under risk (Game of Dice Task-Double, GDT-D), on two tasks evaluating basic decision making under risk, on a task of ratio processing, and on several neuropsychological background tests. Patients performed significantly lower than controls on the GDT-D and on ratio processing, whereas groups performed comparably on basic decision tasks. Specifically, in the GDT-D, patients obtained lower net scores and lower mean expected values, which indicate a less advantageous performance relative to that of controls. Performance on the GDT-D correlated significantly with performance in basic decision tasks, ratio processing, and executive-function measures when the analysis was performed on the whole sample. Patients with MCI make sub-optimal decisions in complex risk situations, whereas they perform at the same level as healthy adults in simple decision situations. Ratio processing and executive functions have an impact on the decision-making performance of both patients and healthy older adults. In order to facilitate advantageous decisions in complex everyday situations, information should be presented in an easily comprehensible form and cognitive training programs for patients with MCI should focus--among other abilities--on executive functions and ratio processing.

How to Assess the Biomechanical Risk Levels in Beekeeping.

PubMed

Maina, G; Rossi, F; Baracco, A

2016-01-01

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

[Risk factors for the spine: nursing assessment and care].

PubMed

Bringuente, M E; de Castro, I S; de Jesus, J C; Luciano, L dos S

1997-01-01

The present work aimed at studying risk factor that affect people with back pain, identifying them and implementing an intervention proposal of a health education program based on self-care teaching, existential humanist philosophical projects and stress equalization approach line, skeletal-muscle reintegration activities, basic techniques on stress equalization and massage. It has been developed for a population of 42 (forty-two) clients. Two instruments which integrate nursing consultation protocol have been used in data collection. The results showed the existence of associated risk factors which are changeable according to health education programs. The assessment process has contributed for therapeutic measures focus, using non-conventional care methods for this approach providing an improvement to these clients life quality.

Conversion of Questionnaire Data

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

Powell, Danny H; Elwood Jr, Robert H

During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC&A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC&A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relativemore » risk values for all of the basic MC&A tasks performed in the facility. If a specific material protection, control, and accountability (MPC&A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC&A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC&A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A.D. Swain and H.E. Guttmann, 'Handbook of Human Reliability Analysis with Emphasis on Nuclear Power Plant Applications,' NUREG/CR-1278). This conversion produces the basic event risk of failure values required for the fault tree calculations. The fault tree is a deductive logic structure that corresponds to the operational nuclear MC&A system at a nuclear facility. The conventional Delphi process is a time-honored approach commonly used in the risk assessment field to extract numerical values for the failure rates of actions or activities when statistically significant data is absent.« less

Quantitative risk assessment for skin sensitization: Success or failure?

PubMed

Kimber, Ian; Gerberick, G Frank; Basketter, David A

2017-02-01

Skin sensitization is unique in the world of toxicology. There is a combination of reliable, validated predictive test methods for identification of skin sensitizing chemicals, a clearly documented and transparent approach to risk assessment, and effective feedback from dermatology clinics around the world delivering evidence of the success or failure of the hazard identification/risk assessment/management process. Recent epidemics of contact allergy, particularly to preservatives, have raised questions of whether the safety/risk assessment process is working in an optimal manner (or indeed is working at all!). This review has as its focus skin sensitization quantitative risk assessment (QRA). The core toxicological principles of QRA are reviewed, and evidence of use and misuse examined. What becomes clear is that skin sensitization QRA will only function adequately if two essential criteria are met. The first is that QRA is applied rigourously, and the second is that potential exposure to the sensitizing substance is assessed adequately. This conclusion will come as no surprise to any toxicologist who appreciates the basic premise that "risk = hazard x exposure". Accordingly, use of skin sensitization QRA is encouraged, not least because the essential feedback from dermatology clinics can be used as a tool to refine QRA in situations where this risk assessment tool has not been properly used. Copyright © 2016 Elsevier Inc. All rights reserved.

Key risk indicators for accident assessment conditioned on pre-crash vehicle trajectory.

PubMed

Shi, X; Wong, Y D; Li, M Z F; Chai, C

2018-08-01

Accident events are generally unexpected and occur rarely. Pre-accident risk assessment by surrogate indicators is an effective way to identify risk levels and thus boost accident prediction. Herein, the concept of Key Risk Indicator (KRI) is proposed, which assesses risk exposures using hybrid indicators. Seven metrics are shortlisted as the basic indicators in KRI, with evaluation in terms of risk behaviour, risk avoidance, and risk margin. A typical real-world chain-collision accident and its antecedent (pre-crash) road traffic movements are retrieved from surveillance video footage, and a grid remapping method is proposed for data extraction and coordinates transformation. To investigate the feasibility of each indicator in risk assessment, a temporal-spatial case-control is designed. By comparison, Time Integrated Time-to-collision (TIT) performs better in identifying pre-accident risk conditions; while Crash Potential Index (CPI) is helpful in further picking out the severest ones (the near-accident). Based on TIT and CPI, the expressions of KRIs are developed, which enable us to evaluate risk severity with three levels, as well as the likelihood. KRI-based risk assessment also reveals predictive insights about a potential accident, including at-risk vehicles, locations and time. Furthermore, straightforward thresholds are defined flexibly in KRIs, since the impact of different threshold values is found not to be very critical. For better validation, another independent real-world accident sample is examined, and the two results are in close agreement. Hierarchical indicators such as KRIs offer new insights about pre-accident risk exposures, which is helpful for accident assessment and prediction. Copyright © 2018 Elsevier Ltd. All rights reserved.

Risk for suicide and risk for violence: a case for separating the current violence diagnoses.

PubMed

Smith, J E; Early, J A; Green, P T; Lauck, D L; Oblaczynski, C; Smochek, M R; Wright, G

1997-01-01

To identify accurate descriptive terms for risk for violence and risk for suicide and to provide operational definitions for these terms The Delphi technique, with two rounds, was used to differentiate the operational definitions that represent risk for suicide from those that represent risk for violence. The expert panel consisted of 23 healthcare professionals with a minimum of a master's degree. In addition to the expert panel, a control group (N = 11) participated to assess content validity. Thirty-six definitions were agreed upon for suicide, 39 for violence. These definitions represent the basic distinctions between the two behavioral manifestations.

[Assessment of user embracement with risk rating in emergency hospital services].

PubMed

Versa, Gelena Lucinéia Gomes da Silva; Vituri, Dagmar Wilamowius; Buriola, Aline Aparecida; Carlos Aparecido de Oliveira; Matsuda, Laura Misue

2014-09-01

Cross-sectional and quantitative study, conducted in 2013, aiming to evaluate the implementation of User Embracement with Risk Rating (ACCR) in four Emergency Hospital Services. One hundred fifty six nurses participated and answered the questionnaire"User Embracement with Risk Rating". The data were treated through descriptive and inferential statistics, from the Kruskal-Wallis test. The implementation of ACCR was assessed as precarious, mainly due to the lack of referral of low complexity cases to the basic health system, the inadequate physical space for companions and the lack of discussion and periodic assessment of the flow of care in ACCR. The dimension Result of Implementation obtained a slightly higher score and Structure was the dimension with the lowest score. It was concluded that the negative assessments by nursing professionals of the referred dimensions in the investigated sites suggests the need for improvements, especially in the dimension Structure.

Modeling an internal gear pump

NASA Astrophysics Data System (ADS)

Chen, Zongbin; Xu, Rongwu; He, Lin; Liao, Jian

2018-05-01

Considering the nature and characteristics of construction waste piles, this paper analyzed the factors affecting the stability of the slope of construction waste piles, and established the system of the assessment indexes for the slope failure risks of construction waste piles. Based on the basic principles and methods of fuzzy mathematics, the factor set and the remark set were established. The membership grade of continuous factor indexes is determined using the "ridge row distribution" function, while that for the discrete factor indexes was determined by the Delphi Method. For the weight of factors, the subjective weight was determined by the Analytic Hierarchy Process (AHP) and objective weight by the entropy weight method. And the distance function was introduced to determine the combination coefficient. This paper established a fuzzy comprehensive assessment model of slope failure risks of construction waste piles, and assessed pile slopes in the two dimensions of hazard and vulnerability. The root mean square of the hazard assessment result and vulnerability assessment result was the final assessment result. The paper then used a certain construction waste pile slope as the example for analysis, assessed the risks of the four stages of a landfill, verified the assessment model and analyzed the slope's failure risks and preventive measures against a slide.

Technical guide for applications of gene expression profiling in human health risk assessment of environmental chemicals.

PubMed

Bourdon-Lacombe, Julie A; Moffat, Ivy D; Deveau, Michelle; Husain, Mainul; Auerbach, Scott; Krewski, Daniel; Thomas, Russell S; Bushel, Pierre R; Williams, Andrew; Yauk, Carole L

2015-07-01

Toxicogenomics promises to be an important part of future human health risk assessment of environmental chemicals. The application of gene expression profiles (e.g., for hazard identification, chemical prioritization, chemical grouping, mode of action discovery, and quantitative analysis of response) is growing in the literature, but their use in formal risk assessment by regulatory agencies is relatively infrequent. Although additional validations for specific applications are required, gene expression data can be of immediate use for increasing confidence in chemical evaluations. We believe that a primary reason for the current lack of integration is the limited practical guidance available for risk assessment specialists with limited experience in genomics. The present manuscript provides basic information on gene expression profiling, along with guidance on evaluating the quality of genomic experiments and data, and interpretation of results presented in the form of heat maps, pathway analyses and other common approaches. Moreover, potential ways to integrate information from gene expression experiments into current risk assessment are presented using published studies as examples. The primary objective of this work is to facilitate integration of gene expression data into human health risk assessments of environmental chemicals. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

DOT National Transportation Integrated Search

2017-04-01

This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

Current Challenges in Neurotoxicity Risk Assessment ...

EPA Pesticide Factsheets

Neurotoxicity risk assessment must continue to evolve in parallel with advances in basic research. Along with this evolution is an expansion in the scope of neurotoxicity assessments of environmental health risks. Examples of this expansion include an increasing emphasis on complex animal models that better replicate human behavior and a wider array of molecular and mechanistic data relevant to interpreting the underlying cause(s) of toxicity. However, modern neurotoxicology studies are often more nuanced and complicated than traditional studies, and they often vary considerably in evaluation methods from one study to the next, impeding comparisons. This can pose particular difficulties for risk assessors, especially given the recent demand for chemical risk assessments to be more systematic and transparent. This presentation will introduce and provide some examples of specific challenges in neurotoxicity assessments of environmental chemicals. Some of these challenges are relatively new to the field, such as the incorporation of data on neuron-supportive glial cells into hazard characterization, while other challenges have persisted for several decades, but only recently are studies being designed to evaluate them, including analyses of latent neurotoxicity. The examples provided illustrate some future research areas of interest for scientists and risk assessors examining human neurotoxicity risk. This abstract will be presented to internal U.S. Food and Drug A

Case complexity scores in congenital heart surgery: a comparative study of the Aristotle Basic Complexity score and the Risk Adjustment in Congenital Heart Surgery (RACHS-1) system.

PubMed

Al-Radi, Osman O; Harrell, Frank E; Caldarone, Christopher A; McCrindle, Brian W; Jacobs, Jeffrey P; Williams, M Gail; Van Arsdell, Glen S; Williams, William G

2007-04-01

The Aristotle Basic Complexity score and the Risk Adjustment in Congenital Heart Surgery system were developed by consensus to compare outcomes of congenital cardiac surgery. We compared the predictive value of the 2 systems. Of all index congenital cardiac operations at our institution from 1982 to 2004 (n = 13,675), we were able to assign an Aristotle Basic Complexity score, a Risk Adjustment in Congenital Heart Surgery score, and both scores to 13,138 (96%), 11,533 (84%), and 11,438 (84%) operations, respectively. Models of in-hospital mortality and length of stay were generated for Aristotle Basic Complexity and Risk Adjustment in Congenital Heart Surgery using an identical data set in which both Aristotle Basic Complexity and Risk Adjustment in Congenital Heart Surgery scores were assigned. The likelihood ratio test for nested models and paired concordance statistics were used. After adjustment for year of operation, the odds ratios for Aristotle Basic Complexity score 3 versus 6, 9 versus 6, 12 versus 6, and 15 versus 6 were 0.29, 2.22, 7.62, and 26.54 (P < .0001). Similarly, odds ratios for Risk Adjustment in Congenital Heart Surgery categories 1 versus 2, 3 versus 2, 4 versus 2, and 5/6 versus 2 were 0.23, 1.98, 5.80, and 20.71 (P < .0001). Risk Adjustment in Congenital Heart Surgery added significant predictive value over Aristotle Basic Complexity (likelihood ratio chi2 = 162, P < .0001), whereas Aristotle Basic Complexity contributed much less predictive value over Risk Adjustment in Congenital Heart Surgery (likelihood ratio chi2 = 13.4, P = .009). Neither system fully adjusted for the child's age. The Risk Adjustment in Congenital Heart Surgery scores were more concordant with length of stay compared with Aristotle Basic Complexity scores (P < .0001). The predictive value of Risk Adjustment in Congenital Heart Surgery is higher than that of Aristotle Basic Complexity. The use of Aristotle Basic Complexity or Risk Adjustment in Congenital Heart Surgery as risk stratification and trending tools to monitor outcomes over time and to guide risk-adjusted comparisons may be valuable.

Randomized Controlled Trial of BASICS for Heavy Drinking Mandated and Volunteer Undergraduates: 12-Month Outcomes

PubMed Central

Terlecki, Meredith A.; Buckner, Julia D.; Larimer, Mary E.; Copeland, Amy L.

2014-01-01

This is the first randomized trial testing whether heavy drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy drinking volunteers up to one year post-intervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; Mage = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months post-intervention. At 4 weeks post-intervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer) BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months post-intervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared to controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to one year post-intervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. PMID:25844834

Sandia and General Motors: Advancing Clean Combustion Engines with

Science.gov Websites

Quantitative Risk Assessment Technical Reference for Hydrogen Compatibility of Materials Hydrogen Battery Abuse Testing Laboratory Center for Infrastructure Research and Innovation Combustion Research Facility Joint BioEnergy Institute Close Energy Research Programs ARPA-E Basic Energy Sciences Materials

HIAA's The Business of Insurance: An Introduction.

ERIC Educational Resources Information Center

Rosen, Anita; Lynch, Margaret E.

This booklet is intended to help students gain a broad understanding of the meaning, characteristics, organization, products, and functions of the insurance industry. The following topics are discussed: the concept of and need for insurance; basic principles of insurance (risk assessment, insurability and insurable interest, determination of…

Safety in Riding Programs: A Director's Guide.

ERIC Educational Resources Information Center

Kpachavi, Teresa

1996-01-01

Camp riding programs should be examined regularly for liability and risk management issues. Elements of a basic safety assessment include requiring proper safety apparel, removing obstructions from riding rings, ensuring doors and gates are closed, requiring use of lead ropes, securing equine medications, banning smoking, posting written…

Selection Criteria for Mathematical Models Used in Exposure Assessments: Atmospheric Dispersion Models

EPA Science Inventory

Before the U.S. Environmental Protection Agency issued the 1988 Guidelines for Estimating Exposures, it published proposed guidelines in the Federal Register for public review and comment. he guidelines are intended to give risk analysis a basic framework and the tools they need ...

How Much Safety Do We Need in ChE Education?

ERIC Educational Resources Information Center

Mewis, Jan

1984-01-01

Discusses aims, objectives, and content of a safety course for chemical engineering students. Course emphasizes awareness of hazards, basic concepts and principles of safety engineering, and the ability to recognize, assess, and remedy specific risks occurring in chemical plants. Course implementation is also discussed. (JN)

School Trips: Are They Worth the Effort?

ERIC Educational Resources Information Center

Johnston, Robert

2015-01-01

Even the most basic of school trips will require booking places, arranging transport, writing to parents, collecting payments, planning activities, producing worksheets and, of course, endless risk assessments. It always leaves teachers wondering: "is it really worth all this effort?" Robert Johnston believes that every teacher should…

Malnutrition in postacute geriatric care: Basic ESPEN diagnosis and etiology based diagnoses analyzed by length of stay, in-hospital mortality, and functional rehabilitation indexes.

PubMed

Sánchez-Rodríguez, Dolores; Marco, Ester; Annweiler, Cédric; Ronquillo-Moreno, Natalia; Tortosa, Andrea; Vázquez-Ibar, Olga; Escalada, Ferran; Duran, Xavier; Muniesa, Josep M

2017-11-01

To determine the relationships between malnutrition and nutrition-related conditions according to the European Society of Clinical Nutrition and Metabolism (ESPEN) consensus and guidelines and clinical outcomes in postacute rehabilitation. Of 102 eligible inpatients, 95 (84.5 years old, 63.2% women) fulfilled inclusion criteria: aged ≥70 years, body mass index <30kg/m 2 , admission for rehabilitation. Mini-Nutritional Assessment-Short Form (MNA-SF≤11) identified patients "at risk" and ESPEN basic and etiology based definitions were applied. Nutrition-related conditions (sarcopenia, frailty, overweight/obesity, micronutrient abnormalities) were determined. We assessed the relationship between these conditions and the clinical and rehabilitation outcomes (relative functional gain, rehabilitation efficiency) during hospitalization. All patients were "at risk" by MNA-SF criteria and 31 reported unintentional weight loss >5% in the last year or 2-3kg in the last 6 months. Nineteen fulfilled the ESPEN basic definition, of which 10 had disease-related malnutrition with inflammation and 9 without inflammation, and 20 had cachexia. Sarcopenia (n=44), frailty (n=94), overweight/obesity (n=59), and micronutrient abnormalities (n=70) were frequent. Unintentional weight loss impaired all functional outcomes and increased length of stay [OR=6.04 (2.87-9.22); p<0.001]. In multivariate analysis, relationships between rehabilitation impact indices and the ESPEN basic and etiology-based definitions observed in univariate analysis persisted only (and marginally) for relative functional gain [OR=13.24 (0.96-181.95); p=0.005]. Infrequent in-hospital mortality prevented meaningful analysis of this outcome. ESPEN basic and etiology-based definitions and nutrition related disorders were determined in postacute care. Malnutrition was associated with poor rehabilitation outcomes, mainly due to unintentional weight loss. Copyright © 2017 Elsevier B.V. All rights reserved.

Basic Science Evidence for the Link Between Erectile Dysfunction and Cardiometabolic Dysfunction

PubMed Central

Musicki, Biljana; Bella, Anthony J.; Bivalacqua, Trinity J.; Davies, Kelvin P.; DiSanto, Michael E.; Gonzalez-Cadavid, Nestor F.; Hannan, Johanna L.; Kim, Noel N.; Podlasek, Carol A.; Wingard, Christopher J.; Burnett, Arthur L.

2016-01-01

Introduction Although clinical evidence supports an association between cardiovascular/metabolic diseases (CVMD) and erectile dysfunction (ED), scientific evidence for this link is incompletely elucidated. Aim This study aims to provide scientific evidence for the link between CVMD and ED. Methods In this White Paper, the Basic Science Committee of the Sexual Medicine Society of North America assessed the current literature on basic scientific support for a mechanistic link between ED and CVMD, and deficiencies in this regard with a critical assessment of current preclinical models of disease. Results A link exists between ED and CVMD on several grounds: the endothelium (endothelium-derived nitric oxide and oxidative stress imbalance); smooth muscle (SM) (SM abundance and altered molecular regulation of SM contractility); autonomic innervation (autonomic neuropathy and decreased neuronal-derived nitric oxide); hormones (impaired testosterone release and actions); and metabolics (hyperlipidemia, advanced glycation end product formation). Conclusion Basic science evidence supports the link between ED and CVMD. The Committee also highlighted gaps in knowledge and provided recommendations for guiding further scientific study defining this risk relationship. This endeavor serves to develop novel strategic directions for therapeutic interventions. PMID:26646025

Improving online risk assessment with equipment prognostics and health monitoring

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

Coble, Jamie B.; Liu, Xiaotong; Briere, Chris

The current approach to evaluating the risk of nuclear power plant (NPP) operation relies on static probabilities of component failure, which are based on industry experience with the existing fleet of nominally similar light water reactors (LWRs). As the nuclear industry looks to advanced reactor designs that feature non-light water coolants (e.g., liquid metal, high temperature gas, molten salt), this operating history is not available. Many advanced reactor designs use advanced components, such as electromagnetic pumps, that have not been used in the US commercial nuclear fleet. Given the lack of rich operating experience, we cannot accurately estimate the evolvingmore » probability of failure for basic components to populate the fault trees and event trees that typically comprise probabilistic risk assessment (PRA) models. Online equipment prognostics and health management (PHM) technologies can bridge this gap to estimate the failure probabilities for components under operation. The enhanced risk monitor (ERM) incorporates equipment condition assessment into the existing PRA and risk monitor framework to provide accurate and timely estimates of operational risk.« less

Framework for Risk Analysis in Multimedia Environmental Systems: Modeling Individual Steps of a Risk Assessment Process

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

Shah, Anuj; Castleton, Karl J.; Hoopes, Bonnie L.

2004-06-01

The study of the release and effects of chemicals in the environment and their associated risks to humans is central to public and private decision making. FRAMES 1.X, Framework for Risk Analysis in Multimedia Environmental Systems, is a systems modeling software platform, developed by PNNL, Pacific Northwest National Laboratory, that helps scientists study the release and effects of chemicals on a source to outcome basis, create environmental models for similar risk assessment and management problems. The unique aspect of FRAMES is to dynamically introduce software modules representing individual components of a risk assessment (e.g., source release of contaminants, fate andmore » transport in various environmental media, exposure, etc.) within a software framework, manipulate their attributes and run simulations to obtain results. This paper outlines the fundamental constituents of FRAMES 2.X, an enhanced version of FRAMES 1.X, that greatly improve the ability of the module developers to “plug” their self-developed software modules into the system. The basic design, the underlying principles and a discussion of the guidelines for module developers are presented.« less

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

PubMed

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

2016-10-01

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

Increasing Student Success: An Interview with Edward A. Morante.

ERIC Educational Resources Information Center

Spann, Milton G.; Calderwood, Barbara J.

1998-01-01

Presents an interview with Edward Morante, Dean of Student Services and Learning Resources at College of the Desert (California), regarding the needs of high-risk community college students. Morante focuses on assessment, placement, basic-skills courses, student-support services, the learning-community concept, student involvement, and evaluation,…

Risk analysis of heat recovery steam generator with semi quantitative risk based inspection API 581

NASA Astrophysics Data System (ADS)

Prayogo, Galang Sandy; Haryadi, Gunawan Dwi; Ismail, Rifky; Kim, Seon Jin

2016-04-01

Corrosion is a major problem that most often occurs in the power plant. Heat recovery steam generator (HRSG) is an equipment that has a high risk to the power plant. The impact of corrosion damage causing HRSG power plant stops operating. Furthermore, it could be threaten the safety of employees. The Risk Based Inspection (RBI) guidelines by the American Petroleum Institute (API) 58 has been used to risk analysis in the HRSG 1. By using this methodology, the risk that caused by unexpected failure as a function of the probability and consequence of failure can be estimated. This paper presented a case study relating to the risk analysis in the HRSG, starting with a summary of the basic principles and procedures of risk assessment and applying corrosion RBI for process industries. The risk level of each HRSG equipment were analyzed: HP superheater has a medium high risk (4C), HP evaporator has a medium-high risk (4C), and the HP economizer has a medium risk (3C). The results of the risk assessment using semi-quantitative method of standard API 581 based on the existing equipment at medium risk. In the fact, there is no critical problem in the equipment components. Damage mechanisms were prominent throughout the equipment is thinning mechanism. The evaluation of the risk approach was done with the aim of reducing risk by optimizing the risk assessment activities.

ASTARTE: Assessment Strategy and Risk Reduction for Tsunamis in Europe

NASA Astrophysics Data System (ADS)

Baptista, M. A.; Yalciner, A. C.; Canals, M.

2014-12-01

Tsunamis are low frequency but high impact natural disasters. In 2004, the Boxing Day tsunami killed hundreds of thousands of people from many nations along the coastlines of the Indian Ocean. Tsunami run-up exceeded 35 m. Seven years later, and in spite of some of the best warning technologies and levels of preparedness in the world, the Tohoku-Oki tsunami in Japan dramatically showed the limitations of scientific knowledge on tsunami sources, coastal impacts and mitigation measures. The experience from Japan raised serious questions on how to improve the resilience of coastal communities, to upgrade the performance of coastal defenses, to adopt a better risk management, and also on the strategies and priorities for the reconstruction of damaged coastal areas. Societal resilience requires the reinforcement of capabilities to manage and reduce risk at national and local scales.ASTARTE (Assessment STrategy And Risk for Tsunami in Europe), a 36-month FP7 project, aims to develop a comprehensive strategy to mitigate tsunami impact in this region. To achieve this goal, an interdisciplinary consortium has been assembled. It includes all CTWPs of NEAM and expert institutions across Europe and worldwide. ASTARTE will improve i) basic knowledge of tsunami generation and recurrence going beyond simple catalogues, with novel empirical data and new statistical analyses for assessing long-term recurrence and hazards of large events in sensitive areas of NEAM, ii) numerical techniques for tsunami simulation, with focus on real-time codes and novel statistical emulation approaches, and iii) methods for assessment of hazard, vulnerability, and risk. ASTARTE will also provide i) guidelines for tsunami Eurocodes, ii) better tools for forecast and warning for CTWPs and NTWCs, and iii) guidelines for decision makers to increase sustainability and resilience of coastal communities. In summary, ASTARTE will develop basic scientific and technical elements allowing for a significant enhancement of the Tsunami Warning System in the NEAM region in terms of monitoring, early warning and forecast, governance and resilience. This work is funded by project ASTARTE - Assessment, STrategy And Risk Reduction for Tsunamis in Europe. Grant 603839, 7th FP (ENV.2013.6.4-3 ENV.2013.6.4-3)

A Critique of Recent Epidemiologic Studies of Cancer Mortality Among Nuclear Workers.

PubMed

Scott, Bobby R

2018-01-01

Current justification by linear no-threshold (LNT) cancer risk model advocates for its use in low-dose radiation risk assessment is now mainly based on results from flawed and unreliable epidemiologic studies that manufacture small risk increases (ie, phantom risks). Four such studies of nuclear workers, essentially carried out by the same group of epidemiologists, are critiqued in this article. Three of the studies that forcibly applied the LNT model (inappropriate null hypothesis) to cancer mortality data and implicated increased mortality risk from any radiation exposure, no matter how small the dose, are demonstrated to manufacture risk increases for doses up to 100 mSv (or 100 mGy). In a study where risk reduction (hormetic effect/adaptive response) was implicated for nuclear workers, it was assumed by the researchers to relate to a "strong healthy worker effect" with no consideration of the possibility that low radiation doses may help prevent cancer mortality (which is consistent with findings from basic radiobiological research). It was found with basic research that while large radiation doses suppress our multiple natural defenses (barriers) against cancer, these barriers are enhanced by low radiation doses, thereby decreasing cancer risk, essentially rendering the LNT model to be inconsistent with the data.

Application of geostatistics to risk assessment.

PubMed

Thayer, William C; Griffith, Daniel A; Goodrum, Philip E; Diamond, Gary L; Hassett, James M

2003-10-01

Geostatistics offers two fundamental contributions to environmental contaminant exposure assessment: (1) a group of methods to quantitatively describe the spatial distribution of a pollutant and (2) the ability to improve estimates of the exposure point concentration by exploiting the geospatial information present in the data. The second contribution is particularly valuable when exposure estimates must be derived from small data sets, which is often the case in environmental risk assessment. This article addresses two topics related to the use of geostatistics in human and ecological risk assessments performed at hazardous waste sites: (1) the importance of assessing model assumptions when using geostatistics and (2) the use of geostatistics to improve estimates of the exposure point concentration (EPC) in the limited data scenario. The latter topic is approached here by comparing design-based estimators that are familiar to environmental risk assessors (e.g., Land's method) with geostatistics, a model-based estimator. In this report, we summarize the basics of spatial weighting of sample data, kriging, and geostatistical simulation. We then explore the two topics identified above in a case study, using soil lead concentration data from a Superfund site (a skeet and trap range). We also describe several areas where research is needed to advance the use of geostatistics in environmental risk assessment.

Casting a wider net for countermeasure R&D funding decisions.

PubMed

Klotz, Lynn

2007-12-01

Among potential bioweapons attacks, endemic infectious diseases (that is, those naturally occurring diseases that afflict us every year), and a potential influenza pandemic, how should we apportion funding and resources for basic research and countermeasure development? To address this question, I argue for a "combined risk assessment" that considers bioweapons attacks with natural pandemics and endemic infectious disease. At present, risk assessments for bioweapons attacks are carried out separately from the assessments long carried out for endemic infectious diseases to make public health and medical care decisions. One result of this separation is that funding decisions may be unduly influenced by an overblown fear of a big bioweapons attack and by political whim. The result of the simplified combined risk assessment presented here argues for more funding and resources for endemic infectious disease and for placing biodefense against anthrax and other bioweapons in a place lower in the risk hierarchy. Since the assessment here considers only fatalities to make the point that our priorities are skewed, the conclusions are only a "first word" on the subject, far from the last. Furthermore, the impact of other issues on priorities, such as national and international policy, is not considered. It is a call for a debate on the public stage of the policy and other rationale and the quantitative risk assessment arguments that now place bioweapons attacks at the top of our risk ranking.

The Battalion Commander’s Handbook, 1991

DTIC Science & Technology

1991-06-01

your battalion’s ARTEP and ATM requirements, read "How to Fight Manuals" FM’s 71-2, 25-100 and NTC 71-2, plus FM 25- series training FM 7-xx. o... risks in training. Tactics are basic, but training innovations and aggressiveness will make your battalion a winner. o Trust, check, and help...o Conduct a risk assessment of every training event you conduct. o Be unmerciful, uncompromising, unwavering and involved in safety at all times

School environment assessment tools to address behavioural risk factors of non-communicable diseases: A scoping review.

PubMed

Saluja, Kiran; Rawal, Tina; Bassi, Shalini; Bhaumik, Soumyadeep; Singh, Ankur; Park, Min Hae; Kinra, Sanjay; Arora, Monika

2018-06-01

We aimed to identify, describe and analyse school environment assessment (SEA) tools that address behavioural risk factors (unhealthy diet, physical inactivity, tobacco and alcohol consumption) for non-communicable diseases (NCD). We searched in MEDLINE and Web of Science, hand-searched reference lists and contacted experts. Basic characteristics, measures assessed and measurement properties (validity, reliability, usability) of identified tools were extracted. We narratively synthesized the data and used content analysis to develop a list of measures used in the SEA tools. Twenty-four SEA tools were identified, mostly from developed countries. Out of these, 15 were questionnaire based, 8 were checklists or observation based tools and one tool used a combined checklist/observation based and telephonic questionnaire approach. Only 1 SEA tool had components related to all the four NCD risk factors, 2 SEA tools has assessed three NCD risk factors (diet/nutrition, physical activity, tobacco), 10 SEA tools has assessed two NCD risk factors (diet/nutrition and physical activity) and 11 SEA tools has assessed only one of the NCD risk factor. Several measures were used in the tools to assess the four NCD risk factors, but tobacco and alcohol was sparingly included. Measurement properties were reported for 14 tools. The review provides a comprehensive list of measures used in SEA tools which could be a valuable resource to guide future development of such tools. A valid and reliable SEA tool which could simultaneously evaluate all NCD risk factors, that has been tested in different settings with varying resource availability is needed.

How biological background assumptions influence scientific risk evaluation of stacked genetically modified plants: an analysis of research hypotheses and argumentations.

PubMed

Rocca, Elena; Andersen, Fredrik

2017-08-14

Scientific risk evaluations are constructed by specific evidence, value judgements and biological background assumptions. The latter are the framework-setting suppositions we apply in order to understand some new phenomenon. That background assumptions co-determine choice of methodology, data interpretation, and choice of relevant evidence is an uncontroversial claim in modern basic science. Furthermore, it is commonly accepted that, unless explicated, disagreements in background assumptions can lead to misunderstanding as well as miscommunication. Here, we extend the discussion on background assumptions from basic science to the debate over genetically modified (GM) plants risk assessment. In this realm, while the different political, social and economic values are often mentioned, the identity and role of background assumptions at play are rarely examined. We use an example from the debate over risk assessment of stacked genetically modified plants (GM stacks), obtained by applying conventional breeding techniques to GM plants. There are two main regulatory practices of GM stacks: (i) regulate as conventional hybrids and (ii) regulate as new GM plants. We analyzed eight papers representative of these positions and found that, in all cases, additional premises are needed to reach the stated conclusions. We suggest that these premises play the role of biological background assumptions and argue that the most effective way toward a unified framework for risk analysis and regulation of GM stacks is by explicating and examining the biological background assumptions of each position. Once explicated, it is possible to either evaluate which background assumptions best reflect contemporary biological knowledge, or to apply Douglas' 'inductive risk' argument.

Risk Assessment of Shellfish Toxins

PubMed Central

Munday, Rex; Reeve, John

2013-01-01

Complex secondary metabolites, some of which are highly toxic to mammals, are produced by many marine organisms. Some of these organisms are important food sources for marine animals and, when ingested, the toxins that they produce may be absorbed and stored in the tissues of the predators, which then become toxic to animals higher up the food chain. This is a particular problem with shellfish, and many cases of poisoning are reported in shellfish consumers each year. At present, there is no practicable means of preventing uptake of the toxins by shellfish or of removing them after harvesting. Assessment of the risk posed by such toxins is therefore required in order to determine levels that are unlikely to cause adverse effects in humans and to permit the establishment of regulatory limits in shellfish for human consumption. In the present review, the basic principles of risk assessment are described, and the progress made toward robust risk assessment of seafood toxins is discussed. While good progress has been made, it is clear that further toxicological studies are required before this goal is fully achieved. PMID:24226039

Relative risk analysis in regulating the use of radiation-emitting medical devices. A preliminary application

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

Jones, E.D.; Banks, W.W.; Altenbach, T.J.

1995-09-01

This report describes a preliminary application of an analysis approach for assessing relative risks in the use of radiation- emitting medical devices. Results are presented on human-initiated actions and failure modes that are most likely to occur in the use of the Gamma Knife, a gamma irradiation therapy device. This effort represents an initial step in a US Nuclear Regulatory Commission (NRC) plan to evaluate the potential role of risk analysis in regulating the use of nuclear medical devices. For this preliminary application of risk assessment, the focus was to develop a basic process using existing techniques for identifying themore » most likely risk contributors and their relative importance. The approach taken developed relative risk rankings and profiles that incorporated the type and quality of data available and could present results in an easily understood form. This work was performed by the Lawrence Livermore National Laboratory for the NRC.« less

The NASA Space Radiation Research Program

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.

2006-01-01

We present a comprehensive overview of the NASA Space Radiation Research Program. This program combines basic research on the mechanisms of radiobiological action relevant for improving knowledge of the risks of cancer, central nervous system and other possible degenerative tissue effects, and acute radiation syndromes from space radiation. The keystones of the NASA Program are five NASA Specialized Center's of Research (NSCOR) investigating space radiation risks. Other research is carried out through peer-reviewed individual investigations and in collaboration with the US Department of Energies Low-Dose Research Program. The Space Radiation Research Program has established the Risk Assessment Project to integrate data from the NSCOR s and other peer-reviewed research into quantitative projection models with the goals of steering research into data and scientific breakthroughs that will reduce the uncertainties in current risk projections and developing the scientific knowledge needed for future individual risk assessment approaches and biological countermeasure assessments or design. The NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory was created by the Program to simulate space radiation on the ground in support of the above research programs. New results from NSRL will be described.

Assessment tools for unrecognized myocardial infarction: a cross-sectional analysis of the REasons for geographic and racial differences in stroke population

PubMed Central

2013-01-01

Background Routine electrocardiograms (ECGs) are not recommended for asymptomatic patients because the potential harms are thought to outweigh any benefits. Assessment tools to identify high risk individuals may improve the harm versus benefit profile of screening ECGs. In particular, people with unrecognized myocardial infarction (UMI) have elevated risk for cardiovascular events and death. Methods Using logistic regression, we developed a basic assessment tool among 16,653 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study using demographics, self-reported medical history, blood pressure, and body mass index and an expanded assessment tool using information on 51 potential variables. UMI was defined as electrocardiogram evidence of myocardial infarction without a self-reported history (n = 740). Results The basic assessment tool had a c-statistic of 0.638 (95% confidence interval 0.617 - 0.659) and included age, race, smoking status, body mass index, systolic blood pressure, and self-reported history of transient ischemic attack, deep vein thrombosis, falls, diabetes, and hypertension. A predicted probability of UMI > 3% provided a sensitivity of 80% and a specificity of 30%. The expanded assessment tool had a c-statistic of 0.654 (95% confidence interval 0.634-0.674). Because of the poor performance of these assessment tools, external validation was not pursued. Conclusions Despite examining a large number of potential correlates of UMI, the assessment tools did not provide a high level of discrimination. These data suggest defining groups with high prevalence of UMI for targeted screening will be difficult. PMID:23530553

Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status.

PubMed

Droogsma, E; van Asselt, D Z B; Schölzel-Dorenbos, C J M; van Steijn, J H M; van Walderveen, P E; van der Hooft, C S

2013-07-01

To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD). Retrospective cross-sectional study. Memory clinic in a rural part of the Netherlands. 312 Community-dwelling AD patients, aged 65 years or older, were included. At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status. The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062). One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.

Workers' knowledge and beliefs about cardiometabolic health risk.

PubMed

Damman, Olga C; van der Beek, Allard J; Timmermans, Danielle R M

2014-01-01

Investigate workers' knowledge and beliefs about cardiometabolic risk. A survey on the risks of diabetes, cardiovascular disease, and chronic kidney disease was disseminated among Dutch construction workers and employees from the general working population. We had 482 respondents (26.8%) among construction workers and 738 respondents (65.1%) among the general working population. Employees showed reasonable basic knowledge, especially about cardiovascular disease risk factors and risk reduction. Nevertheless, they also had knowledge gaps (eg, specific dietary intake) and showed misconceptions of what elevated risk entails. Employees having lower education, being male, and having lower health literacy demonstrated less adequate knowledge and beliefs. To improve the potential effect of health risk assessments in the occupational setting, physicians should explain what it means to be at elevated cardiometabolic risk and target their messages to employee subgroups.

Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

DOT National Transportation Integrated Search

2017-03-01

This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

Medical review practices for driver licensing : Volume 1 : a case study of guidelines and processes in seven U.S. States.

DOT National Transportation Integrated Search

2016-10-01

This report is the first of three examining driver medical review practices in the United States and how they fulfilled the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk drivers. The aim was not to ...

First aid provision in nightclubs and other entertainment venues.

PubMed

Dean, R; Mulligan, J

This article discusses the role and responsibilities of the registered nurse in providing first aid in challenging environments, such as crowded nightclubs. Basic assistance for common emergencies, including substance misuse, wounds, choking and anaphylaxis, are discussed. This article emphasises the importance of risk assessment and reminds readers of the need to maintain personal safety.

Psychosocial Risk Factors for Upper Respiratory Infections: Assessment of Upper Respiratory Illness during Basic Training

DTIC Science & Technology

1988-05-23

association was low enough to ensure that the URI composite was not merely an index of somatic stress reactions or hypochondriasis . The eight-item...report somatic symptoms in response to stress. Adjusted URI Severity also is consistent with the clinical practice of ruling out other possible types

Biological Based Risk Assessment for Space Exploration

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.

2011-01-01

Exposures from galactic cosmic rays (GCR) - made up of high-energy protons and high-energy and charge (HZE) nuclei, and solar particle events (SPEs) - comprised largely of low- to medium-energy protons are the primary health concern for astronauts for long-term space missions. Experimental studies have shown that HZE nuclei produce both qualitative and quantitative differences in biological effects compared to terrestrial radiation, making risk assessments for cancer and degenerative risks, such as central nervous system effects and heart disease, highly uncertain. The goal for space radiation protection at NASA is to be able to reduce the uncertainties in risk assessments for Mars exploration to be small enough to ensure acceptable levels of risks are not exceeded and to adequately assess the efficacy of mitigation measures such as shielding or biological countermeasures. We review the recent BEIR VII and UNSCEAR-2006 models of cancer risks and their uncertainties. These models are shown to have an inherent 2-fold uncertainty as defined by ratio of the 95% percent confidence level to the mean projection, even before radiation quality is considered. In order to overcome the uncertainties in these models, new approaches to risk assessment are warranted. We consider new computational biology approaches to modeling cancer risks. A basic program of research that includes stochastic descriptions of the physics and chemistry of radiation tracks and biochemistry of metabolic pathways, to emerging biological understanding of cellular and tissue modifications leading to cancer is described.

Adolescents' Use of Basic, Intermediate, and Advanced Device Types for Vaping.

PubMed

Pepper, Jessica K; MacMonegle, Anna J; Nonnemaker, James M

2017-12-23

Advanced models of electronic vaping products (EVPs) likely pose a greater risk to adolescent health than basic or intermediate models because advanced models deliver nicotine more effectively and heat e-liquid to higher temperatures, producing more harmful chemical emissions. However, little is known about adolescents' risk factors for using different device types. We used social media to recruit an online sample of 1,508 U.S. adolescents aged 15-17 who reported past 30-day use of e-cigarettes. We assessed tobacco use, beliefs and knowledge about EVPs, and EVP use behavior, including the device type participants use most frequently. We used multinomial logistic regression to examine differences between adolescents who usually use intermediate versus basic and advanced versus basic devices. Most respondents usually used modifiable advanced devices (56.8%) rather than basic "cigalike" (14.5%) or pen-style intermediate (28.7%) devices. Use of multiple device types was common, particularly among those who primarily used basic devices. Younger age and less frequent vaping were associated with mainly using basic devices. Adolescents who were older, male, personally bought their main device, and had ever mixed e-liquids were at elevated risk for usually using advanced devices. Adolescents who primarily use basic devices may be newer users who are experimenting with multiple devices. Future research should examine which adolescents are most likely to transition to advanced devices in order to develop targeted interventions. Regulators should consider strategies to reduce access to all types of EVPs, such as better enforcement of the current ban on sales to minors. This research addresses two gaps in research on adolescent electronic vaping product use: (1) characterizing use of advanced devices as distinct from intermediate devices rather than grouping them together and (2) examining factors associated with use of specific device types. This study suggests that there are distinct profiles of adolescents who use primarily basic, intermediate, or advanced devices. Adolescents who most often use basic devices may be new users experimenting with vaping, whereas adolescents who most often use advanced devices appear to be buying devices for themselves and engaging in risky behaviors such as mixing their own e-liquid. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The relationship between negative life events and suicidal behavior: moderating role of basic psychological needs.

PubMed

Rowe, Catherine A; Walker, Kristin L; Britton, Peter C; Hirsch, Jameson K

2013-01-01

Individuals who experience negative life events may be at increased risk for suicidal behavior. Intrapersonal characteristics, such as basic psychological needs, however, may buffer this association. To assess the potential moderating role of overall basic psychological needs, and the separate components of autonomy, competence, and relatedness, on the association between negative life events and suicidal behavior. Our sample of 439 college students (311 females, 71%) completed the following self-report surveys: Life Events Scale, Basic Psychological Needs Scale, Beck Depression Inventory - II, and the Suicide Behaviors Questionnaire-Revised. In support of our hypotheses, negative life events were associated with greater levels of suicidal ideation and attempts, and satisfaction of basic psychological needs, including autonomy, relatedness, and competence, significantly moderated this relationship, over and above the effects of the covariates of age, sex, and depressive symptoms. Suicidal behavior associated with the experience of negative life events is not inevitable. Therapeutically bolstering competence, autonomy, and relatedness may be an important suicide prevention strategy for individuals experiencing life stressors.

Risk analysis of heat recovery steam generator with semi quantitative risk based inspection API 581

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

Prayogo, Galang Sandy, E-mail: gasandylang@live.com; Haryadi, Gunawan Dwi; Ismail, Rifky

Corrosion is a major problem that most often occurs in the power plant. Heat recovery steam generator (HRSG) is an equipment that has a high risk to the power plant. The impact of corrosion damage causing HRSG power plant stops operating. Furthermore, it could be threaten the safety of employees. The Risk Based Inspection (RBI) guidelines by the American Petroleum Institute (API) 58 has been used to risk analysis in the HRSG 1. By using this methodology, the risk that caused by unexpected failure as a function of the probability and consequence of failure can be estimated. This paper presentedmore » a case study relating to the risk analysis in the HRSG, starting with a summary of the basic principles and procedures of risk assessment and applying corrosion RBI for process industries. The risk level of each HRSG equipment were analyzed: HP superheater has a medium high risk (4C), HP evaporator has a medium-high risk (4C), and the HP economizer has a medium risk (3C). The results of the risk assessment using semi-quantitative method of standard API 581 based on the existing equipment at medium risk. In the fact, there is no critical problem in the equipment components. Damage mechanisms were prominent throughout the equipment is thinning mechanism. The evaluation of the risk approach was done with the aim of reducing risk by optimizing the risk assessment activities.« less

Seismic Hazard Assessment for the Baku City and Absheron Peninsula, Azerbaijan

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

Babayev, Gulam R.

2006-03-23

This paper deals with the seismic hazard assessment for Baku and the Absheron peninsula. The assessment is based on the information on the features of earthquake ground motion excitation, seismic wave propagation (attenuation), and site effect. I analyze active faults, seismicity, soil and rock properties, geological cross-sections, the borehole data of measured shear-wave velocity, lithology, amplification factor of each geological unit, geomorphology, topography, and basic rock and surface ground motions. To estimate peak ground acceleration (PGA) at the surface, PGA at the basic rock is multiplied by the amplification parameter of each surface layers. Quaternary soft deposits, representing a highmore » risk due to increasing PGA values at surface, are studied in detail. For a near-zone target earthquake PGA values are compared to intensity at MSK-64 scale for the Absheron peninsula. The amplification factor for the Baku city is assessed and provides estimations for a level of a seismic motion and seismic intensity of the studied area.« less

Guidelines for personal exposure monitoring of chemicals: Part V.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-05-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part IV.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-03-27

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part III.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2018-01-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part I.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2017-09-28

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided later in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

Guidelines for personal exposure monitoring of chemicals: Part II.

PubMed

Hashimoto, Haruo; Yamada, Kenichi; Hori, Hajime; Kumagai, Shinji; Murata, Masaru; Nagoya, Toshio; Nakahara, Hirohiko; Mochida, Nobuyuki

2017-11-25

This Document, "Guidelines for personal exposure monitoring of chemicals" ("this Guideline"), has been prepared by "The Committee for Personal Exposure Monitoring" ("the Committee") of the Expert Division of Occupational Hygiene & Ergonomics, Japan Society for Occupational Health. Considering the background of the growing importance of personal exposure monitoring in risk assessment and the need to prepare for the introduction of monitoring using personal samplers from an administrative perspective in recent years, the Committee was organized in November 2012. The Committee has prepared this Guideline as a "practical guideline" for personal exposure monitoring, so as to offer proposals and recommendations to the members of the Japan Society for Occupational Health and to society in general. The scope of this Guideline covers all chemical substances and all related workplaces regarded as targets for general assessment and the management of risk. It thus is not to be considered to comment on legal regulations and methodology. The main text provides the basic methods and concepts of personal exposure monitoring, while 31 "Appendices" are provided in this Guideline throughout the series; technical descriptions, statistical bases, and actual workplace examples are provided in these appendices, to assist better understanding. The personal exposure monitoring described as per this Guideline is equivalent to an "expert-centered basic method to reasonably proceed with the assessment and management of risk at workplaces." It is considered that practicing and expanding on this method will significantly contribute in reforming the overall framework of occupational hygiene management in Japan.

The principle of safety evaluation in medicinal drug - how can toxicology contribute to drug discovery and development as a multidisciplinary science?

PubMed

Horii, Ikuo

2016-01-01

Pharmaceutical (drug) safety assessment covers a diverse science-field in the drug discovery and development including the post-approval and post-marketing phases in order to evaluate safety and risk management. The principle in toxicological science is to be placed on both of pure and applied sciences that are derived from past/present scientific knowledge and coming new science and technology. In general, adverse drug reactions are presented as "biological responses to foreign substances." This is the basic concept of thinking about the manifestation of adverse drug reactions. Whether or not toxic expressions are extensions of the pharmacological effect, adverse drug reactions as seen from molecular targets are captured in the category of "on-target" or "off-target", and are normally expressed as a biological defense reaction. Accordingly, reactions induced by pharmaceuticals can be broadly said to be defensive reactions. Recent molecular biological conception is in line with the new, remarkable scientific and technological developments in the medical and pharmaceutical areas, and the viewpoints in the field of toxicology have shown that they are approaching toward the same direction as well. This paper refers to the basic concept of pharmaceutical toxicology, the differences for safety assessment in each stage of drug discovery and development, regulatory submission, and the concept of scientific considerations for risk assessment and management from the viewpoint of "how can multidisciplinary toxicology contribute to innovative drug discovery and development?" And also realistic translational research from preclinical to clinical application is required to have a significant risk management in post market by utilizing whole scientific data derived from basic and applied scientific research works. In addition, the significance for employing the systems toxicology based on AOP (Adverse Outcome Pathway) analysis is introduced, and coming challenges on precision medicine are to be addressed for the new aspect of efficacy and safety evaluation.

Relapse prevention and smoking cessation.

PubMed

Davis, J R; Glaros, A G

1986-01-01

A multicomponent smoking relapse prevention treatment based on Marlatt and Gordon's (1980) model of the relapse process was developed and evaluated. Behavior-analytic methods were used to develop assessment instruments, training situations, and coping responses. The prevention components were presented in the context of a basic broad-spectrum stop-smoking program, and were compared with the basic program plus discussion control, and the basic program alone. Smoking-related dependent variables generally did not differ between groups at any time from pre-treatment to 12 month follow-up. Only the subjects in the relapse prevention condition improved problem-solving and social skills needed to cope with high-risk situations. These subjects also tended to take longer to relapse and smoke fewer cigarettes at the time of relapse. Subjects above the median level of competence on measures of social skill at post-treatment remained abstinent significantly longer. Maintenance of non-smoking was found to be related to the degree of competence with which individuals deal with high-risk situations. Results are discussed in relation to models of compliance with therapeutic regimens.

Cognitively-Related Basic Activities of Daily Living Impairment Greatly Increases the Risk of Death in Alzheimers Disease.

PubMed

Liang, Fu-Wen; Chan, Wenyaw; Chen, Ping-Jen; Zimmerman, Carissa; Waring, Stephen; Doody, Rachelle

2016-01-01

Some Alzheimer's disease (AD) patients die without ever developing cognitively impaired basic activities of daily living (basic ADL), which may reflect slower disease progression or better compensatory mechanisms. Although impaired basic ADL is related to disease severity, it may exert an independent risk for death. This study examined the association between impaired basic ADL and survival of AD patients, and proposed a multistate approach for modeling the time to death for patients who demonstrate different patterns of progression of AD that do or do not include basic ADL impairment. 1029 patients with probable AD at the Baylor College of Medicine Alzheimer's Disease and Memory Disorders Center met the criteria for this study. Two complementary definitions were used to define development of basic ADL impairment using the Physical Self-Maintenance Scale score. A weighted Cox regression model, including a time-dependent covariate (development of basic ADL impairment), and a multistate survival model were applied to examine the effect of basic ADL impairment on survival. As expected decreased ability to perform basic ADL at baseline, age at initial visit, years of education, and sex were all associated with significantly higher mortality risk. In those unimpaired at baseline, the development of basic ADL impairment was also associated with a much greater risk of death (hazard ratios 1.77-4.06) over and above the risk conferred by loss of MMSE points. A multi-state Cox model, controlling for those other variables quantified the substantive increase in hazard ratios for death conferred by the development of basic ADL impairment by two definitions and can be applied to calculate the short term risk of mortality in individual patients. The current study demonstrates that the presence of basic ADL impairment or the development of such impairments are important predictors of death in AD patients, regardless of severity.

Psychosocial correlates of immune responsiveness and illness episodes in US Air Force Academy cadets undergoing basic cadet training

NASA Technical Reports Server (NTRS)

Lee, D. J.; Meehan, R. T.; Robinson, C.; Smith, M. L.; Mabry, T. R.

1995-01-01

This study examined psychosocial correlates of immune function and illness in 89 male first-year US Air Force Academy cadets. A psychosocial questionnaire was administered to cadets prior to their arrival at the academy and was readministered during cadet orientation and during the stressful environment of Basic Cadet Training (BCT). Immune responsiveness was analyzed by PHA-, PMA-, or anti-CD3-stimulated thymidine uptake in mononuclear leucocytes. Illness episodes were assessed via medical chart review and self-reported symptoms. There were significant increases in distress levels as cadets entered BCT. No psychosocial measure assessed prior to arrival at the academy predicted level of PHA-, PMA-, and anti-CD3-stimulated thymidine uptake or risk of illness. However, hostility levels reported during BCT predicted risk of illness in the four weeks following psychosocial assessment (odds ratio = 7.1; 95% confidence interval: 1.4-36.1). Elevated response to environmental stressors and lower well-being levels also predicted impending illness, but only in the cohort of cadets who had not contracted food poisoning prior to assessment during BCT (OR = 9.3, CI = 1.9-46.7; OR = 0.09, CI = 0.02-0.53). These results suggest that self-report measures of hostility, response to environmental stressors and well-being may be useful predictors of impending illness episodes in males encountering high stress environments.

The Research on Safety Management Information System of Railway Passenger Based on Risk Management Theory

NASA Astrophysics Data System (ADS)

Zhu, Wenmin; Jia, Yuanhua

2018-01-01

Based on the risk management theory and the PDCA cycle model, requirements of the railway passenger transport safety production is analyzed, and the establishment of the security risk assessment team is proposed to manage risk by FTA with Delphi from both qualitative and quantitative aspects. The safety production committee is also established to accomplish performance appraisal, which is for further ensuring the correctness of risk management results, optimizing the safety management business processes and improving risk management capabilities. The basic framework and risk information database of risk management information system of railway passenger transport safety are designed by Ajax, Web Services and SQL technologies. The system realizes functions about risk management, performance appraisal and data management, and provides an efficient and convenient information management platform for railway passenger safety manager.

Randomized controlled trial of brief alcohol screening and intervention for college students for heavy-drinking mandated and volunteer undergraduates: 12-month outcomes.

PubMed

Terlecki, Meredith A; Buckner, Julia D; Larimer, Mary E; Copeland, Amy L

2015-03-01

This is the first randomized trial testing whether heavy-drinking undergraduates mandated to the Brief Alcohol Screening and Intervention for College Students (BASICS) program following a campus alcohol violation would benefit as much as heavy-drinking volunteers up to 1 year postintervention using control groups with high-risk drinkers to model disciplinary-related and naturalistic changes in drinking. Participants (61% male; 51% mandated; 84% Caucasian; M age = 20.14 years) were screened for heavy drinking and randomized to BASICS (n = 115) or assessment-only control (n = 110). Outcome measures (drinking, alcohol problems) were collected at baseline, 4 weeks, 3, 6, and 12 months postintervention. At 4 weeks postintervention, intent-to-treat multilevel longitudinal models showed that regardless of referral group (mandated or volunteer), BASICS significantly decreased weekly drinking, typical drinks, and peak drinks relative to controls (ds = .41-.92). BASICS had a large effect on decreases in alcohol problems (d = .87). At 12 months postintervention, BASICS participants (regardless of referral group) reported significantly fewer alcohol problems (d = .56) compared with controls. Significant long-term intervention gains for peak and typical drinks were sustained in both referral groups relative to controls (ds = .42; .11). Referral group had no significant main effect and did not interact with intervention condition to predict outcomes. Given that BASICS was associated with less drinking and fewer alcohol problems (even among heavier drinking mandated students up to 1 year postintervention), provision of BASICS-style programs within disciplinary settings may help reduce heavy and problematic drinking among at-risk students. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Assessing dengue infection risk in the southern region of Taiwan: implications for control.

PubMed

Liao, C-M; Huang, T-L; Cheng, Y-H; Chen, W-Y; Hsieh, N-H; Chen, S-C; Chio, C-P

2015-04-01

Dengue, one of the most important mosquito-borne diseases, is a major international public health concern. This study aimed to assess potential dengue infection risk from Aedes aegypti in Kaohsiung and the implications for vector control. Here we investigated the impact of dengue transmission on human infection risk using a well-established dengue-mosquito-human transmission dynamics model. A basic reproduction number (R 0)-based probabilistic risk model was also developed to estimate dengue infection risk. Our findings confirm that the effect of biting rate plays a crucial role in shaping R 0 estimates. We demonstrated that there was 50% risk probability for increased dengue incidence rates exceeding 0.5-0.8 wk-1 for temperatures ranging from 26°C to 32°C. We further demonstrated that the weekly increased dengue incidence rate can be decreased to zero if vector control efficiencies reach 30-80% at temperatures of 19-32°C. We conclude that our analysis on dengue infection risk and control implications in Kaohsiung provide crucial information for policy-making on disease control.

PRA (Probabilistic Risk Assessments) Participation versus Validation

NASA Technical Reports Server (NTRS)

DeMott, Diana; Banke, Richard

2013-01-01

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

Leisure-time physical activity and incident metabolic syndrome: a systematic review and dose-response meta-analysis of cohort studies.

PubMed

Zhang, Dongdong; Liu, Xuejiao; Liu, Yu; Sun, Xizhuo; Wang, Bingyuan; Ren, Yongcheng; Zhao, Yang; Zhou, Junmei; Han, Chengyi; Yin, Lei; Zhao, Jingzhi; Shi, Yuanyuan; Zhang, Ming; Hu, Dongsheng

2017-10-01

Leisure-time physical activity (LTPA) has been suggested to reduce risk of metabolic syndrome (MetS). However, a quantitative comprehensive assessment of the dose-response association between LTPA and incident MetS has not been reported. We performed a meta-analysis of studies assessing the risk of MetS with LTPA. MEDLINE via PubMed and EMBase databases were searched for relevant articles published up to March 13, 2017. Random-effects models were used to estimate the summary relative risk (RR) of MetS with LTPA. Restricted cubic splines were used to model the dose-response association. We identified 16 articles (18 studies including 76,699 participants and 13,871 cases of MetS). We found a negative linear association between LTPA and incident MetS, with a reduction of 8% in MetS risk per 10 metabolic equivalent of task (MET) h/week increment. According to the restricted cubic splines model, risk of MetS was reduced 10% with LTPA performed according to the basic guideline-recommended level of 150min of moderate PA (MPA) per week (10METh/week) versus inactivity (RR=0.90, 95% CI 0.86-0.94). It was reduced 20% and 53% with LTPA at twice (20METh/week) and seven times (70METh/week) the basic recommended level (RR=0.80, 95% CI 0.74-0.88 and 0.47, 95% CI 0.34-0.64, respectively). Our findings provide quantitative data suggesting that any amount of LTPA is better than none and that LTPA substantially exceeding the current LTPA guidelines is associated with an additional reduction in MetS risk. Copyright © 2017. Published by Elsevier Inc.

Analysis of Income/Commercial Real Estate Transactions.

ERIC Educational Resources Information Center

Apfelberg, Robert S.

Basic concepts in long- and short-term financing of real estate property are discussed in this text for real estate personnel. Two of the more important of these are leverage, the relationship between the return received by the equity and mortgage investors, and risk, the assessment of the probability that all or part of the investment may be…

An Online Risk Monitor System (ORMS) to Increase Safety and Security Levels in Industry

NASA Astrophysics Data System (ADS)

Zubair, M.; Rahman, Khalil Ur; Hassan, Mehmood Ul

2013-12-01

The main idea of this research is to develop an Online Risk Monitor System (ORMS) based on Living Probabilistic Safety Assessment (LPSA). The article highlights the essential features and functions of ORMS. The basic models and modules such as, Reliability Data Update Model (RDUM), running time update, redundant system unavailability update, Engineered Safety Features (ESF) unavailability update and general system update have been described in this study. ORMS not only provides quantitative analysis but also highlights qualitative aspects of risk measures. ORMS is capable of automatically updating the online risk models and reliability parameters of equipment. ORMS can support in the decision making process of operators and managers in Nuclear Power Plants.

Development and Pilot Testing of a Bilingual Environmental Health Assessment Tool to Promote Asthma-friendly Childcares.

PubMed

Evans-Agnew, Robin A; Postma, Julie; Camacho, Ariana Ochoa; Hershberg, Rachel M; Trujilio, Elsa; Tinajera, Maria

2018-01-01

Childhood marks the highest risk for allergic sensitization to asthma triggers. Hispanic/Latino children are at higher risk for hospitalization for asthma than non-Hispanic White children. Childcare providers lack knowledge about reducing asthma triggers. The purpose of this paper is to describe a community-based participatory research (CBPR) initiative aimed at developing and pilot testing a bilingual walk-through assessment tool for asthma-friendly childcare environments. Ten Latina mothers of children with asthma living in the Pacific Northwest collaborated with research partners to develop and pilot test a Childcare Environmental Health (CEH) assessment walk-through survey.Results and Lessons Learned: The women innovated the survey with photography and structural examinations of stress and provision of basic needs. The survey tool identified environmental threats to asthma in all three childcares surveyed. Parents are well-positioned to build trust with childcare providers, assess asthma triggers, and recommend practical mitigation strategies.

Advances in Inhalation Dosimetry Models and Methods for Occupational Risk Assessment and Exposure Limit Derivation

PubMed Central

Kuempel, Eileen D.; Sweeney, Lisa M.; Morris, John B.; Jarabek, Annie M.

2015-01-01

The purpose of this article is to provide an overview and practical guide to occupational health professionals concerning the derivation and use of dose estimates in risk assessment for development of occupational exposure limits (OELs) for inhaled substances. Dosimetry is the study and practice of measuring or estimating the internal dose of a substance in individuals or a population. Dosimetry thus provides an essential link to understanding the relationship between an external exposure and a biological response. Use of dosimetry principles and tools can improve the accuracy of risk assessment, and reduce the uncertainty, by providing reliable estimates of the internal dose at the target tissue. This is accomplished through specific measurement data or predictive models, when available, or the use of basic dosimetry principles for broad classes of materials. Accurate dose estimation is essential not only for dose-response assessment, but also for interspecies extrapolation and for risk characterization at given exposures. Inhalation dosimetry is the focus of this paper since it is a major route of exposure in the workplace. Practical examples of dose estimation and OEL derivation are provided for inhaled gases and particulates. PMID:26551218

Review of Chinese Environmental Risk Assessment Regulations and Case Studies

PubMed Central

Meng, Xiaojie; Zhang, Yan; Zhao, Yuchao; Lou, In Chio; Gao, Jixi

2012-01-01

Environmental risk assessment is an essential step in the development of solutions for pollution problems and new environmental regulations. An assessment system for environmental risks has been developed in China in recent decades. However, many of the Chinese technical guidelines, standards, and regulations were directly adapted from those of developed countries, and were not based on the Chinese environmental and socioeconomic context. Although existing environmental regulations for pollutants are usually obtained by extrapolations from high-dose toxicological data to low-dose scenarios using linear-non-threshold (LNT) models, toxicologists have argued that J-shaped or inverse J-shaped curves may dominate the dose–response relationships for environmental pollutants at low doses because low exposures stimulate biological protective mechanisms that are ineffective at higher doses. The costs of regulations based on LNT and J-shaped models could therefore be dramatically different. Since economic factors strongly affect the decision-making process, particularly for developing countries, it is time to strengthen basic research to provide more scientific support for Chinese environmental regulations. In this paper, we summarize current Chinese environmental policies and standards and the application of environmental risk assessment in China, and recommend a more scientific approach to the development of Chinese regulations. PMID:22740787

[Methodological and operational notes for the assessment and management of the risk of work-related stress].

PubMed

De Ambrogi, Francesco; Ratti, Elisabetta Ceppi

2011-01-01

Today the Italian national debate over the Work-Related Stress Risk Assessment methodology is rather heated. Several methodological proposals and guidelines have been published in recent months, not least those by the "Commissione Consultiva". But despite this wide range of proposals, it appears that there is still a lack of attention to some of the basic methodological issues that must be taken into account in order to correctly implement the above-mentioned guidelines. The aim of this paper is to outline these methodological issues. In order to achieve this, the most authoritative methodological proposals and guidelines have been reviewed. The study focuses in particular on the methodological issues that could lead to important biases if not considered properly. The study leads to some considerations about the methodological validity of a Work-Related Stress Risk Assessment based exclusively on the literal interpretation of the considered proposals. Furthermore, the study provides some hints and working hypotheses on how to overcome these methodological limits. This study should be considered as a starting point for further investigations and debate on the Work-Related Stress Risk Assessment methodology on a national level.

Risk Management in Complex Construction Projects that Apply Renewable Energy Sources: A Case Study of the Realization Phase of the Energis Educational and Research Intelligent Building

NASA Astrophysics Data System (ADS)

Krechowicz, Maria

2017-10-01

Nowadays, one of the characteristic features of construction industry is an increased complexity of a growing number of projects. Almost each construction project is unique, has its project-specific purpose, its own project structural complexity, owner’s expectations, ground conditions unique to a certain location, and its own dynamics. Failure costs and costs resulting from unforeseen problems in complex construction projects are very high. Project complexity drivers pose many vulnerabilities to a successful completion of a number of projects. This paper discusses the process of effective risk management in complex construction projects in which renewable energy sources were used, on the example of the realization phase of the ENERGIS teaching-laboratory building, from the point of view of DORBUD S.A., its general contractor. This paper suggests a new approach to risk management for complex construction projects in which renewable energy sources were applied. The risk management process was divided into six stages: gathering information, identification of the top, critical project risks resulting from the project complexity, construction of the fault tree for each top, critical risks, logical analysis of the fault tree, quantitative risk assessment applying fuzzy logic and development of risk response strategy. A new methodology for the qualitative and quantitative risk assessment for top, critical risks in complex construction projects was developed. Risk assessment was carried out applying Fuzzy Fault Tree analysis on the example of one top critical risk. Application of the Fuzzy sets theory to the proposed model allowed to decrease uncertainty and eliminate problems with gaining the crisp values of the basic events probability, common during expert risk assessment with the objective to give the exact risk score of each unwanted event probability.

[A preliminary mapping methodology for occupational hazards and biomechanical risk evaluation: presentation of a simple, computerized tool kit for ergonomic hazards identification and risk assessment].

PubMed

Colombini, Daniela; Occhipinti, E; Di Leone, G

2011-01-01

During the last Congress of the International Ergonomics Association (IEA), Beijing, August 2009, an international group was founded with the task of developing a "toolkit for MSD prevention" under the IEA and in collaboration with the World Health Organization. The possible users of toolkits are: members of health and safety committees; health and safety representatives; line supervisors; foremen; workers; government representatives; health workers providing basic occupational health services; occupational health and safety specialists. According to the ISO standard 11228 series and the new Draft CD ISO 12259-2009: Application document guides for the potential user, our group developed a preliminary "mapping" methodology of occupational hazards in the craft industry, supported by software (Excel). The proposed methodology, using specific key enters and quick assessment criteria, allows a simple ergonomics hazards identification and risk estimation to be made. It is thus possible to decide for which occupational hazards a more exhaustive risk assessment will be necessary and which occupational consultant should be involved (occupational physician, safety engineer, industrial hygienist, etc.).

Siting industrial waste land disposal facilities in Thailand: A risk based approach

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

Fingleton, D.J.; Habegger, L.; Peters, R.

The Thailand Industrial Works Department (IWD) has established a toxic industrial waste Central Treatment and Stabilization Center (CTSC) for textile dyeing and electroplating industries located in the Thonburi region of the Bangkok metropolitan area. Industrial waste is treated, stabilized, and stored at the CTSC. Although the IWD plans to ship the stabilized sludge to the Ratchaburi Province in western Thailand for burial, the location for the land disposal site has not been selected. Assessing the relative health risks from exposure to toxic chemicals released from an industrial waste land disposal site is a complicated, data-intensive process that requires a multidisciplinarymore » approach. This process is further complicated by the unique physical and cultural characteristics exhibited by the rapidly industrializing Thai economy. The purpose of this paper is to describe the research approach taken and to detail the constraints to health risk assessments in Thailand. issues discussed include data availability and quality, effectiveness of control or mitigation methods, cultural differences, and the basic assumptions inherent in many of the risk assessment components.« less

In Vitro-In Vivo Extrapolation of Metabolism- and Transporter-Mediated Drug-Drug Interactions-Overview of Basic Prediction Methods.

PubMed

Yoshida, Kenta; Zhao, Ping; Zhang, Lei; Abernethy, Darrell R; Rekić, Dinko; Reynolds, Kellie S; Galetin, Aleksandra; Huang, Shiew-Mei

2017-09-01

Evaluation of drug-drug interaction (DDI) risk is vital to establish benefit-risk profiles of investigational new drugs during drug development. In vitro experiments are routinely conducted as an important first step to assess metabolism- and transporter-mediated DDI potential of investigational new drugs. Results from these experiments are interpreted, often with the aid of in vitro-in vivo extrapolation methods, to determine whether and how DDI should be evaluated clinically to provide the basis for proper DDI management strategies, including dosing recommendations, alternative therapies, or contraindications under various DDI scenarios and in different patient population. This article provides an overview of currently available in vitro experimental systems and basic in vitro-in vivo extrapolation methodologies for metabolism- and transporter-mediated DDIs. Published by Elsevier Inc.

Study on Failure of Third-Party Damage for Urban Gas Pipeline Based on Fuzzy Comprehensive Evaluation.

PubMed

Li, Jun; Zhang, Hong; Han, Yinshan; Wang, Baodong

2016-01-01

Focusing on the diversity, complexity and uncertainty of the third-party damage accident, the failure probability of third-party damage to urban gas pipeline was evaluated on the theory of analytic hierarchy process and fuzzy mathematics. The fault tree of third-party damage containing 56 basic events was built by hazard identification of third-party damage. The fuzzy evaluation of basic event probabilities were conducted by the expert judgment method and using membership function of fuzzy set. The determination of the weight of each expert and the modification of the evaluation opinions were accomplished using the improved analytic hierarchy process, and the failure possibility of the third-party to urban gas pipeline was calculated. Taking gas pipelines of a certain large provincial capital city as an example, the risk assessment structure of the method was proved to conform to the actual situation, which provides the basis for the safety risk prevention.

BASIC RADIATION PROTECTION EDUCATION AND TRAINING FOR MEDICAL PROFESSIONALS; GEORGIAN EXPERIENCE AND FUTURE PERSPECTIVE.

PubMed

Todua, F; Nadareishvili, D; Ormotsadze, G; Sanikidze, T

2016-06-01

The level of knowledge provided by the Tbilisi State Medical University (TSMU) standard curriculum modules in 'Medical physics' and 'Radiation risk estimates' was assessed as was the learning outcome of modern standards elective course in 'Radiation protection'. Two groups of medical students were examined: Group 1: 5 y students, participants in elective course 'Radiobiology and radiogenic health risk' and Group 2: 1-2 y students, participants in winter and summer schools. Students were tested before and after training courses with the same tests questionnaire. The results of the tests showed the necessity for improvement of the educational curriculum. The changes needed are the inclusion of a basic radiobiological course in the curricula of the faculty of medicine and expansion of the medical physics course through a more detailed presentation of medical imaging methods. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An Integrated Risk Management Model for Source Water Protection Areas

PubMed Central

Chiueh, Pei-Te; Shang, Wei-Ting; Lo, Shang-Lien

2012-01-01

Watersheds are recognized as the most effective management unit for the protection of water resources. For surface water supplies that use water from upstream watersheds, evaluating threats to water quality and implementing a watershed management plan are crucial for the maintenance of drinking water safe for humans. The aim of this article is to establish a risk assessment model that provides basic information for identifying critical pollutants and areas at high risk for degraded water quality. In this study, a quantitative risk model that uses hazard quotients for each water quality parameter was combined with a qualitative risk model that uses the relative risk level of potential pollution events in order to characterize the current condition and potential risk of watersheds providing drinking water. In a case study of Taipei Source Water Area in northern Taiwan, total coliforms and total phosphorus were the top two pollutants of concern. Intensive tea-growing and recreational activities around the riparian zone may contribute the greatest pollution to the watershed. Our risk assessment tool may be enhanced by developing, recording, and updating information on pollution sources in the water supply watersheds. Moreover, management authorities could use the resultant information to create watershed risk management plans. PMID:23202770

Bridging the boundaries between scientists and clinicians-mechanistic hypotheses and patient stories in risk assessment of drugs.

PubMed

Rocca, Elena

2017-02-01

The cultural divide between scientists and clinicians has been described as undermining the advance of medical science, by hindering the production of practice-relevant research and of research-informed clinical decisions. Here, I consider the field of post-marketing risk assessment of drugs as an example of strict interdependence between basic biomedical research, clinical research, and clinical evaluation and show how it would benefit from a closer collaboration between scientists and clinicians. The risk assessment of drugs after their marketing relies on spontaneous adverse effect reports to drug agencies and on peer-reviewed case reports. I emphasize the importance of qualitative analysis of such reports for the improvement of mechanistic understanding of harmful effects of drugs. I argue that mechanistic explanations of drug effects are at least as important as determination of their frequency, in order to establish causation. An ideal risk assessment, then, verifies not only the frequency of undesired effects but also why and how the harm happens. For this purpose, the frequency or novelty of the unintended outcome, although contextually indicative, should not determine the epistemic value of a report. Details about the context that generated an unexpected outcome, instead, can offer the chance of improving causal understanding about how the intervention works. This is illustrated through examples from medical research. Mechanistic understanding is a domain of joint collaboration among (1) clinicians, in charge of detailed, qualitative reporting of patient stories about side effects, (2) qualitative clinical researchers, in charge of analyzing clinical contexts or harmful effects and formulating explanatory hypotheses, and (3) basic biomedical researchers, in charge of verifying such hypotheses. In addition, direct information flow can on one side focus clinicians' attention on knowledge gaps about drugs/effects where more research is needed, while on the other side create a more contextualized concept of mechanism among scientists. © 2016 John Wiley & Sons, Ltd.

Resilience Associated with Self-Disclosure and Relapse Risks in Patients with Alcohol Use Disorders.

PubMed

Yamashita, Ayako; Yoshioka, Shin-Ichi

2016-12-01

The aim of this study was to clarify the self-disclosure and risks of relapse associated with promoting resilience of patients with alcohol use disorders (AUD) and participating in self-help groups. An anonymous, self-administered questionnaire survey was administered to 48 patients with AUD and participating in self-help groups; this questionnaire consisted of basic attributes, a bidimensional resilience scale to assess both innate and acquired resilience factors, a scale to assess depth of self-disclosure, and a scale assessing relapse risks. We conducted an evaluation by dividing the respondents into a high group and low group based on their median values for both innate and acquired resilience. Innate/acquired resilience had a mutually reinforcing relationship, and, compared with the low resilience group, the high resilience group had significantly reduced risks for relapses and resulted in deeper self-disclosure. Patients with high resilience had lower risk of alcohol relapse and deeper self-disclosure. The results suggest that one way of supporting patients with AUD in recovery is assisting them in building personal relationships with others and in deepening self-disclosure in a setting where they can relax, thus promoting their natural ability to recover.

Assessing the Risk of International Spread of Yellow Fever Virus: A Mathematical Analysis of an Urban Outbreak in Asunción, 2008

PubMed Central

Johansson, Michael A.; Arana-Vizcarrondo, Neysarí; Biggerstaff, Brad J.; Gallagher, Nancy; Marano, Nina; Staples, J. Erin

2012-01-01

Yellow fever virus (YFV), a mosquito-borne virus endemic to tropical Africa and South America, is capable of causing large urban outbreaks of human disease. With the ease of international travel, urban outbreaks could lead to the rapid spread and subsequent transmission of YFV in distant locations. We designed a stochastic metapopulation model with spatiotemporally explicit transmissibility scenarios to simulate the global spread of YFV from a single urban outbreak by infected airline travelers. In simulations of a 2008 outbreak in Asunción, Paraguay, local outbreaks occurred in 12.8% of simulations and international spread in 2.0%. Using simple probabilistic models, we found that local incidence, travel rates, and basic transmission parameters are sufficient to assess the probability of introduction and autochthonous transmission events. These models could be used to assess the risk of YFV spread during an urban outbreak and identify locations at risk for YFV introduction and subsequent autochthonous transmission. PMID:22302873

Assessing the risk of international spread of yellow fever virus: a mathematical analysis of an urban outbreak in Asuncion, 2008.

PubMed

Johansson, Michael A; Arana-Vizcarrondo, Neysarí; Biggerstaff, Brad J; Gallagher, Nancy; Marano, Nina; Staples, J Erin

2012-02-01

Yellow fever virus (YFV), a mosquito-borne virus endemic to tropical Africa and South America, is capable of causing large urban outbreaks of human disease. With the ease of international travel, urban outbreaks could lead to the rapid spread and subsequent transmission of YFV in distant locations. We designed a stochastic metapopulation model with spatiotemporally explicit transmissibility scenarios to simulate the global spread of YFV from a single urban outbreak by infected airline travelers. In simulations of a 2008 outbreak in Asunción, Paraguay, local outbreaks occurred in 12.8% of simulations and international spread in 2.0%. Using simple probabilistic models, we found that local incidence, travel rates, and basic transmission parameters are sufficient to assess the probability of introduction and autochthonous transmission events. These models could be used to assess the risk of YFV spread during an urban outbreak and identify locations at risk for YFV introduction and subsequent autochthonous transmission.

Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010

PubMed Central

Oré, Marianela; Sáenz, Eliana; Cabrera, Rufino; Sanchez, Juan F.; De Los Santos, Maxy B.; Lucas, Carmen M.; Núñez, Jorge H.; Edgel, Kimberly A.; Sopan, Justino; Fernández, Jorge; Carnero, Andres M.; Baldeviano, G. Christian; Arrasco, Juan C.; Graf, Paul C. F.; Lescano, Andres G.

2015-01-01

Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2–36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (∼ 70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries. PMID:26078320

Risk analysis and its link with standards of the World Organisation for Animal Health.

PubMed

Sugiura, K; Murray, N

2011-04-01

Among the agreements included in the treaty that created the World Trade Organization (WTO) in January 1995 is the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement) that sets out the basic rules for food safety and animal and plant health standards. The SPS Agreement designates the World Organisation for Animal Health (OIE) as the organisation responsible for developing international standards for animal health and zoonoses. The SPS Agreement requires that the sanitary measures that WTO members apply should be based on science and encourages them to either apply measures based on the OIE standards or, if they choose to adopt a higher level of protection than that provided by these standards, apply measures based on a science-based risk assessment. The OIE also provides a procedural framework for risk analysis for its Member Countries to use. Despite the inevitable challenges that arise in carrying out a risk analysis of the international trade in animals and animal products, the OIE risk analysis framework provides a structured approach that facilitates the identification, assessment, management and communication of these risks.

A critical assessment of regulatory triggers for products of biotechnology: Product vs. process

PubMed Central

McHughen, Alan

2016-01-01

ABSTRACT Regulatory policies governing the safety of genetic engineering (rDNA) and the resulting products (GMOs) have been contentious and divisive, especially in agricultural applications of the technologies. These tensions led to vastly different approaches to safety regulation in different jurisdictions, even though the intent of regulations—to assure public and environmental safety—are common worldwide, and even though the international scientific communities agree on the basic principles of risk assessment and risk management. So great are the political divisions that jurisdictions cannot even agree on the appropriate triggers for regulatory capture, whether product or process. This paper reviews the historical policy and scientific implications of agricultural biotechnology regulatory approaches taken by the European Union, USA and Canada, using their respective statutes and regulations, and then critically assesses the scientific underpinnings of each. PMID:27813691

A critical assessment of regulatory triggers for products of biotechnology: Product vs. process.

PubMed

McHughen, Alan

2016-10-01

Regulatory policies governing the safety of genetic engineering (rDNA) and the resulting products (GMOs) have been contentious and divisive, especially in agricultural applications of the technologies. These tensions led to vastly different approaches to safety regulation in different jurisdictions, even though the intent of regulations-to assure public and environmental safety-are common worldwide, and even though the international scientific communities agree on the basic principles of risk assessment and risk management. So great are the political divisions that jurisdictions cannot even agree on the appropriate triggers for regulatory capture, whether product or process. This paper reviews the historical policy and scientific implications of agricultural biotechnology regulatory approaches taken by the European Union, USA and Canada, using their respective statutes and regulations, and then critically assesses the scientific underpinnings of each.

Data Mining Techniques for Identifying Students at Risk of Failing a Computer Proficiency Test Required for Graduation

ERIC Educational Resources Information Center

Tsai, Chih-Fong; Tsai, Ching-Tzu; Hung, Chia-Sheng; Hwang, Po-Sen

2011-01-01

Enabling undergraduate students to develop basic computing skills is an important issue in higher education. As a result, some universities have developed computer proficiency tests, which aim to assess students' computer literacy. Generally, students are required to pass such tests in order to prove that they have a certain level of computer…

Immune responsiveness and risk of illness in U.S. Air Force Academy cadets during basic cadet training

NASA Technical Reports Server (NTRS)

Lee, David J.; Meehan, Richard T.; Robinson, Christine; Mabry, Thomas R.; Smith, Morey L.

1992-01-01

It has been proposed, but not confirmed, that environmental stressors alter immune function and increase the risk of viral infection among healthy individuals. This hypothesis was evaluated by examining the relationship among stress, immune function, and illness in 96 first-year U.S. Air Force Academy cadets during orientation and four weeks later during the stressful environment of basic cadet training (BCT). Perceived stress and well-being levels of cadets were assessed via questionnaire. Immune responsiveness was analyzed by PHA-stimulated thymidine uptake in mononuclear leucocytes and by serologic evidence of reactivation of the Epstein-Barr virus (EBV). Results showed significant declines in in vitro PHA-induced lymphocyte transformation (-35 percent)and subjective well-being (-19 percent) from orientation to BCT with corresponding, significant increases in perceived stress (+32 percent). Despite significantly altered in vitro immune responsiveness, there was no serologic evidence of EBV reactivation nor was there an association between these measures and risk of illness as determined by medical chart review and self-reported symptoms.

Expert Views on Regulatory Preparedness for Managing the Risks of Nanotechnologies

PubMed Central

Beaudrie, Christian E. H.; Satterfield, Terre; Kandlikar, Milind; Harthorn, Barbara H.

2013-01-01

The potential and promise of nanotechnologies depends in large part on the ability for regulatory systems to assess and manage their benefits and risks. However, considerable uncertainty persists regarding the health and environmental implications of nanomaterials, hence the capacity for existing regulations to meet this challenge has been widely questioned. Here we draw from a survey (N=254) of US-based nano-scientists and engineers, environmental health and safety scientists, and regulatory scientists and decision-makers, to ask whether nano experts regard regulatory agencies as prepared for managing nanomaterial risks. We find that all three expert groups view regulatory agencies as unprepared. The effect is strongest for regulators themselves, and less so for scientists conducting basic, applied, or health and safety work on nanomaterials. Those who see nanotechnology risks as novel, uncertain, and difficult to assess are particularly likely to see agencies as unprepared. Trust in regulatory agencies, views of stakeholder responsibility regarding the management of risks, and socio-political values were also found to be small but significant drivers of perceived agency preparedness. These results underscore the need for new tools and methods to enable the assessment of nanomaterial risks, and to renew confidence in regulatory agencies’ ability to oversee their growing use and application in society. PMID:24244662

[Uncertainty analysis of ecological risk assessment caused by heavy-metals deposition from MSWI emission].

PubMed

Liao, Zhi-Heng; Sun, Jia-Ren; Wu, Dui; Fan, Shao-Jia; Ren, Ming-Zhong; Lü, Jia-Yang

2014-06-01

The CALPUFF model was applied to simulate the ground-level atmospheric concentrations of Pb and Cd from municipal solid waste incineration (MSWI) plants, and the soil concentration model was used to estimate soil concentration increments after atmospheric deposition based on Monte Carlo simulation, then ecological risk assessment was conducted by the potential ecological risk index method. The results showed that the largest atmospheric concentrations of Pb and Cd were 5.59 x 109-3) microg x m(-3) and 5.57 x 10(-4) microg x m(-3), respectively, while the maxima of soil concentration incremental medium of Pb and Cd were 2.26 mg x kg(-1) and 0.21 mg x kg(-1), respectively; High risk areas were located next to the incinerators, Cd contributed the most to the ecological risk, and Pb was basically free of pollution risk; Higher ecological hazard level was predicted at the most polluted point in urban areas with a 55.30% probability, while in rural areas, the most polluted point was assessed to moderate ecological hazard level with a 72.92% probability. In addition, sensitivity analysis of calculation parameters in the soil concentration model was conducted, which showed the simulated results of urban and rural area were most sensitive to soil mix depth and dry deposition rate, respectively.

The Use of Simulation to Teach Suicide Risk Assessment to Health Profession Trainees-Rationale, Methodology, and a Proof of Concept Demonstration with a Virtual Patient.

PubMed

Foster, Adriana; Chaudhary, Neelam; Murphy, James; Lok, Benjamin; Waller, Jennifer; Buckley, Peter F

2015-12-01

There is increasing use of educational technologies in medical and surgical specialties. Described herein is the development and application of an interactive virtual patient (VP) to teach suicide risk assessment to health profession trainees. We studied the effect of the following: (1) an interaction with a bipolar VP who attempts suicide or (2) completion of a video-teaching module on interviewing a bipolar patient, on medical students' proficiency in assessing suicide risk in standardized patients. We hypothesized that students who interact with a bipolar VP will be at least as likely to assess suicide risk, as their peers who completed a video module. In a randomized, controlled study, we compared the frequency with which second-year students at the Medical College of Georgia asked suicide risk and bipolar symptoms questions by VP/video group. We recruited 67 students. The VP group inquired more frequently than the video group in 4 of 5 suicide risk areas and 11 of 14 other bipolar symptomatology areas. There were minimal to small effect sizes in favor of the VP technology. The students preferred the video over the VP as an educational tool (p = 0.007). Our study provides proof of concept that both VP and video module approaches are feasible for teaching students to assess suicide risk, and we present evidence about the role of active learning to improve communication skills. Depending on the learning context, interviewing a VP or observation of a videotaped interview can enhance the students' suicide risk assessment proficiency in an interview with a standardized patient. An interactive VP is a plausible modality to deliver basic concepts of suicide risk assessment to medical students, can facilitate individual preferences by providing easy access and portability, and has potential generalizability to other aspects of psychiatric training.

Derivation of Failure Rates and Probability of Failures for the International Space Station Probabilistic Risk Assessment Study

NASA Technical Reports Server (NTRS)

Vitali, Roberto; Lutomski, Michael G.

2004-01-01

National Aeronautics and Space Administration s (NASA) International Space Station (ISS) Program uses Probabilistic Risk Assessment (PRA) as part of its Continuous Risk Management Process. It is used as a decision and management support tool to not only quantify risk for specific conditions, but more importantly comparing different operational and management options to determine the lowest risk option and provide rationale for management decisions. This paper presents the derivation of the probability distributions used to quantify the failure rates and the probability of failures of the basic events employed in the PRA model of the ISS. The paper will show how a Bayesian approach was used with different sources of data including the actual ISS on orbit failures to enhance the confidence in results of the PRA. As time progresses and more meaningful data is gathered from on orbit failures, an increasingly accurate failure rate probability distribution for the basic events of the ISS PRA model can be obtained. The ISS PRA has been developed by mapping the ISS critical systems such as propulsion, thermal control, or power generation into event sequences diagrams and fault trees. The lowest level of indenture of the fault trees was the orbital replacement units (ORU). The ORU level was chosen consistently with the level of statistically meaningful data that could be obtained from the aerospace industry and from the experts in the field. For example, data was gathered for the solenoid valves present in the propulsion system of the ISS. However valves themselves are composed of parts and the individual failure of these parts was not accounted for in the PRA model. In other words the failure of a spring within a valve was considered a failure of the valve itself.

Near Earth Asteroid Characterization for Threat Assessment

NASA Technical Reports Server (NTRS)

Dotson, Jessie; Mathias, Donovan; Wheeler, Lorien; Wooden, Diane; Bryson, Kathryn; Ostrowski, Daniel

2017-01-01

Physical characteristics of NEAs are an essential input to modeling behavior during atmospheric entry and to assess the risk of impact but determining these properties requires a non-trivial investment of time and resources. The characteristics relevant to these models include size, density, strength and ablation coefficient. Some of these characteristics cannot be directly measured, but rather must be inferred from related measurements of asteroids and/or meteorites. Furthermore, for the majority of NEAs, only the basic measurements exist so often properties must be inferred from statistics of the population of more completely characterized objects. The Asteroid Threat Assessment Project at NASA Ames Research Center has developed a probabilistic asteroid impact risk (PAIR) model in order to assess the risk of asteroid impact. Our PAIR model and its use to develop probability distributions of impact risk are discussed in other contributions to PDC 2017 (e.g., Mathias et al.). Here we utilize PAIR to investigate which NEA characteristics are important for assessing the impact threat by investigating how changes in these characteristics alter the damage predicted by PAIR. We will also provide an assessment of the current state of knowledge of the NEA characteristics of importance for asteroid threat assessment. The relative importance of different properties as identified using PAIR will be combined with our assessment of the current state of knowledge to identify potential high impact investigations. In addition, we will discuss an ongoing effort to collate the existing measurements of NEA properties of interest to the planetary defense community into a readily accessible database.

Integration of medicine and basic science in dentistry: the role of oral and maxillofacial surgery in the pre-doctoral dental curriculum.

PubMed

Dennis, Matthew J

2010-05-01

It is the premise of this paper that the need for medical and basic science instruction in dentistry will increase over time. However, student and faculty appreciation of the relevance and significance of medicine and basic science to clinical dentistry has been elusive, largely due to difficulties linking biomedical science instruction and clinical dental instruction. The scope of traditional procedure based oral surgery instruction can be expanded in an attempt to bridge the medical science-clinical gap. Topics such as health status evaluation, medical risk assessment, and a variety of other biomedical issues can be presented to students in a way which imparts specific dental meaning to basic medical science in real-life clinical situations. Using didactic and chair side instruction in an oral surgery clinical environment, students are confronted with the need to understand these issues and how they relate to the patients they encounter who present for dental care.

Conceptual Launch Vehicle and Spacecraft Design for Risk Assessment

NASA Technical Reports Server (NTRS)

Motiwala, Samira A.; Mathias, Donovan L.; Mattenberger, Christopher J.

2014-01-01

One of the most challenging aspects of developing human space launch and exploration systems is minimizing and mitigating the many potential risk factors to ensure the safest possible design while also meeting the required cost, weight, and performance criteria. In order to accomplish this, effective risk analyses and trade studies are needed to identify key risk drivers, dependencies, and sensitivities as the design evolves. The Engineering Risk Assessment (ERA) team at NASA Ames Research Center (ARC) develops advanced risk analysis approaches, models, and tools to provide such meaningful risk and reliability data throughout vehicle development. The goal of the project presented in this memorandum is to design a generic launch 7 vehicle and spacecraft architecture that can be used to develop and demonstrate these new risk analysis techniques without relying on other proprietary or sensitive vehicle designs. To accomplish this, initial spacecraft and launch vehicle (LV) designs were established using historical sizing relationships for a mission delivering four crewmembers and equipment to the International Space Station (ISS). Mass-estimating relationships (MERs) were used to size the crew capsule and launch vehicle, and a combination of optimization techniques and iterative design processes were employed to determine a possible two-stage-to-orbit (TSTO) launch trajectory into a 350-kilometer orbit. Primary subsystems were also designed for the crewed capsule architecture, based on a 24-hour on-orbit mission with a 7-day contingency. Safety analysis was also performed to identify major risks to crew survivability and assess the system's overall reliability. These procedures and analyses validate that the architecture's basic design and performance are reasonable to be used for risk trade studies. While the vehicle designs presented are not intended to represent a viable architecture, they will provide a valuable initial platform for developing and demonstrating innovative risk assessment capabilities.

A Framework for the Next Generation of Risk Science

PubMed Central

Krewski, Daniel; Andersen, Melvin E.; Paoli, Gregory M.; Chiu, Weihsueh A.; Al-Zoughool, Mustafa; Croteau, Maxine C.; Burgoon, Lyle D.; Cote, Ila

2014-01-01

Objectives: In 2011, the U.S. Environmental Protection Agency initiated the NexGen project to develop a new paradigm for the next generation of risk science. Methods: The NexGen framework was built on three cornerstones: the availability of new data on toxicity pathways made possible by fundamental advances in basic biology and toxicological science, the incorporation of a population health perspective that recognizes that most adverse health outcomes involve multiple determinants, and a renewed focus on new risk assessment methodologies designed to better inform risk management decision making. Results: The NexGen framework has three phases. Phase I (objectives) focuses on problem formulation and scoping, taking into account the risk context and the range of available risk management decision-making options. Phase II (risk assessment) seeks to identify critical toxicity pathway perturbations using new toxicity testing tools and technologies, and to better characterize risks and uncertainties using advanced risk assessment methodologies. Phase III (risk management) involves the development of evidence-based population health risk management strategies of a regulatory, economic, advisory, community-based, or technological nature, using sound principles of risk management decision making. Conclusions: Analysis of a series of case study prototypes indicated that many aspects of the NexGen framework are already beginning to be adopted in practice. Citation: Krewski D, Westphal M, Andersen ME, Paoli GM, Chiu WA, Al-Zoughool M, Croteau MC, Burgoon LD, Cote I. 2014. A framework for the next generation of risk science. Environ Health Perspect 122:796–805; http://dx.doi.org/10.1289/ehp.1307260 PMID:24727499

Finding Basic Writing's Place.

ERIC Educational Resources Information Center

Sheridan-Rabideau, Mary P.; Brossell, Gordon

1995-01-01

Posits that basic writing serves a vital function by providing writing support for at-risk students and serves the needs of a growing student population that universities accept yet feel needs additional writing instruction. Concludes that the basic writing classroom is the most effective educational support for at-risk students and their writing.…

Reduced order models for prediction of groundwater quality impacts from CO₂ and brine leakage

DOE PAGES

Zheng, Liange; Carroll, Susan; Bianchi, Marco; ...

2014-12-31

A careful assessment of the risk associated with geologic CO₂ storage is critical to the deployment of large-scale storage projects. A potential risk is the deterioration of groundwater quality caused by the leakage of CO₂ and brine leakage from deep subsurface reservoirs. In probabilistic risk assessment studies, numerical modeling is the primary tool employed to assess risk. However, the application of traditional numerical models to fully evaluate the impact of CO₂ leakage on groundwater can be computationally complex, demanding large processing times and resources, and involving large uncertainties. As an alternative, reduced order models (ROMs) can be used as highlymore » efficient surrogates for the complex process-based numerical models. In this study, we represent the complex hydrogeological and geochemical conditions in a heterogeneous aquifer and subsequent risk by developing and using two separate ROMs. The first ROM is derived from a model that accounts for the heterogeneous flow and transport conditions in the presence of complex leakage functions for CO₂ and brine. The second ROM is obtained from models that feature similar, but simplified flow and transport conditions, and allow for a more complex representation of all relevant geochemical reactions. To quantify possible impacts to groundwater aquifers, the basic risk metric is taken as the aquifer volume in which the water quality of the aquifer may be affected by an underlying CO₂ storage project. The integration of the two ROMs provides an estimate of the impacted aquifer volume taking into account uncertainties in flow, transport and chemical conditions. These two ROMs can be linked in a comprehensive system level model for quantitative risk assessment of the deep storage reservoir, wellbore leakage, and shallow aquifer impacts to assess the collective risk of CO₂ storage projects.« less

Comparison of stress fractures of male and female recruits during basic training in the Israeli anti-aircraft forces.

PubMed

Gam, Arnon; Goldstein, Liav; Karmon, Yuval; Mintser, Igor; Grotto, Itamar; Guri, Alex; Goldberg, Avishay; Ohana, Nissim; Onn, Erez; Levi, Yehezkel; Bar-Dayan, Yaron

2005-08-01

In military basic training, stress fractures are a common orthopedic problem. Female recruits have a significantly higher incidence of stress fractures than do male recruits. Because the Israeli Defense Forces opened traditionally male roles in combat units to female recruits, their high risk for stress fractures is of concern. To compare the prevalence of stress fractures during Israeli Defense Forces anti-aircraft basic training among otherwise healthy young male and female recruits, in terms of anatomic distribution and severity. Ten mixed gender batteries, including 375 male recruits and 138 female recruits, carried out basic training in the Israeli anti-aircraft corps between November 1999 and January 2003. Each battery was monitored prospectively for 10 weeks of a basic training course. During that time, recruits who were suspected of having an overuse injury went through a protocol that included an orthopedic specialist physical examination followed by a radionuclide technetium bone scan, which was assessed by consultant nuclear medicine experts. The assessment included the anatomic site and the severity of the fractures, labeled as either high severity or low severity. Stress fractures were significantly more common among female recruits than among male recruits. A total of 42 male (11.2%) and 33 female (23.91%) recruits had positive bone scans for stress fractures (female:male relative ratio, 2.13; p < 0.001). Pelvic, femur, and tibia fractures were significantly more common among female recruits than among male recruits (p < 0.005). Female recruits had significantly more severe fractures in the tibia (p < 0.05). However, there was no significant difference in the severity of stress fractures in the femur or metatarsals between male and female recruits, as assessed by radionuclide uptake. We recommend that different training programs be assigned according to gender, in which female recruits would have a lower level of target strain or a more moderate incline of strain in the training program throughout basic training.

Promoting Health by Addressing Basic Needs: Effect of Problem Resolution on Contacting Health Referrals

ERIC Educational Resources Information Center

Thompson, Tess; Kreuter, Matthew W.; Boyum, Sonia

2016-01-01

Members of vulnerable populations have heightened needs for health services. One advantage of integrating health risk assessment and referrals into social service assistance systems such as 2-1-1 is that such systems help callers resolve problems in other areas (e.g., housing). Callers to 2-1-1 in Missouri (N = 1,090) with at least one behavioral…

Legacy Systems Upgrade for Software Risk Assessment

DTIC Science & Technology

2001-12-01

Nieto, T. R., Visual Basic 6: How to Program , Prentice Hall, Inc., 1999 Edson, David, Professional Development with Visio 2000: The...and the necessity for the program . Second, follow with a review of the enhancement algorithms and software extensions intended to add additional...taken prior to the programming . First, one must gain thorough understanding of the operation of VitéProject software and its interface with Visio

Systems Toxicology: From Basic Research to Risk Assessment

PubMed Central

2014-01-01

Systems Toxicology is the integration of classical toxicology with quantitative analysis of large networks of molecular and functional changes occurring across multiple levels of biological organization. Society demands increasingly close scrutiny of the potential health risks associated with exposure to chemicals present in our everyday life, leading to an increasing need for more predictive and accurate risk-assessment approaches. Developing such approaches requires a detailed mechanistic understanding of the ways in which xenobiotic substances perturb biological systems and lead to adverse outcomes. Thus, Systems Toxicology approaches offer modern strategies for gaining such mechanistic knowledge by combining advanced analytical and computational tools. Furthermore, Systems Toxicology is a means for the identification and application of biomarkers for improved safety assessments. In Systems Toxicology, quantitative systems-wide molecular changes in the context of an exposure are measured, and a causal chain of molecular events linking exposures with adverse outcomes (i.e., functional and apical end points) is deciphered. Mathematical models are then built to describe these processes in a quantitative manner. The integrated data analysis leads to the identification of how biological networks are perturbed by the exposure and enables the development of predictive mathematical models of toxicological processes. This perspective integrates current knowledge regarding bioanalytical approaches, computational analysis, and the potential for improved risk assessment. PMID:24446777

Systems toxicology: from basic research to risk assessment.

PubMed

Sturla, Shana J; Boobis, Alan R; FitzGerald, Rex E; Hoeng, Julia; Kavlock, Robert J; Schirmer, Kristin; Whelan, Maurice; Wilks, Martin F; Peitsch, Manuel C

2014-03-17

Systems Toxicology is the integration of classical toxicology with quantitative analysis of large networks of molecular and functional changes occurring across multiple levels of biological organization. Society demands increasingly close scrutiny of the potential health risks associated with exposure to chemicals present in our everyday life, leading to an increasing need for more predictive and accurate risk-assessment approaches. Developing such approaches requires a detailed mechanistic understanding of the ways in which xenobiotic substances perturb biological systems and lead to adverse outcomes. Thus, Systems Toxicology approaches offer modern strategies for gaining such mechanistic knowledge by combining advanced analytical and computational tools. Furthermore, Systems Toxicology is a means for the identification and application of biomarkers for improved safety assessments. In Systems Toxicology, quantitative systems-wide molecular changes in the context of an exposure are measured, and a causal chain of molecular events linking exposures with adverse outcomes (i.e., functional and apical end points) is deciphered. Mathematical models are then built to describe these processes in a quantitative manner. The integrated data analysis leads to the identification of how biological networks are perturbed by the exposure and enables the development of predictive mathematical models of toxicological processes. This perspective integrates current knowledge regarding bioanalytical approaches, computational analysis, and the potential for improved risk assessment.

The extent of evidence-based information about child maltreatment fatalities in social science textbooks.

PubMed

Douglas, Emily M; Serino, Patricia J

2013-10-01

Previous research has established that child welfare workers lack important information about child maltreatment fatalities and risk factors leading to death. Further, training has not been associated with improvements in knowledge. The authors assessed the presence of evidence-based information about child maltreatment fatalities and risk factors for death in 24 social science textbooks about child abuse and neglect or child welfare. The results indicate that basic information, such as definitions and incidence rates of child maltreatment fatalities are routinely included in social science textbooks, but information about child, parent, and household risk factors are not, and that inaccurate information is often included. Implications of the findings are discussed.

Collagen content as a risk factor in breast cancer? A pilot clinical study

NASA Astrophysics Data System (ADS)

Pifferi, Antonio; Quarto, Giovanna; Abbate, Francesca; Balestreri, Nicola; Menna, Simona; Cassano, Enrico; Cubeddu, Rinaldo; Taroni, Paola

2015-07-01

A retrospective pilot clinical study on time domain multi-wavelength (635 to 1060 nm) optical mammography was exploited to assess collagen as a breast-cancer risk factor on a total of 109 subjects (53 healthy and 56 with malignant lesions). An increased cancer occurrence is observed on the 15% subset of patients with higher age-matched collagen content. Further, a similar clustering based on the percentage breast density leads to a different set of patients, possibly indicating collagen as a new independent breast cancer risk factor. If confirmed statistically and on larger numbers, these results could have huge impact on personalized diagnostics, health care systems, as well as on basic research.

The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co-management.

PubMed

Reuben, David B; Gazarian, Priscilla; Alexander, Neil; Araujo, Katy; Baker, Dorothy; Bean, Jonathan F; Boult, Chad; Charpentier, Peter; Duncan, Pamela; Latham, Nancy; Leipzig, Rosanne M; Quintiliani, Lisa M; Storer, Thomas; McMahon, Siobhan

2017-12-01

In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients' PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Covariance Manipulation for Conjunction Assessment

NASA Technical Reports Server (NTRS)

Hejduk, M. D.

2016-01-01

The manipulation of space object covariances to try to provide additional or improved information to conjunction risk assessment is not an uncommon practice. Types of manipulation include fabricating a covariance when it is missing or unreliable to force the probability of collision (Pc) to a maximum value ('PcMax'), scaling a covariance to try to improve its realism or see the effect of covariance volatility on the calculated Pc, and constructing the equivalent of an epoch covariance at a convenient future point in the event ('covariance forecasting'). In bringing these methods to bear for Conjunction Assessment (CA) operations, however, some do not remain fully consistent with best practices for conducting risk management, some seem to be of relatively low utility, and some require additional information before they can contribute fully to risk analysis. This study describes some basic principles of modern risk management (following the Kaplan construct) and then examines the PcMax and covariance forecasting paradigms for alignment with these principles; it then further examines the expected utility of these methods in the modern CA framework. Both paradigms are found to be not without utility, but only in situations that are somewhat carefully circumscribed.

Number needed to treat (NNT) in clinical literature: an appraisal.

PubMed

Mendes, Diogo; Alves, Carlos; Batel-Marques, Francisco

2017-06-01

The number needed to treat (NNT) is an absolute effect measure that has been used to assess beneficial and harmful effects of medical interventions. Several methods can be used to calculate NNTs, and they should be applied depending on the different study characteristics, such as the design and type of variable used to measure outcomes. Whether or not the most recommended methods have been applied to calculate NNTs in studies published in the medical literature is yet to be determined. The aim of this study is to assess whether the methods used to calculate NNTs in studies published in medical journals are in line with basic methodological recommendations. The top 25 high-impact factor journals in the "General and/or Internal Medicine" category were screened to identify studies assessing pharmacological interventions and reporting NNTs. Studies were categorized according to their design and the type of variables. NNTs were assessed for completeness (baseline risk, time horizon, and confidence intervals [CIs]). The methods used for calculating NNTs in selected studies were compared to basic methodological recommendations published in the literature. Data were analyzed using descriptive statistics. The search returned 138 citations, of which 51 were selected. Most were meta-analyses (n = 23, 45.1%), followed by clinical trials (n = 17, 33.3%), cohort (n = 9, 17.6%), and case-control studies (n = 2, 3.9%). Binary variables were more common (n = 41, 80.4%) than time-to-event (n = 10, 19.6%) outcomes. Twenty-six studies (51.0%) reported only NNT to benefit (NNTB), 14 (27.5%) reported both NNTB and NNT to harm (NNTH), and 11 (21.6%) reported only NNTH. Baseline risk (n = 37, 72.5%), time horizon (n = 38, 74.5%), and CI (n = 32, 62.7%) for NNTs were not always reported. Basic methodological recommendations to calculate NNTs were not followed in 15 studies (29.4%). The proportion of studies applying non-recommended methods was particularly high for meta-analyses (n = 13, 56.5%). A considerable proportion of studies, particularly meta-analyses, applied methods that are not in line with basic methodological recommendations. Despite their usefulness in assisting clinical decisions, NNTs are uninterpretable if incompletely reported, and they may be misleading if calculating methods are inadequate to study designs and variables under evaluation. Further research is needed to confirm the present findings.

Systems Analysis Programs for Hands-on Integrated Reliability Evaluations (SAPHIRE) Tutorial

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

C. L. Smith; S. T. Beck; S. T. Wood

2008-08-01

The Systems Analysis Programs for Hands-on Integrated Reliability Evaluations (SAPHIRE) refers to a set of computer programs that were developed to create and analyze probabilistic risk assessment (PRAs). This volume is the tutorial manual for the SAPHIRE system. In this document, a series of lessons are provided that guide the user through basic steps common to most analyses preformed with SAPHIRE. The tutorial is divided into two major sections covering both basic and advanced features. The section covering basic topics contains lessons that lead the reader through development of a probabilistic hypothetical problem involving a vehicle accident, highlighting the program’smore » most fundamental features. The advanced features section contains additional lessons that expand on fundamental analysis features of SAPHIRE and provide insights into more complex analysis techniques. Together, these two elements provide an overview into the operation and capabilities of the SAPHIRE software.« less

Systematic Omics Analysis Review (SOAR) Tool to Support Risk Assessment

PubMed Central

McConnell, Emma R.; Bell, Shannon M.; Cote, Ila; Wang, Rong-Lin; Perkins, Edward J.; Garcia-Reyero, Natàlia; Gong, Ping; Burgoon, Lyle D.

2014-01-01

Environmental health risk assessors are challenged to understand and incorporate new data streams as the field of toxicology continues to adopt new molecular and systems biology technologies. Systematic screening reviews can help risk assessors and assessment teams determine which studies to consider for inclusion in a human health assessment. A tool for systematic reviews should be standardized and transparent in order to consistently determine which studies meet minimum quality criteria prior to performing in-depth analyses of the data. The Systematic Omics Analysis Review (SOAR) tool is focused on assisting risk assessment support teams in performing systematic reviews of transcriptomic studies. SOAR is a spreadsheet tool of 35 objective questions developed by domain experts, focused on transcriptomic microarray studies, and including four main topics: test system, test substance, experimental design, and microarray data. The tool will be used as a guide to identify studies that meet basic published quality criteria, such as those defined by the Minimum Information About a Microarray Experiment standard and the Toxicological Data Reliability Assessment Tool. Seven scientists were recruited to test the tool by using it to independently rate 15 published manuscripts that study chemical exposures with microarrays. Using their feedback, questions were weighted based on importance of the information and a suitability cutoff was set for each of the four topic sections. The final validation resulted in 100% agreement between the users on four separate manuscripts, showing that the SOAR tool may be used to facilitate the standardized and transparent screening of microarray literature for environmental human health risk assessment. PMID:25531884

A collaborative approach to cancer risk assessment services using genetic counselor extenders in a multi-system community hospital.

PubMed

Cohen, Stephanie A; Nixon, Dawn M

2016-10-01

This study aimed to evaluate a unique approach to cancer risk assessment for improved access by smaller rural communities. Local, on-site nurse navigators were trained and utilized as genetic counselor extenders (GCEs) to provide basic risk assessment and offer BRCA1/2 genetic testing to select patients based on a triaging process in collaboration with board-certified genetic counselors (CGCs). From August 2012 to July 2014, 12,477 family history questionnaires representing 8937 unique patients presenting for a screening mammogram or new oncology appointment were triaged. Of these, 8.2 % patients were identified at increased risk for hereditary breast cancer, and 4.2 % were identified at increased risk for other hereditary causes of cancer. A total of 75 of 1130 at-risk patients identified (6.6 %) completed a genetic risk assessment appointment; 23 with a GCE and 52 with a CGC. A review of the completed genetic test requisition forms from a 9-year pre-collaboration time period found that 16 % (20/125) did not appear to meet genetic testing criteria. Overall, there was a fourfold increase in patients accessing genetic services in this study period compared to the pre-collaboration time period. Efficiency of this model was assessed by determining time spent by the CGC in all activities related to the collaboration, which amounted to approximately 16 h/month. Adjustments have been made and the program continues to be monitored for opportunities to improve efficiency. This study demonstrates the feasibility of CGCs and GCEs collaborating to improve access to quality services in an efficient manner.

Should We Perform an Immediate Coronary Angiogram in All Patients After Cardiac Arrest?: Insights From a Large French Registry.

PubMed

Bougouin, Wulfran; Dumas, Florence; Karam, Nicole; Maupain, Carole; Marijon, Eloi; Lamhaut, Lionel; Jost, Daniel; Geri, Guillaume; Beganton, Frankie; Varenne, Olivier; Spaulding, Christian; Jouven, Xavier; Cariou, Alain

2018-02-12

This study sought to assess the relationship between an immediate invasive strategy and survival after an out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause, according to prognosis evaluated on hospital arrival. An immediate coronary angiogram (CAG) may be associated with better outcome after OHCA in neurologically preserved patients but could be futile in other cases. From May 2011 to May 2015, we collected data for all patients admitted in hospital after OHCA in Paris and its suburbs (France). Risk of in-hospital death was retrospectively calculated using the validated Cardiac Arrest Hospital Prognosis score, which includes age, setting, initial rhythm, durations from collapse to basic life support and from basic life support to return of spontaneous circulation, pH, and epinephrine dose. Independent predictors of survival at discharge (including immediate CAG) were assessed in multivariate logistic regression in each of the 3 pre-defined subgroups of Cardiac Arrest Hospital Prognosis score: low risk (<150 points), medium risk (150 to 200 points), and high risk (>200 points) for in-hospital death. A total of 1,410 patients were included and overall survival rate at hospital discharge was 32%. Distribution in the low-, medium-, and high-risk Cardiac Arrest Hospital Prognosis subgroups was 667 (47%), 469 (33%), and 274 patients (20%), respectively. The rate of early CAG was 86%, 66%, and 47% in the low-, medium-, and high-risk subgroups, respectively (p < 0.001). Early invasive strategy was independently associated with better survival in low-risk patients (odds ratio: 2.3; 95% confidence interval: 1.4 to 3.9; p = 0.001), but not in medium-risk (p = 0.55) and high-risk (p = 0.43) patients. Sensitivity analysis found consistent results. In cardiac arrest patients, our results suggest that investigations regarding early CAG after OHCA should focus on patients with preserved neurological status. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Health literacy among university students in Greece: determinants and association with self-perceived health, health behaviours and health risks

PubMed Central

2014-01-01

Background Health literacy is widely considered as a key determinant of health and a priority in the public health policy agenda. Low health literacy has been associated with poorer health states, broader inequalities and higher health systems’ costs. In the present study we bring into focus the functional health literacy among university students in Greece, researching and assessing mainly their ability to apply basic knowledge in a health context. Methods The study was carried out during the period 15–30 April 2013, among a random sample of 1,526 students of 14 Higher Tertiary Public universities and Technological Educational Institutes in Greece. The objective of the study was to assess the functional health literacy among university students in Greece, adopting the short four-item comprehension test of Bostock and Steptoe. Summary statistics, correlations and regressions were used to assess the determinants of health literacy and the association with self-perceived health, health behaviours and health risks. Results Economic factors, such as family income, demographic factors, such as gender, and health behaviours and risks, namely consumption of alcohol, smoking and physical workout are associated with the level of health literacy and health status of the participant. While the results of the study are consistent with previous work in this area, several findings worth further research. Conclusions Though, health promotion interventions in Greece include health literacy as one of the basic pillars of the public health policy agenda, it is clear, that health literacy needs to become a key policy issue in Greece, mainly focusing in young ages, where healthy (or unhealthy) behaviours are established affecting the health through the life span. PMID:24987522

Health literacy among university students in Greece: determinants and association with self-perceived health, health behaviours and health risks.

PubMed

Vozikis, Athanassios; Drivas, Kyriakos; Milioris, Kostantinos

2014-01-01

Health literacy is widely considered as a key determinant of health and a priority in the public health policy agenda. Low health literacy has been associated with poorer health states, broader inequalities and higher health systems' costs. In the present study we bring into focus the functional health literacy among university students in Greece, researching and assessing mainly their ability to apply basic knowledge in a health context. The study was carried out during the period 15-30 April 2013, among a random sample of 1,526 students of 14 Higher Tertiary Public universities and Technological Educational Institutes in Greece. The objective of the study was to assess the functional health literacy among university students in Greece, adopting the short four-item comprehension test of Bostock and Steptoe. Summary statistics, correlations and regressions were used to assess the determinants of health literacy and the association with self-perceived health, health behaviours and health risks. Economic factors, such as family income, demographic factors, such as gender, and health behaviours and risks, namely consumption of alcohol, smoking and physical workout are associated with the level of health literacy and health status of the participant. While the results of the study are consistent with previous work in this area, several findings worth further research. Though, health promotion interventions in Greece include health literacy as one of the basic pillars of the public health policy agenda, it is clear, that health literacy needs to become a key policy issue in Greece, mainly focusing in young ages, where healthy (or unhealthy) behaviours are established affecting the health through the life span.

Total Probability of Collision as a Metric for Finite Conjunction Assessment and Collision Risk Management

NASA Astrophysics Data System (ADS)

Frigm, R.; Johnson, L.

The Probability of Collision (Pc) has become a universal metric and statement of on-orbit collision risk. Although several flavors of the computation exist and are well-documented in the literature, the basic calculation requires the same input: estimates for the position, position uncertainty, and sizes of the two objects involved. The Pc is used operationally to make decisions on whether a given conjunction poses significant collision risk to the primary object (or space asset of concern). It is also used to determine necessity and degree of mitigative action (typically in the form of an orbital maneuver) to be performed. The predicted post-maneuver Pc also informs the maneuver planning process into regarding the timing, direction, and magnitude of the maneuver needed to mitigate the collision risk. Although the data sources, techniques, decision calculus, and workflows vary for different agencies and organizations, they all have a common thread. The standard conjunction assessment and collision risk concept of operations (CONOPS) predicts conjunctions, assesses the collision risk (typically, via the Pc), and plans and executes avoidance activities for conjunctions as a discrete events. As the space debris environment continues to increase and improvements are made to remote sensing capabilities and sensitivities to detect, track, and predict smaller debris objects, the number of conjunctions will in turn continue to increase. The expected order-of-magnitude increase in the number of predicted conjunctions will challenge the paradigm of treating each conjunction as a discrete event. The challenge will not be limited to workload issues, such as manpower and computing performance, but also the ability for satellite owner/operators to successfully execute their mission while also managing on-orbit collision risk. Executing a propulsive maneuver occasionally can easily be absorbed into the mission planning and operations tempo; whereas, continuously planning evasive maneuvers for multiple conjunction events is time-consuming and would disrupt mission and science operations beyond what is tolerable. At the point when the number of conjunctions is so large that it is no longer possible to consider each individually, some sort of an amalgamation of events and risk must be considered. This shift is to one where each conjunction cannot be treated individually and the effects of all conjunctions within a given period of time must be considered together. This new paradigm is called finite Conjunction Assessment (CA) risk management. This paper considers the use of the Total Probability of Collision (TPc) as an analogous collision risk metric in the finite CA paradigm. TPc is expressed by the equation below and provides an aggregate probability of colliding with any one of the predicted conjunctions under consideration. TPc=1-?(1-Pc,i) While the TPc computation is straightforward and its physical meaning is understandable, the implications of its usage operationally requires a change in mindset and approach to collision risk management. This paper explores the necessary changes to evolve the basic CA and collision risk management CONOPS from discrete to finite CA, including aspects of collision risk assessment and collision risk mitigation. It proposes numerical and graphical decision aids to understand both the “risk outlook” for a given primary as well as mitigation options for the total collision risk. Both concepts make use of the TPc as a metric for finite collision risk management. Several operational scenarios are used to demonstrate the proposed concepts in practice.

Modeling intelligent adversaries for terrorism risk assessment: some necessary conditions for adversary models.

PubMed

Guikema, Seth

2012-07-01

Intelligent adversary modeling has become increasingly important for risk analysis, and a number of different approaches have been proposed for incorporating intelligent adversaries in risk analysis models. However, these approaches are based on a range of often-implicit assumptions about the desirable properties of intelligent adversary models. This "Perspective" paper aims to further risk analysis for situations involving intelligent adversaries by fostering a discussion of the desirable properties for these models. A set of four basic necessary conditions for intelligent adversary models is proposed and discussed. These are: (1) behavioral accuracy to the degree possible, (2) computational tractability to support decision making, (3) explicit consideration of uncertainty, and (4) ability to gain confidence in the model. It is hoped that these suggested necessary conditions foster discussion about the goals and assumptions underlying intelligent adversary modeling in risk analysis. © 2011 Society for Risk Analysis.

Emotional reactivity: Beware its involvement in traffic accidents.

PubMed

M'bailara, Katia; Atzeni, Thierry; Contrand, Benjamin; Derguy, Cyrielle; Bouvard, Manuel-Pierre; Lagarde, Emmanuel; Galéra, Cédric

2018-04-01

Reducing risk attributable to traffic accidents is a public health challenge. Research into risk factors in the area is now moving towards identification of the psychological factors involved, particularly emotional states. The aim of this study was to evaluate the link between emotional reactivity and responsibility in road traffic accidents. We hypothesized that the more one's emotional reactivity is disturbed, the greater the likelihood of being responsible for a traffic accident. This case-control study was based on a sample of 955 drivers injured in a motor vehicle crash. Responsibility levels were determined with a standardized method adapted from the quantitative Robertson and Drummer crash responsibility instrument. Emotional reactivity was assessed with the MATHYS. Hierarchical cluster analysis discriminated four distinctive driver's emotional reactivity profiles: basic emotional reactivity (54%), mild emotional hyper-reactivity (29%), emotional hyper-reactivity (11%) and emotional hypo-reactivity (6%). Drivers who demonstrated emotional hypo-reactivity had a 2.3-fold greater risk of being responsible for a traffic accident than those with basic emotional reactivity. Drivers' responsibility in traffic accidents depends on their emotional status. The latter can change the ability of drivers, modifying their behavior and thus increasing their propensity to exhibit risk behavior and to cause traffic accidents. Copyright © 2017 Elsevier B.V. All rights reserved.

Modelling West Nile virus transmission risk in Europe: effect of temperature and mosquito biotypes on the basic reproduction number.

PubMed

Vogels, Chantal B F; Hartemink, Nienke; Koenraadt, Constantianus J M

2017-07-10

West Nile virus (WNV) is a mosquito-borne flavivirus which has caused repeated outbreaks in humans in southern and central Europe, but thus far not in northern Europe. The main mosquito vector for WNV, Culex pipiens, consists of two behaviourally distinct biotypes, pipiens and molestus, which can form hybrids. Differences between biotypes, such as vector competence and host preference, could be important in determining the risk of WNV outbreaks. Risks for WNV establishment can be modelled with basic reproduction number (R 0 ) models. However, existing R 0 models have not differentiated between biotypes. The aim of this study was, therefore, to explore the role of temperature-dependent and biotype-specific effects on the risk of WNV establishment in Europe. We developed an R 0 model with temperature-dependent and biotype-specific parameters, and calculated R 0 values using the next-generation matrix for several scenarios relevant for Europe. In addition, elasticity analysis was done to investigate the contribution of each biotype to R 0 . Global warming and increased mosquito-to-host ratios can possibly result in more intense WNV circulation in birds and spill-over to humans in northern Europe. Different contributions of the Cx. pipiens biotypes to R 0 shows the importance of including biotype-specific parameters in models for reliable WNV risk assessments.

[Suicide Risk Assessment in the Clinical Practice Guidelines for the Diagnosis and Management of Depression in Colombia].

PubMed

Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana Patricia; Gil Lemus, Laura Marcela; Jaramillo, Luis Eduardo; García Valencia, Jenny; Bravo Narváez, Eliana; de la Hoz Bradford, Ana María; Palacio, Carlos

2013-01-01

Suicide is the most serious complications of depression. It has high associated health costs and causes millions of deaths worldwide per year. Given its implications, it is important to know the factors that increase the risk of its occurrence and the most useful tools for addressing it. To identify the signs and symptoms that indicate an increased risk of suicide, and factors that increase the risk in patients diagnosed with depression. To establish the tools best fitted to identify suicide risk in people with depression. Clinical practice guidelines were developed, following those of the methodmethodological guidelines of the Ministry of Social Protection, to collect evidence and to adjust recommendations. Recommendations from the NICE90 and CANMAT guidelines were adopted and updated for questions found in these guidelines, while new recommendations were developed for questions not found in them. Basic points and recommendations are presented from a chapter of the clinical practice guidelines on depressive episodes and recurrent depressive disorder related to suicide risk assessment. Their corresponding recommendation levels are included. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Target assessment for antiparasitic drug discovery

PubMed Central

Frearson, Julie A.; Wyatt, Paul G.; Gilbert, Ian H.; Fairlamb, Alan H.

2010-01-01

Drug discovery is a high-risk, expensive and lengthy process taking at least 12 years and costing upwards of US$500 million per drug to reach the clinic. For neglected diseases, the drug discovery process is driven by medical need and guided by pre-defined target product profiles. Assessment and prioritisation of the most promising targets for entry into screening programmes is crucial for maximising chances of success. Here we describe criteria used in our drug discovery unit for target assessment and introduce the ‘traffic light’ system as a prioritisation and management tool. We hope this brief review will stimulate basic scientists to acquire additional information necessary for drug discovery. PMID:17962072

Assessment of cognitive safety in clinical drug development

PubMed Central

Roiser, Jonathan P.; Nathan, Pradeep J.; Mander, Adrian P.; Adusei, Gabriel; Zavitz, Kenton H.; Blackwell, Andrew D.

2016-01-01

Cognitive impairment is increasingly recognised as an important potential adverse effect of medication. However, many drug development programmes do not incorporate sensitive cognitive measurements. Here, we review the rationale for cognitive safety assessment, and explain several basic methodological principles for measuring cognition during clinical drug development, including study design and statistical analysis, from Phase I through to postmarketing. The crucial issue of how cognition should be assessed is emphasized, especially the sensitivity of measurement. We also consider how best to interpret the magnitude of any identified effects, including comparison with benchmarks. We conclude by discussing strategies for the effective communication of cognitive risks. PMID:26610416

The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care

PubMed Central

Brodsky, Beth S.; Spruch-Feiner, Aliza; Stanley, Barbara

2018-01-01

Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice. These include risk assessment, means restriction, evidence-based treatments, population screening combined with chain of care, monitoring, and follow-up. In this article, we review how suicide prevention research informs implementation in clinical settings where those most at risk present for care. Evidence-based and best practices address the fluctuating nature of suicide risk, which requires ongoing risk assessment, direct intervention and monitoring. In the US, the National Action Alliance for Suicide Prevention has put forth the Zero Suicide (ZS) Model, a framework to coordinate a multilevel approach to implementing evidence-based practices. We present the Assess, Intervene and Monitor for Suicide Prevention model (AIM-SP) as a guide for implementation of ZS evidence-based and best practices in clinical settings. Ten basic steps for clinical management model will be described and illustrated through case vignette. These steps are designed to be easily incorporated into standard clinical practice to enhance suicide risk assessment, brief interventions to increase safety and teach coping strategies and to improve ongoing contact and monitoring of high-risk individuals during transitions in care and high risk periods. PMID:29527178

Risk assessment and management of Chlamydia psittaci in poultry processing plants.

PubMed

Deschuyffeleer, Thomas P G; Tyberghien, Laurens F V; Dickx, Veerle L C; Geens, Tom; Saelen, Jacques M M M; Vanrompay, Daisy C G; Braeckman, Lutgard A C M

2012-04-01

Chlamydia psittaci causes respiratory disease in poultry and can be transmitted to humans. Historical outbreaks of psittacosis in poultry workers indicated the need for higher awareness and an efficient risk assessment and management. This group reviewed relevant previous research, practical guidelines, and European directives. Subsequently, basic suggestions were made on how to assess and manage the risk of psittacosis in poultry processing plants based on a classical four-step approach. Collective and personal protective measures as well as the role of occupational medicine are described. Despite the finding that exposure is found in every branch, abattoir workstations seem to be associated with the highest prevalence of psittacosis. Complete eradication is difficult to achieve. Ventilation, cleaning, hand hygiene, and personal protective equipment are the most important protective measures to limit and control exposure to C. psittaci. Adequate information, communication, and health surveillance belong to the responsibilities of the occupational physician. Future challenges lay in the rigorous reporting of infections in both poultry and poultry workers and in the development of an avian and human vaccine.

Study on Failure of Third-Party Damage for Urban Gas Pipeline Based on Fuzzy Comprehensive Evaluation

PubMed Central

Li, Jun; Zhang, Hong; Han, Yinshan; Wang, Baodong

2016-01-01

Focusing on the diversity, complexity and uncertainty of the third-party damage accident, the failure probability of third-party damage to urban gas pipeline was evaluated on the theory of analytic hierarchy process and fuzzy mathematics. The fault tree of third-party damage containing 56 basic events was built by hazard identification of third-party damage. The fuzzy evaluation of basic event probabilities were conducted by the expert judgment method and using membership function of fuzzy set. The determination of the weight of each expert and the modification of the evaluation opinions were accomplished using the improved analytic hierarchy process, and the failure possibility of the third-party to urban gas pipeline was calculated. Taking gas pipelines of a certain large provincial capital city as an example, the risk assessment structure of the method was proved to conform to the actual situation, which provides the basis for the safety risk prevention. PMID:27875545

Hormonal predisposition to menstrual dysfunction in collegiate dance students.

PubMed

To, W W; Wong, M W; Lam, I Y

2000-12-01

To evaluate the effect of dance training on menstrual function in teenage dance students and to identify risk factors associated with menstrual dysfunction. Dance students from a collegiate school of performing arts were recruited when they were first admitted to the school. Basic epidemiological data and menstrual history were gathered using a structured questionnaire. The subjects' self image appraisal was scored utilizing the Offer Self Image Questionnaire. Anthropometric measurements, body fat percentages and hormonal profiles were measured. The subjects were followed up after 12 months of intensive dance training, and the menstrual pattern, self image scoring and fat composition assays were repeated. A total of 50 students completed the study. The mean age was 18.9 years (s.d. 1.86). While all were eumenorrheic at first assessment, eight were amenorrheic and eight were oligomenorrheic at the second assessment, giving an incidence of menstrual dysfunction of 32%. A general reduction in weight and body fat composition was observed after training. Those with menstrual dysfunction did not differ from those that remained eumenorrheic in their basic anthropometric parameters, nor was the serial change in these parameters in the second assessment different between the two groups. Psychological assessment scores also showed an identical trend. All hormonal values were within the normal range, but the group with menstrual dysfunction showed a significantly higher LH/FSH ratio (p=0.012) and DHEAS levels (p=0.036) at the pre-training assessment while other hormonal parameters did not differ. The incidence of menstrual dysfunction in adolescent dance students undergoing intensive training was high. Those with pre-existing hormonal predisposition prior to entering training appeared particularly at risk.

Identifying and treating agitated behaviors in the long-term care setting.

PubMed

Hastings, S N; Thompson-Heisterman, A; Farrell, S P

1999-01-01

This article provides information on identification, assessment, and intervention techniques for agitated behaviors in the long-term care setting. Although the emphasis is on prevention and management of agitation, the article offers suggestions to assist health care providers in differentiating between delirium, psychosis, depression, anxiety, and dementia, which may place a resident at risk for agitation. Basic treatment approaches for each of these disorders is also reviewed.

Shuttle derived vehicle analysis solid booster unmanned launch vehicle concept definition study, volume 2

NASA Technical Reports Server (NTRS)

1983-01-01

The technical effort associated with the selection and definition of the recommended SRB-X concept is documented. Included are discussions concerning the trades leading to the selected concept, the analysis that established the concept's basic subsystem characteristics, selected configuration description and performance capabilities, launch site operations and facility needs, development schedule, cost characteristics, risk assessment, and a cursory comparison with other launch systems.

Auditory Processing, Speech Perception and Phonological Ability in Pre-School Children at High-Risk for Dyslexia: A Longitudinal Study of the Auditory Temporal Processing Theory

ERIC Educational Resources Information Center

Boets, Bart; Wouters, Jan; van Wieringen, Astrid; Ghesquiere, Pol

2007-01-01

This study investigates whether the core bottleneck of literacy-impairment should be situated at the phonological level or at a more basic sensory level, as postulated by supporters of the auditory temporal processing theory. Phonological ability, speech perception and low-level auditory processing were assessed in a group of 5-year-old pre-school…

The United South and Eastern Tribe (USET) Proper Functioning Condition (PFC) and Tribal Focused Environmental Risk and Sustainability Tool (Tribal-FERST) Train the Trainers Workshop.October 6-9, 2014, in Nashville, Tennessee: PFC Assessment for Management and Monitoring

EPA Science Inventory

The maintenance of wildlife and aquatic habitat is dependent on the development of a riparian area management strategy, which considers and adapts to certain basic ecological and economic relationships. These relationships are functions of riparian and terrestrial ecosystems, gro...

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

PubMed

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

2017-10-01

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

Shift in performance of food safety management systems in supply chains: case of green bean chain in Kenya versus hot pepper chain in Uganda.

PubMed

Nanyunja, Jessica; Jacxsens, Liesbeth; Kirezieva, Klementina; Kaaya, Archileo N; Uyttendaele, Mieke; Luning, Pieternel A

2016-08-01

This study investigates the level of design and operation of food safety management systems (FSMS) of farmers and export traders in Kenya and Uganda. FSMS diagnostic tools developed for the fresh produce chain were used to assess the levels of context riskiness, FSMS activities and system output in primary production (n = 60) and trade (n = 60). High-risk context characteristics combined with basic FSMS are expected to increase the risk on unsafe produce. In Uganda both farmers and export traders of hot peppers operate in a high- to moderate-risk context but have basic FSMS and low systems output. In Kenya, both farmers and export traders of green beans operate in a low- to moderate-risk context. The farmers have average performing FSMS, whereas export trade companies showed more advanced FSMS and system output scores ranging from satisfactory to good. Large retailers supplying the EU premium market play a crucial role in demanding compliance with strict voluntary food safety standards, which was reflected in the more advanced FSMS and good system output in Kenya, especially traders. In Kenya, a clear shift in more fit-for-purpose FSMS and higher system output was noticed between farms and trade companies. In the case of Uganda, traders commonly supply to the less demanding EU wholesale markets such as ethnic specialty shops. They only have to comply with the legal phytosanitary and pesticide residue requirements for export activities, which apparently resulted in basic FSMS and low system output present with both farmers and traders. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

Can RSScan footscan(®) D3D™ software predict injury in a military population following plantar pressure assessment? A prospective cohort study.

PubMed

Franklyn-Miller, Andrew; Bilzon, James; Wilson, Cassie; McCrory, Paul

2014-03-01

Injury in initial military training is common with incidences from 25 to 65% of recruits sustaining musculoskeletal injury. Risk factors for injury include extrinsic factors such as rapid onset of high volume training, but intrinsic factors such as lower limb biomechanics and foot type. Prediction of injury would allow more effective training delivery, reduce manpower wastage and improve duty of care to individuals by addressing potential interventions. Plantar pressure interpretation of footfall has been shown to reflect biomechanical intrinsic abnormality although no quantifiable method of risk stratification exists. To identify if pressure plate assessment of walking gait is predictive of injury in a military population. 200 male subjects commencing Naval Officer training were assessed by plantar pressure plate recording, of foot contact pressures. A software interpretation, D3D™, stratified the interpretation to measure 4 specific areas of potential correction. Participants were graded as to high, medium and low risk of injury and subsequently followed up for injury through their basic training. Seventy two percent of all injuries were attributed to subjects in the high and medium risk of injury as defined by the risk categorization. 47% of all injuries were sustained in the high-risk group. Participants categorized in the high-risk group for injury were significantly more likely to sustain injury than in medium or low groups (p<0.001, OR 5.28 with 95% CI 2.88, 9.70). Plantar pressure assessment of risk for overuse lower limb injury can be predictive of sustaining an overuse injury in a controlled training environment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sex differences in sleep-disordered breathing after stroke: results from the BASIC project.

PubMed

McDermott, Mollie; Brown, Devin L; Li, Chengwei; Garcia, Nelda M; Case, Erin; Chervin, Ronald D; Morgenstern, Lewis B; Lisabeth, Lynda D

2018-03-01

Sleep-disordered breathing (SDB), an independent risk factor for stroke, is associated with worse post-stroke outcomes. Differences in the relationship between SDB and stroke may exist for women versus men. In this population-based study, we compared the prevalence of both pre- and post-stroke SDB by sex. We also explored whether menopausal status is related to post-stroke SDB. We performed a cross-sectional study of subjects enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) project. Each subject (n = 1815) underwent a baseline interview including the Berlin Questionnaire to assess pre-stroke SDB risk and, if relevant, questions regarding menopausal status. Subjects were offered overnight SDB screening with a validated portable respiratory device (n = 832 with complete data). Log Poisson and linear regression models were used to assess the differences in SDB between men and women with adjustment for demographics, stroke risk factors, stroke severity, and other potential confounders. Women were less likely than men to be at high risk for pre-stroke SDB (56.6% versus 61.9%) (prevalence ratio [PR] 0.87 for women; 95% confidence interval [CI], 0.81-0.95). A lower proportion of women than men (50.8% versus 70.2%) had post-stroke SDB by respiratory monitoring (PR 0.71; 95% CI, 0.63-0.80). SDB severity was higher for men than for women (mean difference in respiratory event index [REI] 6.5; 95% CI, 4.3-8.7). No significant association existed between post-stroke SDB and either menopausal status or age at menopause. After acute ischemic stroke, SDB was more prevalent and more severe in men than in women. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment of printed patient-educational materials for chronic kidney disease

PubMed Central

Tuot, Delphine S; Davis, Elizabeth; Velasquez, Alexandra; Banerjee, Tanushree; Powe, Neil R

2013-01-01

Background Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health. Methods Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (Superior=70–100; Adequate=40–69; Inadequate=<40). Linear regression was used to determine the impact of literacy level on mean rating. Results We reviewed 69 PEMs from 19 organizations, divided into 113 content area sections. Most (79%) PEM sections were “Adequate” (mean rating, 58.3%). Inclusion of patient-centered content and opportunities for patient interaction were associated with “Superior” ratings. Mean ratings (SD) were similar across content areas: basics of CKD, 58.9% [9.1]; risk factors for CKD development, 57.0% [12.3]; risk factors for CKD progression, 58.5% [12.0]; CKD complications, 62.3% [15.7] and self-management strategies, 62.2% [12.3]. ≤ 6th grade literacy level (vs >6th grade) was associated with an 11.7 point higher mean rating. Conclusion Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD. PMID:23970127

Assessment of printed patient-educational materials for chronic kidney disease.

PubMed

Tuot, Delphine S; Davis, Elizabeth; Velasquez, Alexandra; Banerjee, Tanushree; Powe, Neil R

2013-01-01

Awareness of chronic kidney disease (CKD) is suboptimal among patients with CKD, perhaps due to poor readability of patient education materials (PEMs). We reviewed the suitability and readability of common PEMs that focused on 5 content areas: basics of CKD, risk factors for CKD development, risk factors for CKD progression, complications of CKD and self-management strategies to improve kidney health. Three reviewers (nephrologist, primary care physician, patient) used the Suitability Assessment of Materials to rate PEMs on message content/stimulation of learning, typography, visuals and layout and determined literacy level. Mean ratings were calculated for each PEM by content area and overall (superior = 70-100; adequate = 40-69; inadequate = <40). Linear regression was used to determine the impact of literacy level on mean rating. We reviewed 69 PEMs from 19 organizations, divided into 113 content area sections. Most (79%) PEM sections were 'adequate' (mean rating, 58.3%). Inclusion of patient-centered content and opportunities for patient interaction were associated with 'superior' ratings. Mean ratings (SD) were similar across content areas: basics of CKD, 58.9% (9.1); risk factors for CKD development, 57.0% (12.3); risk factors for CKD progression, 58.5% (12.0); CKD complications, 62.3% (15.7), and self-management strategies, 62.2% (12.3). ≤6th grade literacy level (vs. >6th grade) was associated with an 11.7 point higher mean rating. Most PEMs for kidney disease were adequate. Outstanding PEMs shared characteristics of patient centeredness, a low literacy level, and patient interaction. Providers should be aware of strengths and limitations of PEMs when educating their patients about CKD. Copyright © 2013 S. Karger AG, Basel.

Conference summary: Navigating the Sea of Genomic Data, October 28-29, 2015.

PubMed

Pihlstrom, Bruce L; Barnett, Michael L

2016-03-01

The rapid pace of biomedical discoveries in the past few years has resulted in substantial advances in our ability to diagnose, treat, and prevent a wide variety of diseases. The sequencing of the human genome offered the possibility of understanding the etiology, pathogenesis, and risk of developing disease from a genetic perspective and has resulted, for example, in the development of genomic-based diagnostic or risk-assessment tests for a number of medical and dental conditions. To assess the scientific evidence underlying such tests and determine whether they may be useful in clinical practice, practitioners need to have a basic understanding of the state-of-the-science of genomics and genetic testing. To assist practitioners in understanding the science of genomics, the American Dental Association and the Task Force on Design and Analysis in Oral Health Research co-sponsored a landmark conference, Navigating the Sea of Genomic Data, held October 28-29, 2015, at the American Dental Association headquarters building in Chicago, IL. The purpose of this conference was to review the basics of genomic science, promote sound design and analysis of genomic studies of oral diseases, and provide a basis or "framework" to guide practitioners in assessing new development in genomics and genetic tests for oral diseases. Presentations at this conference were made by 9 world-renowned scientists who discussed a wide range of topics involving genomic science, genetic testing for rare mendelian single gene disorders, and genetic testing for assessing the risk of experiencing common complex diseases. This article summarizes the key points and concepts presented by the speakers. It is essential for oral health care professionals to have a fundamental understanding of genomic science so that they can evaluate new advances in this field and the use of genetic testing for the benefit of their patients. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Geographic Region, Weather, Pilot Age and Air Carrier Crashes: a Case-Control Study

PubMed Central

Li, Guohua; Pressley, Joyce C.; Qiang, Yandong; Grabowski, Jurek G.; Baker, Susan P.; Rebok, George W.

2009-01-01

Background Information about risk factors of aviation crashes is crucial for developing effective intervention programs. Previous studies assessing factors associated with crash risk were conducted primarily in general aviation, air taxis and commuter air carriers. Methods A matched case-control design was used to examine the associations of geographic region, basic weather condition, and pilot age with the risk of air carrier (14 CFR Part 121) crash involvement. Cases (n=373) were air carrier crashes involving aircraft made by Boeing, McDonnell Douglas, and Airbus, recorded in the National Transportation Safety Board’s aviation crash database during 1983 through 2002, and controls (n=746) were air carrier incidents involving aircraft of the same three makes selected at random from the Federal Aviation Administration’s aviation incident database. Each case was matched with two controls on the calendar year when the index crash occurred. Conditional logistic regression was used for statistical analysis. Results With adjustment for basic weather condition, pilot age, and total flight time, the risk of air carrier crashes in Alaska was more than three times the risk for other regions [adjusted odds ratio (OR) 3.18, 95% confidence interval (CI) 1.35 – 7.49]. Instrument meteorological conditions were associated with an increased risk for air carrier crashes involving pilot error (adjusted OR 2.26, 95% CI 1.15 – 4.44) and a decreased risk for air carrier crashes without pilot error (adjusted OR 0.57, 95% CI 0.40 – 0.87). Neither pilot age nor total flight time was significantly associated with the risk of air carrier crashes. Conclusions The excess risk of air carrier crashes in Alaska and the effect of adverse weather on pilot-error crashes underscore the importance of environmental hazards in flight safety. PMID:19378910

Geographic region, weather, pilot age, and air carrier crashes: a case-control study.

PubMed

Li, Guohua; Pressley, Joyce C; Qiang, Yandong; Grabowski, Jurek G; Baker, Susan P; Rebok, George W

2009-04-01

Information about risk factors of aviation crashes is crucial for developing effective intervention programs. Previous studies assessing factors associated with crash risk were conducted primarily in general aviation, air taxis, and commuter air carriers. A matched case-control design was used to examine the associations of geographic region, basic weather condition, and pilot age with the risk of air carrier (14 CFR Part 121) crash involvement. Cases (N = 373) were air carrier crashes involving aircraft made by Boeing, McDonnell Douglas, and Airbus recorded in the National Transportation Safety Board's aviation crash database during 1983 through 2002, and controls (N = 746) were air carrier incidents involving aircraft of the same three makes selected at random from the Federal Aviation Administration's aviation incident database. Each case was matched with two controls on the calendar year when the index crash occurred. Conditional logistic regression was used for statistical analysis. With adjustment for basic weather condition, pilot age, and total flight time, the risk of air carrier crashes in Alaska was more than three times the risk for other regions ladjusted odds ratio (OR) 3.18, 95% confidence interval (CI) 1.35-7.49]. Instrument meteorological conditions were associated with an increased risk for air carrier crashes involving pilot error (adjusted OR 2.26, 95% CI 1.15-4.44) and a decreased risk for air carrier crashes without pilot error (adjusted OR 0.60, 95% CI 0.37-0.96). Neither pilot age nor total flight time were significantly associated with the risk of air carrier crashes. The excess risk of air carrier crashes in Alaska and the effect of adverse weather on pilot-error crashes underscore the importance of environmental hazards in flight safety.

Reliability and Probabilistic Risk Assessment - How They Play Together

NASA Technical Reports Server (NTRS)

Safie, Fayssal; Stutts, Richard; Huang, Zhaofeng

2015-01-01

Since the Space Shuttle Challenger accident in 1986, NASA has extensively used probabilistic analysis methods to assess, understand, and communicate the risk of space launch vehicles. Probabilistic Risk Assessment (PRA), used in the nuclear industry, is one of the probabilistic analysis methods NASA utilizes to assess Loss of Mission (LOM) and Loss of Crew (LOC) risk for launch vehicles. PRA is a system scenario based risk assessment that uses a combination of fault trees, event trees, event sequence diagrams, and probability distributions to analyze the risk of a system, a process, or an activity. It is a process designed to answer three basic questions: 1) what can go wrong that would lead to loss or degraded performance (i.e., scenarios involving undesired consequences of interest), 2) how likely is it (probabilities), and 3) what is the severity of the degradation (consequences). Since the Challenger accident, PRA has been used in supporting decisions regarding safety upgrades for launch vehicles. Another area that was given a lot of emphasis at NASA after the Challenger accident is reliability engineering. Reliability engineering has been a critical design function at NASA since the early Apollo days. However, after the Challenger accident, quantitative reliability analysis and reliability predictions were given more scrutiny because of their importance in understanding failure mechanism and quantifying the probability of failure, which are key elements in resolving technical issues, performing design trades, and implementing design improvements. Although PRA and reliability are both probabilistic in nature and, in some cases, use the same tools, they are two different activities. Specifically, reliability engineering is a broad design discipline that deals with loss of function and helps understand failure mechanism and improve component and system design. PRA is a system scenario based risk assessment process intended to assess the risk scenarios that could lead to a major/top undesirable system event, and to identify those scenarios that are high-risk drivers. PRA output is critical to support risk informed decisions concerning system design. This paper describes the PRA process and the reliability engineering discipline in detail. It discusses their differences and similarities and how they work together as complementary analyses to support the design and risk assessment processes. Lessons learned, applications, and case studies in both areas are also discussed in the paper to demonstrate and explain these differences and similarities.

Risk factors for a 6-year decline in physical disability and functional limitations among elderly people with type 2 diabetes in the Japanese Elderly Diabetes Intervention Trial.

PubMed

Sakurai, Takashi; Iimuro, Satoshi; Sakamaki, Kentaro; Umegaki, Hiroyuki; Araki, Atsushi; Ohashi, Yasuo; Ito, Hideki

2012-04-01

Type 2 diabetes increases the risk of disability. The purpose of this study was to clarify the explanatory factors for disability in Japanese diabetic elderly. The 6-year decline in physical disability and functional limitations was investigated among 317 elderly people with type 2 diabetes recruited in a large-scale prospective study of the Japanese Elderly Diabetes Intervention Trial. Information about diabetes, blood examinations and complications was obtained, and basic activities of daily living (ADL) and instrumental ADL (IADL) were assessed by total score of the Barthel index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. After 6 years of follow up, 13.6% of patients had developed a new ADL disability and 38.3% had developed a new functional impairment. In the 65-74 years age group, basic ADL decreased only in males, whereas females became functionally impaired. In the 75-84 years age group, basic and IADL decreased in both males and females. Older age and metabolic syndrome were prognostic for impairment of basic ADL, whereas baseline IADL problems, lower cognitive function, physical inactivity and insulin therapy were significant predictors of a future decline in the IADL. This study identified several factors predicting the future decline of basic ADL and IADL in diabetic elderly patients, and provided a conceptual framework that might help to clarify the pathways leading to disability. Because the specific causes of each functional problem are modifiable, comprehensive treatment and care are needed to allow Japanese diabetic elderly patients to have more favorable living conditions. © 2012 Japan Geriatrics Society.

Uncertainty analysis in vulnerability estimations for elements at risk- a review of concepts and some examples on landslides

NASA Astrophysics Data System (ADS)

Ciurean, R. L.; Glade, T.

2012-04-01

Decision under uncertainty is a constant of everyday life and an important component of risk management and governance. Recently, experts have emphasized the importance of quantifying uncertainty in all phases of landslide risk analysis. Due to its multi-dimensional and dynamic nature, (physical) vulnerability is inherently complex and the "degree of loss" estimates imprecise and to some extent even subjective. Uncertainty analysis introduces quantitative modeling approaches that allow for a more explicitly objective output, improving the risk management process as well as enhancing communication between various stakeholders for better risk governance. This study presents a review of concepts for uncertainty analysis in vulnerability of elements at risk to landslides. Different semi-quantitative and quantitative methods are compared based on their feasibility in real-world situations, hazard dependency, process stage in vulnerability assessment (i.e. input data, model, output), and applicability within an integrated landslide hazard and risk framework. The resulted observations will help to identify current gaps and future needs in vulnerability assessment, including estimation of uncertainty propagation, transferability of the methods, development of visualization tools, but also address basic questions like what is uncertainty and how uncertainty can be quantified or treated in a reliable and reproducible way.

Relationship among food-safety knowledge, beliefs, and risk-reduction behavior in university students in Japan.

PubMed

Takeda, Sayaka; Akamatsu, Rie; Horiguchi, Itsuko; Marui, Eiji

2011-01-01

To identify whether university students who have both food-safety knowledge and beliefs perform risk-reduction behaviors. Cross-sectional research using a questionnaire that included food-safety knowledge, perceptions, risk-reduction behavior, stages for the selection of safer food based on the Transtheoretical Model, and demographic characteristics. Four universities in eastern Japan and 2 universities in western Japan. University students (n = 799). Food-safety knowledge, beliefs, and risk-reduction behaviors. Answers on measures assessing risk perception and food-safety knowledge were combined to form 4 groups of participants. Relationships among demographic characteristics, the 4 groups, risk-reduction behaviors, stage of change, and severity and susceptibility were assessed. The proportion of students who had more knowledge of food safety and a belief that "there are no 100% safe food items" was high in the group that frequently performed risk-reduction behaviors, as it was in the group who had taken a basic class about food or health care and who had, or were working toward, a food or nutrition qualification. University students who thought that there were no 100% safe food items and who had more knowledge about food safety were more likely to confirm food-safety information when selecting food. Copyright © 2011 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Software reliability through fault-avoidance and fault-tolerance

NASA Technical Reports Server (NTRS)

Vouk, Mladen A.; Mcallister, David F.

1993-01-01

Strategies and tools for the testing, risk assessment and risk control of dependable software-based systems were developed. Part of this project consists of studies to enable the transfer of technology to industry, for example the risk management techniques for safety-concious systems. Theoretical investigations of Boolean and Relational Operator (BRO) testing strategy were conducted for condition-based testing. The Basic Graph Generation and Analysis tool (BGG) was extended to fully incorporate several variants of the BRO metric. Single- and multi-phase risk, coverage and time-based models are being developed to provide additional theoretical and empirical basis for estimation of the reliability and availability of large, highly dependable software. A model for software process and risk management was developed. The use of cause-effect graphing for software specification and validation was investigated. Lastly, advanced software fault-tolerance models were studied to provide alternatives and improvements in situations where simple software fault-tolerance strategies break down.

Reference guide to odor thresholds for hazardous air pollutants listed in the Clean Air Act amendments of 1990

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

Cain, W.S.; Shoaf, C.R.; Velasquez, S.F.

1992-03-01

In response to numerous requests for information related to odor thresholds, this document was prepared by the Air Risk Information Support Center in its role in providing technical assistance to State and Local government agencies on risk assessment of air pollutants. A discussion of basic concepts related to olfactory function and the measurement of odor thresholds is presented. A detailed discussion of criteria which are used to evaluate the quality of published odor threshold values is provided. The use of odor threshold information in risk assessment is discussed. The results of a literature search and review of odor threshold informationmore » for the chemicals listed as hazardous air pollutants in the Clean Air Act amendments of 1990 is presented. The published odor threshold values are critically evaluated based on the criteria discussed and the values of acceptable quality are used to determine a geometric mean or best estimate.« less

The Individual Basic Facts Assessment Tool

ERIC Educational Resources Information Center

Tait-McCutcheon, Sandi; Drake, Michael

2015-01-01

There is an identified and growing need for a levelled diagnostic basic facts assessment tool that provides teachers with formative information about students' mastery of a broad range of basic fact sets. The Individual Basic Facts Assessment tool has been iteratively and cumulatively developed, trialled, and refined with input from teachers and…

Covariance Manipulation for Conjunction Assessment

NASA Technical Reports Server (NTRS)

Hejduk, M. D.

2016-01-01

Use of probability of collision (Pc) has brought sophistication to CA. Made possible by JSpOC precision catalogue because provides covariance. Has essentially replaced miss distance as basic CA parameter. Embrace of Pc has elevated methods to 'manipulate' covariance to enable/improve CA calculations. Two such methods to be examined here; compensation for absent or unreliable covariances through 'Maximum Pc' calculation constructs, projection (not propagation) of epoch covariances forward in time to try to enable better risk assessments. Two questions to be answered about each; situations to which such approaches are properly applicable, amount of utility that such methods offer.

Use of new scientific developments in regulatory risk assessments: challenges and opportunities.

PubMed

Tarazona, Jose V

2013-07-01

Since the 1990s, science based ecological risk assessments constitute an essential tool for supporting decision making in the regulatory context. Using the European REACH Regulation as example, this article presents the challenges and opportunities for new scientific developments within the area of chemical control and environmental protection. These challenges can be sorted out in 3 main related topics (sets). In the short term, the challenges are directly associated with the regulatory requirements, required for facilitating a scientifically sound implementation of the different obligations for industry and authorities. It is important to mention that although the actual tools are different due to the regulatory requirements, the basic needs are still the same as those addressed in the early 1990s: understanding the ecological relevance of the predicted effects, including the uncertainty, and facilitating the link with the socio-economic assessment. The second set of challenges covers the opportunities for getting an added value from the regulatory efforts. The information compiled through REACH registration and notification processes is analyzed as source for new integrative developments for assessing the combined chemical risk at the regional level. Finally, the article discusses the challenge of inverting the process and developing risk assessment methods focusing on the receptor, the individual or ecosystem, instead of on the stressor or source. These approaches were limited in the past due to the lack of information, but the identification and dissemination of standard information, including uses, manufacturing sites, physical-chemical, environmental, ecotoxicological, and toxicological properties as well as operational conditions and risk management measures for thousands of chemicals, combined by the knowledge gathered through large scale monitoring programs and spatial information systems is generating new opportunities. The challenge is liking predictions and measured data in an integral "-omic type" approach, considering collectively data from different sources and offering a complete assessment of the chemical risk of individuals and ecosystems, with new conceptual approaches that could be defined as "risk-omics based" paradigms and models. Copyright © 2013 SETAC.

Engineering risk assessment for emergency disposal projects of sudden water pollution incidents.

PubMed

Shi, Bin; Jiang, Jiping; Liu, Rentao; Khan, Afed Ullah; Wang, Peng

2017-06-01

Without an engineering risk assessment for emergency disposal in response to sudden water pollution incidents, responders are prone to be challenged during emergency decision making. To address this gap, the concept and framework of emergency disposal engineering risks are reported in this paper. The proposed risk index system covers three stages consistent with the progress of an emergency disposal project. Fuzzy fault tree analysis (FFTA), a logical and diagrammatic method, was developed to evaluate the potential failure during the process of emergency disposal. The probability of basic events and their combination, which caused the failure of an emergency disposal project, were calculated based on the case of an emergency disposal project of an aniline pollution incident in the Zhuozhang River, Changzhi, China, in 2014. The critical events that can cause the occurrence of a top event (TE) were identified according to their contribution. Finally, advices on how to take measures using limited resources to prevent the failure of a TE are given according to the quantified results of risk magnitude. The proposed approach could be a potential useful safeguard for the implementation of an emergency disposal project during the process of emergency response.

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

ERIC Educational Resources Information Center

Blackman, James

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

Dietary Assessment of U.S. Army Basic Trainees at Fort Jackson, South Carolina

DTIC Science & Technology

1988-12-19

butter is in this group Fruit - Fruits and juices Deart Desserts and sweets Fats - Table fats Condi - Condiments such as sugar and salt Bever - Beverages ...total sodium intake in the present study compared to 10% in earlier studies. increased availability and consumption of high sodium cuumiercially proc...intakes without increasing their risk of inadequate intakes of other essential nutrients. However, a vast majority of soldiers select foods for reasons

Incorporation of Novel MRI and Biomarkers into Prostate Cancer Active Surveillance Risk Assessment

DTIC Science & Technology

2017-09-01

preparation for a career in clinical research. These goals include 1) training in T1 translational research; 2) training in the development and...clinical trials network). In addition to basic mentoring tasks, we have identified four sources of mentorship in particular to my career , which...to meet the goals of my grant and career development. Research: We have successfully implemented the acquisition portion of the RSI MRI. There

Chemical carcinogens: a review of the science and its associated principles. U.S. Interagency Staff Group on Carcinogens.

PubMed Central

1986-01-01

In order to articulate a view of chemical carcinogenesis that scientists generally hold in common today and to draw upon this understanding to compose guiding principles that can be used as a bases for the efforts of the regulatory agencies to establish guidelines for assessing carcinogenic risk to meet the specific requirements of the legislative acts they are charged to implement, the Office of Science and Technology Policy, Executive Office, the White House drew on the expertise of a number of regulatory agencies to elucidate present scientific views in critical areas of the major disciplines important to the process of risk assessment. The document is composed of two major sections, Principles and the State-of-the-Science. The latter consists of subsections on the mechanisms of carcinogenesis, short-term and long-term testing, and epidemiology, which are important components in the risk assessment step of hazard identification. These subsections are followed by one on exposure assessment, and a final section which includes analyses of dose-response (hazard) assessment and risk characterization. The principles are derived from considerations in each of the subsections. Because of present gaps in understanding, the principles contain judgmental (science policy) decisions on major unresolved issues as well as statements of what is generally accepted as fact. These judgments are basically assumptions which are responsible for much of the uncertainty in the process of risk assessment. There was an attempt to clearly distinguish policy and fact. The subsections of the State-of-the-Science portion provide the underlying support to the principles articulated, and to read the "Principles" section without a full appreciation of the State-of-the-Science section is to invite oversimplification and misinterpretation. Finally, suggestions are made for future research efforts which will improve the process of risk assessment. PMID:3530737

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study.

PubMed

Dunlop, Dorothy D; Song, Jing; Semanik, Pamela A; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Chang, Rowland W

2014-04-29

To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. Prospective multisite cohort study from September 2008 to December 2012. Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of the knee or risk factors for knee osteoarthritis. An increase in daily physical activity time may reduce the risk of disability, even if the intensity of that additional activity is not increased.

Application of the BRAFO tiered approach for benefit-risk assessment to case studies on heat processing contaminants.

PubMed

Schütte, Katrin; Boeing, Heiner; Hart, Andy; Heeschen, Walther; Reimerdes, Ernst H; Santare, Dace; Skog, Kerstin; Chiodini, Alessandro

2012-11-01

The aim of the European Funded Project BRAFO (benefit-risk analysis of foods) project was to develop a framework that allows quantitative comparison of human health risks and benefits of foods based on a common scale of measurement. This publication describes the application of the BRAFO methodology to three different case studies: the formation of acrylamide in potato and cereal based products, the formation of benzo(a)pyrene through smoking and grilling of meat and fish and the heat-treatment of milk. Reference, alternative scenario and target population represented the basic structure to test the tiers of the framework. Various intervention methods intended to reduce acrylamide in potato and cereal products were evaluated against the historical production methods. In conclusion the benefits of the acrylamide-reducing measures were considered prevailing. For benzo(a)pyrene, three illustrated alternative scenarios were evaluated against the most common smoking practice. The alternative scenarios were assessed as delivering benefits, introducing only minimal potential risks. Similar considerations were made for heat treatment of milk where the comparison of the microbiological effects of heat treatment, physico-chemical changes of milk constituents with positive and negative health effects was assessed. In general, based on data available, benefits of the heat treatment were outweighing any risks. Copyright © 2012 ILSI Europe. Published by Elsevier Ltd.. All rights reserved.

Testing REACH draft technical guidance notes for conducting chemical safety assessments-the experience of a downstream user of a preparation.

PubMed

Gade, Anne Lill; Ovrebø, Steinar; Hylland, Ketil

2008-07-01

The goal of REACH is the safe use of chemicals. This study examines the efficiency and usefulness of two draft technical guidance notes in the REACH Interim Project 3.2-2 for the development of the chemical safety report and exposure scenarios. A case study was carried out for a paint system for protection of structural steel. The focuses of the study were risk assessment of preparations based on Derived No Effect Level (DNEL) and Predicted No Effect Concentrations (PNEC) and on effective and accurate communication in the supply chain. Exposure scenarios and generic descriptions of uses, risk management measures, and exposure determinants were developed. The study showed that communication formats, software tools, and guidelines for chemical risk assessment need further adjustment to preparations and real-life situations. Web platforms may simplify such communication. The downstream formulator needs basic substance data from the substance manufacturer during the pre-registration phase to develop exposure scenarios for preparations. Default values need to be communicated in the supply chain because these were critical for the derivation of applicable risk management demands. The current guidelines which rely on the available toxicological knowledge are insufficient to advise downstream users on how to develop exposure scenarios for preparations.

Accounting for inherent variability of growth in microbial risk assessment.

PubMed

Marks, H M; Coleman, M E

2005-04-15

Risk assessments of pathogens need to account for the growth of small number of cells under varying conditions. In order to determine the possible risks that occur when there are small numbers of cells, stochastic models of growth are needed that would capture the distribution of the number of cells over replicate trials of the same scenario or environmental conditions. This paper provides a simple stochastic growth model, accounting only for inherent cell-growth variability, assuming constant growth kinetic parameters, for an initial, small, numbers of cells assumed to be transforming from a stationary to an exponential phase. Two, basic, microbial sets of assumptions are considered: serial, where it is assume that cells transform through a lag phase before entering the exponential phase of growth; and parallel, where it is assumed that lag and exponential phases develop in parallel. The model is based on, first determining the distribution of the time when growth commences, and then modelling the conditional distribution of the number of cells. For the latter distribution, it is found that a Weibull distribution provides a simple approximation to the conditional distribution of the relative growth, so that the model developed in this paper can be easily implemented in risk assessments using commercial software packages.

Applying under-sampling techniques and cost-sensitive learning methods on risk assessment of breast cancer.

PubMed

Hsu, Jia-Lien; Hung, Ping-Cheng; Lin, Hung-Yen; Hsieh, Chung-Ho

2015-04-01

Breast cancer is one of the most common cause of cancer mortality. Early detection through mammography screening could significantly reduce mortality from breast cancer. However, most of screening methods may consume large amount of resources. We propose a computational model, which is solely based on personal health information, for breast cancer risk assessment. Our model can be served as a pre-screening program in the low-cost setting. In our study, the data set, consisting of 3976 records, is collected from Taipei City Hospital starting from 2008.1.1 to 2008.12.31. Based on the dataset, we first apply the sampling techniques and dimension reduction method to preprocess the testing data. Then, we construct various kinds of classifiers (including basic classifiers, ensemble methods, and cost-sensitive methods) to predict the risk. The cost-sensitive method with random forest classifier is able to achieve recall (or sensitivity) as 100 %. At the recall of 100 %, the precision (positive predictive value, PPV), and specificity of cost-sensitive method with random forest classifier was 2.9 % and 14.87 %, respectively. In our study, we build a breast cancer risk assessment model by using the data mining techniques. Our model has the potential to be served as an assisting tool in the breast cancer screening.

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

Clinical classification of age-related macular degeneration.

PubMed

Ferris, Frederick L; Wilkinson, C P; Bird, Alan; Chakravarthy, Usha; Chew, Emily; Csaky, Karl; Sadda, SriniVas R

2013-04-01

To develop a clinical classification system for age-related macular degeneration (AMD). Evidence-based investigation, using a modified Delphi process. Twenty-six AMD experts, 1 neuro-ophthalmologist, 2 committee chairmen, and 1 methodologist. Each committee member completed an online assessment of statements summarizing current AMD classification criteria, indicating agreement or disagreement with each statement on a 9-step scale. The group met, reviewed the survey results, discussed the important components of a clinical classification system, and defined new data analyses needed to refine a classification system. After the meeting, additional data analyses from large studies were provided to the committee to provide risk estimates related to the presence of various AMD lesions. Delphi review of the 9-item set of statements resulting from the meeting. Consensus was achieved in generating a basic clinical classification system based on fundus lesions assessed within 2 disc diameters of the fovea in persons older than 55 years. The committee agreed that a single term, age-related macular degeneration, should be used for the disease. Persons with no visible drusen or pigmentary abnormalities should be considered to have no signs of AMD. Persons with small drusen (<63 μm), also termed drupelets, should be considered to have normal aging changes with no clinically relevant increased risk of late AMD developing. Persons with medium drusen (≥ 63-<125 μm), but without pigmentary abnormalities thought to be related to AMD, should be considered to have early AMD. Persons with large drusen or with pigmentary abnormalities associated with at least medium drusen should be considered to have intermediate AMD. Persons with lesions associated with neovascular AMD or geographic atrophy should be considered to have late AMD. Five-year risks of progressing to late AMD are estimated to increase approximately 100 fold, ranging from a 0.5% 5-year risk for normal aging changes to a 50% risk for the highest intermediate AMD risk group. The proposed basic clinical classification scale seems to be of value in predicting the risk of late AMD. Incorporating consistent nomenclature into the practice patterns of all eye care providers may improve communication and patient care. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Prediction of near-term breast cancer risk using local region-based bilateral asymmetry features in mammography

NASA Astrophysics Data System (ADS)

Li, Yane; Fan, Ming; Li, Lihua; Zheng, Bin

2017-03-01

This study proposed a near-term breast cancer risk assessment model based on local region bilateral asymmetry features in Mammography. The database includes 566 cases who underwent at least two sequential FFDM examinations. The `prior' examination in the two series all interpreted as negative (not recalled). In the "current" examination, 283 women were diagnosed cancers and 283 remained negative. Age of cancers and negative cases completely matched. These cases were divided into three subgroups according to age: 152 cases among the 37-49 age-bracket, 220 cases in the age-bracket 50- 60, and 194 cases with the 61-86 age-bracket. For each image, two local regions including strip-based regions and difference-of-Gaussian basic element regions were segmented. After that, structural variation features among pixel values and structural similarity features were computed for strip regions. Meanwhile, positional features were extracted for basic element regions. The absolute subtraction value was computed between each feature of the left and right local-regions. Next, a multi-layer perception classifier was implemented to assess performance of features for prediction. Features were then selected according stepwise regression analysis. The AUC achieved 0.72, 0.75 and 0.71 for these 3 age-based subgroups, respectively. The maximum adjustable odds ratios were 12.4, 20.56 and 4.91 for these three groups, respectively. This study demonstrate that the local region-based bilateral asymmetry features extracted from CC-view mammography could provide useful information to predict near-term breast cancer risk.

Leg Power As an Indicator of Risk of Injury or Illness in Police Recruits.

PubMed

Orr, Robin; Pope, Rodney; Peterson, Samantha; Hinton, Benjamin; Stierli, Michael

2016-02-19

Tactical trainees, like those entering the police force, are required to undergo vigorous training as part of their occupational preparation. This training has the potential to cause injuries. In addition, the physical training, communal living and pressures of tactical training are known to induce immune suppression and have the potential to increase the risk of illness. The aim of this study was to investigate the relationship between leg power, as measured by a vertical jump (VJ), and rates of reported injuries and illnesses during police recruit training. Retrospective data from recruits (n = 1021) undergoing basic police recruit training at an Australian Police Force College was collected. Recruits completed a VJ assessment at the commencement of their second state of training. Formally reported illness and injuries were collected 12 weeks later, following completion of training. Correlations between VJ height and rates of reported illness and injury were low (r = -0.16 and -0.09, respectively) but significant (p < 0.005), with VJ height accounting for 2.6% and 0.8% of the variance in illness and injury rates, respectively. In terms of relative risks, recruits with the lowest recorded VJ heights were more than three times as likely as those with highest VJ heights to suffer injury and/or illness. Police recruits with lower VJ height are at a significantly greater risk of suffering an injury or illness during police basic recruit training.

Surgical errors and risks – the head and neck cancer patient

PubMed Central

Harréus, Ulrich

2013-01-01

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

A simple tool for preliminary hazard identification and quick assessment in craftwork and small/medium enterprises (SME).

PubMed

Colombini, Daniela; Occhipinti, E; Di Leone, G

2012-01-01

During the last Congress of the International Ergonomics Association (IEA), Beijing, August 2009, an international group was founded aimed at developing a "toolkit for MSD prevention" within IEA and in collaboration with World Health Organization (WHO). Possible users of toolkits are: members of health and safety committees, health and safety representatives, line supervisors; labor inspectors; health workers implementing basic occupational health services; occupational health and safety specialists.According to ISO standard 11228 series and the new Draft CD ISO 12259-2009: Application document guides for the potential user, a computer software ( in Excel®) was create dealing with hazard "mapping" in handicraft The proposed methodology, using specific key enters and quick assessment criteria, allows a simple ergonomics hazard identification and risk estimation. Thus it makes possible to decide for which professional hazards a more exhaustive risk assessment will be necessary and which professional consultant should be involved (occupational physician, safety engineer, industrial hygienist, etc.).

Injury-reduction effectiveness of prescribing running shoes on the basis of foot arch height: summary of military investigations.

PubMed

Knapik, Joseph J; Trone, Daniel W; Tchandja, Juste; Jones, Bruce H

2014-10-01

Secondary analysis of 3 randomized controlled trials. Objective Analysis of studies that examined whether prescribing running shoes on the basis of foot arch height influenced injury risk during military basic training. Prior to 2007, running magazines and running-shoe companies suggested that imprints of the bottom of the feet (plantar shape) could be used as an indication of foot arch height and that this could be used to select individually appropriate types of running shoes. Similar studies were conducted in US Army (2168 men, 951 women), Air Force (1955 men, 718 women), and Marine Corps (840 men, 571 women) basic training. After foot examinations, recruits were randomized to either an experimental or a control group. Recruits in the experimental group selected or were assigned motion-control, stability, or cushioned shoes to match their plantar shape, which represented a low, medium, or high foot arch, respectively. The control group received a stability shoe regardless of plantar shape. Injuries during basic training were assessed from outpatient medical records. Meta-analyses that pooled results of the 3 investigations showed little difference between the experimental and control groups in the injury rate (injuries per 1000 person-days) for either men (summary rate ratio = 0.97; 95% confidence interval [CI]: 0.88, 1.06) or women (summary rate ratio = 0.97; 95% CI: 0.85, 1.08). When injury rates for specific types of running shoes were compared, there were no differences. Selecting running shoes based on arch height had little influence on injury risk in military basic training. Prevention, level 1b.

Identification of ballast water discharge profiles of a port to enable effective ballast water management and environmental studies

NASA Astrophysics Data System (ADS)

David, Matej; Gollasch, Stephan; Penko, Ludvik

2018-03-01

Information about the profile of ballast water discharges in a port is one of the basic elements of the decision making process in ballast water risk assessment and management, and supports the evaluation of dimensions and processes of aquatic species invasions with vessels ballast water. In the lack of ballast water reporting, ballast water discharge assessments need to be conducted. In this study we have assessed and compared ballast water discharge profiles of two ports with different maritime traffic and cargo profiles, the Port of Hamburg (Germany) and the Muuga Harbour, Port of Tallinn (Estonia). This study shows methods and approaches which can be used to assess volumes and donor ports of ballast water discharges for a port at the level of each vessel call. These methods and approaches can be applied to any port to support the implementation of feasible and efficient ballast water management measures and to enable environmental studies including long-term accumulation risks of disinfection by-products from ballast water management systems making use of active substances, as well as for discharges of other chemical compounds.

Detection and diagnosis of periodontal conditions amenable to prevention

PubMed Central

2015-01-01

Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory diseases. Gingivitis affects the majority of people, and advanced periodontitis is estimated to affect 5-15% of adults. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. All patients should undergo periodontal assessment as part of routine oral examination. Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodontal Index or Periodontal Screening Record should be performed for all new patients, and also on a regular basis as part of ongoing oral health care. If periodontitis is identified, full periodontal assessment is required, involving recording of full mouth probing and bleeding data, together with assessment of other relevant parameters such as plaque levels, furcation involvement, recession and tooth mobility. Radiographic assessment of alveolar bone levels is driven by the clinical situation, and is required to assess bone destruction in patients with periodontitis. Risk assessment (such as assessing diabetes status and smoking) and risk management (such as promoting smoking cessation) should form a central component of periodontal therapy. This article provides guidance to the oral health care team regarding methods and frequencies of appropriate clinical and radiographic examinations to assess periodontal status, to enable appropriate detection and diagnosis of periodontal conditions. PMID:26390822

Incorporation of Novel MRI and Biomarkers into Prostate Cancer Active Surveillance Risk Assessment

DTIC Science & Technology

2016-09-01

that are integral in the preparation for a career in clinical research. These goals are 1) training in T1 translational research; 2) training in the...Texas. In addition to basic mentoring tasks, we have identified four sources of mentorship in particular to my career , which include opportunities at...clinical schedule for protected time to ensure I meet the goals of my grant and career development. Research: We have successfully implemented

Design of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)

PubMed Central

Kessler, Ronald C.; Colpe, Lisa J.; Fullerton, Carol S.; Gebler, Nancy; Naifeh, James A.; Nock, Matthew K.; Sampson, Nancy A.; Schoenbaum, Michael; Zaslavsky, Alan M.; Stein, Murray B.; Ursano, Robert J.; Heeringa, Steven G.

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 evidence-based recommendations to reduce U.S. Army suicides and increase basic knowledge about the determinants of suicidality. This report presents an overview of the designs of the six component Army STARRS studies. These include: an integrated study of historical administrative data systems (HADS) designed to provide data on significant administrative predictors of suicides among the more than 1.6 million soldiers on active duty in 2004–2009; retrospective case-control studies of suicide attempts and fatalities; separate large-scale cross-sectional studies of new soldiers (i.e., those just beginning Basic Combat Training [BCT], who completed self-administered questionnaires [SAQ] and neurocognitive tests and provided blood samples) and soldiers exclusive of those in BCT (who completed SAQs); a pre-post deployment study of soldiers in three Brigade Combat Teams about to deploy to Afghanistan (who completed SAQs and provided blood samples) followed multiple times after returning from deployment; and a platform for following up Army STARRS participants who have returned to civilian life. DoD/Army administrative data records are linked with SAQ data to examine prospective associations between self-reports and subsequent suicidality. The presentation closes with a discussion of the methodological advantages of cross-component coordination. PMID:24318217

Design of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

PubMed

Kessler, Ronald C; Colpe, Lisa J; Fullerton, Carol S; Gebler, Nancy; Naifeh, James A; Nock, Matthew K; Sampson, Nancy A; Schoenbaum, Michael; Zaslavsky, Alan M; Stein, Murray B; Ursano, Robert J; Heeringa, Steven G

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 evidence-based recommendations to reduce US Army suicides and increase basic knowledge about the determinants of suicidality. This report presents an overview of the designs of the six components of the Army STARRS. These include: an integrated analysis of the Historical Administrative Data Study (HADS) designed to provide data on significant administrative predictors of suicides among the more than 1.6 million soldiers on active duty in 2004-2009; retrospective case-control studies of suicide attempts and fatalities; separate large-scale cross-sectional studies of new soldiers (i.e. those just beginning Basic Combat Training [BCT], who completed self-administered questionnaires [SAQs] and neurocognitive tests and provided blood samples) and soldiers exclusive of those in BCT (who completed SAQs); a pre-post deployment study of soldiers in three Brigade Combat Teams about to deploy to Afghanistan (who completed SAQs and provided blood samples) followed multiple times after returning from deployment; and a platform for following up Army STARRS participants who have returned to civilian life. Department of Defense/Army administrative data records are linked with SAQ data to examine prospective associations between self-reports and subsequent suicidality. The presentation closes with a discussion of the methodological advantages of cross-component coordination. Copyright © 2013 John Wiley & Sons, Ltd.

[Assessment criteria in the choice of aids for the lifting of patients].

PubMed

Panciera, D; Menoni, O; Ricci, M G; Occhipinti, E

1999-01-01

A fundamental part of the prevention strategies aimed at reducing risk due to manual handling of patients is the use of appropriate aids. This paper defines the basic types of aids for hospital wards: patient lifting devices, aids for hygiene and minor aids; and also proposes a procedure for choice of the type of aid: the procedure uses a specific protocol and also analyzes work organization and the environmental features of the ward. The proposed criteria for choice concern in the first place the fundamental requirements of the equipment: safety for operator and patient, simplicity of use and comfort for the patient. Secondly the basic determinants for choice of the type of aid are the type of disabled patient usually present in the ward and the analysis of the movements made in handling patients. On this basis, for each type of aid, the specific features are defined which direct the choice of supply for the various wards that will be adequate and effective both in reducing risk due to manual handling of patients and in improving the comfort of the patients.

Should the scope of human mixture risk assessment span legislative/regulatory silos for chemicals?

PubMed

Evans, Richard M; Martin, Olwenn V; Faust, Michael; Kortenkamp, Andreas

2016-02-01

Current chemicals regulation operates almost exclusively on a chemical-by-chemical basis, however there is concern that this approach may not be sufficiently protective if two or more chemicals have the same toxic effect. Humans are indisputably exposed to more than one chemical at a time, for example to the multiple chemicals found in food, air and drinking water, and in household and consumer products, and in cosmetics. Assessment of cumulative risk to human health and/or the environment from multiple chemicals and routes can be done in a mixture risk assessment (MRA). Whilst there is a broad consensus on the basic science of mixture toxicology, the path to regulatory implementation of MRA within chemical risk assessment is less clear. In this discussion piece we pose an open question: should the scope of human MRA cross legislative remits or 'silos'? We define silos as, for instance, legislation that defines risk assessment practice for a subset of chemicals, usually on the basis of substance/product, media or process orientation. Currently any form of legal mandate for human MRA in the EU is limited to only a few pieces of legislation. We describe two lines of evidence, illustrated with selected examples, that are particularly pertinent to this question: 1) evidence that mixture effects have been shown for chemicals regulated in different silos and 2) evidence that humans are co-exposed to chemicals from different silos. We substantiate the position that, because there is no reason why chemicals allocated to specific regulatory silos would have non-overlapping risk profiles, then there is also no reason to expect that MRA limited only to chemicals within one silo can fully capture the risk that may be present to human consumers. Finally, we discuss possible options for implementation of MRA and we hope to prompt wider discussion of this issue. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

ASSESSMENT OF RADIATION DOSE AND EXCESSIVE LIFE-TIME CANCER RISK FROM THE BUNAIR GRANITE, NORTHERN PAKISTAN.

PubMed

Qureshi, A A; Manzoor, S; Younis, H; Shah, K H; Ahmed, T

2018-01-01

Natural radioactivity was measured in Bunair Granite using high purity germanium gamma-ray spectrometer and compared to world's granites and building materials to access its suitability for the construction purpose. Average gamma-activities of 226Ra, 232Th and 40K were found to be 52.41, 58.41 and 1130.12 Bq kg-1, respectively. The Indoor and outdoor radiation indices including excessive life-time cancer risk (ELCR) were calculated. The average indoor ELCR was estimated as 3.49 × 10-3. The average outdoor ELCR was assessed as 0.46 × 10-3. As a basic building material Bunair Granite should be on low propriety. For flooring, facing the buildings and as Table tops, in kitchens and other utilities it is safe. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Chemical alternatives assessment: the case of flame retardants.

PubMed

Howard, Gregory J

2014-12-01

Decisions on chemical substitution are made rapidly and by many stakeholders; these decisions may have a direct impact on consumer exposures, and, when a hazard exists, to consumer risks. Flame retardants (FRs) represent particular challenges, including very high production volumes, designed-in persistence, and often direct consumer exposure. Newer FR products, as with other industrial chemicals, typically lack data on hazard and exposure, and in many cases even basic information on structure and use in products is unknown. Chemical alternatives assessment (CAA) provides a hazard-focused approach to distinguishing between possible substitutions; variations on this process are used by several government and numerous corporate entities. By grouping chemicals according to functional use, some information on exposure potential can be inferred, allowing for decisions based on those hazard properties that are most distinguishing. This approach can help prevent the "regrettable substitution" of one chemical with another of equal, or even higher, risk. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exploring the Life Expectancy Increase in Poland in the Context of CVD Mortality Fall

PubMed Central

Kobza, Joanna; Geremek, Mariusz

2015-01-01

Life expectancy at birth is considered the best mortality-based summary indicator of the health status of the population and is useful for measuring long-term health changes. The objective of this article was to present the concept of the bottom-up policy risk assessment approach, developed to identify challenges involved in analyzing risk factor reduction policies and in assessing how the related health indicators have changed over time. This article focuses on the reasons of the significant life expectancy prolongation in Poland over the past 2 decades, thus includes policy context. The methodology details a bottom-up risk assessment approach, a chain of relations between the health outcome, risk factors, and health policy, based on Risk Assessment From Policy to Impact Dimension project guidance. A decline in cardiovascular disease mortality was a key factor that followed life expectancy prolongation. Among basic factors, tobacco and alcohol consumption, diet, physical activity, and new treatment technologies were identified. Poor health outcomes of the Polish population at the beginning of 1990s highlighted the need of the implementation of various health promotion programs, legal acts, and more effective public health policies. Evidence-based public health policy needs translating scientific research into policy and practice. The bottom-up case study template can be one of the focal tools in this process. Accountability for the health impact of policies and programs and legitimization of the decisions of policy makers has become one of the key questions nowadays in European countries’ decision-making process and in EU public health strategy. PMID:26546595

Pressure ulcers: Back to the basics

PubMed Central

Agrawal, Karoon; Chauhan, Neha

2012-01-01

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of “prevention is better than cure” suits this condition the most. PMID:23162223

A Retrospective Performance Assessment of the Developmental Neurotoxicity Study in Support of OECD Test Guideline 426

PubMed Central

Makris, Susan L.; Raffaele, Kathleen; Allen, Sandra; Bowers, Wayne J.; Hass, Ulla; Alleva, Enrico; Calamandrei, Gemma; Sheets, Larry; Amcoff, Patric; Delrue, Nathalie; Crofton, Kevin M.

2009-01-01

Objective We conducted a review of the history and performance of developmental neurotoxicity (DNT) testing in support of the finalization and implementation of Organisation of Economic Co-operation and Development (OECD) DNT test guideline 426 (TG 426). Information sources and analysis In this review we summarize extensive scientific efforts that form the foundation for this testing paradigm, including basic neurotoxicology research, interlaboratory collaborative studies, expert workshops, and validation studies, and we address the relevance, applicability, and use of the DNT study in risk assessment. Conclusions The OECD DNT guideline represents the best available science for assessing the potential for DNT in human health risk assessment, and data generated with this protocol are relevant and reliable for the assessment of these end points. The test methods used have been subjected to an extensive history of international validation, peer review, and evaluation, which is contained in the public record. The reproducibility, reliability, and sensitivity of these methods have been demonstrated, using a wide variety of test substances, in accordance with OECD guidance on the validation and international acceptance of new or updated test methods for hazard characterization. Multiple independent, expert scientific peer reviews affirm these conclusions. PMID:19165382

An early warning system for groundwater pollution based on the assessment of groundwater pollution risks.

NASA Astrophysics Data System (ADS)

Zhang, Weihong.; Zhao, Yongsheng; Hong, Mei; Guo, Xiaodong

2009-04-01

Groundwater pollution usually is complex and concealed, remediation of which is difficult, high cost, time-consuming, and ineffective. An early warning system for groundwater pollution is needed that detects groundwater quality problems and gets the information necessary to make sound decisions before massive groundwater quality degradation occurs. Groundwater pollution early warning were performed by considering comprehensively the current groundwater quality, groundwater quality varying trend and groundwater pollution risk . The map of the basic quality of the groundwater was obtained by fuzzy comprehensive evaluation or BP neural network evaluation. Based on multi-annual groundwater monitoring datasets, Water quality state in sometime of the future was forecasted using time-sequenced analyzing methods. Water quality varying trend was analyzed by Spearman's rank correlative coefficient.The relative risk map of groundwater pollution was estimated through a procedure that identifies, cell by cell,the values of three factors, that is inherent vulnerability, load risk of pollution source and contamination hazard. DRASTIC method was used to assess inherent vulnerability of aquifer. Load risk of pollution source was analyzed based on the potential of contamination and pollution degree. Assessment index of load risk of pollution source which involves the variety of pollution source, quantity of contaminants, releasing potential of pollutants, and distance were determined. The load risks of all sources considered by GIS overlay technology. Early warning model of groundwater pollution combined with ComGIS technology organically, the regional groundwater pollution early-warning information system was developed, and applied it into Qiqiha'er groundwater early warning. It can be used to evaluate current water quality, to forecast water quality changing trend, and to analyze space-time influencing range of groundwater quality by natural process and human activities. Keywords: groundwater pollution, early warning, aquifer vulnerability, pollution load, pollution risk, ComGIS

Assessment of physical vulnerability of buildings and analysis of landslide risk at the municipal scale: application to the Loures municipality, Portugal

NASA Astrophysics Data System (ADS)

Guillard-Gonçalves, C.; Zêzere, J. L.; Pereira, S.; Garcia, R. A. C.

2016-02-01

This study offers a semi-quantitative assessment of the physical vulnerability of buildings to landslides in a Portuguese municipality (Loures), as well as the quantitative landslide risk analysis computed as the product of the landslide hazard by the vulnerability and the economic value of the buildings. The hazard was assessed by combining the spatiotemporal probability and the frequency-magnitude relationship of the landslides. The physical vulnerability assessment was based on an inquiry of a pool of European landslide experts and a sub-pool of landslide experts who know the study area, and the answers' variability was assessed with standard deviation. The average vulnerability of the basic geographic entities was compared by changing the map unit and applying the vulnerability to all the buildings of a test site, the inventory of which was listed on the field. The economic value was calculated using an adaptation of the Portuguese Tax Services approach, and the risk was computed for different landslide magnitudes and different spatiotemporal probabilities. As a rule, the vulnerability values given by the sub-pool of experts who know the study area are higher than those given by the European experts, namely for the high-magnitude landslides. The obtained vulnerabilities vary from 0.2 to 1 as a function of the structural building types and the landslide magnitude, and are maximal for 10 and 20 m landslide depths. However, the highest risk was found for the landslides that are 3 m deep, because these landslides combine a relatively high frequency in the Loures municipality with a substantial potential damage.

An Entropy Approach to Disclosure Risk Assessment: Lessons from Real Applications and Simulated Domains

PubMed Central

Airoldi, Edoardo M.; Bai, Xue; Malin, Bradley A.

2011-01-01

We live in an increasingly mobile world, which leads to the duplication of information across domains. Though organizations attempt to obscure the identities of their constituents when sharing information for worthwhile purposes, such as basic research, the uncoordinated nature of such environment can lead to privacy vulnerabilities. For instance, disparate healthcare providers can collect information on the same patient. Federal policy requires that such providers share “de-identified” sensitive data, such as biomedical (e.g., clinical and genomic) records. But at the same time, such providers can share identified information, devoid of sensitive biomedical data, for administrative functions. On a provider-by-provider basis, the biomedical and identified records appear unrelated, however, links can be established when multiple providers’ databases are studied jointly. The problem, known as trail disclosure, is a generalized phenomenon and occurs because an individual’s location access pattern can be matched across the shared databases. Due to technical and legal constraints, it is often difficult to coordinate between providers and thus it is critical to assess the disclosure risk in distributed environments, so that we can develop techniques to mitigate such risks. Research on privacy protection has so far focused on developing technologies to suppress or encrypt identifiers associated with sensitive information. There is growing body of work on the formal assessment of the disclosure risk of database entries in publicly shared databases, but a less attention has been paid to the distributed setting. In this research, we review the trail disclosure problem in several domains with known vulnerabilities and show that disclosure risk is influenced by the distribution of how people visit service providers. Based on empirical evidence, we propose an entropy metric for assessing such risk in shared databases prior to their release. This metric assesses risk by leveraging the statistical characteristics of a visit distribution, as opposed to person-level data. It is computationally efficient and superior to existing risk assessment methods, which rely on ad hoc assessment that are often computationally expensive and unreliable. We evaluate our approach on a range of location access patterns in simulated environments. Our results demonstrate the approach is effective at estimating trail disclosure risks and the amount of self-information contained in a distributed system is one of the main driving factors. PMID:21647242

Risk assessment for stonecutting enterprises Accidental risks in the course of petroleum production and stone extraction

NASA Astrophysics Data System (ADS)

Aleksandrova, A. J.; Timofeeva, S. S.

2018-01-01

The paper is devoted to the assessment of accidental risks occurring at the works engaged in stone extracting and petroleum production. Two basic kinds of accidents common for stone extracting and petroleum production have been chosen to be discussed in the part under consideration. The most dangerous accidental situation characteristic for a stone milling line is an unsanctioned explosion, UE, of blasting agents used for the development of stone deposits. The analysis of a risk occurrence in certain accidental situations is to be carried out. With reference to petroleum extraction, a combustibles and lubricants (C & L) explosion is the most dangerous of characteristic accidental situations. To reveal the most probable causes of accidental situations to be realized, a graph of cause and effect relations has been constructed for each of the accidental situations most probable causes to real situation of an accident. Disasters of a natural origin are the most probable causes of unsanctioned explosions at the deposits of stone raw materials. Technology related natural disasters are the most probable causes of unsanctioned explosions to be realized at multiple well platforms engaged in petroleum production.

Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

PubMed

Qiao, Yuanhua; Keren, Nir; Mannan, M Sam

2009-08-15

Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

Prevention of falls in older people.

PubMed

Close, Jacqueline C T

In recent years the evidence base for prevention of falls in older people has increased and associated with this has been an inevitable expansion in clinical services which attempt to localize and implement what is described in the literature. This article reviews the basic physiology implicit in maintenance of the upright posture; highlights the diversity of medical and non-medical risk factors associated with falls; describes the clinical assessment of an older person at risk of falls; reviews the evidence for intervention in the prevention of falls in older people; and acknowledges the need for a clear strategic direction to successfully prevent falls and the requirement for ongoing research as well as much needed service evaluation.

Department of Defense Basic Research Program.

DTIC Science & Technology

1983-01-01

25 Environmental Sciences oceanography ........................................................................... 27...budget category and increased emphasis on high- risk , high-payoff, and named Basic Research, most of the effort funded under long-term research was...proximity fue, °.tchooie-o examplsi, radar, theus prxiit fuzenan asrsk purchasing power because of inflation and was risking nuclear weapons, homing

Systematic risk assessment methodology for critical infrastructure elements - Oil and Gas subsectors

NASA Astrophysics Data System (ADS)

Gheorghiu, A.-D.; Ozunu, A.

2012-04-01

The concern for the protection of critical infrastructure has been rapidly growing in the last few years in Europe. The level of knowledge and preparedness in this field is beginning to develop in a lawfully organized manner, for the identification and designation of critical infrastructure elements of national and European interest. Oil and gas production, refining, treatment, storage and transmission by pipelines facilities, are considered European critical infrastructure sectors, as per Annex I of the Council Directive 2008/114/EC of 8 December 2008 on the identification and designation of European critical infrastructures and the assessment of the need to improve their protection. Besides identifying European and national critical infrastructure elements, member states also need to perform a risk analysis for these infrastructure items, as stated in Annex II of the above mentioned Directive. In the field of risk assessment, there are a series of acknowledged and successfully used methods in the world, but not all hazard identification and assessment methods and techniques are suitable for a given site, situation, or type of hazard. As Theoharidou, M. et al. noted (Theoharidou, M., P. Kotzanikolaou, and D. Gritzalis 2009. Risk-Based Criticality Analysis. In Critical Infrastructure Protection III. Proceedings. Third Annual IFIP WG 11.10 International Conference on Critical Infrastructure Protection. Hanover, New Hampshire, USA, March 23-25, 2009: revised selected papers, edited by C. Palmer and S. Shenoi, 35-49. Berlin: Springer.), despite the wealth of knowledge already created, there is a need for simple, feasible, and standardized criticality analyses. The proposed systematic risk assessment methodology includes three basic steps: the first step (preliminary analysis) includes the identification of hazards (including possible natural hazards) for each installation/section within a given site, followed by a criterial analysis and then a detailed analysis step. The criterial evaluation is used as a ranking system in order to establish the priorities for the detailed risk assessment. This criterial analysis stage is necessary because the total number of installations and sections on a site can be quite large. As not all installations and sections on a site contribute significantly to the risk of a major accident occurring, it is not efficient to include all installations and sections in the detailed risk assessment, which can be time and resource consuming. The selected installations are then taken into consideration in the detailed risk assessment, which is the third step of the systematic risk assessment methodology. Following this step, conclusions can be drawn related to the overall risk characteristics of the site. The proposed methodology can as such be successfully applied to the assessment of risk related to critical infrastructure elements falling under the energy sector of Critical Infrastructure, mainly the sub-sectors oil and gas. Key words: Systematic risk assessment, criterial analysis, energy sector critical infrastructure elements

Comparative risk analysis of technological hazards (a review).

PubMed Central

Kates, R W; Kasperson, J X

1983-01-01

Hazards are threats to people and what they value and risks are measures of hazards. Comparative analyses of the risks and hazards of technology can be dated to Starr's 1969 paper [Starr, C. (1969) Science 165, 1232-1238] but are rooted in recent trends in the evolution of technology, the identification of hazard, the perception of risk, and the activities of society. These trends have spawned an interdisciplinary quasi profession with new terminology, methodology, and literature. A review of 54 English-language monographs and book-length collections, published between 1970 and 1983, identified seven recurring themes: (i) overviews of the field of risk assessment, (ii) efforts to estimate and quantify risk, (iii) discussions of risk acceptability, (iv) perception, (v) analyses of regulation, (vi) case studies of specific technological hazards, and (vii) agenda for research. Within this field, science occupies a unique niche, for many technological hazards transcend the realm of ordinary experience and require expert study. Scientists can make unique contributions to each area of hazard management but their primary contribution is the practice of basic science. Beyond that, science needs to further risk assessment by understanding the more subtle processes of hazard creation and by establishing conventions for estimating risk and for presenting and handling uncertainty. Scientists can enlighten the discussion of tolerable risk by setting risks into comparative contexts, by studying the process of evaluation, and by participating as knowledgeable individuals, but they cannot decide the issue. Science can inform the hazard management process by broadening the range of alternative control actions and modes of implementation and by devising methods to evaluate their effectiveness. PMID:6580625

Incorporating Social Determinants into a Groundwater Risk Framework

NASA Astrophysics Data System (ADS)

Simpson, M.; Allen, D. M.; Journeay, M.; Korteling, B.

2009-12-01

The remediation of polluted groundwater is often very costly, therefore water managers utilize various proactive measures, such as wellhead protection planning, to prevent contamination events. With limited available resources, it is essential to prioritize where these measures are introduced; systematic and integrated methodologies of assessing risk to groundwater can be utilized for this prioritization. To quantify the resistance of the physical system to pollution, Aquifer Vulnerability is commonly mapped for the area of interest. This information is useful for focusing monitoring efforts and identifying data gaps, but is a relative measure of contaminant risk. To more accurately assess the probability of contamination, an inventory of hazards can be integrated with intrinsic vulnerability of the physical system. This Threat indicator links land-use with chemicals and quantifies the risk based on the toxicity and environmental fate of these substances. Local knowledge of the quantity stored and likelihood of release can be utilized to further assess these threats. Both of these steps form part of an existing frameworks for assessing risk to groundwater. In this study, a groundwater risk framework is developed and tested in two study areas; Pender Island and the Lower Fraser Valley in British Columbia, Canada. Enhancements of a basic groundwater risk framework include not only incorporating points sources such as septic systems, landfills and fuel storage, but also various social determinants of risk. These social determinants include the Resistance of a community, which represents the planning and protection initiatives designed to safeguard the resource. These include items such as land-use planning that consider groundwater vulnerability and best management practices enforced by local governments. The ability to recover following an event is the Capacity of a community; indicators include the presence or absence of spill response plans, treatment systems or an alternative supply of water. The determinant of Loss quantifies the financial impact of this work. This indicator may be altered in future applications to include loss associated with human health and/or that stemming from a reduction in ecosystem health.

Raw material ‘criticality’—sense or nonsense?

NASA Astrophysics Data System (ADS)

Frenzel, M.; Kullik, J.; Reuter, M. A.; Gutzmer, J.

2017-03-01

The past decade has seen a resurgence of interest in the supply security of mineral raw materials. A key to the current debate is the concept of ‘criticality’. The present article reviews the criticality concept, as well as the methodologies used in its assessment, including a critical evaluation of their validity in view of classical risk theory. Furthermore, it discusses a number of risks present in global raw materials markets that are not captured by most criticality assessments. Proposed measures for the alleviation of these risks are also presented. We find that current assessments of raw material criticality are fundamentally flawed in several ways. This is mostly due to a lack of adherence to risk theory, and highly limits their applicability. Many of the raw materials generally identified as critical are probably not critical. Still, the flaws of current assessments do not mean that the general issue of supply security can simply be ignored. Rather, it implies that new assessments are required. While the basic theoretical framework for such assessments is outlined in this review, detailed method development will require a major collaborative effort between different disciplines along the raw materials value chain. In the opinion of the authors, the greatest longer-term challenge in the raw materials sector is to stop, or counteract the effects of, the escalation of unit energy costs of production. This issue is particularly pressing due to its close link with the renewable energy transition, requiring more metal and mineral raw materials per unit energy produced. The solution to this problem will require coordinated policy action, as well as the collaboration of scientists from many different fields—with physics, as well as the materials and earth sciences in the lead.

Youth Participation and Injury Risk in Martial Arts.

PubMed

Demorest, Rebecca A; Koutures, Chris

2016-12-01

The martial arts can provide children and adolescents with vigorous levels of physical exercise that can improve overall physical fitness. The various types of martial arts encompass noncontact basic forms and techniques that may have a lower relative risk of injury. Contact-based sparring with competitive training and bouts have a higher risk of injury. This clinical report describes important techniques and movement patterns in several types of martial arts and reviews frequently reported injuries encountered in each discipline, with focused discussions of higher risk activities. Some of these higher risk activities include blows to the head and choking or submission movements that may cause concussions or significant head injuries. The roles of rule changes, documented benefits of protective equipment, and changes in training recommendations in attempts to reduce injury are critically assessed. This information is intended to help pediatric health care providers counsel patients and families in encouraging safe participation in martial arts. Copyright © 2016 by the American Academy of Pediatrics.

Grip Strength and Its Relationship to Police Recruit Task Performance and Injury Risk: A Retrospective Cohort Study

PubMed Central

Stierli, Michael; Hinton, Benjamin

2017-01-01

Suitable grip strength is a police occupational requirement. The aim of this study was to investigate the association between grip strength, task performance and injury risk in a police population. Retrospective data of police recruits (n = 169) who had undergone basic recruit training were provided, including handgrip strength results, occupational task performance measures (consisting of police task simulations [SIM], tactical options [TACOPS] and marksmanship assessments) and injury records. Left hand grip strength (41.91 ± 8.29 kg) measures showed a stronger correlation than right hand grip strength (42.15 ± 8.53 kg) with all outcome measures. Recruits whose grip strength scores were lower were significantly more susceptible to failing the TACOPS occupational task assessment than those with greater grip strength scores, with significant (p ≤ 0.003) weak to moderate, positive correlations found between grip strength and TACOPS performance. A significant (p < 0.0001) correlation was found between grip strength, most notably of the left hand, and marksmanship performance, with those performing better in marksmanship having higher grip strength. Left hand grip strength was significantly associated with injury risk (r = −0.181, p = 0.018) but right hand grip strength was not. A positive association exists between handgrip strength and police recruit task performance (notably TACOPS and marksmanship) with recruits who scored poorly on grip strength being at greatest risk of occupational assessment task failure. PMID:28825688

Grip Strength and Its Relationship to Police Recruit Task Performance and Injury Risk: A Retrospective Cohort Study.

PubMed

Orr, Robin; Pope, Rodney; Stierli, Michael; Hinton, Benjamin

2017-08-21

Suitable grip strength is a police occupational requirement. The aim of this study was to investigate the association between grip strength, task performance and injury risk in a police population. Retrospective data of police recruits (n = 169) who had undergone basic recruit training were provided, including handgrip strength results, occupational task performance measures (consisting of police task simulations [SIM], tactical options [TACOPS] and marksmanship assessments) and injury records. Left hand grip strength (41.91 ± 8.29 kg) measures showed a stronger correlation than right hand grip strength (42.15 ± 8.53 kg) with all outcome measures. Recruits whose grip strength scores were lower were significantly more susceptible to failing the TACOPS occupational task assessment than those with greater grip strength scores, with significant ( p ≤ 0.003) weak to moderate, positive correlations found between grip strength and TACOPS performance. A significant ( p < 0.0001) correlation was found between grip strength, most notably of the left hand, and marksmanship performance, with those performing better in marksmanship having higher grip strength. Left hand grip strength was significantly associated with injury risk ( r = -0.181, p = 0.018) but right hand grip strength was not. A positive association exists between handgrip strength and police recruit task performance (notably TACOPS and marksmanship) with recruits who scored poorly on grip strength being at greatest risk of occupational assessment task failure.

Towards AN Inventory for Archaeological Heritage Management in Israel

NASA Astrophysics Data System (ADS)

Alef, Y.

2017-08-01

The vast amount of archaeological data and information that is systematically accumulated in the Israel Antiquities Authority database, has not yet been transformed into a tool for heritage management, i.e. accessible knowledge of the sites' cultural significance and risk assessment that is needed to support wise decision making regarding its future. As a response, a pilot project for developing an inventory for the archaeological heritage management was launched. A basic ESRI ArcGIS Online system was developed as a prototype, following the categories recommended in international standards for documentation. Five field surveys implementing the GIS system were conducted to examine different aspects and workflows: ancient synagogues in the Galilee, sites at risk, mosaics in Tel Shiqmona, the ancient settlement of Huqoq and sites included in The National Master Plan for Forests and Afforestation. The pilot project revealed the main gaps in knowledge and the critical faults in the working procedures. In spite of the systems' technological limitations, the results were convincing enough to promote a multidisciplinary discussion about the need for integration of significance and risk assessment in the working processes of the organization.

Comparison of main-shock and aftershock fragility curves developed for New Zealand and US buildings

USGS Publications Warehouse

Uma, S.R.; Ryu, H.; Luco, N.; Liel, A.B.; Raghunandan, M.

2011-01-01

Seismic risk assessment involves the development of fragility functions to express the relationship between ground motion intensity and damage potential. In evaluating the risk associated with the building inventory in a region, it is essential to capture 'actual' characteristics of the buildings and group them so that 'generic building types' can be generated for further analysis of their damage potential. Variations in building characteristics across regions/countries largely influence the resulting fragility functions, such that building models are unsuitable to be adopted for risk assessment in any other region where a different set of building is present. In this paper, for a given building type (represented in terms of height and structural system), typical New Zealand and US building models are considered to illustrate the differences in structural model parameters and their effects on resulting fragility functions for a set of main-shocks and aftershocks. From this study, the general conclusion is that the methodology and assumptions used to derive basic capacity curve parameters have a considerable influence on fragility curves.

Assessing the potential risk of Zika virus epidemics in temperate areas with established Aedes albopictus populations.

PubMed

Guzzetta, Giorgio; Poletti, Piero; Montarsi, Fabrizio; Baldacchino, Frederic; Capelli, Gioia; Rizzoli, Annapaola; Rosà, Roberto; Merler, Stefano

2016-04-14

Based on 2015 abundance of Aedes albopictus in nine northern Italian municipalities with temperate continental/oceanic climate, we estimated the basic reproductive number R0 for Zika virus (ZIKV) to be systematically below the epidemic threshold in most scenarios. Results were sensitive to the value of the probability of mosquito infection after biting a viraemic host. Therefore, further studies are required to improve models and predictions, namely evaluating vector competence and potential non-vector transmissions.

[Ultrasound examination for lower extremity deep vein thrombosis].

PubMed

Toyota, Kosaku

2014-09-01

Surgery is known to be a major risk factor of vein thrombosis. Progression from lower extremity deep vein thrombosis (DVT) to pulmonary embolism can lead to catastrophic outcome, although the incidence ratio is low. The ability to rule in or rule out DVT is becoming essential for anesthesiologists. Non-invasive technique of ultrasonography is a sensitive and specific tool for the assessment of lower extremity DVT. This article introduces the basics and practical methods of ultrasound examination for lower extremity DVT.

Research needs for assessing iodine intake, iodine status, and the effects of maternal iodine supplementation12

PubMed Central

Ershow, Abby G; Coates, Paul M; Swanson, Christine A

2016-01-01

The Office of Dietary Supplements of the NIH convened 3 workshops on iodine nutrition in Rockville, Maryland, in 2014. The purpose of the current article is to summarize and briefly discuss a list of research and resource needs developed with the input of workshop participants. This list is composed of the basic, clinical, translational, and population studies required for characterizing the benefits and risks of iodine supplementation, along with related data, analyses, evaluations, methods development, and supporting activities. Ancillary studies designed to use the participant, biological sample, and data resources of ongoing and completed studies (including those not originally concerned with iodine) may provide an efficient, cost-effective means to address some of these research and resource needs. In the United States, the foremost question is whether neurobehavioral development in the offspring of mildly to moderately iodine-deficient women is improved by maternal iodine supplementation during pregnancy. It is important to identify the benefits and risks of iodine supplementation in all population subgroups so that supplementation can be targeted, if necessary, to avoid increasing the risk of thyroid dysfunction and related adverse health effects in those with high iodine intakes. Ultimately, there will be a need for well-designed trials and other studies to assess the impact of maternal supplementation on neurodevelopmental outcomes in the offspring. However, 2 basic information gaps loom ahead of such a study: the development of robust, valid, and convenient biomarkers of individual iodine status and the identification of infant and toddler neurobehavioral development endpoints that are sensitive to mild maternal iodine deficiency during pregnancy and its reversal by supplementation. PMID:27534640

To what extent can theory account for the findings of road safety evaluation studies?

PubMed

Elvik, Rune

2004-09-01

This paper proposes a conceptual framework that can be used to assess to what extent the findings of road safety evaluation research make sense from a theoretical point of view. The effects of road safety measures are modelled as passing through two causal chains. One of these, termed the engineering effect, refers to the intended effects of a road safety measure on a set of risk factors related to accident occurrence or injury severity. The engineering effect of road safety measures is modelled in terms of nine basic risk factors, one or more of which any road safety measure needs to influence in order to have the intended effect on accidents or injuries. The other causal chain producing the effects of road safety measures is termed the behavioural effect, and refers to road user behavioural adaptations to road safety measures. The behavioural effect is related to the engineering effect, in the sense that certain properties of the engineering effect of a road safety measure influence the likelihood that behavioural adaptation will occur. The behavioural effect of a road safety measure is modelled in terms of six factors that influence the likelihood that behavioural adaptation will occur. The nine basic risk factors representing the engineering effect of a road safety measure, and the six factors influencing the likelihood of behavioural adaptation can be used as checklists in assessing whether or not the findings of road safety evaluation studies make sense from a theoretical point of view. At the current state of knowledge, a more stringent evaluation of the extent to which theory can explain the findings of road safety evaluation studies is, in most cases, not possible. Copyright 2003 Elsevier Ltd.

The VIDA Framework as an Education Tool: Leveraging Volcanology Data for Educational Purposes

NASA Astrophysics Data System (ADS)

Faied, D.; Sanchez, A.

2009-04-01

The VIDA Framework as an Education Tool: Leveraging Volcanology Data for Educational Purposes Dohy Faied, Aurora Sanchez (on behalf of SSP08 VAPOR Project Team) While numerous global initiatives exist to address the potential hazards posed by volcanic eruption events and assess impacts from a civil security viewpoint, there does not yet exist a single, unified, international system of early warning and hazard tracking for eruptions. Numerous gaps exist in the risk reduction cycle, from data collection, to data processing, and finally dissemination of salient information to relevant parties. As part of the 2008 International Space University's Space Studies Program, a detailed gap analysis of the state of volcano disaster risk reduction was undertaken, and this paper presents the principal results. This gap analysis considered current sensor technologies, data processing algorithms, and utilization of data products by various international organizations. Recommendations for strategies to minimize or eliminate certain gaps are also provided. In the effort to address the gaps, a framework evolved at system level. This framework, known as VIDA, is a tool to develop user requirements for civil security in hazardous contexts, and a candidate system concept for a detailed design phase. While the basic intention of VIDA is to support disaster risk reduction efforts, there are several methods of leveraging raw science data to support education across a wide demographic. Basic geophysical data could be used to educate school children about the characteristics of volcanoes, satellite mappings could support informed growth and development of societies in at-risk areas, and raw sensor data could contribute to a wide range of university-level research projects. Satellite maps, basic geophysical data, and raw sensor data are combined and accessible in a way that allows the relationships between these data types to be explored and used in a training environment. Such a resource naturally lends itself to research efforts in the subject but also research in operational tools, system architecture, and human/machine interaction in civil protection or emergency scenarios.

Using the basic reproduction number to assess the effects of climate change in the risk of Chagas disease transmission in Colombia.

PubMed

Cordovez, Juan M; Rendon, Lina Maria; Gonzalez, Camila; Guhl, Felipe

2014-01-01

The dynamics of vector-borne diseases has often been linked to climate change. However the commonly complex dynamics of vector-borne diseases make it very difficult to predict risk based on vector or host distributions. The basic reproduction number (R0) integrates all factors that determine whether a pathogen can establish or not. To obtain R0 for complex vector-borne diseases one can use the next-generation matrix (NGM) approach. We used the NGM to compute R0 for Chagas disease in Colombia incorporating the effect of temperature in some of the transmission routes of Trypanosoma cruzi. We used R0 to generate a risk map of present conditions and a forecast risk map at 20 years from now based on mean annual temperature (data obtained from Worldclim). In addition we used the model to compute elasticity and sensitivity indexes on all model parameters and routes of transmission. We present this work as an approach to indicate which transmission pathways are more critical for disease transmission but acknowledge the fact that results and projections strongly depend on better knowledge of entomological parameters and transmission routes. We concluded that the highest contribution to R0 comes from transmission of the parasites from humans to vectors, which is a surprising result. In addition,parameters related to contacts between human and vectors and the efficiency of parasite transmission between them also show a prominent effect on R0.

Basic life support training into cardiac rehabilitation programs: A chance to give back. A community intervention controlled manikin study.

PubMed

González-Salvado, Violeta; Abelairas-Gómez, Cristian; Peña-Gil, Carlos; Neiro-Rey, Carmen; Barcala-Furelos, Roberto; González-Juanatey, José Ramón; Rodríguez-Núñez, Antonio

2018-03-12

Early basic life support is crucial to enhance survival from out-of-hospital cardiac arrest but rates remain low, especially in households. High-risk groups' training has been advocated, but the optimal method is unclear. The CArdiac REhabilitation and BAsic life Support (CAREBAS) project aims to compare the effectiveness of two basic life support educational strategies implemented in a cardiac rehabilitation program. A community intervention study including consecutive patients enrolled on an exercise-based cardiac rehabilitation program after acute coronary syndrome or revascularization was conducted. A standard basic life support training (G-Stan) and a novel approach integrating cardiopulmonary resuscitation hands-on rolling refreshers (G-CPR) were randomly assigned to each group and compared. Basic life support performance was assessed by means of simulation at baseline, following brief instruction and after the 2-month program. 114 participants were included and 108 completed the final evaluation (G-Stan:58, G-CPR:50). Basic life support performance was equally poor at baseline and significantly improved following a brief instruction. A better skill retention was found after the 2-month program in G-CPR, significantly superior for safety and sending for an automated external defibrillator. Confidence and self-perceived preparation were also significantly greater in G-CPR after the program. Integrating cardiopulmonary resuscitation hands-on rolling refreshers in the training of an exercise-based cardiac rehabilitation program is feasible and improves patients' skill retention and confidence to perform a basic life support sequence, compared to conventional training. Exporting this formula to other programs may result in increased numbers of trained citizens, enhanced social awareness and bystander resuscitation. Copyright © 2018 Elsevier B.V. All rights reserved.

[The Basic-Symptom Concept and its Influence on Current International Research on the Prediction of Psychoses].

PubMed

Schultze-Lutter, F

2016-12-01

The early detection of psychoses has become increasingly relevant in research and clinic. Next to the ultra-high risk (UHR) approach that targets an immediate risk of developing frank psychosis, the basic symptom approach that targets the earliest possible detection of the developing disorder is being increasingly used worldwide. The present review gives an introduction to the development and basic assumptions of the basic symptom concept, summarizes the results of studies on the specificity of basic symptoms for psychoses in different age groups as well as on studies of their psychosis-predictive value, and gives an outlook on future results. Moreover, a brief introduction to first recent imaging studies is given that supports one of the main assumptions of the basic symptom concept, i. e., that basic symptoms are the most immediate phenomenological expression of the cerebral aberrations underlying the development of psychosis. From this, it is concluded that basic symptoms might be able to provide important information on future neurobiological research on the etiopathology of psychoses. © Georg Thieme Verlag KG Stuttgart · New York.

Is basic self-disturbance in ultra-high risk for psychosis ('prodromal') patients associated with borderline personality pathology?

PubMed

Nelson, Barnaby; Thompson, Andrew; Chanen, Andrew M; Amminger, Günther Paul; Yung, Alison R

2013-08-01

Research in the phenomenological tradition suggests that the schizophrenia spectrum is characterized by disturbance of the 'basic' self, whereas borderline personality disorder involves disturbance of the 'narrative' self. The current study investigated this proposal in an ultra-high risk for psychosis sample. The sample consisted of 42 ultra-high-risk participants with a mean age of 19.22 years. Basic self-disturbance was measured using the Examination of Anomalous Self-Experience. Borderline personality pathology was measured using the borderline personality disorder items from the structured clinical interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis II Personality Questionnaire. No correlation was found between the measures of basic self-disturbance and borderline personality pathology. The finding is consistent with the proposal that different (although not mutually exclusive) types of self-disturbance characterize the schizophrenia spectrum and borderline personality disorder. Further research should further examine the question of basic self-disturbance in patients with established borderline personality disorder. © 2013 Wiley Publishing Asia Pty Ltd.

Issues in Basic Skills Assessment and Placement in the California Community Colleges

ERIC Educational Resources Information Center

Academic Senate for California Community Colleges, 2004

2004-01-01

When the Academic Senate for California Community Colleges compiled best practices for serving basic skills students in 2002-2003, assessment practices were notably absent. In this paper, problems with current assessment and placement practices with regards to basic skills are explored. The paper begins with a review of the matriculation process…

Near Earth Asteroid Characteristics for Asteroid Threat Assessment

NASA Technical Reports Server (NTRS)

Dotson, Jessie

2015-01-01

Information about the physical characteristics of Near Earth Asteroids (NEAs) is needed to model behavior during atmospheric entry, to assess the risk of an impact, and to model possible mitigation techniques. The intrinsic properties of interest to entry and mitigation modelers, however, rarely are directly measureable. Instead we measure other properties and infer the intrinsic physical properties, so determining the complete set of characteristics of interest is far from straightforward. In addition, for the majority of NEAs, only the basic measurements exist so often properties must be inferred from statistics of the population of more completely characterized objects. We will provide an assessment of the current state of knowledge about the physical characteristics of importance to asteroid threat assessment. In addition, an ongoing effort to collate NEA characteristics into a readily accessible database for use by the planetary defense community will be discussed.

Comparison of landslide hazard and risk assessment practices in Europe

NASA Astrophysics Data System (ADS)

Corominas, J.; Mavrouli, O.

2012-04-01

An overview is made of the landslide hazard and risk assessment practices that are officially promoted or applied in Europe by administration offices, geological surveys, and decision makers (recommendations, regulations and codes). The reported countries are: Andorra, Austria, France, Italy (selected river basins), Romania, Spain (Catalonia), Switzerland and United Kingdom. The objective here was to compare the different practices for hazard and risk evaluation with respect to the official policies, the methodologies used (qualitative and quantitative), the provided outputs and their contents, and the terminology and map symbols used. The main observations made are illustrated with examples and the possibility of harmonization of the policies and the application of common practices to bridge the existing gaps is discussed. Some of the conclusions reached include the following: zoning maps are legally binding for public administrators and land owners only in some cases and generally when referring to site-specific or local scales rather than regional or national ones; so far, information is mainly provided on landslide susceptibility and hazard and risk assessment is performed only in a few countries; there is a variation in the use of scales between countries; the classification criteria for landslide types and mechanisms present large diversity even within the same country (in some cases no landslide mechanisms are specified while in others there is an exhaustive list); the techniques to obtain input data for the landslide inventory and susceptibility maps vary from basic to sophisticated, resulting in various levels of data quality and quantity; the procedures followed for hazard and risk assessment include analytical procedures supported by computer simulation, weighted-indicators, expert judgment and field survey-based, or a combination of all; there is an important variation between hazard and risk matrices with respect to the used parameters, the thresholds defining the different hazard or risk levels and the number and physical interpretation of the latter. In this context suggestions are made to bridge the gaps between the practices and to enhance homogenization of the hazard and risk assessment procedures and of their outputs. This work is presented within the framework of the SafeLand project funded by the European Commission's FP7 programme.

Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI).

PubMed

Alvarez-Nebreda, Maria Loreto; Bentov, Nathalie; Urman, Richard D; Setia, Sabeena; Huang, Joe Chin-Sun; Pfeifer, Kurt; Bennett, Katherine; Ong, Thuan D; Richman, Deborah; Gollapudi, Divya; Alec Rooke, G; Javedan, Houman

2018-06-01

Frailty is an age-related, multi-dimensional state of decreased physiologic reserve that results in diminished resiliency and increased vulnerability to stressors. It has proven to be an excellent predictor of unfavorable health outcomes in the older surgical population. There is agreement in recommending that a frailty evaluation should be part of the preoperative assessment in the elderly. However, the consensus is still building with regards to how it should affect perioperative care. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in the fields of gerontology, anesthesiology and preoperative assessment to outline practical steps for clinicians to assess and address frailty in elderly patients who require elective intermediate or high risk surgery. These recommendations summarize evidence-based principles of measuring and screening for frailty, as well as basic interventions that can help improve patient outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Tailoring a Human Reliability Analysis to Your Industry Needs

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2016-01-01

Companies at risk of accidents caused by human error that result in catastrophic consequences include: airline industry mishaps, medical malpractice, medication mistakes, aerospace failures, major oil spills, transportation mishaps, power production failures and manufacturing facility incidents. Human Reliability Assessment (HRA) is used to analyze the inherent risk of human behavior or actions introducing errors into the operation of a system or process. These assessments can be used to identify where errors are most likely to arise and the potential risks involved if they do occur. Using the basic concepts of HRA, an evolving group of methodologies are used to meet various industry needs. Determining which methodology or combination of techniques will provide a quality human reliability assessment is a key element to developing effective strategies for understanding and dealing with risks caused by human errors. There are a number of concerns and difficulties in "tailoring" a Human Reliability Assessment (HRA) for different industries. Although a variety of HRA methodologies are available to analyze human error events, determining the most appropriate tools to provide the most useful results can depend on industry specific cultures and requirements. Methodology selection may be based on a variety of factors that include: 1) how people act and react in different industries, 2) expectations based on industry standards, 3) factors that influence how the human errors could occur such as tasks, tools, environment, workplace, support, training and procedure, 4) type and availability of data, 5) how the industry views risk & reliability, and 6) types of emergencies, contingencies and routine tasks. Other considerations for methodology selection should be based on what information is needed from the assessment. If the principal concern is determination of the primary risk factors contributing to the potential human error, a more detailed analysis method may be employed versus a requirement to provide a numerical value as part of a probabilistic risk assessment. Industries involved with humans operating large equipment or transport systems (ex. railroads or airlines) would have more need to address the man machine interface than medical workers administering medications. Human error occurs in every industry; in most cases the consequences are relatively benign and occasionally beneficial. In cases where the results can have disastrous consequences, the use of Human Reliability techniques to identify and classify the risk of human errors allows a company more opportunities to mitigate or eliminate these types of risks and prevent costly tragedies.

Predicting Risk-Taking Behavior from Prefrontal Resting-State Activity and Personality

PubMed Central

Studer, Bettina; Pedroni, Andreas; Rieskamp, Jörg

2013-01-01

Risk-taking is subject to considerable individual differences. In the current study, we tested whether resting-state activity in the prefrontal cortex and trait sensitivity to reward and punishment can help predict risk-taking behavior. Prefrontal activity at rest was assessed in seventy healthy volunteers using electroencephalography, and compared to their choice behavior on an economic risk-taking task. The Behavioral Inhibition System/Behavioral Activation System scale was used to measure participants’ trait sensitivity to reward and punishment. Our results confirmed both prefrontal resting-state activity and personality traits as sources of individual differences in risk-taking behavior. Right-left asymmetry in prefrontal activity and scores on the Behavioral Inhibition System scale, reflecting trait sensitivity to punishment, were correlated with the level of risk-taking on the task. We further discovered that scores on the Behavioral Inhibition System scale modulated the relationship between asymmetry in prefrontal resting-state activity and risk-taking. The results of this study demonstrate that heterogeneity in risk-taking behavior can be traced back to differences in the basic physiology of decision-makers’ brains, and suggest that baseline prefrontal activity and personality traits might interplay in guiding risk-taking behavior. PMID:24116176

Barriers to management of cardiovascular risk in a low-resource setting using hypertension as an entry point.

PubMed

Mendis, Shanthi; Abegunde, Dele; Oladapo, Olulola; Celletti, Francesca; Nordet, Porfirio

2004-01-01

Assess capacity of health-care facilities in a low-resource setting to implement the absolute risk approach for assessment of cardiovascular risk in hypertensive patients and effective management of hypertension. A descriptive cross-sectional study in Egbeda and Oluyole local government areas of Oyo State in Nigeria in 56 randomly selected primary- (n = 42) and secondary-level (n = 2) health-care and private health-care (n = 12) facilities. One thousand consecutive, known hypertensives attending the selected facilities for follow-up, and health-care providers working in the above randomly selected facilities, were interviewed. About two-thirds of hypertensives utilized primary-care centers both for diagnosis and for follow-up. Laboratory and other investigations to exclude secondary hypertension or to assess target organ damage were not available in the majority of facilities, particularly in primary care. A considerable knowledge and awareness gap related to hypertension and its complications was found, both among patients and health-care providers. Blood pressure control rates were poor (28% with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg] and drug prescription patterns were not evidence based and cost effective. The majority of patients (73%) in this low socio-economic group (mean monthly income 73 US dollars) had to pay fully, out of their own pocket, for consultations and medications. If the absolute risk approach for assessment of risk and effective management of hypertension is to be implemented in low-resource settings, appropriate policy measures need to be taken to improve the competency of health-care providers, to provide basic laboratory facilities and to develop affordable financing mechanisms.

Interpersonal-psychological theory and parental bonding predict suicidal ideation among soldiers in Taiwan.

PubMed

Huang, Kai-Cheng; Tzeng, Dong-Sheng; Lin, Chi-Hung; Chung, Wei-Ching

2017-03-01

Suicide is an important issue among military personnel, who have higher suicide rates compared with the general population. The interpersonal-psychological theory of suicide (IPTS) might provide an empirical explanation of this phenomenon, and parental bonding influences social adjustment and suicide. To investigate the relevance of IPTS and parental bonding for suicide among Taiwanese soldiers, a case-control study was conducted. Using a suicide-reporting system in a teaching general hospital in Southern Taiwan, 226 at-risk maladjusted soldiers and 229 well-adjusted controls were enrolled. We collected basic information, and participants answered four IPTS-based questions. Suicide risk was assessed using the Brief Symptom Rating Scale item 6. A four-factor model of the Parental Bonding Instrument assessed parental bonding. All participants were interviewed using the Mini International Neuropsychiatric Interview for primary screening and to recheck the accuracy of the Brief Symptom Rating Scale item 6 score. A parsimonious model obtained by regression analysis of risk factors indicated that poor academic performance, conduct-related issues in childhood, and exposure to life-threatening situations are risk factors for suicide intention. Maladjusted suicidal soldiers showed a sense of thwarted belongingness (β = 0.145; P < 0.001), higher perceived burdensomeness (β = 0.311; P < 0.001), less fear of death (β = 0.124; P < 0.05), lower paternal autonomy (β = -0.122; P < 0.05), and higher maternal indifference (β = 0.162; P < 0.0001). Interpersonal-psychological theory of suicide, accompanied by an assessment of parental bonding, could be used for assessing suicide risk and preventing suicide attempts. © 2016 John Wiley & Sons Australia, Ltd.

Towards a Proactive Risk Mitigation Strategy at La Fossa Volcano, Vulcano Island

NASA Astrophysics Data System (ADS)

Biass, S.; Gregg, C. E.; Frischknecht, C.; Falcone, J. L.; Lestuzzi, P.; di Traglia, F.; Rosi, M.; Bonadonna, C.

2014-12-01

A comprehensive risk assessment framework was built to develop proactive risk reduction measures for Vulcano Island, Italy. This framework includes identification of eruption scenarios; probabilistic hazard assessment, quantification of hazard impacts on the built environment, accessibility assessment on the island and risk perception study. Vulcano, a 21 km2 island with two primary communities host to 900 permanent residents and up to 10,000 visitors during summer, shows a strong dependency on the mainland for basic needs (water, energy) and relies on a ~2 month tourism season for its economy. The recent stratigraphy reveals a dominance of vulcanian and subplinian eruptions, producing a range of hazards acting at different time scales. We developed new methods to probabilistically quantify the hazard related to ballistics, lahars and tephra for all eruption styles. We also elaborated field- and GIS- based methods to assess the physical vulnerability of the built environment and created dynamic models of accessibility. Results outline the difference of hazard between short and long-lasting eruptions. A subplinian eruption has a 50% probability of impacting ~30% of the buildings within days after the eruption, but the year-long damage resulting from a long-lasting vulcanian eruption is similar if tephra is not removed from rooftops. Similarly, a subplinian eruption results in a volume of 7x105 m3 of material potentially remobilized into lahars soon after the eruption. Similar volumes are expected for a vulcanian activity over years, increasing the hazard of small lahars. Preferential lahar paths affect critical infrastructures lacking redundancy, such as the road network, communications systems, the island's only gas station, and access to the island's two evacuation ports. Such results from hazard, physical and systemic vulnerability help establish proactive volcanic risk mitigation strategies and may be applicable in other island settings.

Evaluation of environmental aspects significance in ISO 14001.

PubMed

Põder, Tõnis

2006-05-01

The methodological framework set by standards ISO 14001 and ISO 14004 gives only general principles for environmental aspects assessment, which is regarded as one of the most critical stages of implementing environmental management system. In Estonia, about 100 organizations have been certified to the ISO 14001. Experience obtained from numerous companies has demonstrated that limited transparency and reproducibility of the assessment process serves as a common shortcoming. Despite rather complicated assessment schemes sometimes used, the evaluation procedures have been largely based on subjective judgments because of ill-defined and inadequate assessment criteria. A comparison with some similar studies in other countries indicates a general nature of observed inconsistencies. The diversity of approaches to the aspects' assessment in concept literature and to the related problems has been discussed. The general structure of basic assessment criteria, compatible with environmental impact assessment and environmental risk analysis has also been outlined. Based on this general structure, the article presents a tiered approach to help organize the assessment in a more consistent manner.

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study

PubMed Central

Song, Jing; Semanik, Pamela A; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Chang, Rowland W

2014-01-01

Objective To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression. Design Prospective multisite cohort study from September 2008 to December 2012. Setting Baltimore, Maryland; Columbus, Ohio; Pittsburgh, Pennsylvania; and Pawtucket, Rhode Island, USA. Participants Disability onset cohort of 1680 community dwelling adults aged 49 years or older with knee osteoarthritis or risk factors for knee osteoarthritis; the disability progression cohort included 1814 adults. Main outcome measures Physical activity was measured by accelerometer monitoring. Disability was ascertained from limitations in instrumental and basic activities of daily living at baseline and two years. The primary outcome was incident disability. The secondary outcome was progression of disability defined by a more severe level (no limitations, limitations to instrumental activities only, 1-2 basic activities, or ≥3 basic activities) at two years compared with baseline. Results Greater time spent in light intensity activities had a significant inverse association with incident disability. Less incident disability and less disability progression were each significantly related to increasing quartile categories of daily time spent in light intensity physical activities (hazard ratios for disability onset 1.00, 0.62, 0.47, and 0.58, P for trend=0.007; hazard ratios for progression 1.00, 0.59, 0.50, and 0.53, P for trend=0.003) with control for socioeconomic factors (age, sex, race/ethnicity, education, income) and health factors (comorbidities, depressive symptoms, obesity, smoking, lower extremity pain and function, and knee assessments: osteoarthritis severity, pain, symptoms, prior injury). This finding was independent of time spent in moderate-vigorous activities. Conclusion These prospective data showed an association between greater daily time spent in light intensity physical activities and reduced risk of onset and progression of disability in adults with osteoarthritis of the knee or risk factors for knee osteoarthritis. An increase in daily physical activity time may reduce the risk of disability, even if the intensity of that additional activity is not increased. PMID:24782514

Probabilistic modeling of the fate of Listeria monocytogenes in diced bacon during the manufacturing process.

PubMed

Billoir, Elise; Denis, Jean-Baptiste; Cammeau, Natalie; Cornu, Marie; Zuliani, Veronique

2011-02-01

To assess the impact of the manufacturing process on the fate of Listeria monocytogenes, we built a generic probabilistic model intended to simulate the successive steps in the process. Contamination evolution was modeled in the appropriate units (breasts, dice, and then packaging units through the successive steps in the process). To calibrate the model, parameter values were estimated from industrial data, from the literature, and based on expert opinion. By means of simulations, the model was explored using a baseline calibration and alternative scenarios, in order to assess the impact of changes in the process and of accidental events. The results are reported as contamination distributions and as the probability that the product will be acceptable with regards to the European regulatory safety criterion. Our results are consistent with data provided by industrial partners and highlight that tumbling is a key step for the distribution of the contamination at the end of the process. Process chain models could provide an important added value for risk assessment models that basically consider only the outputs of the process in their risk mitigation strategies. Moreover, a model calibrated to correspond to a specific plant could be used to optimize surveillance. © 2010 Society for Risk Analysis.

Spatial characterization, risk assessment, and statistical source identification of the dissolved trace elements in the Ganjiang River-feeding tributary of the Poyang Lake, China.

PubMed

Zhang, Hua; Jiang, Yinghui; Wang, Min; Wang, Peng; Shi, Guangxun; Ding, Mingjun

2017-01-01

Surface water samples were collected from 20 sampling sites throughout the Ganjiang River during pre-monsoon, monsoon, and post-monsoon seasons, and the concentrations of dissolved trace elements were determined by inductively coupled plasma-mass spectrometry (ICP-MS) for the spatial and seasonal variations, risk assessment, source identification, and categorization for risk area. The result demonstrated that concentrations of the elements exhibited significant seasonality. The high total element concentrations were detected at sites close to the intensive mining and urban activities. The concentrations of the elements were under the permissible limits as prescribed by related standards with a few exceptions. The most of heavy metal pollution index (HPI) values were lower than the critical index limit, indicating the basically clean water used as habitat for aquatic life. As was identified as the priority pollutant of non-carcinogenic and carcinogenic concerns, and the inhabitants ingesting the surface water at particular site might be subjected to the integrated health risks for exposure to the mixed trace elements. Multivariate statistical analyses confirmed that Zn, As, Cd, and Tl were derived from mining and urban activities; V, Cd, and Pb exhibited mixed origin; and Co, Ni, and Cu mainly resulted from natural processes. Three categorized risk areas corresponded to high, moderate, and low risks, respectively. As a whole, the upstream of the Ganjiang River was identified as the high-risk area relatively.

Results for Learning Report 2014-15: Basic Education at Risk

ERIC Educational Resources Information Center

Bernard, Jean-Marc; Amelewonou, Kokou; Bonnet, Gabrielle; Rubiano-Matulevich, Eliana; Soman, Kouassi; Sonnenberg, Krystyna

2014-01-01

The 2014/2015 Results for Learning Report: Basic Education at Risk examines the progress achieved by Global Partnership for Education (GPE) partner developing countries over the period 2008-2012. Universal primary education has never been so close, yet there are still 58 million children of primary school age who do not go to school around the…

Aligning CASAS Competencies and Assessments to Basic Skills Content Standards. Second Edition

ERIC Educational Resources Information Center

CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2009

2009-01-01

Since its inception, the Comprehensive Adult Student Assessment System (CASAS) has focused on teaching and assessing basic skills in contexts that are relevant and important to adult learners. CASAS has developed and continues to refine a highly formalized hierarchy of competencies, the application of basic skills that adults need to be fully…

Assessment, Referral and Placement Kit for Adult Literacy & Basic Education Programs in Victoria.

ERIC Educational Resources Information Center

Purdey, Margaret

This kit is an aid to the assessment, referral, placement, and recognition of achievement of adult literacy and basic education students across Victoria (Australia). It is designed as a guide to the integration of current assessment with new placement processes within the context of the new Adult Basic Education Accreditation Framework and the…

Substance Abuse Prevention, Assessment, and Treatment for Lesbian, Gay, Bisexual, and Transgender Youth.

PubMed

Aromin, Romulo Alcalde

2016-12-01

Knowing how to manage substance abuse in all youth is an important aspect of pediatric care, including providing clinically appropriate anticipatory guidance, monitoring, assessment, and treatment. Although most lesbian, gay, bisexual, and transgender (LGBT) youth do not abuse substances, as a group they experience unique challenges in self-identity development that put them at an increased risk for substance abuse. This article addresses prevention and management of substance use in LGBT youth relevant to pediatrics and allied professions as an aspect of their overall health care. It reviews basic information about substance abuse in youth and special considerations for LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessing performance of feedlot operations using epidemiology.

PubMed

Corbin, Marilyn J; Griffin, Dee

2006-03-01

The progressive feedlot veterinarian must be well versed not only in individual production animal medicine, but also in population-based medicine. Feedlot health programs must be goal oriented, and evaluation of these goals is accomplished through diligent use of record systems and analytic evaluation of these record systems. Basic feedlot monitoring parameters include health and economic parameters in addition to the use of bench marking parameters between and among feed yards. When these parameters have significant changes, steps should be initiated to begin field investigations. Feedlot epidemiology uses several novel applications such as partial budgeting, risk assessment, and packing plant audits to provide scientifically sound and economically feasible solutions for the feeding industry.

A rubber-covered ceramic weapon reduces the incidence of dental trauma in recruits during combat basic training.

PubMed

Becker, Talia; Ashkenazi, Malka

2011-10-01

The effect of a rubber-covered ceramic weapon was assessed on the incidence of dental trauma during basic training, since soldiers are more at risk of impact from a personal weapon. Dental files of soldiers (n = 4,542), who completed 8 months of training during 2008, were analyzed for incidence and type of dental trauma from a personal weapon. A rubber-covered ceramic weapon (n = 2,972) or a conventional one (n = 1,570, control) was used. Dental trauma was 0.4% per 8 months (0.6% per year) from the ceramic weapon and 1.5% per 8 months (2.3% per year) from the conventional one (p<0.001). The most prevalent type of injury was a simple/noncomplicated crown fracture (82% in study group, 75% in control group). The ceramic weapon significantly reduced dental trauma by diminishing the impact while in direct contact with the teeth or by absorbing and/or distributing the impact force. In conclusion, when possible a rubber-covered ceramic weapon should be preferred for basic combat training.

What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions.

PubMed

Enzo, Aya; Okita, Taketoshi; Asai, Atsushi

2018-05-29

The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.

Introduction of a new laboratory test: an econometric approach with the use of neural network analysis.

PubMed

Jabor, A; Vlk, T; Boril, P

1996-04-15

We designed a simulation model for the assessment of the financial risks involved when a new diagnostic test is introduced in the laboratory. The model is based on a neural network consisting of ten neurons and assumes that input entities can have assigned appropriate uncertainty. Simulations are done on a 1-day interval basis. Risk analysis completes the model and the financial effects are evaluated for a selected time period. The basic output of the simulation consists of total expenses and income during the simulation time, net present value of the project at the end of simulation, total number of control samples during simulation, total number of patients evaluated and total number of used kits.

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network.

PubMed

Aggarwal, Brooke; Makarem, Nour; Shah, Riddhi; Emin, Memet; Wei, Ying; St-Onge, Marie-Pierre; Jelic, Sanja

2018-06-09

Insufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women. Women who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20-79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow-mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow-mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders ( P =0.04 and P =0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6; P =0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6; P =0.002 and β=8.26; P =0.02, respectively). No evidence was found for an association between sleep and flow-mediated dilation. These findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02835261. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Phase-Angle Dependence of Determinations of Diameter, Albedo, and Taxonomy: A Case Study of NEO 3691 Bede

NASA Technical Reports Server (NTRS)

Wooden, Diane H.; Lederer, Susan M.; Jehin, Emmanuel; Howell, Ellen S.; Fernandez, Yan; Harker, David E.; Ryan, Erin; Lovell, Amy; Woodward, Charles E.; Benner, Lance A.

2015-01-01

Parameters important for NEO risk assessment and mitigation include Near-Earth Object diameter and taxonomic classification, which translates to surface composition. Diameters of NEOs are derived from the thermal fluxes measured by WISE, NEOWISE, Spitzer Warm Mission and ground-based telescopes including the IRTF and UKIRT. Diameter and its coupled parameters Albedo and IR beaming parameter (a proxy for thermal inertia and/or surface roughness) are dependent upon the phase angle, which is the Sun-target-observer angle. Orbit geometries of NEOs, however, typically provide for observations at phase angles greater than 20 degrees. At higher phase angles, the observed thermal emission is sampling both the day and night sides of the NEO. We compare thermal models for NEOs that exclude (NEATM) and include (NESTM) night-side emission. We present a case study of NEO 3691 Bede, which is a higher albedo object, X (Ec) or Cgh taxonomy, to highlight the range of H magnitudes for this object (depending on the albedo and phase function slope parameter G), and to examine at different phase angles the taxonomy and thermal model fits for this NEO. Observations of 3691 Bede include our observations with IRTF+SpeX and with the 10 micrometer UKIRT+Michelle instrument, as well as WISE and Spitzer Warm mission data. By examining 3691 Bede as a case study, we highlight the interplay between the derivation of basic physical parameters and observing geometry, and we discuss the uncertainties in H magnitude, taxonomy assignment amongst the X-class (P, M, E), and diameter determinations. Systematic dependencies in the derivation of basic characterization parameters of H-magnitude, diameter, albedo and taxonomy with observing geometry are important to understand. These basic characterization parameters affect the statistical assessments of the NEO population, which in turn, affects the assignment of statistically-assessed basic parameters to discovered but yet-to-be-fully-characterized NEOs.

Risk analysis for biological hazards: What we need to know about invasive species

USGS Publications Warehouse

Stohlgren, T.J.; Schnase, J.L.

2006-01-01

Risk analysis for biological invasions is similar to other types of natural and human hazards. For example, risk analysis for chemical spills requires the evaluation of basic information on where a spill occurs; exposure level and toxicity of the chemical agent; knowledge of the physical processes involved in its rate and direction of spread; and potential impacts to the environment, economy, and human health relative to containment costs. Unlike typical chemical spills, biological invasions can have long lag times from introduction and establishment to successful invasion, they reproduce, and they can spread rapidly by physical and biological processes. We use a risk analysis framework to suggest a general strategy for risk analysis for invasive species and invaded habitats. It requires: (1) problem formation (scoping the problem, defining assessment endpoints); (2) analysis (information on species traits, matching species traits to suitable habitats, estimating exposure, surveys of current distribution and abundance); (3) risk characterization (understanding of data completeness, estimates of the “potential” distribution and abundance; estimates of the potential rate of spread; and probable risks, impacts, and costs); and (4) risk management (containment potential, costs, and opportunity costs; legal mandates and social considerations and information science and technology needs).

Chemical facility vulnerability assessment project.

PubMed

Jaeger, Calvin D

2003-11-14

Sandia National Laboratories, under the direction of the Office of Science and Technology, National Institute of Justice, conducted the chemical facility vulnerability assessment (CFVA) project. The primary objective of this project was to develop, test and validate a vulnerability assessment methodology (VAM) for determining the security of chemical facilities against terrorist or criminal attacks (VAM-CF). The project also included a report to the Department of Justice for Congress that in addition to describing the VAM-CF also addressed general observations related to security practices, threats and risks at chemical facilities and chemical transport. In the development of the VAM-CF Sandia leveraged the experience gained from the use and development of VAs in other areas and the input from the chemical industry and Federal agencies. The VAM-CF is a systematic, risk-based approach where risk is a function of the severity of consequences of an undesired event, the attack potential, and the likelihood of adversary success in causing the undesired event. For the purpose of the VAM-CF analyses Risk is a function of S, L(A), and L(AS), where S is the severity of consequence of an event, L(A) is the attack potential and L(AS) likelihood of adversary success in causing a catastrophic event. The VAM-CF consists of 13 basic steps. It involves an initial screening step, which helps to identify and prioritize facilities for further analysis. This step is similar to the prioritization approach developed by the American Chemistry Council (ACC). Other steps help to determine the components of the risk equation and ultimately the risk. The VAM-CF process involves identifying the hazardous chemicals and processes at a chemical facility. It helps chemical facilities to focus their attention on the most critical areas. The VAM-CF is not a quantitative analysis but, rather, compares relative security risks. If the risks are deemed too high, recommendations are developed for measures to reduce the risk. This paper will briefly discuss the CFVA project and VAM-CF process.

Combination antiretroviral therapy and cancer risk.

PubMed

Borges, Álvaro H

2017-01-01

To review the newest research about the effects of combination antiretroviral therapy (cART) on cancer risk. HIV+ persons are at increased risk of cancer. As this risk is higher for malignancies driven by viral and bacterial coinfections, classifying malignancies into infection-related and infection-unrelated has been an emerging trend. Cohorts have detected major reductions in the incidence of Kaposi sarcoma and non-Hodgkin lymphoma (NHL) following cART initiation among immunosuppressed HIV+ persons. However, recent randomized data indicate that cART reduces risk of Kaposi sarcoma and NHL also during early HIV infection before overt immunosuppression occurs. Long-term effects of cART exposure on cancer risk are not well defined; according to basic and epidemiological research, there might be specific associations of each cART class with distinct patterns of cancer risk. The relationship between cART exposure and cancer risk is complex and nuanced. It is an intriguing fact that, whether initiated during severe immunosuppression or not, cART reduces risk of Kaposi sarcoma and NHL. Further research should identify mediators of the benefit of immediate cART initiation in reducing cancer risk, understand the relationship between long-term cART exposure and cancer incidence and assess whether adjuvant anti-inflammatory therapies can reduce cancer risk during treated HIV infection.

Planning & Priority Setting for Basic Research

DTIC Science & Technology

2010-05-05

Integrated into numerous commercial codes in aerospace, automotive , semiconductor, and chemical industries Fast Multipole Methods (ONR 31) Applications... Use knowledge (even failures) to reduce risk in acquisition Provide the basis for future Navy and arine Corps syste s Ensure research...relevancy to Naval S&T strategy Transition pro ising Basic Research to applications Use kno ledge (even failures) to reduce risk in acquisition Maintain

[Functional deterioration of basic daily living activities after an emergency service consultation].

PubMed

Gutiérrez Rodríguez, J; Varela Suárez, C; Alonso Alvarez, M; Solano Jaurrieta, J J

2000-05-01

To determine the incidence of functional decline of elderly patients discharged from an emergency department and to analized functional impairment as a risk of readmission. A prospective cohort aged 75 or older were followed up after discharge from an emergency department between 01-02-95 and 01-04-95. The study protocol included sociodemografics, clinicals, functionals and mentalsoutcomes. We studied the incidence of functional decline in basic activities of daily living, with Barthel Index, and association with the risk of readmission. The sample was composed by 125 elders (mean aged 81.9 +/- 4.6 years and 60.8% were women). The incidence of functional decline in basic activities of daily living at the visit to emergency department was 20.8% and one moth after discharge was 18.4%. Both activities with more functional impairment were bathing, dressing and movility activities. Functional decline was associated with the risk of readmission at emergency department (Odds Ratio = 4.1 [1.4-11.8]) 20% of patients who are discharged of emergency department present a new functional impairment in basics activities of daily living. Functional decline is associated with the risk of readmission one moth after discharged.

Fault and event tree analyses for process systems risk analysis: uncertainty handling formulations.

PubMed

Ferdous, Refaul; Khan, Faisal; Sadiq, Rehan; Amyotte, Paul; Veitch, Brian

2011-01-01

Quantitative risk analysis (QRA) is a systematic approach for evaluating likelihood, consequences, and risk of adverse events. QRA based on event (ETA) and fault tree analyses (FTA) employs two basic assumptions. The first assumption is related to likelihood values of input events, and the second assumption is regarding interdependence among the events (for ETA) or basic events (for FTA). Traditionally, FTA and ETA both use crisp probabilities; however, to deal with uncertainties, the probability distributions of input event likelihoods are assumed. These probability distributions are often hard to come by and even if available, they are subject to incompleteness (partial ignorance) and imprecision. Furthermore, both FTA and ETA assume that events (or basic events) are independent. In practice, these two assumptions are often unrealistic. This article focuses on handling uncertainty in a QRA framework of a process system. Fuzzy set theory and evidence theory are used to describe the uncertainties in the input event likelihoods. A method based on a dependency coefficient is used to express interdependencies of events (or basic events) in ETA and FTA. To demonstrate the approach, two case studies are discussed. © 2010 Society for Risk Analysis.

Unmet basic needs and health intervention effectiveness in low-income populations.

PubMed

Kreuter, Matthew W; McQueen, Amy; Boyum, Sonia; Fu, Qiang

2016-10-01

In the face of unmet basic needs, low SES adults are less likely to obtain needed preventive health services. The study objective was to understand how these hardships may cluster and how the effectiveness of different health-focused interventions might vary across vulnerable population sub-groups with different basic needs profiles. From June 2010-2012, a random sample of low-income adult callers to Missouri 2-1-1 completed a cancer risk assessment and received up to 3 health referrals for needed services (mammography, pap testing, colonoscopy, HPV vaccination, smoking cessation and smoke-free home policies). Participants received either a verbal referral only (N=365), verbal referral+tailored print reminder (N=372), or verbal referral+navigator (N=353). Participants reported their unmet basic needs at baseline and contacts with health referrals at 1-month post-intervention. We examined latent classes of unmet basic needs using SAS. Logistic regression examined the association between latent classes and contacting a health referral, by intervention condition. A 3 class solution best fit the data. For participants with relatively more unmet needs (C2) and those with money needs (C3), the navigator intervention was more effective than the tailored or verbal referral only conditions in leading to health referrals contacts. For participants with fewer unmet basic needs (C1), the tailored intervention was as effective as the navigator intervention. The distribution and nature of unmet basic needs in this sample of low-income adults was heterogeneous, and those with the greatest needs benefitted most from a more intensive navigator intervention in helping them seek needed preventive health services. Copyright © 2016 Elsevier Inc. All rights reserved.

Cardiometabolic risk in US Army recruits and the effects of basic combat training.

PubMed

Pasiakos, Stefan M; Karl, J Philip; Lutz, Laura J; Murphy, Nancy E; Margolis, Lee M; Rood, Jennifer C; Cable, Sonya J; Williams, Kelly W; Young, Andrew J; McClung, James P

2012-01-01

Cardiometabolic disease risk in US military recruits and the effects of military training have not been determined. This study examined lifestyle factors and biomarkers associated with cardiometabolic risk in US Army recruits (209; 118 male, 91 female, 23 ± 5 yr) before, during, and after basic combat training (BCT). Anthropometrics; fasting total (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol; triglycerides (TG); glucose; and insulin were measured at baseline and every 3 wks during the 10 wk BCT course. At baseline, 14% of recruits were obese (BMI>30 kg/m(2)), 27% were cigarette smokers, 37% were sedentary, and 34% reported a family history of cardiometabolic disease. TC was above recommended levels in 8%, LDL in 39%, TG in 5%, and glucose in 8% of recruits, and HDL was below recommended levels in 33% of recruits at baseline. By week 9, TC decreased 8%, LDL 10%, TG 13%, glucose 6% and homeostasis model assessment of insulin resistance (HOMA-IR) 40% in men (P<0.05). In women, TC, LDL, glucose and HOMA-IR were decreased from baseline at weeks 3 and 6 (P<0.05), but were not different from baseline levels at week 9. During BCT, body weight declined in men but not women, while body fat percentage declined in both men and women (P<0.05). At the start of military service, the prevalence of cardiometabolic risk in US military recruits is comparable to that reported in similar, college-aged populations. Military training appears to be an effective strategy that may mitigate risk in young people through improvements in lipid profiles and glycemic control.

Cardiometabolic Risk in US Army Recruits and the Effects of Basic Combat Training

PubMed Central

Lutz, Laura J.; Murphy, Nancy E.; Margolis, Lee M.; Rood, Jennifer C.; Cable, Sonya J.; Williams, Kelly W.; Young, Andrew J.; McClung, James P.

2012-01-01

Background Cardiometabolic disease risk in US military recruits and the effects of military training have not been determined. This study examined lifestyle factors and biomarkers associated with cardiometabolic risk in US Army recruits (209; 118 male, 91 female, 23±5 yr) before, during, and after basic combat training (BCT). Methodology/Principal Findings Anthropometrics; fasting total (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol; triglycerides (TG); glucose; and insulin were measured at baseline and every 3 wks during the 10 wk BCT course. At baseline, 14% of recruits were obese (BMI>30 kg/m2), 27% were cigarette smokers, 37% were sedentary, and 34% reported a family history of cardiometabolic disease. TC was above recommended levels in 8%, LDL in 39%, TG in 5%, and glucose in 8% of recruits, and HDL was below recommended levels in 33% of recruits at baseline. By week 9, TC decreased 8%, LDL 10%, TG 13%, glucose 6% and homeostasis model assessment of insulin resistance (HOMA-IR) 40% in men (P<0.05). In women, TC, LDL, glucose and HOMA-IR were decreased from baseline at weeks 3 and 6 (P<0.05), but were not different from baseline levels at week 9. During BCT, body weight declined in men but not women, while body fat percentage declined in both men and women (P<0.05). Conclusions/Significance At the start of military service, the prevalence of cardiometabolic risk in US military recruits is comparable to that reported in similar, college-aged populations. Military training appears to be an effective strategy that may mitigate risk in young people through improvements in lipid profiles and glycemic control. PMID:22384004

Uncertainty Modeling of Pollutant Transport in Atmosphere and Aquatic Route Using Soft Computing

NASA Astrophysics Data System (ADS)

Datta, D.

2010-10-01

Hazardous radionuclides are released as pollutants in the atmospheric and aquatic environment (ATAQE) during the normal operation of nuclear power plants. Atmospheric and aquatic dispersion models are routinely used to assess the impact of release of radionuclide from any nuclear facility or hazardous chemicals from any chemical plant on the ATAQE. Effect of the exposure from the hazardous nuclides or chemicals is measured in terms of risk. Uncertainty modeling is an integral part of the risk assessment. The paper focuses the uncertainty modeling of the pollutant transport in atmospheric and aquatic environment using soft computing. Soft computing is addressed due to the lack of information on the parameters that represent the corresponding models. Soft-computing in this domain basically addresses the usage of fuzzy set theory to explore the uncertainty of the model parameters and such type of uncertainty is called as epistemic uncertainty. Each uncertain input parameters of the model is described by a triangular membership function.

Development and assessment of healthy properties of meat and meat products designed as functional foods.

PubMed

Olmedilla-Alonso, Begoña; Jiménez-Colmenero, Francisco; Sánchez-Muniz, Francisco J

2013-12-01

This review deals with the two major aspects to be considered in the context of meat-based functional foods and human health. One involves the different strategies used to improve (increase or reduce) the presence of bioactive (healthy and unhealthy) compounds in meat and meat products in order to develop potential meat-based functional foods; these strategies are basically concerned with animal production practices, meat processing and storage, distribution and consumption conditions. Since the link between the consumption of those foods and their potentially beneficial effects (improving health and/or reducing the risk of several chronic diseases) needs to be demonstrated scientifically, the second aspect considered is related to intervention studies to examine the functional capacity of meat-based potentially functional foods in humans, discussing how the functionality of a food can be assessed in terms of its effects on health in relation to both target body functions and risk factors. Copyright © 2013 Elsevier Ltd. All rights reserved.

The spread of pathogens through trade in wildlife.

PubMed

Travis, D A; Watson, R P; Tauer, A

2011-04-01

Discussions on diseases of wildlife have generally focused on two basic models: the effect of disease on wildlife, and the role that wildlife plays in diseases affecting people or domestic animal health, welfare, economics and trade. Traditionally, wildlife professionals and conservationists have focused on the former, while most human/animal health specialists have been concerned largely with the latter. Lately, the (re-)emergence of many high-profile infectious diseases in a world with ever-increasing globalisation has led to a more holistic approach in the assessment and mitigation of health risks involving wildlife (with a concurrent expansion of literature). In this paper, the authors review the role of wildlife in the ecology of infectious disease, the staggering magnitude of the movement of wild animals and products across international borders in trade, the pathways by which they move, and the growing body of risk assessments from a multitude of disciplines. Finally, they highlight existing recommendations and offer solutions for a collaborative way forward.

Evaluation of volcanic risk management in Merapi and Bromo Volcanoes

NASA Astrophysics Data System (ADS)

Bachri, S.; Stöetter, J.; Sartohadi, J.; Setiawan, M. A.

2012-04-01

Merapi (Central Java Province) and Bromo (East Java Province) volcanoes have human-environmental systems with unique characteristics, thus causing specific consequences on their risk management. Various efforts have been carried out by many parties (institutional government, scientists, and non-governmental organizations) to reduce the risk in these areas. However, it is likely that most of the actions have been done for temporary and partial purposes, leading to overlapping work and finally to a non-integrated scheme of volcanic risk management. This study, therefore, aims to identify and evaluate actions of risk and disaster reduction in Merapi and Bromo Volcanoes. To achieve this aims, a thorough literature review was carried out to identify earlier studies in both areas. Afterward, the basic concept of risk management cycle, consisting of risk assessment, risk reduction, event management and regeneration, is used to map those earlier studies and already implemented risk management actions in Merapi and Bromo. The results show that risk studies in Merapi have been developed predominantly on physical aspects of volcanic eruptions, i.e. models of lahar flows, hazard maps as well as other geophysical modeling. Furthermore, after the 2006 eruption of Merapi, research such on risk communication, social vulnerability, cultural vulnerability have appeared on the social side of risk management research. Apart from that, disaster risk management activities in the Bromo area were emphasizing on physical process and historical religious aspects. This overview of both study areas provides information on how risk studies have been used for managing the volcano disaster. This result confirms that most of earlier studies emphasize on the risk assessment and only few of them consider the risk reduction phase. Further investigation in this field work in the near future will accomplish the findings and contribute to formulate integrated volcanic risk management cycles for both Merapi and Bromo. Keywords: Risk management, volcanoes hazard, Merapi and Bromo Volcano Indonesia

Assessment of the menstrual cycle, eating disorders and self-esteem of Polish adolescents.

PubMed

Drosdzol-Cop, Agnieszka; Bąk-Sosnowska, Monika; Sajdak, Dominika; Białka, Agnieszka; Kobiołka, Agnieszka; Franik, Grzegorz; Skrzypulec-Plinta, Violetta

2017-03-01

Eating disorders are an important factor in menstrual cycle disorders in girls. Moreover, low self-esteem among adolescent girls may be a risk factor for eating disorders. The aim of the study was to assess the menstrual cycle, eating habits and self-esteem of Polish adolescents. The study was conducted from January 2014 to March 2015 and included 623 girls, aged 15-19, from randomly selected junior high schools in Silesia, Poland, in which their menstrual cycle, risk of eating disorders and self-esteem were evaluated. A five-part questionnaire was used to assess basic demographic data, lifestyle and physical activity, gynecological history, as well as Rosenberg Self-Esteem Scale (SES) and Eating Attitude Test (EAT-26). Irregular menstrual cycles were observed in 236 (37.88%) girls; 5.20% presented secondary amenorrhea. Based on the EAT-26 test, 101 (16.21%) girls were indicated being at risk for an eating disorder. Low self-esteem was observed in 340 (54.57%) study girls on the base of SES. Girls with irregular menses had higher scores on the EAT-26 test in subscales: EAT-overall score, EAT-diet and EAT-bulimia, while lower scores on the SES. In our study, we did not observe a significant relationship between exercise intensity, body mass, BMI and menstrual cycle regularity. Low self-esteem among adolescent girls may be a risk factor for eating disorders which could interrupt the menstrual cycle.

78 FR 38483 - Area Risk Protection Insurance Regulations and Area Risk Protection Insurance Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

...The Federal Crop Insurance Corporation (FCIC) finalizes the Area Risk Protection Insurance (ARPI) Basic Provisions, ARPI Barley Crop Insurance Provisions, ARPI Corn Crop Insurance Provisions, ARPI Cotton Crop Insurance Provisions, ARPI Forage Crop Insurance Provisions, ARPI Grain Sorghum Crop Insurance Provisions, ARPI Peanut Crop Insurance Provisions, ARPI Soybean Crop Insurance Provisions, and ARPI Wheat Crop Insurance Provisions to provide area yield protection and area revenue protection. These provisions will replace the Group Risk Plan (GRP) provisions in 7 CFR part 407, which includes the: GRP Basic Provisions, GRP Barley Crop Provisions, GRP Corn Crop Provisions, GRP Cotton Crop Provisions, GRP Forage Crop Provisions, GRP Peanut Crop Provisions, GRP Sorghum Crop Provisions, GRP Soybean Crop Provisions, and GRP Wheat Crop Provisions. The ARPI provisions will also replace the Group Risk Income Protection (GRIP) Basic Provisions, the GRIP Crop Provisions, and the GRIP-Harvest Revenue Option (GRIP-HRO). The GRP and GRIP plans of insurance will no longer be available. The intended effect of this action is to offer producers a choice of Area Revenue Protection, Area Revenue Protection with the Harvest Price Exclusion, or Area Yield Protection, all within one Basic Provision and the applicable Crop Provisions. This will reduce the amount of information producers must read to determine the best risk management tool for their operation and will improve the provisions to better meet the needs of insureds. The changes will apply for the 2014 and succeeding crop years.

Failure Modes and Effects Analysis (FMEA): A Bibliography

NASA Technical Reports Server (NTRS)

2000-01-01

Failure modes and effects analysis (FMEA) is a bottom-up analytical process that identifies process hazards, which helps managers understand vulnerabilities of systems, as well as assess and mitigate risk. It is one of several engineering tools and techniques available to program and project managers aimed at increasing the likelihood of safe and successful NASA programs and missions. This bibliography references 465 documents in the NASA STI Database that contain the major concepts, failure modes or failure analysis, in either the basic index of the major subject terms.

Remote Sensing Technologies and Geospatial Modelling Hierarchy for Smart City Support

NASA Astrophysics Data System (ADS)

Popov, M.; Fedorovsky, O.; Stankevich, S.; Filipovich, V.; Khyzhniak, A.; Piestova, I.; Lubskyi, M.; Svideniuk, M.

2017-12-01

The approach to implementing the remote sensing technologies and geospatial modelling for smart city support is presented. The hierarchical structure and basic components of the smart city information support subsystem are considered. Some of the already available useful practical developments are described. These include city land use planning, urban vegetation analysis, thermal condition forecasting, geohazard detection, flooding risk assessment. Remote sensing data fusion approach for comprehensive geospatial analysis is discussed. Long-term city development forecasting by Forrester - Graham system dynamics model is provided over Kiev urban area.

BRITE/EURAM: Third Technological Days for the Basic Research in Industrial Technologies in Europe/European Research in Advanced Materials 1990, Held in Brussels, Belgium on May 21-22, 1990

DTIC Science & Technology

1990-06-29

characterized by a end, and a risk assessment. multifaceted midsurface of varying thickness. Briefly, the ideal BRITE/EURAM project solves a A specific...sists of selecting, at the outset, a well-behaved mesh strengthens all participants, yet preserves their identity. covering the whole midsurface . During...developing sion in the gar direction, heat advection in the midsurface software for the manufacturing industry. The company is dirccltin, and viscous

The educational gradient in coronary heart disease: the association with cognition in a cohort of 57,279 male conscripts.

PubMed

Ariansen, Inger; Mortensen, Laust; Igland, Jannicke; Tell, Grethe S; Tambs, Kristian; Graff-Iversen, Sidsel; Strand, Bjørn Heine; Næss, Øyvind

2015-04-01

Independently of cardiovascular disease (CVD) risk factors, cognitive ability may account for some of the excess risk of coronary heart disease (CHD) associated with lower education. We aimed to assess how late adolescence cognitive ability and midlife CVD risk factors are associated with the educational gradient in CHD in Norway. In a cohort of 57 279 men born during 1949-1959, health survey information was linked to military conscription records of cognitive ability, to national educational data, to hospitalisation records from the Cardiovascular Disease in Norway (CVDNOR) project and to the Norwegian Cause of Death Registry. Age and period adjusted HR for incident CHD events was 3.62 (95% CI 2.50 to 5.24) for basic relative to tertiary education, and was attenuated after adjustment; to 2.86 (1.87 to 4.38) for cognitive ability, to 1.90 (1.30 to 2.78) for CVD risk factors, and to 1.84 (1.20 to 2.83) when adjusting for both. Age and period adjusted absolute rate difference was 51 (33 to 70) incident CHD events per 100,000 person years between basic and tertiary educated, and was attenuated after adjustment; to 42 (22 to 61) for cognitive ability, to 25 (7 to 42) for CVD risk factors, and to 24 (5 to 43) when adjusting for both. Late adolescence cognitive ability attenuated the educational gradient in incident CHD events. CVD risk factors further attenuated the gradient, and to the same extent regardless of whether cognitive ability was included or not. Cognitive ability might be linked to the educational gradient through CVD risk factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Micro-insurance in Bangladesh: Risk Protection for the Poor?

PubMed Central

2009-01-01

Health services and modern medicines are out of reach for over one billion people globally. Micro-insurance for health is one method to address unmet health needs. This case study used a social exclusion perspective to assess the health and poverty impact of micro-insurance for health in Bangladesh and contrasts this with several micro-insurance systems for health offered in India. Micro-insurance for health in Bangladesh targeted towards the poor and the ultra-poor provides basic healthcare at an affordable rate whereas the Indian micro-insurance schemes for health have been implemented across larger populations and include high-cost and low-frequency events. Results of analysis of the existing literature showed that micro-insurance for health as currently offered in Bangladesh increased access to, and use of, basic health services among excluded populations but did not reduce the likelihood that essential health-related costs would be a catastrophic expense for a marginalized household. PMID:19761089

Basic anthropometry and health status of elderly: findings of the Maracaibo Aging Study.

PubMed

Muñoz, Angélica M; Falque-Madrid, Luis; Zambrano, Raquel Ch; Maestre, Gladys E

2010-03-01

Determine basic anthropometry for elderly participants in a Venezuelan community and compare results for subgroups with different health status. Standardized anthropometric, nutritional, neurological, neuropsychiatric, and cardiovascular assessments generated data on weight, height, and body mass index (BMI) by sex and age for the total sample, for normative groups without health problems that might impact anthropometry, and for reference groups with no major health problems. Centile curves of anthropometric measurements versus age are determined for women and men in the normative group. Mean weight and height are significantly different between sexes, but not BMI. All three parameters show gradual declines with age. The mean 90% central interval for BMI in the normative and reference groups is 20-29 kg/m(2). The anthropometric data for healthy elderly Venezuelans can be used in monitoring anthropometric changes and disease risk analysis for this population and possibly for other Latin American populations.

Role of socioeconomic status measures in long-term mortality risk prediction after myocardial infarction.

PubMed

Molshatzki, Noa; Drory, Yaacov; Myers, Vicki; Goldbourt, Uri; Benyamini, Yael; Steinberg, David M; Gerber, Yariv

2011-07-01

The relationship of risk factors to outcomes has traditionally been assessed by measures of association such as odds ratio or hazard ratio and their statistical significance from an adjusted model. However, a strong, highly significant association does not guarantee a gain in stratification capacity. Using recently developed model performance indices, we evaluated the incremental discriminatory power of individual and neighborhood socioeconomic status (SES) measures after myocardial infarction (MI). Consecutive patients aged ≤65 years (N=1178) discharged from 8 hospitals in central Israel after incident MI in 1992 to 1993 were followed-up through 2005. A basic model (demographic variables, traditional cardiovascular risk factors, and disease severity indicators) was compared with an extended model including SES measures (education, income, employment, living with a steady partner, and neighborhood SES) in terms of Harrell c statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI). During the 13-year follow-up, 326 (28%) patients died. Cox proportional hazards models showed that all SES measures were significantly and independently associated with mortality. Furthermore, compared with the basic model, the extended model yielded substantial gains (all P<0.001) in c statistic (0.723 to 0.757), NRI (15.2%), IDI (5.9%), and relative IDI (32%). Improvement was observed both for sensitivity (classification of events) and specificity (classification of nonevents). This study illustrates the additional insights that can be gained from considering the IDI and NRI measures of model performance and suggests that, among community patients with incident MI, incorporating SES measures into a clinical-based model substantially improves long-term mortality risk prediction.

Limits of Risk Predictability in a Cascading Alternating Renewal Process Model.

PubMed

Lin, Xin; Moussawi, Alaa; Korniss, Gyorgy; Bakdash, Jonathan Z; Szymanski, Boleslaw K

2017-07-27

Most risk analysis models systematically underestimate the probability and impact of catastrophic events (e.g., economic crises, natural disasters, and terrorism) by not taking into account interconnectivity and interdependence of risks. To address this weakness, we propose the Cascading Alternating Renewal Process (CARP) to forecast interconnected global risks. However, assessments of the model's prediction precision are limited by lack of sufficient ground truth data. Here, we establish prediction precision as a function of input data size by using alternative long ground truth data generated by simulations of the CARP model with known parameters. We illustrate the approach on a model of fires in artificial cities assembled from basic city blocks with diverse housing. The results confirm that parameter recovery variance exhibits power law decay as a function of the length of available ground truth data. Using CARP, we also demonstrate estimation using a disparate dataset that also has dependencies: real-world prediction precision for the global risk model based on the World Economic Forum Global Risk Report. We conclude that the CARP model is an efficient method for predicting catastrophic cascading events with potential applications to emerging local and global interconnected risks.

Still at Risk: What Students Don't Know, Even Now--A Report from Common Core

ERIC Educational Resources Information Center

Hess, Frederick M.

2009-01-01

A report from Common Core finds that many of America's high school students do not possess the basic knowledge they need to succeed in the world. The report shows that, twenty-five years after the publication of the landmark study, "A Nation at Risk," America's children continue to demonstrate a stunning ignorance about basic facts of America's…

Risk communication basics

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

Corrado, P.G.

In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information.

Reducing the risk of HIV infection among South African sex workers: socioeconomic and gender barriers.

PubMed

Karim, Q A; Karim, S S; Soldan, K; Zondi, M

1995-11-01

The social context within which women engaged in sex work at a popular truck stop in South Africa are placed at risk of human immunodeficiency virus (HIV) infection and the factors that influence their ability to reduce their risk were assessed. Using qualitative and quantitative techniques, an elected sex worker from within the group collected all data. Given the various pressing needs for basic survival, the risk of HIV infection is viewed as one more burden imposed on these women by their lack of social, legal, and economic power. Violence, or the threat thereof, plays an important role in their disempowerment. In the few instances in which sex workers were able to insist on condom use, it resulted in a decrease in earnings, loss of clients, and physical abuse. Recommendations to reduce the sex workers' risk for HIV infection include negotiation and communication skills to enable them to persuade their clients to use condoms; development of strategies through which they can maximally use their group strength to facilitate unified action; and accessibility of protective methods they can use and control, such as intravaginal microbicides.

[Interview study on autonomous chemical management system and the contribution of occupational health specialists in companies].

PubMed

Mori, Koji; Takebayashi, Toru

2004-09-01

Under the circumstance that autonomous risk management for chemicals is required in Japan, it is necessary to define fundamental steps for developing chemical management system that are applicable in various types of companies and to understand the effective contribution of chemical or occupational health specialists to the system. For the purposes, we conducted interviews with companies which have an advanced chemical management system in Japan. As the result, each company had a certain policy about detailedness level of collected hazard and exposure information, and also had an efficient risk management system to ensure workers' health in depending on the business type and situations. Moreover, it was commonly observed that the specialists played major roles in developing tools for risk assessment and control, and then business lines led execution of the risk management with their supports. Based on the interviews, we showed a hypothesis of basic steps in introducing autonomous chemical risk management system at the workplaces. It is necessary to verify the hypothesis and to develop a simple system that is applicable to middle or small size companies as the next step.

Principles of Safety Pharmacology

PubMed Central

Pugsley, M K; Authier, S; Curtis, M J

2008-01-01

Safety Pharmacology is a rapidly developing discipline that uses the basic principles of pharmacology in a regulatory-driven process to generate data to inform risk/benefit assessment. The aim of Safety Pharmacology is to characterize the pharmacodynamic/pharmacokinetic (PK/PD) relationship of a drug's adverse effects using continuously evolving methodology. Unlike toxicology, Safety Pharmacology includes within its remit a regulatory requirement to predict the risk of rare lethal events. This gives Safety Pharmacology its unique character. The key issues for Safety Pharmacology are detection of an adverse effect liability, projection of the data into safety margin calculation and finally clinical safety monitoring. This article sets out to explain the drivers for Safety Pharmacology so that the wider pharmacology community is better placed to understand the discipline. It concludes with a summary of principles that may help inform future resolution of unmet needs (especially establishing model validation for accurate risk assessment). Subsequent articles in this issue of the journal address specific aspects of Safety Pharmacology to explore the issues of model choice, the burden of proof and to highlight areas of intensive activity (such as testing for drug-induced rare event liability, and the challenge of testing the safety of so-called biologics (antibodies, gene therapy and so on.). PMID:18604233

Issues in the Pharmacokinetics of Trichloroethylene and Its Metabolites

PubMed Central

Chiu, Weihsueh A.; Okino, Miles S.; Lipscomb, John C.; Evans, Marina V.

2006-01-01

Much progress has been made in understanding the complex pharmacokinetics of trichloroethylene (TCE). Qualitatively, it is clear that TCE is metabolized to multiple metabolites either locally or into systemic circulation. Many of these metabolites are thought to have toxicologic importance. In addition, efforts to develop physiologically based pharmacokinetic (PBPK) models have led to a better quantitative assessment of the dosimetry of TCE and several of its metabolites. As part of a mini-monograph on key issues in the health risk assessment of TCE, this article is a review of a number of the current scientific issues in TCE pharmacokinetics and recent PBPK modeling efforts with a focus on literature published since 2000. Particular attention is paid to factors affecting PBPK modeling for application to risk assessment. Recent TCE PBPK modeling efforts, coupled with methodologic advances in characterizing uncertainty and variability, suggest that rigorous application of PBPK modeling to TCE risk assessment appears feasible at least for TCE and its major oxidative metabolites trichloroacetic acid and trichloroethanol. However, a number of basic structural hypotheses such as enterohepatic recirculation, plasma binding, and flow- or diffusion-limited treatment of tissue distribution require additional evaluation and analysis. Moreover, there are a number of metabolites of potential toxicologic interest, such as chloral, dichloroacetic acid, and those derived from glutathione conjugation, for which reliable pharmacokinetic data is sparse because of analytical difficulties or low concentrations in systemic circulation. It will be a challenge to develop reliable dosimetry for such cases. PMID:16966104

Assessment of heavy metal pollution and human health risk in urban soils of steel industrial city (Anshan), Liaoning, Northeast China.

PubMed

Qing, Xiao; Yutong, Zong; Shenggao, Lu

2015-10-01

The purpose of this study was to determine the concentrations and health risk of heavy metals in urban soils from a steel industrial district in China. A total of 115 topsoil samples from Anshan city, Liaoning, Northeast China were collected and analyzed for Cr, Cd, Pb, Zn, Cu, and Ni. The geoaccumulation index (Igeo), pollution index (PI), and potential ecological risk index (PER) were calculated to assess the pollution level in soils. The hazard index (HI) and carcinogenic risk (RI) were used to assess human health risk of heavy metals. The average concentration of Cr, Cd, Pb, Zn, Cu, and Ni were 69.9, 0.86, 45.1, 213, 52.3, and 33.5mg/kg, respectively. The Igeo and PI values of heavy metals were in the descending order of Cd>Zn>Cu>Pb>Ni>Cr. Higher Igeo value for Cd in soil indicated that Cd pollution was moderate. Pollution index indicated that urban soils were moderate to highly polluted by Cd, Zn, Cu, and Pb. The spatial distribution maps of heavy metals revealed that steel industrial district was the contamination hotspots. Principal component analysis (PCA) and matrix cluster analysis classified heavy metals into two groups, indicating common industrial sources for Cu, Zn, Pb, and Cd. Matrix cluster analysis classified the sampling sites into four groups. Sampling sites within steel industrial district showed much higher concentrations of heavy metals compared to the rest of sampling sites, indicating significant contamination introduced by steel industry on soils. The health risk assessment indicated that non-carcinogenic values were below the threshold values. The hazard index (HI) for children and adult has a descending order of Cr>Pb>Cd>Cu>Ni>Zn. Carcinogenic risks due to Cr, Cd, and Ni in urban soils were within acceptable range for adult. Carcinogenic risk value of Cr for children is slightly higher than the threshold value, indicating that children are facing slight threat of Cr. These results provide basic information of heavy metal pollution control and environment management in steel industrial regions. Copyright © 2015 Elsevier Inc. All rights reserved.

Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa.

PubMed

Francis, Shelley A; Nelson, Jennifer; Liverpool, Joan; Soogun, Soji; Mofammere, Nokuthula; Thorpe, Roland J

2010-11-23

Developing countries account for 85% of the nearly 500,000 yearly cases of cervical cancer worldwide with approximately 250,000 deaths occurring in Sub-Saharan Africa, South Asia, and Latin America. In South Africa, cervical cancer is the 3(rd) leading cause of death among women. Although cervical cancer can be screened for with regular Pap tests, access to preventive screenings may be nearly non-existent in resource poor settings that have limited public health infrastructure and where women may lack basic health education. Therefore, it is important to understand women's attitudes, knowledge, and beliefs about HPV, cervical cancer, and the HPV vaccine, and assess their access to preventive screening in order to mitigate their risk for developing the disease. Eighty-six women, ages 18-44 with at least one child who presented at an antenatal clinic in a township in Johannesburg were recruited to complete a brief questionnaire. Using both descriptive and multivariate statistics, we assessed knowledge of cervical cancer, HPV, and the vaccine; assessed maternal-child communication about sex and STDs, assessed willingness to vaccinate child; and identified barriers to assessing medical care and the vaccine. The majority of participants were unfamiliar with HPV and cervical cancer, were concerned about their child's and their own risk for HPV and cervical cancer, faced numerous barriers to accessing screening, and were willing to vaccinate their child. Our findings indicate that women in developing countries need increased access to screening and education about HPV and cervical cancer prevention. Copyright © 2010 Elsevier Ltd. All rights reserved.

Insulin Basics

MedlinePlus

... Risk? Home Prevention Diagnosing Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk ... Chat Closed engagement en -- So…Do You Have Prediabetes? - 2017-01-ad-council.html So…Do You ...

Quantitative risk assessment of Cryptosporidium in tap water in Ireland.

PubMed

Cummins, E; Kennedy, R; Cormican, M

2010-01-15

Cryptosporidium species are protozoan parasites associated with gastro-intestinal illness. Following a number of high profile outbreaks worldwide, it has emerged as a parasite of major public health concern. A quantitative Monte Carlo simulation model was developed to evaluate the annual risk of infection from Cryptosporidium in tap water in Ireland. The assessment considers the potential initial contamination levels in raw water, oocyst removal and decontamination events following various process stages, including coagulation/flocculation, sedimentation, filtration and disinfection. A number of scenarios were analysed to represent potential risks from public water supplies, group water schemes and private wells. Where surface water is used additional physical and chemical water treatment is important in terms of reducing the risk to consumers. The simulated annual risk of illness for immunocompetent individuals was below 1 x 10(-4) per year (as set by the US EPA) except under extreme contamination events. The risk for immunocompromised individuals was 2-3 orders of magnitude greater for the scenarios analysed. The model indicates a reduced risk of infection from tap water that has undergone microfiltration, as this treatment is more robust in the event of high contamination loads. The sensitivity analysis highlighted the importance of watershed protection and the importance of adequate coagulation/flocculation in conventional treatment. The frequency of failure of the treatment process is the most important parameter influencing human risk in conventional treatment. The model developed in this study may be useful for local authorities, government agencies and other stakeholders to evaluate the likely risk of infection given some basic input data on source water and treatment processes used. Copyright 2009 Elsevier B.V. All rights reserved.

Dental student perception and assessment of their clinical knowledge in educating patients about preventive dentistry.

PubMed

Metz, M J; Miller, C J; Lin, W S; Abdel-Azim, T; Zandinejad, A; Crim, G A

2015-05-01

In today's dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cardiac output monitoring using indicator-dilution techniques: basics, limits, and perspectives.

PubMed

Reuter, Daniel A; Huang, Cecil; Edrich, Thomas; Shernan, Stanton K; Eltzschig, Holger K

2010-03-01

The ability to monitor cardiac output is one of the important cornerstones of hemodynamic assessment for managing critically ill patients at increased risk for developing cardiac complications, and in particular in patients with preexisting cardiovascular comorbidities. For >30 years, single-bolus thermodilution measurement through a pulmonary artery catheter for assessment of cardiac output has been widely accepted as the "clinical standard" for advanced hemodynamic monitoring. In this article, we review this clinical standard, along with current alternatives also based on the indicator-dilution technique, such as the transcardiopulmonary thermodilution and lithium dilution techniques. In this review, not only the underlying technical principles and the unique features but also the limitations of each application of indicator dilution are outlined.

Developing a tool for observing group critical thinking skills in first-year medical students: a pilot study using physiology-based, high-fidelity patient simulations.

PubMed

Nguyen, Khoa; Ben Khallouq, Bertha; Schuster, Amanda; Beevers, Christopher; Dil, Nyla; Kay, Denise; Kibble, Jonathan D; Harris, David M

2017-12-01

Most assessments of physiology in medical school use multiple choice tests that may not provide information about a student's critical thinking (CT) process. There are limited performance assessments, but high-fidelity patient simulations (HFPS) may be a feasible platform. The purpose of this pilot study was to determine whether a group's CT process could be observed over a series of HFPS. An instrument [Critical Thinking Skills Rating Instrument CTSRI)] was designed with the IDEAS framework. Fifteen groups of students participated in three HFPS that consisted of a basic knowledge quiz and introduction, HFPS session, and debriefing. HFPS were video recorded, and two raters reviewed and scored all HFPS encounters with the CTSRI independently. Interrater analysis suggested good reliability. There was a correlation between basic knowledge scores and three of the six observations on the CTSRI providing support for construct validity. The median CT ratings significantly increased for all observations between the groups' first and last simulation. However, there were still large percentages of video ratings that indicated students needed substantial prompting during the HFPS. The data from this pilot study suggest that it is feasible to observe CT skills in HFPS using the CTSRI. Based on the findings from this study, we strongly recommend that first-year medical students be competent in basic knowledge of the relevant physiology of the HFPS before participating, to minimize the risk of a poor learning experience. Copyright © 2017 the American Physiological Society.

On the historical account of disastrous landslides in Mexico: the challenge of risk management and disaster prevention

NASA Astrophysics Data System (ADS)

Alcántara-Ayala, I.

2008-01-01

Landslides disasters in Mexico caused more than 3500 deaths between 1935 and 2006. Such disasters have been mainly associated to intense precipitation events derived from hurricanes, tropical storms and their interactions with cold fronts, although earthquake triggered landslides have also occurred to a lesser extent. The impact of landsliding in Mexico is basically determined by the geomorphic features of mountain ranges and dissected plateaus inhabited by vulnerable communities. The present contribution provides a comprehensive temporal assessment of historical landslide disasters in Mexico. Moreover, it aims at exploring the future directions of risk management and disaster prevention, in order to reduce the impact of landslides on populations as a result of climatic change, urban sprawl, land use change and social vulnerability.

"SHOUT" to improve the quality of care delivered to patients with acute kidney injury at Great Western Hospital.

PubMed

Brady, Paul; Gorham, James; Kosti, Angeliki; Seligman, William; Courtney, Alona; Mazan, Karolina; Paterson, Stuart; Ramcharitar, Steve; Chandrasekaran, Badri; Juniper, Mark; Greamspet, Mala; Daniel, Jessica; Chalstrey, Sue; Ahmed, Ijaz; Dasgupta, Tanaji

2015-01-01

Acute kidney injury (AKI) affects up to 20% of all patients admitted to hospital, and is associated with a higher risk of adverse clinical outcomes, increased healthcare costs, as well as long term risks of chronic kidney disease and end stage renal failure. The aim of this project was to improve the quality of care for patients with AKI admitted to the acute medical unit (AMU) at the Great Western Hospital (GWH). We assessed awareness and self reported confidence among physicians in our Trust, in addition to basic aspects of care relevant to AKI on our AMU. A multifaceted quality improvement strategy was developed, which included measures to improve awareness such as a Trust wide AKI awareness day, and reconfiguring the admission proforma on our AMU in order to enhance risk assessment, staging, and early response to AKI. Ancillary measures such as the dissemination of flashcards for lanyards containing core information were also used. Follow up assessments showed that foundation year one (FY1) doctors' self reported confidence in managing AKI increased from 2.8 to 4.2, as measured on a five point Likert scale (P=0.0003). AKI risk assessment increased from 13% to 57% (P=0.07) following a change in the admission proforma. Documentation of the diagnosis of AKI increased from 66% to 95% (P=0.038) among flagged patients. Documentation of urine dip results increased from 33% to 73% (P=0.01), in addition to a rise in appropriate referral for specialist input, although this was not statistically significant. Our results suggest that using the twin approaches of improving awareness, and small changes to systemic factors such as modification of the admission proforma, can lead to significant enhancements in the quality of care of patients with AKI.

More ecological ERA: incorporating natural environmental factors and animal behavior.

PubMed

Bednarska, Agnieszka J; Jevtić, Dragan M; Laskowski, Ryszard

2013-07-01

We discuss the importance of selected natural abiotic and biotic factors in ecological risk assessment based on simplistic laboratory bioassays. Although it is impossible to include all possible natural factors in standard lower-tier ecotoxicological testing, neglecting them is not an option. Therefore, we try to identify the most important factors and advocate redesigning standard testing procedures to include theoretically most potent interactions. We also point out a few potentially important factors that have not been studied enough so far. The available data allowed us to identify temperature and O2 depletion as the most critical factors that should be included in ecotoxicity testing as soon as possible. Temporal limitations and fluctuations in food availability also appear important, but at this point more fundamental research in this area is necessary before making decisions on their inclusion in risk assessment procedures. We propose using specific experimental designs, such as Box-Behnken or Central Composite, which allow for simultaneous testing of 3 or more factors for their individual and interactive effects with greater precision and without increasing the effort and costs of tests dramatically. Factorial design can lead to more powerful tests and help to extend the validity of conclusions. Finally, ecological risk assessment procedures should include information on animal behavior, especially feeding patterns. This requires more basic studies, but already at this point adequate mechanistic effect models can be developed for some species. Copyright © 2013 SETAC.

[From complexity to simplification: contribution of the EPM Research Unit to producing a toolkit for risk assessment and management of biomechanical overload and WMSDs prevention].

PubMed

Occhipinti, E; Colombini, Daniela

2011-01-01

When studying musculoskeletal disorders and their connection with working conditions (WMSDs), several factors of different nature (mechanical, organizational, psychophysical, individual) and their interrelationship have been considered important in general models for epidemiologic surveys and risk assessment and management. Hence the necessity of a "holistic" (that is to say complex, global, multifactorial and interdisciplinary) approach to MSD prevention, especially when establishing technical norms, guidelines and strategic plans of action at national or international level. On the other hand, considering the widespread presence of these factors and WMSDs in many working contexts, there is a great demand by OSH agencies and operators to develop "simple" tools for risk assessment and management, usable also by non-experts in both developed and developing countries. Both these needs are perfectly justified but are also to a certain extent in conflict. How can we address the problem, i.e., simplify complexity? METHODS AND CRITERIA: The proposals are based on two essential criteria: 1) Act on a step-by-step approach using basic tools first and more complex tools only when necessary. 2) Take into account the complexity and the presence of multiple influencing factors at every step (even if with different degrees of in-depth analysis). The proposals are mainly developed within the framework of an IEA-WHO collaboration initiative for a "Toolkit for MSD prevention" but they are also derived from other converging issues (i.e. ISO application document of LSO series 11228 on manual handling). The proposals consider: 1) A Basic Step devoted to preliminary occupational hazard identification and priority check by operative "key enter" questions (at this step all potential hazards--including those influencing WMSDs--should be considered). This step also can be carried out by non-experts with limited training. 2) First Step, focused on WMSDs risk factors, consisting of a "quick assessment" and mainly addressed to identifying 3 possible conditions: acceptable/no consequences; high risk present/redesign urgently needed; a more detailed analysis (via tools proposed in second step) is necessary. This step can also be carried out by non-experts with only limited training. 3) Second Step, where recognized tools (i.e. from international standards or guidelines) for risk (of WMSDs) estimation are used as a consequence of the first step outcome. Examples of such tools are "adaptations" of the Revised NIOSH Lifting Equation, Liberty Mutual Psychophysical Tables, OCRA Checklist, etc. These tools should be able to adequately take account of most of the influencing factors. For some particular working sectors (i.e. agriculture) these tools need to be specifically adapted. For particular working sectors a database could be envisaged where the most common tasks (with their "variants") are "intrinsically" evaluated by experts and could provide non-experts with the relevant knowledge to be applied to the specific work context. This step can be carried out only by persons with some sort of specific training.

Assessment of exposure to PCDD/F, PCB, and PAH at a basic oxygen Steelmaking (BOS) and an iron ore sintering plant in the UK.

PubMed

Jackson, Kevin; Aries, Eric; Fisher, Raymond; Anderson, David R; Parris, Adrian

2012-01-01

An assessment was carried out at a UK integrated steelworks to investigate the exposure of workers via inhalation to dioxins [polychlorinated dibenzo-p-dioxins (PCDD/F)], polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons (PAH) including benzo[a]pyrene (B[a]P). Investigations focused on a basic oxygen steelmaking (BOS) plant and an iron ore sintering plant. The highest concentrations of PCDD/F and dioxin-like PCB were found at the BOS vessels and sinter strand area at the BOS and sinter plant, respectively. A risk assessment was carried out by comparing the daily intake of PCDD/F and PCB via inhalation with the recommended tolerable daily intake (TDI) proposed by the World Health Organisation (WHO). For the most exposed category of worker in this study (i.e. sinter plant workers inside the strand area), the estimated daily intake via inhalation was estimated to be 0.25 pg WHO-toxic equivalent concentrations (TEQ) kg(-1) body weight (bw). Considering that the average UK adult exposure to PCDD/F from the diet is 1.8 pg WHO-TEQ kg(-1) bw day(-1), the results indicated that the estimated daily intake of PCDD/F and PCB via inhalation for sinter plant workers would not result in the recommended range of the TDI (1-4 pg WHO-TEQ kg(-1) bw day(-1)) being exceeded. Cancer risks for a 40-year occupational exposure period were determined by multiplying the estimated intake by the inhalation cancer potency factor for 2,3,7,8-tetrachlorodibenzo-p-dioxin. For the most exposed category of worker, cancer risks from exposure to PCDD/F and PCB ranged from 2.5 × 10(-6) to 5.2 × 10(-5). Under most regulatory programmes, excess cancer risks between 1.0 × 10(-6) and 1.0 × 10(-4) indicate an acceptable range of cancer risk, suggesting a limited risk from PCDD/F and PCB exposure for workers in the sinter plant. With regard to PAH, B[a]P concentrations were typically <10 ng m(-3) at all locations at both the sinter plant and the BOS plant. In several cases, particularly at the sinter plant, B[a]P concentrations were well below or only marginally above the target value of 1 ng m(-3) specified in ambient air by the European Commission in the fourth 'Daughter' Directive of the Air Quality Framework Directive suggesting a very low risk of exposure for workers. For PAH, excess cancer risks ranged from 2.4 × 10(-6) to 7.3 × 10(-6) for BOS plant workers and from for 5.3 × 10(-7) to 1.5 × 10(-5) for sinter plant workers, well within the acceptable range proposed by the US EPA.

Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity.

PubMed

Paganini, Matteo; Borrelli, Francesco; Cattani, Jonathan; Ragazzoni, Luca; Djalali, Ahmadreza; Carenzo, Luca; Della Corte, Francesco; Burkle, Frederick M Jr; Ingrassia, Pier Luigi

2016-08-15

Since the 1990s, Italian hospitals are required to comply with emergency disaster plans known as Emergency Plan for Massive Influx of Casualties. While various studies reveal that hospitals overall suffer from an insufficient preparedness level, the aim of this study was to better determine the preparedness level of Emergency Departments of Italian hospitals by assessing the knowledge-base of emergency physicians regarding basic disaster planning and procedures. A prospective observational study utilized a convenience sample of Italian Emergency Departments identified from the Italian Ministry of Health website. Anonymous telephone interviews were conducted of medical consultants in charge at the time in the respective Emergency Departments, and were structured in 3 parts: (1) general data and demographics, (2) the current disaster plan and (3) protocols and actions of the disaster plan. Eighty-five Emergency Departments met inclusion criteria, and 69 (81 %) agreed to undergo the interview. Only 45 % of participants declared to know what an Emergency Plan for Massive Influx of Casualties is, 41 % believed to know who has the authority to activate the plan, 38 % knew who is in charge of intra-hospital operations. In Part 3 physicians revealed a worrisome inconsistency in critical content knowledge of their answers. Results demonstrate a poor knowledge-base of basic hospital disaster planning concepts by Italian Emergency Department physicians-on-duty. These findings should alert authorities to enhance staff disaster preparedness education, training and follow-up to ensure that these plans are known to all who have responsibility for disaster risk reduction and management capacity.

Uncertainty assessment of urban pluvial flood risk in a context of climate change adaptation decision making

NASA Astrophysics Data System (ADS)

Arnbjerg-Nielsen, Karsten; Zhou, Qianqian

2014-05-01

There has been a significant increase in climatic extremes in many regions. In Central and Northern Europe, this has led to more frequent and more severe floods. Along with improved flood modelling technologies this has enabled development of economic assessment of climate change adaptation to increasing urban flood risk. Assessment of adaptation strategies often requires a comprehensive risk-based economic analysis of current risk, drivers of change of risk over time, and measures to reduce the risk. However, such studies are often associated with large uncertainties. The uncertainties arise from basic assumptions in the economic analysis and the hydrological model, but also from the projection of future societies to local climate change impacts and suitable adaptation options. This presents a challenge to decision makers when trying to identify robust measures. We present an integrated uncertainty analysis, which can assess and quantify the overall uncertainty in relation to climate change adaptation to urban flash floods. The analysis is based on an uncertainty cascade that by means of Monte Carlo simulations of flood risk assessments incorporates climate change impacts as a key driver of risk changes over time. The overall uncertainty is then attributed to six bulk processes: climate change impact, urban rainfall-runoff processes, stage-depth functions, unit cost of repair, cost of adaptation measures, and discount rate. We apply the approach on an urban hydrological catchment in Odense, Denmark, and find that the uncertainty on the climate change impact appears to have the least influence on the net present value of the studied adaptation measures-. This does not imply that the climate change impact is not important, but that the uncertainties are not dominating when deciding on action or in-action. We then consider the uncertainty related to choosing between adaptation options given that a decision of action has been taken. In this case the major part of the uncertainty on the estimated net present values is identical for all adaptation options and will therefore not affect a comparison between adaptation measures. This makes the chose among the options easier. Furthermore, the explicit attribution of uncertainty also enables a reduction of the overall uncertainty by identifying the processes which contributes the most. This knowledge can then be used to further reduce the uncertainty related to decision making, as a substantial part of the remaining uncertainty is epistemic.

Rationale and Methods for Archival Sampling and Analysis of Atmospheric Trace Chemical Contaminants On Board Mir and Recommendations for the International Space Station

NASA Technical Reports Server (NTRS)

Perry, J. L.; James, J. T.; Cole, H. E.; Limero, T. F.; Beck, S. W.

1997-01-01

Collection and analysis of spacecraft cabin air samples are necessary to assess the cabin air quality with respect to crew health. Both toxicology and engineering disciplines work together to achieve an acceptably clean cabin atmosphere. Toxicology is concerned with limiting the risk to crew health from chemical sources, setting exposure limits, and analyzing air samples to determine how well these limits are met. Engineering provides the means for minimizing the contribution of the various contaminant generating sources by providing active contamination control equipment on board spacecraft and adhering to a rigorous material selection and control program during the design and construction of the spacecraft. A review of the rationale and objectives for sampling spacecraft cabin atmospheres is provided. The presently-available sampling equipment and methods are reviewed along with the analytical chemistry methods employed to determine trace contaminant concentrations. These methods are compared and assessed with respect to actual cabin air quality monitoring needs. Recommendations are presented with respect to the basic sampling program necessary to ensure an acceptably clean spacecraft cabin atmosphere. Also, rationale and recommendations for expanding the scope of the basic monitoring program are discussed.

Affected Aspects Regarding Literacy and Numeracy in Children Treated for Brain Tumors.

PubMed

Lönnerblad, Malin; Lovio, Riikka; Berglund, Eva; Van't Hooft, Ingrid

The aim of this study was to investigate the test results of reading speed, reading comprehension, word comprehension, spelling, basic arithmetic skills, and number sense (intuitive understanding of numbers) by children treated for brain tumors. This is a retrospective study based on medical records, including standardized academic tests. In the years of 2010 to 2014, all children in the area of Stockholm between 7 and 18 years (IQ <70) who had no major linguistic or motor difficulties after they had undergone treatment for brain tumors were offered a special education assessment one year after treatment, at school start, or the year before a transition from one stage to another. Our results indicate that children treated for a brain tumor are at risk of having difficulties in spelling, reading speed, and arithmetic and that the test performance may decline over years in arithmetic and spelling. Children diagnosed at age 0 to 6 years may need extra tutoring at school start, especially in basic arithmetic skills. In both reading and mathematics, many children perform better on tests focused on understanding than on tests focused on speed. Continuous special needs assessments including different aspects of literacy and numeracy, are important for understanding each child's specific needs.

Cancer Training for Frontline Healthcare Providers in Tanzania.

PubMed

Rick, Tara J; Deming, Cassondra M; Helland, Janey R; Hartwig, Kari A

2017-08-16

Cervical and breast cancer are responsible for the highest cancer-related mortality in Tanzania, although both are preventable or curable if diagnosed at an early stage. Limited knowledge of cervical cancer by clinic and dispensary level healthcare providers in Tanzania is a barrier for prevention and control strategies. The purpose of the study was to provide basic oncology training to frontline healthcare workers with a focus on cervical and breast cancer in order to increase knowledge. A 1-day cancer training symposium was conducted in Arusha, Tanzania, with 43 clinicians. Pre- and post-intervention surveys assessed cancer knowledge and confidence of clinicians in risk assessment. Sixty-nine percent of the participants reported never receiving any cervical cancer training in the past. A significant difference was found between the pre- and post-test in a majority of knowledge questions and in reported confidence recognizing signs and symptoms of breast and cervical cancer (p < 0.05). The 1-day community oncology training symposium was effective in delivering and increasing basic knowledge about cervical and breast cancers to these healthcare providers. The low level of baseline cancer knowledge among frontline medical providers in Tanzania illustrates the need for increased training around the country.

Rock Slide Risk Assessment: A Semi-Quantitative Approach

NASA Astrophysics Data System (ADS)

Duzgun, H. S. B.

2009-04-01

Rock slides can be better managed by systematic risk assessments. Any risk assessment methodology for rock slides involves identification of rock slide risk components, which are hazard, elements at risk and vulnerability. For a quantitative/semi-quantitative risk assessment for rock slides, a mathematical value the risk has to be computed and evaluated. The quantitative evaluation of risk for rock slides enables comparison of the computed risk with the risk of other natural and/or human-made hazards and providing better decision support and easier communication for the decision makers. A quantitative/semi-quantitative risk assessment procedure involves: Danger Identification, Hazard Assessment, Elements at Risk Identification, Vulnerability Assessment, Risk computation, Risk Evaluation. On the other hand, the steps of this procedure require adaptation of existing or development of new implementation methods depending on the type of landslide, data availability, investigation scale and nature of consequences. In study, a generic semi-quantitative risk assessment (SQRA) procedure for rock slides is proposed. The procedure has five consecutive stages: Data collection and analyses, hazard assessment, analyses of elements at risk and vulnerability and risk assessment. The implementation of the procedure for a single rock slide case is illustrated for a rock slope in Norway. Rock slides from mountain Ramnefjell to lake Loen are considered to be one of the major geohazards in Norway. Lake Loen is located in the inner part of Nordfjord in Western Norway. Ramnefjell Mountain is heavily jointed leading to formation of vertical rock slices with height between 400-450 m and width between 7-10 m. These slices threaten the settlements around Loen Valley and tourists visiting the fjord during summer season, as the released slides have potential of creating tsunami. In the past, several rock slides had been recorded from the Mountain Ramnefjell between 1905 and 1950. Among them, four of the slides caused formation of tsunami waves which washed up to 74 m above the lake level. Two of the slides resulted in many fatalities in the inner part of the Loen Valley as well as great damages. There are three predominant joint structures in Ramnefjell Mountain, which controls failure and the geometry of the slides. The first joint set is a foliation plane striking northeast-southwest and dipping 35˚ -40˚ to the east-southeast. The second and the third joint sets are almost perpendicular and parallel to the mountain side and scarp, respectively. These three joint sets form slices of rock columns with width ranging between 7-10 m and height of 400-450 m. It is stated that the joints in set II are opened between 1-2 m, which may bring about collection of water during heavy rainfall or snow melt causing the slices to be pressed out. It is estimated that water in the vertical joints both reduces the shear strength of sliding plane and causes reduction of normal stress on the sliding plane due to formation of uplift force. Hence rock slides in Ramnefjell mountain occur in plane failure mode. The quantitative evaluation of rock slide risk requires probabilistic analysis of rock slope stability and identification of consequences if the rock slide occurs. In this study failure probability of a rock slice is evaluated by first-order reliability method (FORM). Then in order to use the calculated probability of failure value (Pf) in risk analyses, it is required to associate this Pf with frequency based probabilities (i.ePf / year) since the computed failure probabilities is a measure of hazard and not a measure of risk unless they are associated with the consequences of the failure. This can be done by either considering the time dependent behavior of the basic variables in the probabilistic models or associating the computed Pf with frequency of the failures in the region. In this study, the frequency of previous rock slides in the previous century in Remnefjell is used for evaluation of frequency based probability to be used in risk assessment. The major consequence of a rock slide is generation of a tsunami in the lake Loen, causing inundation of residential areas around the lake. Risk is assessed by adapting damage probability matrix approach, which is originally developed for risk assessment for buildings in case of earthquake.

Examining the Efficacy of a Basic Functional Behavioral Assessment Training Package for School Personnel

ERIC Educational Resources Information Center

Loman, Sheldon L.; Horner, Robert H.

2014-01-01

This study evaluated the effects of manualized training in "Basic" functional behavioral assessment (FBA) for typical school professionals on the ability of these professionals to complete technically adequate FBAs. Twelve school professionals participated in four 1-hr training sessions using the Basic FBA training handbook. After…

Knowledge, awareness, and preparedness unlinked in layperson

NASA Astrophysics Data System (ADS)

Oki, S.; Nakayachi, K.

2012-12-01

Risk assessment is of importance for the reduction of natural disasters. By utilizing the risk information such as producing shake maps or tsunami hazard maps, people can learn what kind of natural hazards they have to deal with. Japanese government takes it as an effective strategy in mitigating earthquake disaster to transfer the basic knowledge of the tectonic background of Japan and of the latest research results. In fact, the Headquarters for Earthquake Research Promotion describes in their webpage that their basic concept is: to transfer the knowledge of research results such as long-term evaluation of large earthquake occurrence to the public, so that people will be aware and conscious of the existing risks, and then they take action to mitigate earthquake disaster. On the other hand, it goes without saying that there always exists a constant risk of earthquake disaster in Japan and every single person living in this earthquake prone country knows that. Moreover, residents know what will happen when a big earthquake occurs such as collapse of houses or tsunamis unlike cases for unknown infectious diseases. Thus they do not have to wait for the government's releasing latest research results of long-term evaluation and possibility of large earthquake occurrence to take action to mitigate disaster. Yet, people die from earthquakes of magnitude-7 class almost every year in Japan, and the causes of death are very common ones such as collapse of houses, falloff of furniture, fire or tsunamis. This fact tells us that the knowledge itself will not give serious awareness of earthquake risks or not motivate people to take action for disaster prevention. We have to have another look at the personnel risk management of earthquake disaster, for the concept of 3-steps; giving knowledge, giving awareness, and taking action would not work as expected. To examine this, we conducted experiments to see if knowledge of earthquake science helps people to be aware the risks or to take action for disaster prevention. Examinees are 200 high school and undergraduate students who do not major in Earth science. We first gave them information of basic knowledge such as tectonic backgrounds of Japan and the latest research outcomes such as long-term evaluation of large earthquake occurrence or the strong ground motion, and then asked what they felt. The results show that neither the basic knowledge nor the latest research outcomes motivate examinees to take action for the disaster prevention or even to give awareness. We then showed them the movies of the past earthquake disasters and some episodes who had lost their loved ones from the recent earthquakes, and asked the same question. As psychology implies, this information made examinees feel dread and they became aware of the risks lie ahead. But still, they did not mention what to do to prevent the tragedy. In the presentation, we would like to show the difficulty to make people take action to protect their lives from earthquake disasters. We also show peoples' preparedness/unpreparedness with the information released by a Japanese research group in the late January saying the possibility of metropolitan Tokyo earthquake being 70% in this coming 4-year.

Health Literacy and Adult Basic Education Assessments

ERIC Educational Resources Information Center

Golbeck, Amanda L.; Ahlers-Schmidt, Carolyn R.; Paschal, Angelia M.

2005-01-01

Adult basic education (ABE) is an ideal venue for developing health literacy skills. Literacy and numeracy assessments used in ABE were identified and the most common were examined for health components. Only the Comprehensive Adult Student Assessment System (CASAS) included health. The two most common health literacy assessments used in general…

Cross-cultural standardization of the South Texas Assessment of Neurocognition in India.

PubMed

Cherkil, S; Satish, S; Mathew, S S; Dinesh, N; Kumar, C T S; Lombardo, L E; Glahn, D C; Frangou, S

2012-08-01

Despite the central role of cognition for mental disorders most studies have been conducted in western countries. Similar research from other parts of the world, particularly India, is very limited. As a first step in closing this gap this cross-cultural comparability study of the South Texas Assessment of Neurocognition (STAN) battery was conducted between USA and India. One hundred healthy adults from Kerala, India, were administered six language independent subtests of the Java Neuropsychological Test (JANET) version of the STAN, assessing aspects of general intellectual ability (Matrix Reasoning), attention (Identical Pairs Continuous Performance, 3 Symbol Version Test; IPCPTS), working memory (Spatial Capacity Delayed Response Test; SCAP), response inhibition (Stop Signal Reaction Time; SSRT), Emotional Recognition and Risk taking (Balloon Analogue Risk Task; BART). Test results were compared to a demographically matched US sample. Overall test performance in the Kerala sample was comparable to that of the US sample and commensurate to that generally described in studies from western countries. Our results support the metric equivalence of currently available cognitive test batteries developed in western countries for use in India. However, the sample was restricted to individuals who were literate and had completed basic primary and secondary education.

Comparative studies of groundwater vulnerability assessment

NASA Astrophysics Data System (ADS)

Maria, Rizka

2018-02-01

Pollution of groundwater is a primary issue because aquifers are susceptible to contamination from land use and anthropogenic impacts. Groundwater susceptibility is intrinsic and specific. Intrinsic vulnerability refers to an aquifer that is susceptible to pollution and to the geological and hydrogeological features. Vulnerability assessment is an essential step in assessing groundwater contamination. This approach provides a visual analysis for helping planners and decision makers to achieve the sustainable management of water resources. Comparative studies are applying different methodologies to result in the basic evaluation of the groundwater vulnerability. Based on the comparison of methods, there are several advantages and disadvantages. SI can be overlaid on DRASTIC and Pesticide DRASTIC to extract the divergence in sensitivity. DRASTIC identifies low susceptibility and underestimates the pollution risk while Pesticide DRASTIC and SI represents better risk and is recommended for the future. SINTACS method generates very high vulnerability zones with surface waters and aquifer interactions. GOD method could be adequate for vulnerability mapping in karstified carbonate aquifers at small-moderate scales, and EPIK method can be used for large scale. GOD method is suitable for designing large area such as land management while DRASTIC has good accuracy and more real use in geoenvironmental detailed studies.

Multi-criteria decision assessments using Subjective Logic: Methodology and the case of urban water strategies

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Sharma, Ashok K.; Maheepala, Shiroma

2012-07-01

SummaryPlanning of regional and urban water resources, and in particular with Integrated Urban Water Management approaches, often considers inter-relationships between human uses of water, the health of the natural environment as well as the cost of various management strategies. Decision makers hence typically need to consider a combination of social, environmental and economic goals. The types of strategies employed can include water efficiency measures, water sensitive urban design, stormwater management, or catchment management. Therefore, decision makers need to choose between different scenarios and to evaluate them against a number of criteria. This type of problem has a discipline devoted to it, i.e. Multi-Criteria Decision Analysis, which has often been applied in water management contexts. This paper describes the application of Subjective Logic in a basic Bayesian Network to a Multi-Criteria Decision Analysis problem. By doing this, it outlines a novel methodology that explicitly incorporates uncertainty and information reliability. The application of the methodology to a known case study context allows for exploration. By making uncertainty and reliability of assessments explicit, it allows for assessing risks of various options, and this may help in alleviating cognitive biases and move towards a well formulated risk management policy.

Risks associated with clinical databases.

PubMed

Eleazar, P Y

1991-11-01

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

Prediction of Injuries and Injury Types in Army Basic Training, Infantry, Armor, and Cavalry Trainees Using a Common Fitness Screen.

PubMed

Sefton, JoEllen M; Lohse, K R; McAdam, J S

2016-11-01

 Musculoskeletal injuries (MSIs) are among the most important challenges facing our military. They influence career success and directly affect military readiness. Several methods of screening initial entry training (IET) soldiers are being tested in an effort to predict which soldiers will sustain an MSI and to develop injury-prevention programs. The Army 1-1-1 Fitness Assessment was examined to determine if it could be used as a screening and MSI prediction mechanism in male IET soldiers.  To determine if a relationship existed among the Army 1-1-1 Fitness Assessment results and MSI, MSI type, and program of instruction (POI) in male IET soldiers.  Retrospective cohort study.  Fort Benning, Georgia.  Male Army IET soldiers (N = 1788).  The likelihood of sustaining acute and overuse MSI was modelled using separate logistic regression analyses. The POI, run time, push-ups and sit-ups (combined into a single score), and IET soldier age were tested as predictors in a series of linear models.  With POI controlled, slower run time, fewer push-ups and sit-ups, and older age were positively correlated with acute MSI; only slower run time was correlated with overuse MSI. For both MSI types, cavalry POIs had a higher risk of acute and overuse MSIs than did basic combat training, armor, or infantry POIs.  The 1-1-1 Fitness Assessment predicted both the likelihood of MSI occurrence and type of MSI (acute or overuse). One-mile (1.6-km) run time predicted both overuse and acute MSIs, whereas the combined push-up and sit-up score predicted only acute MSIs. The MSIs varied by type of training (infantry, basic, armor, cavalry), which allowed the development of prediction equations by POI. We determined 1-1-1 Fitness Assessment cutoff scores for each event, thereby allowing the evaluation to be used as an MSI screening mechanism for IET soldiers.

Prediction of Injuries and Injury Types in Army Basic Training, Infantry, Armor, and Cavalry Trainees Using a Common Fitness Screen

PubMed Central

Sefton, JoEllen M.; Lohse, K. R.; McAdam, J. S.

2016-01-01

Context: Musculoskeletal injuries (MSIs) are among the most important challenges facing our military. They influence career success and directly affect military readiness. Several methods of screening initial entry training (IET) soldiers are being tested in an effort to predict which soldiers will sustain an MSI and to develop injury-prevention programs. The Army 1-1-1 Fitness Assessment was examined to determine if it could be used as a screening and MSI prediction mechanism in male IET soldiers. Objective: To determine if a relationship existed among the Army 1-1-1 Fitness Assessment results and MSI, MSI type, and program of instruction (POI) in male IET soldiers. Design: Retrospective cohort study. Setting: Fort Benning, Georgia. Patients or Other Participants: Male Army IET soldiers (N = 1788). Main Outcome Measure(s): The likelihood of sustaining acute and overuse MSI was modelled using separate logistic regression analyses. The POI, run time, push-ups and sit-ups (combined into a single score), and IET soldier age were tested as predictors in a series of linear models. Results: With POI controlled, slower run time, fewer push-ups and sit-ups, and older age were positively correlated with acute MSI; only slower run time was correlated with overuse MSI. For both MSI types, cavalry POIs had a higher risk of acute and overuse MSIs than did basic combat training, armor, or infantry POIs. Conclusions: The 1-1-1 Fitness Assessment predicted both the likelihood of MSI occurrence and type of MSI (acute or overuse). One-mile (1.6-km) run time predicted both overuse and acute MSIs, whereas the combined push-up and sit-up score predicted only acute MSIs. The MSIs varied by type of training (infantry, basic, armor, cavalry), which allowed the development of prediction equations by POI. We determined 1-1-1 Fitness Assessment cutoff scores for each event, thereby allowing the evaluation to be used as an MSI screening mechanism for IET soldiers. PMID:28068160

Safety assessment for hair-spray resins: risk assessment based on rodent inhalation studies.

PubMed

Carthew, Philip; Griffiths, Heather; Keech, Stephen; Hartop, Peter

2002-04-01

The methods involved in the safety assessment of resins used in hair-spray products have received little peer review, or debate in the published literature, despite their widespread use, in both hairdressing salons and the home. The safety assessment for these resins currently involves determining the type of lung pathology that can be caused in animal inhalation exposure studies, and establishing the no-observable-effect level (NOEL) for these pathologies. The likely human consumer exposure is determined by techniques that model the simulated exposure under "in use" conditions. From these values it is then possible to derive the likely safety factors for human exposure. An important part of this process would be to recognize the intrinsic differences between rodents and humans in terms of the respiratory doses that each species experiences during inhalation exposures, for the purpose of the safety assessment. Interspecies scaling factors become necessary when comparing the exposure doses experienced by rats, compared to humans, because of basic differences between species in lung clearance rates and the alveolar area in the lungs. The rodent inhalation data and modeled human exposure to Resin 6965, a resin polymer that is based on vinyl acetate, has been used to calculate the safety factor for human consumer exposure to this resin, under a range of "in use" exposure conditions. The use of this safety assessment process clearly demonstrates that Resin 6965 is acceptable for human consumer exposure under the conditions considered in this risk assessment.

Advancing Risk Analysis for Nanoscale Materials: Report from an International Workshop on the Role of Alternative Testing Strategies for Advancement: Advancing Risk Analysis for Nanoscale Materials

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

Shatkin, J. A.; Ong, Kimberly J.; Beaudrie, Christian

The Society for Risk Analysis (SRA) has a history of bringing thought leadership to topics of emerging risk. In September 2014, the SRA Emerging Nanoscale Materials Specialty Group convened an international workshop to examine the use of alternative testing strategies (ATS) for manufactured nanomaterials (NM) from a risk analysis perspective. Experts in NM environmental health and safety, human health, ecotoxicology, regulatory compliance, risk analysis, and ATS evaluated and discussed the state of the science for in vitro and other alternatives to traditional toxicology testing for NM. Based on this review, experts recommended immediate and near-term actions that would advance ATSmore » use in NM risk assessment. Three focal areas-human health, ecological health, and exposure considerations-shaped deliberations about information needs, priorities, and the next steps required to increase confidence in and use of ATS in NM risk assessment. The deliberations revealed that ATS are now being used for screening, and that, in the near term, ATS could be developed for use in read-across or categorization decision making within certain regulatory frameworks. Participants recognized that leadership is required from within the scientific community to address basic challenges, including standardizing materials, protocols, techniques and reporting, and designing experiments relevant to real-world conditions, as well as coordination and sharing of large-scale collaborations and data. Experts agreed that it will be critical to include experimental parameters that can support the development of adverse outcome pathways. Numerous other insightful ideas for investment in ATS emerged throughout the discussions and are further highlighted in this article.« less

Advancing Risk Analysis for Nanoscale Materials: Report from an International Workshop on the Role of Alternative Testing Strategies for Advancement.

PubMed

Shatkin, J A; Ong, Kimberly J; Beaudrie, Christian; Clippinger, Amy J; Hendren, Christine Ogilvie; Haber, Lynne T; Hill, Myriam; Holden, Patricia; Kennedy, Alan J; Kim, Baram; MacDonell, Margaret; Powers, Christina M; Sharma, Monita; Sheremeta, Lorraine; Stone, Vicki; Sultan, Yasir; Turley, Audrey; White, Ronald H

2016-08-01

The Society for Risk Analysis (SRA) has a history of bringing thought leadership to topics of emerging risk. In September 2014, the SRA Emerging Nanoscale Materials Specialty Group convened an international workshop to examine the use of alternative testing strategies (ATS) for manufactured nanomaterials (NM) from a risk analysis perspective. Experts in NM environmental health and safety, human health, ecotoxicology, regulatory compliance, risk analysis, and ATS evaluated and discussed the state of the science for in vitro and other alternatives to traditional toxicology testing for NM. Based on this review, experts recommended immediate and near-term actions that would advance ATS use in NM risk assessment. Three focal areas-human health, ecological health, and exposure considerations-shaped deliberations about information needs, priorities, and the next steps required to increase confidence in and use of ATS in NM risk assessment. The deliberations revealed that ATS are now being used for screening, and that, in the near term, ATS could be developed for use in read-across or categorization decision making within certain regulatory frameworks. Participants recognized that leadership is required from within the scientific community to address basic challenges, including standardizing materials, protocols, techniques and reporting, and designing experiments relevant to real-world conditions, as well as coordination and sharing of large-scale collaborations and data. Experts agreed that it will be critical to include experimental parameters that can support the development of adverse outcome pathways. Numerous other insightful ideas for investment in ATS emerged throughout the discussions and are further highlighted in this article. © 2016 Society for Risk Analysis.

Diagnostic Value of Vaginal Discharge, Wet Mount and Vaginal pH – An Update on the Basics of Gynecologic Infectiology

PubMed Central

Frobenius, W.; Bogdan, C.

2015-01-01

The majority of uncomplicated vulvovaginal complaints (e.g. bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis) can be detected with uncomplicated basic infectiological tests and can usually be treated effectively without requiring further diagnostic procedures. Tests include measurement of vaginal pH, preparation and assessment of wet mount slides prepared from vaginal or cervical discharge, and the correct clinical and microbiological classification of findings. In Germany, at least in recent years, this has not been sufficiently taught or practiced. As new regulations on specialist gynecologic training in Germany are currently being drawn up, this overview provides basic information on gynecologic infectiology and summarizes clinically relevant aspects of recent microbiological findings on the physiology and pathology of vaginal flora. The clinical signs and symptoms of aerobic vaginitis, the pathogenesis of which is still not completely understood, are also reviewed. Finally, the symptoms, indications and risk factors for pelvic inflammatory disease (PID) are presented. In contrast to the above-listed infections, PID requires immediate culture of the pathogen from samples (e.g. obtained by laparoscopy) with microbiological diagnostic procedures carried out by specialist laboratories. A schematic summary of all pathologies discussed here is presented. PMID:26028693

Executive functions and basic symptoms in adolescent antisocial behavior: a cross-sectional study on an Italian sample of late-onset offenders.

PubMed

Muscatello, Maria Rosaria A; Scimeca, Giuseppe; Pandolfo, Gianluca; Micò, Umberto; Romeo, Vincenzo M; Mallamace, Domenico; Mento, Carmela; Zoccali, Rocco; Bruno, Antonio

2014-04-01

Executive cognitive functions (ECFs) and other cognitive impairments, such as lower IQ and verbal deficits, have been associated with the pattern of antisocial and delinquent behavior starting in childhood (early-onset), but not with late-onset antisocial behavior. Beyond objective measures of ECF, basic symptoms are prodromal, subjectively experienced cognitive, perceptual, affective, and social disturbances, associated with a range of psychiatric disorders, mainly with psychosis. The goal of the present study was to examine ECF and basic symptoms in a sample of late-onset juvenile delinquents. Two-hundred nine male adolescents (aged 15-20 years) characterized by a pattern of late-onset delinquent behavior with no antecedents of Conduct Disorder, were consecutively recruited from the Social Services of the Department of Juvenile Justice of the city of Messina (Italy), and compared with nonantisocial controls matched for age, educational level, and socio-demographic features on measures for ECF dysfunction and basic symptoms. Significant differences between late-onset offenders (completers=147) and control group (n=150) were found on ECF and basic symptoms measures. Chi-square analysis showed that a significantly greater number of late-onset offending participants scored in the clinical range on several ECF measures. Executive cognitive impairment, even subtle and subclinical, along with subjective symptoms of cognitive dysfunction (basic symptom), may be contributing factor in the development and persistence of antisocial behaviors displayed by late-onset adolescent delinquents. The findings also suggest the need for additional research aimed to assess a broader range of cognitive abilities and specific vulnerability and risk factors for late-onset adolescent offenders. Copyright © 2014 Elsevier Inc. All rights reserved.

A retrospective cohort study on the risk assessment of newly certificated long-term care need of elderly individuals in a community: Basic checklist and specific health checkup.

PubMed

Katsura, Toshiki; Fujimoto, Megumi; Shizawa, Miho; Hoshino, Akiko; Usui, Kanae; Yokoyama, Eri; Hara, Mayumi

2017-11-01

Objective: This study aimed to examine the factors influencing the requirement of a certificate of long-term care using a basic checklist and items listed in the Special Health Checkup. Method: This study included 7,820 individuals living in Uji city, who were selected from among 8,000 elderly individuals who, in 2008, underwent a specific health checkup (hereafter referred to as the 'specific health checkup for the old-old elderly individuals') for those aged 75 years and above. They answered questions from basic checklists at the time, and 180 individuals were excluded as they had already qualified for requiring the certificate of long-term care at the time of the checkup. The follow-up period extended from the day of the specific health checkup for the old-old elderly individuals to March 31, 2013. The data were analyzed using the certificate of needing long-term care as the response variable. The explanatory variables were the basic attributes, items listed in the specific health checkup for the old-old elderly individuals, interview sheets, and basic checklists. Cox proportional hazards regression analysis was conducted. Results: In total, 1,280 elderly individuals qualified for requiring the certificate of needing long-term care. The risk factors for the young-old elderly individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio {HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the previous year (HR=1.87), the use of support for standing up after being seated on a chair (HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down (HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as well as an increased difficulty in eating tough food items compared with 6 months prior (HR=1.44). The risk factors for the old-old elderly individuals were as follows: a positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of appreciation of the activities they had previously participated in, over a span of 2 weeks (HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and the anxiety of falling down (HR=1.20). Conclusion: The items listed in the specific medical checkup as well as the basic checklists were found to be risk factors for both the young-old elderly individuals and the old-old elderly individuals, indicating the need to utilize these lists for the prevention of nursing even in the late stages of life. Moreover, these results suggest the importance of screening elderly individuals suffering from hyperkinesis using the basic checklist and conducting preventive interventions in order to maintain and improve their physical functions.

Reliability and Probabilistic Risk Assessment - How They Play Together

NASA Technical Reports Server (NTRS)

Safie, Fayssal M.; Stutts, Richard G.; Zhaofeng, Huang

2015-01-01

PRA methodology is one of the probabilistic analysis methods that NASA brought from the nuclear industry to assess the risk of LOM, LOV and LOC for launch vehicles. PRA is a system scenario based risk assessment that uses a combination of fault trees, event trees, event sequence diagrams, and probability and statistical data to analyze the risk of a system, a process, or an activity. It is a process designed to answer three basic questions: What can go wrong? How likely is it? What is the severity of the degradation? Since 1986, NASA, along with industry partners, has conducted a number of PRA studies to predict the overall launch vehicles risks. Planning Research Corporation conducted the first of these studies in 1988. In 1995, Science Applications International Corporation (SAIC) conducted a comprehensive PRA study. In July 1996, NASA conducted a two-year study (October 1996 - September 1998) to develop a model that provided the overall Space Shuttle risk and estimates of risk changes due to proposed Space Shuttle upgrades. After the Columbia accident, NASA conducted a PRA on the Shuttle External Tank (ET) foam. This study was the most focused and extensive risk assessment that NASA has conducted in recent years. It used a dynamic, physics-based, integrated system analysis approach to understand the integrated system risk due to ET foam loss in flight. Most recently, a PRA for Ares I launch vehicle has been performed in support of the Constellation program. Reliability, on the other hand, addresses the loss of functions. In a broader sense, reliability engineering is a discipline that involves the application of engineering principles to the design and processing of products, both hardware and software, for meeting product reliability requirements or goals. It is a very broad design-support discipline. It has important interfaces with many other engineering disciplines. Reliability as a figure of merit (i.e. the metric) is the probability that an item will perform its intended function(s) for a specified mission profile. In general, the reliability metric can be calculated through the analyses using reliability demonstration and reliability prediction methodologies. Reliability analysis is very critical for understanding component failure mechanisms and in identifying reliability critical design and process drivers. The following sections discuss the PRA process and reliability engineering in detail and provide an application where reliability analysis and PRA were jointly used in a complementary manner to support a Space Shuttle flight risk assessment.

Assessing population exposure for landslide risk analysis using dasymetric cartography

NASA Astrophysics Data System (ADS)

Garcia, Ricardo A. C.; Oliveira, Sérgio C.; Zêzere, José L.

2016-12-01

Assessing the number and locations of exposed people is a crucial step in landslide risk management and emergency planning. The available population statistical data frequently have insufficient detail for an accurate assessment of potentially exposed people to hazardous events, mainly when they occur at the local scale, such as with landslides. The present study aims to apply dasymetric cartography to improving population spatial resolution and to assess the potentially exposed population. An additional objective is to compare the results with those obtained with a more common approach that uses, as spatial units, basic census units, which are the best spatial data disaggregation and detailed information available for regional studies in Portugal. Considering the Portuguese census data and a layer of residential building footprint, which was used as ancillary information, the number of exposed inhabitants differs significantly according to the approach used. When the census unit approach is used, considering the three highest landslide susceptible classes, the number of exposed inhabitants is in general overestimated. Despite the associated uncertainties of a general cost-benefit analysis, the presented methodology seems to be a reliable approach for gaining a first approximation of a more detailed estimation of exposed people. The approach based on dasymetric cartography allows the spatial resolution of population over large areas to be increased and enables the use of detailed landslide susceptibility maps, which are valuable for improving the exposed population assessment.

The psychological toll of slum living in Mumbai, India: a mixed methods study

PubMed Central

Subbaraman, Ramnath; Nolan, Laura; Shitole, Tejal; Sawant, Kiran; Shitole, Shrutika; Sood, Kunal; Nanarkar, Mahesh; Ghannam, Jess; Betancourt, Theresa S.; Bloom, David E.; Patil-Deshmukh, Anita

2014-01-01

In India, “non-notified” slums are not officially recognized by city governments; they suffer from insecure tenure and poorer access to basic services than “notified” (government-recognized) slums. We conducted a study in a non-notified slum of about 12,000 people in Mumbai to determine the prevalence of individuals at high risk for having a common mental disorder (i.e., depression and anxiety), to ascertain the impact of mental health on the burden of functional impairment, and to assess the influence of the slum environment on mental health. We gathered qualitative data (six focus group discussions and 40 individual interviews in July-November 2011), with purposively sampled participants, and quantitative data (521 structured surveys in February 2012), with respondents selected using community-level random sampling. For the surveys, we administered the General Health Questionnaire-12 (GHQ) to screen for common mental disorders (CMDs), the WHO Disability Assessment Schedule 2.0 (WHO DAS) to screen for functional impairment, and a slum adversity questionnaire, which we used to create a composite Slum Adversity Index (SAI) score. Twenty-three percent of individuals have a GHQ score ≥5, suggesting they are at high risk for having a CMD. Psychological distress is a major contributor to the slum’s overall burden of functional impairment. In a multivariable logistic regression model, household income, poverty-related factors, and the SAI score all have strong independent associations with CMD risk. The qualitative findings suggest that non-notified status plays a central role in creating psychological distress—by creating and exacerbating deprivations that serve as sources of stress, by placing slum residents in an inherently antagonistic relationship with the government through the criminalization of basic needs, and by shaping a community identity built on a feeling of social exclusion from the rest of the city. PMID:25189736

The psychological toll of slum living in Mumbai, India: a mixed methods study.

PubMed

Subbaraman, Ramnath; Nolan, Laura; Shitole, Tejal; Sawant, Kiran; Shitole, Shrutika; Sood, Kunal; Nanarkar, Mahesh; Ghannam, Jess; Betancourt, Theresa S; Bloom, David E; Patil-Deshmukh, Anita

2014-10-01

In India, "non-notified" slums are not officially recognized by city governments; they suffer from insecure tenure and poorer access to basic services than "notified" (government-recognized) slums. We conducted a study in a non-notified slum of about 12,000 people in Mumbai to determine the prevalence of individuals at high risk for having a common mental disorder (i.e., depression and anxiety), to ascertain the impact of mental health on the burden of functional impairment, and to assess the influence of the slum environment on mental health. We gathered qualitative data (six focus group discussions and 40 individual interviews in July-November 2011), with purposively sampled participants, and quantitative data (521 structured surveys in February 2012), with respondents selected using community-level random sampling. For the surveys, we administered the General Health Questionnaire-12 (GHQ) to screen for common mental disorders (CMDs), the WHO Disability Assessment Schedule 2.0 (WHO DAS) to screen for functional impairment, and a slum adversity questionnaire, which we used to create a composite Slum Adversity Index (SAI) score. Twenty-three percent of individuals have a GHQ score≥5, suggesting they are at high risk for having a CMD. Psychological distress is a major contributor to the slum's overall burden of functional impairment. In a multivariable logistic regression model, household income, poverty-related factors, and the SAI score all have strong independent associations with CMD risk. The qualitative findings suggest that non-notified status plays a central role in creating psychological distress-by creating and exacerbating deprivations that serve as sources of stress, by placing slum residents in an inherently antagonistic relationship with the government through the criminalization of basic needs, and by shaping a community identity built on a feeling of social exclusion from the rest of the city. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Forecasting COPD hospitalization in the clinic: optimizing the chronic respiratory questionnaire

PubMed Central

Abascal-Bolado, Beatriz; Novotny, Paul J; Sloan, Jeff A; Karpman, Craig; Dulohery, Megan M; Benzo, Roberto P

2015-01-01

Purpose Forecasting hospitalization in patients with COPD has gained significant interest in the field of COPD care. There is a need to find simple tools that can help clinicians to stratify the risk of hospitalization in these patients at the time of care. The perception of quality of life has been reported to be independently associated with hospitalizations, but questionnaires are impractical for daily clinical use. Individual questions from valid questionnaires can have robust predictive abilities, as has been suggested in previous reports, as a way to use patient-reported outcomes to forecast important events like hospitalizations in COPD. Our primary aim was to assess the predictive value of individual questions from the Chronic Respiratory Questionnaire Self-Assessment Survey (CRQ-SAS) on the risk of hospitalization and to develop a clinically relevant and simple algorithm that clinicians can use in routine practice to identify patients with an increased risk of hospitalization. Patients and methods A total of 493 patients with COPD prospectively recruited from an outpatient pulmonary clinic completed the CRQ-SAS, demographic information, pulmonary function testing, and clinical outcomes. The cohort had a mean age of 70 years, was 54% male, with forced expiratory volume in 1 second percentage predicted 42.8±16.7, and modified Medical Research Council dyspnea scale score of 2±1.13. Results Our analysis validated the original CRQ-SAS domains. Importantly, recursive partitioning analysis identified three CRQ-SAS items regarding fear or panic of breathlessness, dyspnea with basic activities of daily living, and depressive symptoms that were highly predictive of hospitalization. We propose a robust (area under the curve =0.70) but short and easy algorithm for daily clinical care to forecast hospitalizations in patients with COPD. Conclusion We identified three themes – fear of breathlessness, dyspnea with basic activities of daily living, and depressive symptoms – as important patient-reported outcomes to predict hospitalizations, and propose a short and easy algorithm to forecast hospitalizations in patients with COPD. PMID:26543362

Forecasting COPD hospitalization in the clinic: optimizing the chronic respiratory questionnaire.

PubMed

Abascal-Bolado, Beatriz; Novotny, Paul J; Sloan, Jeff A; Karpman, Craig; Dulohery, Megan M; Benzo, Roberto P

2015-01-01

Forecasting hospitalization in patients with COPD has gained significant interest in the field of COPD care. There is a need to find simple tools that can help clinicians to stratify the risk of hospitalization in these patients at the time of care. The perception of quality of life has been reported to be independently associated with hospitalizations, but questionnaires are impractical for daily clinical use. Individual questions from valid questionnaires can have robust predictive abilities, as has been suggested in previous reports, as a way to use patient-reported outcomes to forecast important events like hospitalizations in COPD. Our primary aim was to assess the predictive value of individual questions from the Chronic Respiratory Questionnaire Self-Assessment Survey (CRQ-SAS) on the risk of hospitalization and to develop a clinically relevant and simple algorithm that clinicians can use in routine practice to identify patients with an increased risk of hospitalization. A total of 493 patients with COPD prospectively recruited from an outpatient pulmonary clinic completed the CRQ-SAS, demographic information, pulmonary function testing, and clinical outcomes. The cohort had a mean age of 70 years, was 54% male, with forced expiratory volume in 1 second percentage predicted 42.8±16.7, and modified Medical Research Council dyspnea scale score of 2±1.13. Our analysis validated the original CRQ-SAS domains. Importantly, recursive partitioning analysis identified three CRQ-SAS items regarding fear or panic of breathlessness, dyspnea with basic activities of daily living, and depressive symptoms that were highly predictive of hospitalization. We propose a robust (area under the curve =0.70) but short and easy algorithm for daily clinical care to forecast hospitalizations in patients with COPD. We identified three themes - fear of breathlessness, dyspnea with basic activities of daily living, and depressive symptoms - as important patient-reported outcomes to predict hospitalizations, and propose a short and easy algorithm to forecast hospitalizations in patients with COPD.

Auditory risk assessment of college music students in jazz band-based instructional activity.

PubMed

Gopal, Kamakshi V; Chesky, Kris; Beschoner, Elizabeth A; Nelson, Paul D; Stewart, Bradley J

2013-01-01

It is well-known that musicians are at risk for music-induced hearing loss, however, systematic evaluation of music exposure and its effects on the auditory system are still difficult to assess. The purpose of the study was to determine if college students in jazz band-based instructional activity are exposed to loud classroom noise and consequently exhibit acute but significant changes in basic auditory measures compared to non-music students in regular classroom sessions. For this we (1) measured and compared personal exposure levels of college students (n = 14) participating in a routine 50 min jazz ensemble-based instructional activity (experimental) to personal exposure levels of non-music students (n = 11) participating in a 50-min regular classroom activity (control), and (2) measured and compared pre- to post-auditory changes associated with these two types of classroom exposures. Results showed that the L eq (equivalent continuous noise level) generated during the 50 min jazz ensemble-based instructional activity ranged from 95 dBA to 105.8 dBA with a mean of 99.5 ± 2.5 dBA. In the regular classroom, the L eq ranged from 46.4 dBA to 67.4 dBA with a mean of 49.9 ± 10.6 dBA. Additionally, significant differences were observed in pre to post-auditory measures between the two groups. The experimental group showed a significant temporary threshold shift bilaterally at 4000 Hz (P < 0.05), and a significant decrease in the amplitude of transient-evoked otoacoustic emission response in both ears (P < 0.05) after exposure to the jazz ensemble-based instructional activity. No significant changes were found in the control group between pre- and post-exposure measures. This study quantified the noise exposure in jazz band-based practice sessions and its effects on basic auditory measures. Temporary, yet significant, auditory changes seen in music students place them at risk for hearing loss compared to their non-music cohorts.

Genetically modified crops: success, safety assessment, and public concern.

PubMed

Singh, Om V; Ghai, Shivani; Paul, Debarati; Jain, Rakesh K

2006-08-01

With the emergence of transgenic technologies, new ways to improve the agronomic performance of crops for food, feed, and processing applications have been devised. In addition, ability to express foreign genes using transgenic technologies has opened up options for producing large quantities of commercially important industrial or pharmaceutical products in plants. Despite this high adoption rate and future promises, there is a multitude of concerns about the impact of genetically modified (GM) crops on the environment. Potential contamination of the environment and food chains has prompted detailed consideration of how such crops and the molecules that they produce can be effectively isolated and contained. One of the reasonable steps after creating a transgenic plant is to evaluate its potential benefits and risks to the environment and these should be compared to those generated by traditional agricultural practices. The precautionary approach in risk management of GM plants may make it necessary to monitor significant wild and weed populations that might be affected by transgene escape. Effective risk assessment and monitoring mechanisms are the basic prerequisites of any legal framework to adequately address the risks and watch out for new risks. Several agencies in different countries monitor the release of GM organisms or frame guidelines for the appropriate application of recombinant organisms in agro-industries so as to assure the safe use of recombinant organisms and to achieve sound overall development. We feel that it is important to establish an internationally harmonized framework for the safe handling of recombinant DNA organisms within a few years.

Inexperience and risky decisions of young adolescents, as pedestrians and cyclists, in interactions with lorries, and the effects of competency versus awareness education.

PubMed

Twisk, Divera; Vlakveld, Willem; Mesken, Jolieke; Shope, Jean T; Kok, Gerjo

2013-06-01

Road injuries are a prime cause of death in early adolescence. Often road safety education (RSE) is used to target risky road behaviour in this age group. These RSE programmes are frequently based on the assumption that deliberate risk taking rather than lack of competency underlies risk behaviour. This study tested the competency of 10-13 year olds, by examining their decisions - as pedestrians and cyclists - in dealing with blind spot areas around lorries. Also, the effects of an awareness programme and a competency programme on these decisions were evaluated. Table-top models were used, representing seven scenarios that differed in complexity: one basic scenario to test the identification of blind spot areas, and 6 traffic scenarios to test behaviour in traffic situations of low or high task complexity. Using a quasi-experimental design (pre-test and post-test reference group design without randomization), the programme effects were assessed by requiring participants (n=62) to show, for each table-top traffic scenario, how they would act if they were in that traffic situation. On the basic scenario, at pre-test 42% of the youngsters identified all blind spots correctly, but only 27% showed safe behaviour in simple scenarios and 5% in complex scenarios. The competency programme yielded improved performance on the basic scenario but not on the traffic scenarios, whereas the awareness programme did not result in any improvements. The correlation between improvements on the basic scenarios and the traffic scenarios was not significant. Young adolescents have not yet mastered the necessary skills for safe performance in simple and complex traffic situations, thus underlining the need for effective prevention programmes. RSE may improve the understanding of blind spot areas but this does not 'automatically' transfer to performance in traffic situations. Implications for the design of RSE are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

GERMcode: A Stochastic Model for Space Radiation Risk Assessment

NASA Technical Reports Server (NTRS)

Kim, Myung-Hee Y.; Ponomarev, Artem L.; Cucinotta, Francis A.

2012-01-01

A new computer model, the GCR Event-based Risk Model code (GERMcode), was developed to describe biophysical events from high-energy protons and high charge and energy (HZE) particles that have been studied at the NASA Space Radiation Laboratory (NSRL) for the purpose of simulating space radiation biological effects. In the GERMcode, the biophysical description of the passage of HZE particles in tissue and shielding materials is made with a stochastic approach that includes both particle track structure and nuclear interactions. The GERMcode accounts for the major nuclear interaction processes of importance for describing heavy ion beams, including nuclear fragmentation, elastic scattering, and knockout-cascade processes by using the quantum multiple scattering fragmentation (QMSFRG) model. The QMSFRG model has been shown to be in excellent agreement with available experimental data for nuclear fragmentation cross sections. For NSRL applications, the GERMcode evaluates a set of biophysical properties, such as the Poisson distribution of particles or delta-ray hits for a given cellular area and particle dose, the radial dose on tissue, and the frequency distribution of energy deposition in a DNA volume. By utilizing the ProE/Fishbowl ray-tracing analysis, the GERMcode will be used as a bi-directional radiation transport model for future spacecraft shielding analysis in support of Mars mission risk assessments. Recent radiobiological experiments suggest the need for new approaches to risk assessment that include time-dependent biological events due to the signaling times for activation and relaxation of biological processes in cells and tissue. Thus, the tracking of the temporal and spatial distribution of events in tissue is a major goal of the GERMcode in support of the simulation of biological processes important in GCR risk assessments. In order to validate our approach, basic radiobiological responses such as cell survival curves, mutation, chromosomal aberrations, and representative mouse tumor induction curves are implemented into the GERMcode. Extension of these descriptions to other endpoints related to non-targeted effects and biochemical pathway responses will be discussed.

Assessing the risks of trace elements in environmental materials under selected greenhouse vegetable production systems of China.

PubMed

Chen, Yong; Huang, Biao; Hu, Wenyou; Weindorf, David C; Liu, Xiaoxiao; Niedermann, Silvana

2014-02-01

The risk assessment of trace elements of different environmental media in conventional and organic greenhouse vegetable production systems (CGVPS and OGVPS) can reveal the influence of different farming philosophy on the trace element accumulations and their effects on human health. These provide important basic data for the environmental protection and human health. This paper presents trace element accumulation characteristics of different land uses; reveals the difference of soil trace element accumulation both with and without consideration of background levels; compares the trace element uptake by main vegetables; and assesses the trace element risks of soils, vegetables, waters and agricultural inputs, using two selected greenhouse vegetable systems in Nanjing, China as examples. Results showed that greenhouse vegetable fields contained significant accumulations of Zn in CGVPS relative to rice-wheat rotation fields, open vegetable fields, and geochemical background levels, and this was the case for organic matter in OGVPS. The comparative analysis of the soil medium in two systems with consideration of geochemical background levels and evaluation of the geo-accumulation pollution index achieved a more reasonable comparison and accurate assessment relative to the direct comparison analysis and the evaluation of the Nemerow pollution index, respectively. According to the Chinese food safety standards and the value of the target hazard quotient or hazard index, trace element contents of vegetables were safe for local residents in both systems. However, the spatial distribution of the estimated hazard index for producers still presented certain specific hotspots which may cause potential risk for human health in CGVPS. The water was mainly influenced by nitrogen, especially for CGVPS, while the potential risk of Cd and Cu pollution came from sediments in OGVPS. The main inputs for trace elements were fertilizers which were relatively safe based on relevant standards; but excess application caused trace element accumulations in the environmental media. Copyright © 2013 Elsevier B.V. All rights reserved.

Assessing Risks of Mine Tailing Dam Failures

NASA Astrophysics Data System (ADS)

Concha Larrauri, P.; Lall, U.

2017-12-01

The consequences of tailings dam failures can be catastrophic for communities and ecosystems in the vicinity of the dams. The failure of the Fundão tailings dam at the Samarco mine in 2015 killed 19 people with severe consequences for the environment. The financial and legal consequences of a tailings dam failure can also be significant for the mining companies. For the Fundão tailings dam, the company had to pay 6 billion dollars in fines and twenty-one executives were charged with qualified murder. There are tenths of thousands of active, inactive, and abandoned tailings dams in the world and there is a need to better understand the hazards posed by these structures to downstream populations and ecosystems. A challenge to assess the risks of tailings dams in a large scale is that many of them are not registered in publicly available databases and there is little information about their current physical state. Additionally, hazard classifications of tailings dams - common in many countries- tend to be subjective, include vague parameter definitions, and are not always updated over time. Here we present a simple methodology to assess and rank the exposure to tailings dams using ArcGIS that removes subjective interpretations. The method uses basic information such as current dam height, storage volume, topography, population, land use, and hydrological data. A hazard rating risk was developed to compare the potential extent of the damage across dams. This assessment provides a general overview of what in the vicinity of the tailings dams could be affected in case of a failure and a way to rank tailings dams that is directly linked to the exposure at any given time. One hundred tailings dams in Minas Gerais, Brazil were used for the test case. This ranking approach could inform the risk management strategy of the tailings dams within a company, and when disclosed, it could enable shareholders and the communities to make decisions on the risks they are taking.

Basic numerical competences in large-scale assessment data: Structure and long-term relevance.

PubMed

Hirsch, Stefa; Lambert, Katharina; Coppens, Karien; Moeller, Korbinian

2018-03-01

Basic numerical competences are seen as building blocks for later numerical and mathematical achievement. The current study aimed at investigating the structure of early numeracy reflected by different basic numerical competences in kindergarten and its predictive value for mathematical achievement 6 years later using data from large-scale assessment. This allowed analyses based on considerably large sample sizes (N > 1700). A confirmatory factor analysis indicated that a model differentiating five basic numerical competences at the end of kindergarten fitted the data better than a one-factor model of early numeracy representing a comprehensive number sense. In addition, these basic numerical competences were observed to reliably predict performance in a curricular mathematics test in Grade 6 even after controlling for influences of general cognitive ability. Thus, our results indicated a differentiated view on early numeracy considering basic numerical competences in kindergarten reflected in large-scale assessment data. Consideration of different basic numerical competences allows for evaluating their specific predictive value for later mathematical achievement but also mathematical learning difficulties. Copyright © 2017 Elsevier Inc. All rights reserved.

The Distribution and Health Risk Assessment of Metals in Soils in the Vicinity of Industrial Sites in Dongguan, China

PubMed Central

Liu, Chao; Lu, Liwen; Huang, Ting; Huang, Yalin; Ding, Lei; Zhao, Weituo

2016-01-01

Exponential industrialization and rapid urbanization have resulted in contamination of soil by metals from anthropogenic sources in Dongguan, China. The aims of this research were to determine the concentration and distribution of various metals (arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), lead (Pb) and zinc (Zn)) in soils and identify their potential health risks for local residents. A total of 106 soil samples were collected from the vicinity of industrial sites in Dongguan. Two types of samples were collected from each site: topsoil (0–20 cm, TS) and shallow soil (20–50 cm, SS). Results showed that the soils were contaminated by metals and pollution was mainly focused on TS. The geoaccumulation index (Igeo) and pollution indexes (PI) implied that there was a slight increase in the concentrations of Cd, Cu, Hg, Ni, and Pb, but the metal pollution caused by industrial activities was less severe, and elements of As and Cr exhibited non-pollution level. The risk assessment results suggested that there was a potential health risk associated with As and Cr exposure for residents because the carcinogenic risks of As and Cr via corresponding exposure pathways exceeded the safety limit of 10−6 (the acceptable level of carcinogenic risk for humans). Furthermore, oral ingestion and inhalation of soil particles are the main exposure pathways for As and Cr to enter the human body. This study may provide basic information of metal pollution control and human health protection in the vicinity of industrial regions. PMID:27548198

Improving health, safety and energy efficiency in New Zealand through measuring and applying basic housing standards.

PubMed

Gillespie-Bennett, Julie; Keall, Michael; Howden-Chapman, Philippa; Baker, Michael G

2013-08-02

Substandard housing is a problem in New Zealand. Historically there has been little recognition of the important aspects of housing quality that affect people's health and safety. In this viewpoint article we outline the importance of assessing these factors as an essential step to improving the health and safety of New Zealanders and household energy efficiency. A practical risk assessment tool adapted to New Zealand conditions, the Healthy Housing Index (HHI), measures the physical characteristics of houses that affect the health and safety of the occupants. This instrument is also the only tool that has been validated against health and safety outcomes and reported in the international peer-reviewed literature. The HHI provides a framework on which a housing warrant of fitness (WOF) can be based. The HHI inspection takes about one hour to conduct and is performed by a trained building inspector. To maximise the effectiveness of this housing quality assessment we envisage the output having two parts. The first would be a pass/fail WOF assessment showing whether or not the house meets basic health, safety and energy efficiency standards. The second component would rate each main assessment area (health, safety and energy efficiency), potentially on a five-point scale. This WOF system would establish a good minimum standard for rental accommodation as well encouraging improved housing performance over time. In this article we argue that the HHI is an important, validated, housing assessment tool that will improve housing quality, leading to better health of the occupants, reduced home injuries, and greater energy efficiency. If required, this tool could be extended to also cover resilience to natural hazards, broader aspects of sustainability, and the suitability of the dwelling for occupants with particular needs.

Survey of critical failure events in on-chip interconnect by fault tree analysis

NASA Astrophysics Data System (ADS)

Yokogawa, Shinji; Kunii, Kyousuke

2018-07-01

In this paper, a framework based on reliability physics is proposed for adopting fault tree analysis (FTA) to the on-chip interconnect system of a semiconductor. By integrating expert knowledge and experience regarding the possibilities of failure on basic events, critical issues of on-chip interconnect reliability will be evaluated by FTA. In particular, FTA is used to identify the minimal cut sets with high risk priority. Critical events affecting the on-chip interconnect reliability are identified and discussed from the viewpoint of long-term reliability assessment. The moisture impact is evaluated as an external event.

The biology of cancer: what do oncology nurses really need to know.

PubMed

Eggert, Julie

2011-02-01

To describe the impact of genetics and genomics on the biology of cancer and the implications for patient care. Pubmed; CINAHL. Cancer research in genetics/genomics has identified new mechanisms influencing personalized risk assessment/management, early detection, cancer treatment, and long-term screening/surveillance. Understanding the basics of genetics/genomics on the biology of cancer will facilitate patient education and care delivery, including the administration and monitoring of genetically targeted therapies whose toxicities may in part be mediated by the molecular pathways targeted by the specific agent. Copyright © 2011 Elsevier Inc. All rights reserved.

Navigating Declining Budgets, Political Hurdles: A New Vision for the Future of Geoscience

NASA Astrophysics Data System (ADS)

Gagosian, Robert B.

2013-06-01

The Oklahoma tornadoes, Superstorm Sandy, the Tohoku tsunami, and the Deepwater Horizon oil spill are just a few examples of oceanic, atmospheric, and other Earth system disasters in the past 3 years that together claimed thousands of lives and caused hundreds of billions of dollars of damage. Basic and applied research in the geosciences were essential in supporting early warnings and forecasts that were used not only to protect lives when these natural disasters struck but also to assess risks and help society to be better able to adapt and recover after disaster struck.

[Investments of research and treatment of brain diseases will pay of time].

PubMed

Lindsberg, Perttu J; Castrén, Eero; Korkeila, Jyrki; Alho, Hannu; Erkinjuntti, Timo; Isometsä, Erkki; Kalso, Eija; Marttunen, Mauri; Pihko, Helena; Tienari, Pentti; Wartiovaara, Anu; Jäkälä, Pekka; Kälviäinen, Reetta; Soininen, Hilkka; Tiihonen, Jari; Karlsson, Hasse; Rinne, Juha; Roine, Risto O; Elovaara, Irina; Tamminen, Tuula; Ohman, Juha; Majamaa, Kari; Hari, Riitta

2014-01-01

In 2010, a quarter of direct healthcare cost in Europe were spent on brain diseases. The importance of preventing and treating brain diseases and maintaining of functional capacity of the brain will increase in our society with ageing population and with increasing cognitive requirements of modern working life. Public funding of basic and clinical neuroscience has, however, frozen to levels achieved years ago, clinical research of brain diseases being at a particular risk. Research projects directed to prevention, treatment, and rehabilitation of brain diseases will pay off, also when assessed by economic measures.

Vaccination of Ferrets for Rabies and Distemper.

PubMed

Wade, Laura L

2018-01-01

Companion ferrets need to be vaccinated against 2 viral diseases that cause neurologic illness: canine distemper and rabies. Although not common in ferrets, both viruses are fatal in ferrets and rabies virus is also fatal in humans. In this article, we provide a basic review of the 2 diseases, highlighting key neurologic concerns. We also review and update current vaccine concerns from a practitioner's perspective, including available vaccines, vaccine schedule recommendations, vaccine reactions, and risk assessment. Last, we mention the ferret and its use in cutting-edge vaccine development. Copyright © 2017 Elsevier Inc. All rights reserved.

A new quality of bone ultrasound research.

PubMed

Gluer, C C

2008-07-01

Quantitative ultrasound (QUS) methods have strong power to predict osteoporotic fractures, but they are also very relevant for the assessment of bone quality. A representative sample of recent studies addressing these topics can be found in this special issue. Further pursuit of these methods will establish micro-QUS imaging methods as tools for measuring specific aspects of bone quality. Once this is achieved, we will be able to link such data to the clinical QUS methods used in vivo to determine which aspects of bone quality cause QUS to be a predictor of fracture risk that is independent of bone mineral density (BMD). Potentially this could lead to the development of a new generation of QUS devices for improved and expanded clinical assessment. Good quality of basic science work will thus lead to good quality of clinical patient examinations on the basis of a more detailed assessment of bone quality.

A Value Measure for Public-Sector Enterprise Risk Management: A TSA Case Study.

PubMed

Fletcher, Kenneth C; Abbas, Ali E

2018-05-01

This article presents a public value measure that can be used to aid executives in the public sector to better assess policy decisions and maximize value to the American people. Using Transportation Security Administration (TSA) programs as an example, we first identify the basic components of public value. We then propose a public value account to quantify the outcomes of various risk scenarios, and we determine the certain equivalent of several important TSA programs. We illustrate how this proposed measure can quantify the effects of two main challenges that government organizations face when conducting enterprise risk management: (1) short-term versus long-term incentives and (2) avoiding potential negative consequences even if they occur with low probability. Finally, we illustrate how this measure enables the use of various tools from decision analysis to be applied in government settings, such as stochastic dominance arguments and certain equivalent calculations. Regarding the TSA case study, our analysis demonstrates the value of continued expansion of the TSA trusted traveler initiative and increasing the background vetting for passengers who are afforded expedited security screening. © 2017 Society for Risk Analysis.

The evolution and provision of expert knowledge and its effective utilisation

NASA Astrophysics Data System (ADS)

Sammonds, Peter

2017-04-01

The specific aims of increasing Resilience to Natural Hazards in China programme are (i) to improve hazard forecasting, risk mitigation and preparedness based upon reliable knowledge of the fundamental processes involved and underpinned by basic science and, (ii) to improve the uptake of and responses to scientific advice, by developing risk-based approaches to natural hazards in collaboration with the communities at risk. One of the programme's principal goals is to integrate natural and social science research to increase the benefits for those affected by natural hazards. To that end a co-productive approach to research is expected, involving a framework for sharing knowledge and values between natural and social scientists and consultation with policy makers, civil society and other stakeholders. This paper explore knowledge relationships and reflective learning across disciplines. There is commonly a disjunction between the evolution and provision of expert knowledge and its effective utilisation. Building on experience as Strategic Advisor to the Increasing Resilience to Natural Hazards programme, this paper addresses the research needs to assess how scientific knowledge and risk reduction strategies can be most effectively developed and communicated.

Perception of Business and Industry: Basic Skills Necessary for Successful Employment Compared to Competencies of Entry Level Employees.

ERIC Educational Resources Information Center

Junge, Denis A.; And Others

This study was conducted to assess business and industry's perceptions of the basic skills needed for entry-level successful employment. It also assessed business and industry's perceptions of the competencies that entry-level employees now have. Information was gathered via a basic skills questionnaire that was mailed to the personnel directors…

Two Reading Assessments for Youth in Alternative Basic Skills and Livelihood Skills Training Programs

ERIC Educational Resources Information Center

Comings, John P.; Strucker, John; Bell, Brenda

2017-01-01

This article describes two assessment tools that have been used to assess the reading skills of youth participating in alternative basic skills and livelihood skills training programs. The Rapid Assessment of Reading Skills (RARS) was developed to identify potential participants who needed to improve their reading skills before beginning training…

Evaluation of paediatric cardiosurgical model in Croatia by using the Aristotle basic complexity score and the risk adjustment for congenital cardiac surgery-1 method.

PubMed

Dilber, Daniel; Malcic, Ivan

2010-08-01

The Aristotle basic complexity score and the risk adjustment in congenital cardiac surgery-1 method were developed and used to compare outcomes of congenital cardiac surgery. Both methods were used to compare results of procedures performed on our patients in Croatian cardiosurgical centres and results of procedures were taken abroad. The study population consisted of all patients with congenital cardiac disease born to Croatian residents between 1 October, 2002 and 1 October, 2007 undergoing a cardiovascular operation during this period. Of the 556 operations, the Aristotle basic complexity score could be assigned to 553 operations and the risk adjustment in congenital cardiac surgery-1 method to 536 operations. Procedures were performed in two institutions in Croatia and seven institutions abroad. The average complexity for cardiac procedures performed in Croatia was significantly lower. With both systems, along with the increase in complexity, there is also an increase in mortality before discharge and postoperative length of stay. Only after the adjustment for complexity there are marked differences in mortality and occurrence of postoperative complications. Both, the Aristotle basic complexity score and the risk adjustment in congenital cardiac surgery-1 method were predictive of in-hospital mortality as well as prolonged postoperative length to stay, and can be used as a tool in our country to evaluate a cardiosurgical model and recognise potential problems.

Risk assessment and economic impact analysis of the implementation of new European legislation on radiopharmaceuticals in Italy: the case of the new monograph chapter Compounding of Radiopharmaceuticals (PHARMEUROPA, Vol. 23, No. 4, October 2011).

PubMed

Chitto, Giuseppe; Di Domenico, Elvira; Gandolfo, Patrizia; Ria, Francesco; Tafuri, Chiara; Papa, Sergio

2013-12-01

An assessment of the new monograph chapter Compounding of Radiopharmaceuticals has been conducted on the basis of the first period of implementation of Italian legislation on Good Radiopharmaceuticals Practice (NBP) in the preparation of radiopharmaceuticals, in keeping with Decree by the Italian Ministry of Health dated March 30, 2005. This approach is well grounded in the several points of similarity between the two sets of regulations. The impact on patient risk, on staff risk, and on healthcare organization risk, has been assessed. At the same time, the actual costs of coming into compliance with regulations have been estimated. A change risk analysis has been performed through the identification of healthcare-associated risks, the analysis and measurement of the likelihood of occurrence and of the potential impact in terms of patient harm and staff harm, and the determination of the healthcare organization's controlling capability. In order to evaluate the economic impact, the expenses directly related to the implementation of the activities as per ministerial decree have been estimated after calculating the overall costs unrelated to NBP implementation. The resulting costs have then been averaged over the total number of patient services delivered. NBP implementation shows an extremely positive impact on risk management for both patients receiving Nuclear Medicine services and the healthcare organization. With regard to healthcare workers, instead, the implementation of these regulations has a negative effect on the risk for greater exposure and a positive effect on the defense against litigation. The economic impact analysis of NBP implementation shows a 34% increase in the costs for a single patient service. The implementation of the ministerial decree allows for greater detectability of and control over a number of critical elements, paving the way for risk management and minimization. We, therefore, believe that the proposed tool can provide basic criteria for analysis that could be used by other organizations setting about completing the same process.

Laparoscopic skills acquisition: a study of simulation and traditional training.

PubMed

Marlow, Nicholas; Altree, Meryl; Babidge, Wendy; Field, John; Hewett, Peter; Maddern, Guy J

2014-12-01

Training in basic laparoscopic skills can be undertaken using traditional methods, where trainees are educated by experienced surgeons through a process of graduated responsibility or by simulation-based training. This study aimed to assess whether simulation trained individuals reach the same level of proficiency in basic laparoscopic skills as traditional trained participants when assessed in a simulated environment. A prospective study was undertaken. Participants were allocated to one of two cohorts according to surgical experience. Participants from the inexperienced cohort were randomized to receive training in basic laparoscopic skills on either a box trainer or a virtual reality simulator. They were then assessed on the simulator on which they did not receive training. Participants from the experienced cohort, considered to have received traditional training in basic laparoscopic skills, did not receive simulation training and were randomized to either the box trainer or virtual reality simulator for skills assessment. The assessment scores from different cohorts on either simulator were then compared. A total of 138 participants completed the assessment session, 101 in the inexperienced simulation-trained cohort and 37 on the experienced traditionally trained cohort. There was no statistically significant difference between the training outcomes of simulation and traditionally trained participants, irrespective of the simulator type used. The results demonstrated that participants trained on either a box trainer or virtual reality simulator achieved a level of basic laparoscopic skills assessed in a simulated environment that was not significantly different from participants who had been traditionally trained in basic laparoscopic skills. © 2013 Royal Australasian College of Surgeons.

[Ecological risk assessment of typical karst basin based on land use change: A case study of Lijiang River basin, Southern China].

PubMed

Hu, Jin Long; Zhou, Zhi Xiang; Teng, Ming Jun; Luo, Nan

2017-06-18

Taking Lijiang River basin as study area, and based on the remote sensing images of 1973, 1986, 2000 and 2013, the land-use data were extracted, the ecological risk index was constructed, and the characteristics of spatiotemporal variation of ecological risk were analyzed by "3S" technique. The results showed that land use structure of Lijiang River basin was under relatively reasonable state and it was constantly optimizing during 1973-2013. Overall, the ecological risk of Lijiang River basin was maintained at a low level. Lowest and lower ecological risk region was dominant in Lijiang River basin, but the area of highest ecological risk expanded quickly. The spatial distribution of ecological risk was basically stable and showed an obvious ring structure, which gra-dually decreased from the axis of Xingan County Town-Lingchuan County Town-Guilin City-Yangshuo County Town to other regions. Region with lowest ecological risk mainly distributed in natural mountain forest area of the north and mid-eastern parts of Lijiang River basin, and region with highe-st ecological risk concentrated in Guilin City. The ecological risk distribution of Lijiang River basin presented significant slope and altitude differences, and it decreased with increasing slope and altitude. During the study period, the area of low ecological risk converted to high ecological risk gra-dually decreased and vice versa. On the whole, the ecological risk tended to decline rapidly in the Lijiang River basin.

ELICITED EXPERT PERCEPTIONS FOR CLIMATE CHANGE RISKS AND ADAPTATION IN AGRICULTURE AND FOOD PRODUCTION THROUGH MENTAL MODELS APPROACH

NASA Astrophysics Data System (ADS)

Suda, Eiko; Kubota, Hiromi; Baba, Kenshi; Hijioka, Yasuaki; Takahashi, Kiyoshi; Hanasaki, Naota

Impacts of climate change have become obvious in agriculture and food production in Japan these days, and researches to adapt to their risks have been conducted as a key effort to cope with the climate change. Numerous scientific findings on climate change impacts have been presented so far; however, prospective risks to be adapted to and their management in the context of individual on-site situations have not been investigated in detail. The structure of climate change risks and their management vary depending on geographical and social features in the regions where the adaptation options should be applied; therefore, a practical adaptation strategy should consider actual on-site situations. This study intended to clarify climate change risks to be adapted to in the Japanese agricultural sector, and factors to be considered in adaptation options, for encouragement of decision-making on adaptation implementation in the field. Semi-structured individual interviews have been conducted with 9 multidisciplinary experts engaging in climate change impacts research in agricultural production, economics, engineering, policy, and so on. Based on the results of the interviews, and the latest literatures available for risk assessment and adaptation, an expert mental model including their perceptions which cover the process from climate change impacts assessment to adaptation has been developed. The prospective risks, adaptation options, and issues to be examined to progress the development of practical and effective adaptation options and to support individual or social decision-making, have been shown on the developed expert mental model. It is the basic information for developing social communication and stakeholders cooperations in climate change adaptation strategies in agriculture and food production in Japan.

HIV prevalence and correlates of unprotected anal intercourse among men who have sex with men, Jinan, China.

PubMed

Ruan, Shiman; Yang, Hui; Zhu, Yanwen; Ma, Yanhui; Li, Jinxing; Zhao, Jinkou; McFarland, Willi; Raymond, H Fisher

2008-05-01

China's HIV epidemic may be shifting towards predominantly sexual transmission and emerging data point to potential increases in HIV prevalence among men who have sex with men (MSM). There is particular need to assess the extent of risk behavior among MSM outside of China's most cosmopolitan cities. We conducted a respondent-driven sampling survey (N = 428) to measure HIV seroprevalence and risk behavior among MSM in Jinan, China, the provincial capital of Shandong. HIV prevalence was 0.5% (95% confidence interval [CI] 0.1-1.0). Unprotected anal intercourse (UAI) in the last 6 months (reported by 61.4%) was associated with buying or selling sex to a man in the last 6 months, syphilis infection, multiple partners in the last month, low HIV knowledge and migrant status. No participant had previously tested for HIV. Risk for HIV transmission is widespread among MSM throughout China; basic prevention programs are urgently needed.

[Anaesthesia for patients with obstructive airway diseases].

PubMed

Groeben, H; Keller, V; Silvanus, M T

2014-01-01

Obstructive lung diseases like asthma or chronic obstructive lung diseases have a high prevalence and are one of the four most frequent causes of death. Obstructive lung diseases can be significantly influenced by the choice of anesthetic techniques and anesthetic agents. Basically, the severity of the COPD and the degree of bronchial hyperreactivity will determine the perioperative anesthetic risk. This risk has to be assessed by a thorough preoperative evaluation and will give the rationale on which to decide for the adequate anaesthetic technique. In particular, airway instrumentation can cause severe reflex bronchoconstriction. The use of regional anaesthesia alone or in combination with general anaesthesia can help to avoid airway irritation and leads to reduced postoperative complications. Prophylactic antiobstructive treatment, volatile anesthetics, propofol, opioids, and an adequate choice of muscle relaxants minimize the anesthetic risk, when general anesthesia is required In case, despite all precautions intra-operative bronchospasm occurs, deepening of anaesthesia, repeated administration of beta2-adrenergic agents and parasympatholytics, and a single systemic dose of corticosteroids represent the main treatment options.

Randomized controlled trial to test the RHANI Wives HIV intervention for women in India at risk for HIV from husbands.

PubMed

Raj, Anita; Saggurti, Niranjan; Battala, Madhusudana; Nair, Saritha; Dasgupta, Anindita; Naik, D D; Abramovitz, Daniela; Silverman, Jay G; Balaiah, Donta

2013-11-01

This study involved evaluation of the short-term impact of the RHANI Wives HIV intervention among wives at risk for HIV from husbands in Mumbai, India. A two-armed cluster RCT was conducted with 220 women surveyed on marital sex at baseline and 4-5 month follow-up. RHANI Wives was a multisession intervention focused on safer sex, marital communication, gender inequities and violence; control participants received basic HIV prevention education. Generalized linear mixed models were conducted to assess program impact, with cluster as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects. A significant time by treatment effect on proportion of unprotected sex with husband (p = 0.01) was observed, and the rate of unprotected sex for intervention participants was lower than that of control participants at follow-up (RR = 0.83, 95 % CI = 0.75, 0.93). RHANI Wives is a promising model for women at risk for HIV from husbands.

Epigenetics: relevance and implications for public health.

PubMed

Rozek, Laura S; Dolinoy, Dana C; Sartor, Maureen A; Omenn, Gilbert S

2014-01-01

Improved understanding of the multilayer regulation of the human genome has led to a greater appreciation of environmental, nutritional, and epigenetic risk factors for human disease. Chromatin remodeling, histone tail modifications, and DNA methylation are dynamic epigenetic changes responsive to external stimuli. Careful interpretation can provide insights for actionable public health through collaboration between population and basic scientists and through integration of multiple data sources. We review key findings in environmental epigenetics both in human population studies and in animal models, and discuss the implications of these results for risk assessment and public health protection. To ultimately succeed in identifying epigenetic mechanisms leading to complex phenotypes and disease, researchers must integrate the various animal models, human clinical approaches, and human population approaches while paying attention to life-stage sensitivity, to generate effective prescriptions for human health evaluation and disease prevention.

Application of GIS Rapid Mapping Technology in Disaster Monitoring

NASA Astrophysics Data System (ADS)

Wang, Z.; Tu, J.; Liu, G.; Zhao, Q.

2018-04-01

With the rapid development of GIS and RS technology, especially in recent years, GIS technology and its software functions have been increasingly mature and enhanced. And with the rapid development of mathematical statistical tools for spatial modeling and simulation, has promoted the widespread application and popularization of quantization in the field of geology. Based on the investigation of field disaster and the construction of spatial database, this paper uses remote sensing image, DEM and GIS technology to obtain the data information of disaster vulnerability analysis, and makes use of the information model to carry out disaster risk assessment mapping.Using ArcGIS software and its spatial data modeling method, the basic data information of the disaster risk mapping process was acquired and processed, and the spatial data simulation tool was used to map the disaster rapidly.

Practice of Regulatory Science (Drug Development).

PubMed

Kawanishi, Toru

2017-01-01

The practice of regulatory science (RS) for drug development is described. In the course material for education in pharmaceutical sciences drafted by the RS Division of the Pharmaceutical Society of Japan, RS for pharmaceuticals is defined as the science of predicting, assessing, and judging the quality, efficacy, and safety of pharmaceutical products throughout their lifespan. RS is also described as an integrated science based on basic and applied biomedical sciences, including analytical chemistry, biochemistry, pharmacology, toxicology, genetics, biostatistics, epidemiology, and clinical trial methodology, and social sciences such as decision science, risk assessment, and communication science. The involvement of RS in drug development generally starts after the optimization of lead compounds. RS plays important roles governing pharmaceuticals during their entire life cycle management phase as well as the drug development phase.

Application of omics data in regulatory toxicology: report of an international BfR expert workshop.

PubMed

Marx-Stoelting, P; Braeuning, A; Buhrke, T; Lampen, A; Niemann, L; Oelgeschlaeger, M; Rieke, S; Schmidt, F; Heise, T; Pfeil, R; Solecki, R

2015-11-01

Advances in omics techniques and molecular toxicology are necessary to provide new perspectives for regulatory toxicology. By the application of modern molecular techniques, more mechanistic information should be gained to support standard toxicity studies and to contribute to a reduction and refinement of animal experiments required for certain regulatory purposes. The relevance and applicability of data obtained by omics methods to regulatory purposes such as grouping of chemicals, mode of action analysis or classification and labelling needs further improvement, defined validation and cautious expert judgment. Based on the results of an international expert workshop organized 2014 by the Federal Institute for Risk Assessment in Berlin, this paper is aimed to provide a critical overview of the regulatory relevance and reliability of omics methods, basic requirements on data quality and validation, as well as regulatory criteria to decide which effects observed by omics methods should be considered adverse or non-adverse. As a way forward, it was concluded that the inclusion of omics data can facilitate a more flexible approach for regulatory risk assessment and may help to reduce or refine animal testing.

Risk assessment for ecotoxicity of pharmaceuticals--an emerging issue.

PubMed

Kar, Supratik; Roy, Kunal

2012-03-01

Existence of a large amount of pharmaceuticals and their active metabolites in the environment has recently been considered as one of the most serious concerns in environmental sciences. Large diversity of pharmaceuticals has been found in the environmental domain in considerable amounts that are not only destructive to environment but also fatal for human and animal fraternity. There is a considerable lack of knowledge about the environmental fate and quantification of a large number of pharmaceuticals. This communication aims to review the literature information regarding occurrence of pharmaceuticals and their metabolites in the environment, their persistence, environmental fate and toxicity as well as application of theoretical, non-experimental, non-animal, alternative and, in particular, in silico methods to provide information about the basic physicochemical and fate properties of pharmaceuticals to the environment. The reader will gain an overview of risk assessment strategies for ecotoxicity of pharmaceuticals and advances in application of quantitative structure-toxicity relationship (QSTR) in this field. This review justifies the need to develop more QSTR models for prediction of ecotoxicity of pharmaceuticals in order to reduce time and cost involvement in such exercise.

Reconnaissance Of The Year 2000 And Beyond

NASA Astrophysics Data System (ADS)

Dresser, M. M.

1981-12-01

The reconnaissance systems of the year 2000 and beyond may be merely an extension of current technology or may utilize bold new technology and concepts still in the embryonic stages. The five basic reconnaissance mission stages: collection, processing, interpretation, reporting, and dissemination, are reviewed in terms of the potential application of new and emerging technology such as high density multispectral focal plane arrays, new radar techniques, VLSI/VHSIC computational resources, artificial intelligence, multisensor integration, pattern and target recognition, image compression, advanced display and targeting techniques, and even new fields not thought of as exact sciences today. The application of these technologies is viewed in the context of the reconnaissance missions: targeting, damage assessment, order of battle assessment, terrain evaluation and planning. The traditional neeos for varying levels of detail and timeliness of reconnaissance data are shown to be largely removed by the use of the most advanced and highest development risk systems. Lower development risk systems show excellent capabilities with the potential for high capability at low cost. New fields may totally change or even eliminate reconnaissance as we know it today.

Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions.

PubMed

Lipkus, Isaac M; Skinner, Celette Sugg; Dement, John; Pompeii, Lisa; Moser, Barry; Samsa, Gregory P; Ransohoff, David

2005-05-01

Individuals in the carpentry trade, due to lifestyle habits and occupational exposures, may be at above-average risk for colorectal cancer (CRC). Based on the literature which suggests that increasing perceived risk motivates behavior change, we report on the effectiveness of four risk-communication interventions targeted to increase initial, yearly and repeat fecal occult screening (FOBT) among carpenters (N = 860) over a 3-year period. Our 2 x 2 factorial design intervention study varied two dimensions of providing CRC risk factor information: (1) type of risk factor-one set of interventions emphasized three basic risk factors (age, family history and polyps); the other set emphasized a comprehensive set of risk factors including basic, lifestyle, and occupational factors, and (2) tailoring/not tailoring risk factor information. Participants were provided FOBTs. Outcomes were the proportion of returned FOBTs. Varying the amount and intensity of delivering CRC risk factors information affected neither risk perceptions nor initial, yearly, or repeat screening. However, yearly and repeat screening rates were greater among participants who received interventions addressing comprehensive set of risk factors, especially with increasing age. Tailoring on several CRC risk factors appears insufficient to increase and sustain elevated perceptions of CRC risks to promote screening.

A Primer on Sampling for Statewide Assessment.

ERIC Educational Resources Information Center

Jaeger, Richard M.

This paper is a primer on sampling procedures for statewide assessment. The careful reader should gain substantial knowledge about the promises and pitfalls of sampling for assessment. The primer has three basic objectives: (1) to define terms and concepts basic to sampling theory and its application, including population, sampling unit, sampling…

Spillway sizing of large dams in Austria

NASA Astrophysics Data System (ADS)

Reszler, Ch.; Gutknecht, D.; Blöschl, G.

2003-04-01

This paper discusses the basic philosophy of defining and calculating design floods for large dams in Austria, both for the construction of new dams and for a re-assessment of the safety of existing dams. Currently the consensus is to choose flood peak values corresponding to a probability of exceedance of 2*10-4 for a given year. A two step procedure is proposed to estimate the design flood discharges - a rapid assessment and a detailed assessment. In the rapid assessment the design discharge is chosen as a constant multiple of flood values read from a map of regionalised floods. The safety factor or multiplier takes care of the uncertainties of the local estimation and the regionalisation procedure. If the current design level of a spillway exceeds the value so estimated, no further calculations are needed. Otherwise (and for new dams) a detailed assessment is required. The idea of the detailed assessment is to draw upon all existing sources of information to constrain the uncertainties. The three main sources are local flood frequency analysis, where flood data are available; regional flood estimation from hydrologically similar catchments; and rainfall-runoff modelling using design storms as inputs. The three values obtained by these methods are then assessed and weighted in terms of their reliability to facilitate selection of the design flood. The uncertainty assessment of the various methods is based on confidence intervals, estimates of regional heterogeneity, data availability and sensitivity analyses of the rainfall-runoff model. As the definition of the design floods discussed above is based on probability concepts it is also important to examine the excess risk, i.e. the possibility of the occurrence of a flood exceeding the design levels. The excess risk is evaluated based on a so called Safety Check Flood (SCF), similar to the existing practice in other countries in Europe. The SCF is a vehicle to analyse the damage potential of an event of this magnitude. This is to provide guidance for protective measures to dealing with very extreme floods. The SCF is used to check the vulnerability of the system with regard to structural stability, morphological effects, etc., and to develop alarm plans and disaster mitigation procedures. The basis for estimating the SCF are the uncertainty assessments of the design flood values estimated by the three methods including unlikely combinations of the controlling factors and attending uncertainties. Finally we discuss the impact on the downstream valley of floods exceeding the design values and of smaller floods and illustrate the basic concepts by examples from the recent flood in August 2002.

Earthquake Hazard Assessment: Basics of Evaluation

NASA Astrophysics Data System (ADS)

Kossobokov, Vladimir

2016-04-01

Seismic hazard assessment (SHA) is not an easy task that implies a delicate application of statistics to data of limited size and different accuracy. Earthquakes follow the Unified Scaling Law that generalizes the Gutenberg-Richter relationship by taking into account naturally fractal distribution of their sources. Moreover, earthquakes, including the great and mega events, are clustered in time and their sequences have irregular recurrence intervals. Furthermore, earthquake related observations are limited to the recent most decades (or centuries in just a few rare cases). Evidently, all this complicates reliable assessment of seismic hazard and associated risks. Making SHA claims, either termless or time dependent (so-called t-DASH), quantitatively probabilistic in the frames of the most popular objectivists' viewpoint on probability requires a long series of "yes/no" trials, which cannot be obtained without an extended rigorous testing of the method predictions against real observations. Therefore, we reiterate the necessity and possibility of applying the modified tools of Earthquake Prediction Strategies, in particular, the Error Diagram, introduced by G.M. Molchan in early 1990ies for evaluation of SHA, and the Seismic Roulette null-hypothesis as a measure of the alerted space. The set of errors, i.e. the rates of failure and of the alerted space-time volume, compared to those obtained in the same number of random guess trials permits evaluating the SHA method effectiveness and determining the optimal choice of the parameters in regard to specified cost-benefit functions. These and other information obtained in such a testing supplies us with a realistic estimate of confidence in SHA results and related recommendations on the level of risks for decision making in regard to engineering design, insurance, and emergency management. These basics of SHA evaluation are exemplified in brief with a few examples, which analyses in more detail are given in a poster of NH4.7 session.

Development of the National Institutes of Health Guidelines for Recombinant DNA Research.

PubMed Central

Talbot, B

1983-01-01

Recombinant DNA is a technique of major importance in basic biomedical research and, increasingly, in industrial applications. Although the risks of this research remain hypothetical, scientists working in the field have spearheaded discussions of safety. The original National Institutes of Health (NIH) Guidelines for Recombinant DNA Research were issued in June 1976. They assigned each type of recombinant DNA experiment a specific level of "physical containment" and of "biological containment." Responsibility for overseeing the application of the guidelines belongs to the NIH Recombinant DNA Advisory Committee (RAC)--composed of scientists and laymen, including non-voting representatives from many Federal agencies--and local institutional biosafety committees at each university where recombinant DNA research is conducted. The NIH guidelines were subsequently adopted by other Federal agencies, but congressional proposals aimed at extending the guidelines to private industry did not result in national legislation. Some States and localities regulate recombinant DNA research, however, and many private companies have voluntarily submitted information on their recombinant DNA work for RAC and NIH approval. The NIH guidelines underwent a major revision in December 1978 and have been revised approximately every 3 months since then. NIH supports experiments to assess recombinant DNA risks and publishes and updates a plan for a risk assessment program. PMID:6611823

Evaluating the technical feasibility of aflatoxin risk reduction strategies in Africa.

PubMed

Wu, Felicia; Khlangwiset, Pornsri

2010-05-01

Public health interventions must be readily accepted by their target populations to have any meaningful impact and must have financial and infrastructural support to be feasible in the parts of the world where they are most needed. At the same time, these interventions must be assessed for potential unintended consequences, either to the environment or to human health. In this paper, we evaluate the technical feasibility of interventions to control aflatoxin risk, to be potentially deployed in parts of Africa where aflatoxin exposure poses a significant public health concern. We have applied a conceptual framework for feasibility to four interventions, one associated with each of four different stages of aflatoxin risk: biocontrol (pre-harvest), a post-harvest intervention package (post-harvest), NovaSil clay (dietary), and hepatitis B vaccination (clinical). For each intervention, we have assessed the following four components of technical feasibility: (1) characteristics of the basic intervention, (2) characteristics of delivery, (3) requirements on government capacity, and (4) usage characteristics. We propose ways in which feasibility of each intervention is currently high or low from the perspective of adoption in Africa, how public education is crucial for each of these interventions to succeed, and how to align economic incentives to make the interventions more suitable for less developed countries.

Evaluating the technical feasibility of aflatoxin risk reduction strategies in Africa

PubMed Central

Wu, Felicia; Khlangwiset, Pornsri

2010-01-01

Public health interventions must be readily accepted by their target populations to have any meaningful impact, and must have financial and infrastructural support to be feasible in the parts of the world where they are most needed. At the same time, these interventions must be assessed for potential unintended consequences, either to the environment or to human health. In this paper, we evaluate the technical feasibility of interventions to control aflatoxin risk, to be potentially deployed in parts of Africa where aflatoxin exposure poses a significant public health concern. We have applied a conceptual framework for feasibility to four interventions, one associated with each of four different stages of aflatoxin risk: biocontrol (pre-harvest), a post-harvest intervention package (post-harvest), NovaSil clay (dietary), and hepatitis B vaccination (clinical). For each intervention, we have assessed the following four components of technical feasibility: 1) characteristics of the basic intervention, 2) characteristics of delivery, 3) requirements on government capacity, and 4) usage characteristics. We propose ways in which feasibility of each intervention is currently high or low from the perspective of adoption in Africa, how public education is crucial for each of these interventions to succeed, and how to align economic incentives to make the interventions more suitable for less developed countries. PMID:20455160

Reducing the risk of HIV infection among South African sex workers: socioeconomic and gender barriers.

PubMed Central

Karim, Q A; Karim, S S; Soldan, K; Zondi, M

1995-01-01

OBJECTIVES. The social context within which women engaged in sex work at a popular truck stop in South Africa are placed at risk of human immunodeficiency virus (HIV) infection and the factors that influence their ability to reduce their risk were assessed. METHODS. Using qualitative and quantitative techniques, an elected sex worker from within the group collected all data. RESULTS. Given the various pressing needs for basic survival, the risk of HIV infection is viewed as one more burden imposed on these women by their lack of social, legal, and economic power. Violence, or the threat thereof, plays an important role in their disempowerment. In the few instances in which sex workers were able to insist on condom use, it resulted in a decrease in earnings, loss of clients, and physical abuse. CONCLUSIONS. Recommendations to reduce the sex workers' risk for HIV infection include negotiation and communication skills to enable them to persuade their clients to use condoms; development of strategies through which they can maximally use their group strength to facilitate unified action; and accessibility of protective methods they can use and control, such as intravaginal microbicides. PMID:7485664

Association of Injury History and Incident Injury in Cadet Basic Military Training

PubMed Central

Kucera, Kristen L.; Marshall, Stephen W.; Wolf, Susanne H.; Padua, Darin A.; Cameron, Kenneth L.; Beutler, Anthony I.

2016-01-01

Purpose To determine the association between injury history at enrollment and incident lower extremity (LE) injury during cadet basic training among first-year military cadets. Methods Medically treated LE injuries during cadet basic training documented in the Defense Medical Surveillance System (DMSS) were ascertained in a prospective cohort study of three large U.S. military academies from 2005–2008. Both acute injuries (ICD-9 codes in the 800–900s, including fracture, dislocations, sprains/strains) and injury-related musculoskeletal injuries (ICD-9 codes in the 700s, including inflammation and pain, joint derangement, stress fracture, sprain/strain/rupture, and dislocation) were included. Risk ratios (RR) and 95% confidence intervals (CI) were computed using multivariate log-binomial models stratified by gender. Results During basic training there were 1,438 medically treated acute and 1,719 musculoskeletal-related LE injuries in the 9,811 cadets. The most frequent LE injuries were sprains/strains (73.6% of acute) and inflammation and pain (89.6% of musculoskeletal-related). The overall risk of incident LE injury was 23.2% [95%CI: 22.3%, 24.0%]. Cadets with a previous history of LE injury were at increased risk for incident LE injury. This association was identical in males (RR=1.74 [1.55, 1.94]) and females (RR=1.74 [1.52, 1.99]). In site-specific analyses, strong associations between injury history and incident injury were observed for hip, knee ligament, stress fracture, and ankle sprain. Injury risk was greater (p<0.01) for females (39.1%) compared to males (18.0%). The elevated injury risk in females (RR=2.19 [2.04, 2.36]) was independent of injury history (adjusted RR=2.09 [1.95, 2.24]). Conclusion Injury history upon entry to the military is associated with incidence of LE injuries sustained during cadet basic training. Prevention programs targeted at modifiable factors in cadets with a prior history of LE injury should be considered. PMID:26765627

Usefulness of parametric renal clearance images in the assessment of basic risk factors for renalnal clearance images in the assessment of basic risk factors for renal scarring in children with recurrent urinary tract infections.

PubMed

Pietrzak-Stelasiak, Ewa; Bieńkiewicz, Małgorzata; Woźnicki, Wojciech; Bubińska, Krystyna; Kowalewska-Pietrzak, Magdalena; Płachcińska, Anna; Kuśmierek, Jacek

2017-01-01

Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study. To establish a clinical value of parametric renal clearance images in detection of renal scarring. A prospective study was performed in a group of 91 children at the age of 4 to 18 years with recurrent UTI. Clinically documented incidents of APN were noted in 32 children: in 8 cases - one and in the remaining 24 - 2 to 5 (mean 3) incidents. In the remaining 59 patients only infections of the lower part of urinary tract were diagnosed. Static renal 99mTc-DMSA SPECT study and after 2-4 days dynamic renal studies (99mTc-EC) were performed in every patient not earlier than 6 months after the last documented incident of UTI. PAR images generated from a dynamic study by in-house developed software and SUM images were compared with a gold standard SPECT study. Percentages of children with detected renal scar(s) with SPECT and PAR methods amounted to 55% and 54%, respectively and were statistically significantly higher (p < 0.0001) than with SUM method - 31%. Scars in children with history of APN detected with SPECT and PAR methods were significantly more frequent than with infections of only lower part of urinary tract (72% vs. 46%; p = 0.017 and 69% vs. 46%; p = 0.036, respectively). A SUM method did not reveal statistically significant differences between frequencies of detection of scars in groups specified above - 38% vs. 27% (p = 0.31). Both SPECT and PAR methods showed also that frequencies of occurrence of renal scars in children with higher grades of VUR were higher than without or with lower grades of VUR: 79% vs. 50% (p = 0.048) and 79% vs. 49% (p = 0.04). A SUM method did not reveal higher frequency of renal scars in children with high VUR grades: 36% vs. 30% (p = 0.44). Results obtained with PAR and SPECT methods were similar. An advantage of PAR over SUM images obtained from a dynamic renal scintigraphy in detection of renal scars in children with UTI was confirmed.

POLLUTION PREVENTION RESEARCH ONGOING - EPA'S RISK REDUCTION ENGINEERING LABORATORY

EPA Science Inventory

The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied researc...

Self-rated health is associated with subsequent functional decline among older adults in Japan.

PubMed

Hirosaki, Mayumi; Okumiya, Kiyohito; Wada, Taizo; Ishine, Masayuki; Sakamoto, Ryota; Ishimoto, Yasuko; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wen Ling; Nakatsuka, Masahiro; Fujisawa, Michiko; Otsuka, Kuniaki; Matsubayashi, Kozo

2017-09-01

Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan. A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0-100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later. One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3-4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16-1.61). SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.

Assessment of Department of Defense Basic Research

DTIC Science & Technology

2005-01-01

Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council: • Download hundreds of free books in PDF...with our innovative research tools Thank you for downloading this free PDF. If you have comments, questions or just want more information... downloaded from: http://www.nap.edu/catalog/11177.html Assessment of Department of Defense Basic Research Committee on Department of Defense Basic

The assessment of seismic hazard for Gori, (Georgia) and preliminary studies of seismic microzonation

NASA Astrophysics Data System (ADS)

Gogoladze, Z.; Moscatelli, M.; Giallini, S.; Avalle, A.; Gventsadze, A.; Kvavadze, N.; Tsereteli, N.

2016-12-01

Seismic risk is a crucial issue for South Caucasus, which is the main gateway between Asia and Europe. The goal of this work is to propose new methods and criteria for defining an overall approach aimed at assessing and mitigating seismic risk in Georgia. In this reguard seismic microzonation represents a highly useful tool for seismic risk assessmentin land management, for design of buildings or structures and for emergency planning.Seismic microzonation assessment of local seismic hazard,which is a component of seismicity resulting from specific local characteristics which cause local amplification and soil instability, through identification of zones with seismically homogeneous behavior. This paper presents the results of preliminary study of seismic microzonation of Gori, Georgia. Gori is and is located in the Shida Kartli region and on both sides of Liachvi and Mtkvari rivers, with area of about 135 km2around the Gori fortress. Gori is located in Achara-Trialeti fold-thrust belt, that is tectonically unstable. Half of all earthquakes in Gori area with magnitude M≥3.5 have happened along this fault zone and on basis of damage caused by previous earthquakes, this territory show the highest level of risk (the maximum value of direct losses) in central part of the town. The seismic microzonation map of level 1 for Gori was carried out using: 1) Already available data (i.e., topographic map and boreholes data), 2) Results of new geological surveys and 3) Geophysical measurements (i.e., MASW and noise measurements processed with HVSR technique). Our preliminary results highlight the presence of both stable zones susceptible to local amplifications and unstable zones susceptible to geological instability. Our results are directed to establish set of actions aimed at risk mitigation before initial onset of emergency, and to management of the emergency once the seismic event has occurred. The products obtained, will contain the basic elements of an integrated system aimed at reducing risk and improving over all safety of people and infrastructure in Georgia.

Design and Implementation of an Assessment Model for Students Entering Vocational Education Programs in the State of Colorado. Welding.

ERIC Educational Resources Information Center

Hartley, Nancy K.; And Others

This basic vocational related skills assessment module in welding is one of sixteen modules designed to help teachers assess and identify some of the areas in which special needs students may encounter learning difficulties. The materials in the module allow for informal assessment in three basic areas: academic skills, motor skills, and…

Assessing the Basic Traits Associated with Psychopathy: Development and Validation of the Elemental Psychopathy Assessment

ERIC Educational Resources Information Center

Lynam, Donald R.; Gaughan, Eric T.; Miller, Joshua D.; Miller, Drew J.; Mullins-Sweatt, Stephanie; Widiger, Thomas A.

2011-01-01

A new self-report assessment of the basic traits of psychopathy was developed with a general trait model of personality (five-factor model [FFM]) as a framework. Scales were written to assess maladaptive variants of the 18 FFM traits that are robustly related to psychopathy across a variety of perspectives including empirical correlations, expert…

Predicting outbreaks: a spatial risk assessment of West Nile virus in British Columbia

PubMed Central

Tachiiri, Kaoru; Klinkenberg, Brian; Mak, Sunny; Kazmi, Jamil

2006-01-01

Background West Nile virus (WNv) has recently emerged as a health threat to the North American population. After the initial disease outbreak in New York City in 1999, WNv has spread widely and quickly across North America to every contiguous American state and Canadian province, with the exceptions of British Columbia (BC), Prince Edward Island and Newfoundland. In this study we develop models of mosquito population dynamics for Culex tarsalis and C. pipiens, and create a spatial risk assessment of WNv prior to its arrival in BC by creating a raster-based mosquito abundance model using basic geographic and temperature data. Among the parameters included in the model are spatial factors determined from the locations of BC Centre for Disease Control mosquito traps (e.g., distance of the trap from the closest wetland or lake), while other parameters were obtained from the literature. Factors not considered in the current assessment but which could influence the results are also discussed. Results Since the model performs much better for C. tarsalis than for C. pipiens, the risk assessment is carried out using the output of C. tarsalis model. The result of the spatially-explicit mosquito abundance model indicates that the Okanagan Valley, the Thompson Region, Greater Vancouver, the Fraser Valley and southeastern Vancouver Island have the highest potential abundance of the mosquitoes. After including human population data, Greater Vancouver, due to its high population density, increases in significance relative to the other areas. Conclusion Creating a raster-based mosquito abundance map enabled us to quantitatively evaluate WNv risk throughout BC and to identify the areas of greatest potential risk, prior to WNv introduction. In producing the map important gaps in our knowledge related to mosquito ecology in BC were identified, as well, it became evident that increased efforts in bird and mosquito surveillance are required if more accurate models and maps are to be produced. Access to real time climatic data is the key for developing a real time early warning system for forecasting vector borne disease outbreaks, while including social factors is important when producing a detailed assessment in urban areas. PMID:16704737

Study on the prevalence and neonatal lethality in patients with selected congenital anomalies as per the data of the National Registry of Congenital Anomalies of Argentina.

PubMed

Bidondo, María Paz; Groisman, Boris; Gili, Juan A; Liascovich, Rosa; Barbero, Pablo; Pingray, Verónica

2015-08-01

Congenital anomalies (CAs) account for 26% of infant mortality in Argentina. The lethality rate for CAs measures the risk of death among affected infants. To describe the prevalence at birth of a group of selected CAs, to estimate the neonatal lethality rate, and to examine its association with different variables. The study was conducted using data provided by the National Registry of Congenital Anomalies. Prevalences of encephalocele, spina bifida, gastroschisis, omphalocele, diaphragmatic hernia, esophageal atresia, intestinal atresia, or anorectal malformation were estimated (2009-2013 period). Lethality was assessed at 7 and 28 days of life in affected infants with an isolated anomaly (2013). Association with the following variables was analyzed: sex, gestational age, birth weight, antenatal ultrasound screening, percentage of unmet basic needs in the district where the mother lives, geographic region, and level of care at the hospital where the delivery took place. Gastroschisis was the most prevalent CA (8.53/10,000 births), while diaphragmatic hernia was the CA with the highest neonatal lethality rate (66.67%). Out of all selected CAs, there was a significant association between an higher gestational age and survival at 7 days -OR: 0.81 (0.70-0.95)- and survival at 28 days -OR: 0.79 (95% confidence interval |-CI-|: 0.68-0.91)-. A higher percentage of unmet basic needs was associated with a higher lethality for diaphragmatic hernia -OR: 1.59 (95% CI: 1.30-1.95)- and for intestinal atresia or anorectal malformation -OR: 16.00 (95% CI: 1.63-157.24)-. The high prevalence of gastroschisis is consistent with the increase observed globally. Prematurity and a high percentage of unmet basic needs increased the risk of death among affected infants.

Stata Modules for Calculating Novel Predictive Performance Indices for Logistic Models.

PubMed

Barkhordari, Mahnaz; Padyab, Mojgan; Hadaegh, Farzad; Azizi, Fereidoun; Bozorgmanesh, Mohammadreza

2016-01-01

Prediction is a fundamental part of prevention of cardiovascular diseases (CVD). The development of prediction algorithms based on the multivariate regression models loomed several decades ago. Parallel with predictive models development, biomarker researches emerged in an impressively great scale. The key question is how best to assess and quantify the improvement in risk prediction offered by new biomarkers or more basically how to assess the performance of a risk prediction model. Discrimination, calibration, and added predictive value have been recently suggested to be used while comparing the predictive performances of the predictive models' with and without novel biomarkers. Lack of user-friendly statistical software has restricted implementation of novel model assessment methods while examining novel biomarkers. We intended, thus, to develop a user-friendly software that could be used by researchers with few programming skills. We have written a Stata command that is intended to help researchers obtain cut point-free and cut point-based net reclassification improvement index and (NRI) and relative and absolute Integrated discriminatory improvement index (IDI) for logistic-based regression analyses.We applied the commands to a real data on women participating the Tehran lipid and glucose study (TLGS) to examine if information of a family history of premature CVD, waist circumference, and fasting plasma glucose can improve predictive performance of the Framingham's "general CVD risk" algorithm. The command is addpred for logistic regression models. The Stata package provided herein can encourage the use of novel methods in examining predictive capacity of ever-emerging plethora of novel biomarkers.

History of the Voluntary Intermodal Sealift Agreement

DTIC Science & Technology

2002-06-01

reflect executed Voluntary Enrollment Contracts (VEC) for VISA Stages I, II, and III to include basic activation procedures; DOD annual minimums for...provisions; and on-the-shelf basic agreements (such as VISA Intermodal Contingency Contracts (VICC) for Stages I, II, and III). The anticipated...insufficient Program incentives are revised annually, but the basic tenets remain in place. Activation, capacity required to commit and carrier risk clauses

America's Basic Research: Prosperity Through Discovery. A Policy Statement by the Research and Policy Committee of the Committee for Economic Development

ERIC Educational Resources Information Center

Committee for Economic Development, 1998

1998-01-01

This policy statement looks at America's basic research enterprise and lays out the processes and systematic reforms needed to meet emerging risks to the outcomes from investments in basic research. The Committee for Economic Development (CED) undertook this project in the belief that significant progress with many of society's problems and new…

Characterization of the thrombin generation profile in systemic lupus erythematosus.

PubMed

Kern, A; Barabás, E; Balog, A; Burcsár, Sz; Kiszelák, M; Vásárhelyi, B

2017-03-01

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory autoimmune disorder. Thrombotic events occur at a higher incidence among SLE patients. The investigation of thrombin generation (TG) with calibrated automated thrombogram (CAT) test as a global hemostasis assay is applicable for the overall functional assessment of the hemostasis. The aim of this study was to characterize the hemostatic alterations observed in SLE by CAT assay. In this study, CAT parameters and basic coagulation parameters of SLE patients (n = 22) and healthy control subjects (n = 34) were compared. CAT area under the curve (i.e., endogenous thrombin potential) was lower than normal in SLE (807 vs. 1,159 nM*min, respectively), whereas other CAT parameters (peak, lag time, time to peak, and velocity index) and the basic coagulation tests were within the normal range. The presence of anti-phospholipid antibodies and the applied therapy was not associated with hemostasis parameters in SLE. We concluded that the reported high risk of thrombosis is not related to TG potential.

Student engagement and its relationship with early high school dropout.

PubMed

Archambault, Isabelle; Janosz, Michel; Fallu, Jean-Sébastien; Pagani, Linda S

2009-06-01

Although the concept of school engagement figures prominently in most school dropout theories, there has been little empirical research conducted on its nature and course and, more importantly, the association with dropout. Information on the natural development of school engagement would greatly benefit those interested in preventing student alienation during adolescence. Using a longitudinal sample of 11,827 French-Canadian high school students, we tested behavioral, affective, cognitive indices of engagement both separately and as a global construct. We then assessed their contribution as prospective predictors of school dropout using factor analysis and structural equation modeling. Global engagement reliably predicted school dropout. Among its three specific dimensions, only behavioral engagement made a significant contribution in the prediction equation. Our findings confirm the robustness of the overall multidimensional construct of school engagement, which reflects both cognitive and psychosocial characteristics, and underscore the importance attributed to basic participation and compliance issues in reliably estimating risk of not completing basic schooling during adolescence.

Road Infrastructure Safety Management in Poland

NASA Astrophysics Data System (ADS)

Budzynski, Marcin; Jamroz, Kazimierz; Kustra, Wojciech; Michalski, Lech; Gaca, Stanislaw

2017-10-01

The objective of road safety infrastructure management is to ensure that when roads are planned, designed, built and used road risks can be identified, assessed and mitigated. Road transport safety is significantly less developed than that of rail, water and air transport. The average individual risk of being a fatality in relation to the distance covered is thirty times higher in road transport that in the other modes. This is mainly because the different modes have a different approach to safety management and to the use of risk management methods and tools. In recent years Poland has had one of the European Union’s highest road death numbers. In 2016 there were 3026 fatalities on Polish roads with 40,766 injuries. Protecting road users from the risk of injury and death should be given top priority. While Poland’s national and regional road safety programmes address this problem and are instrumental in systematically reducing the number of casualties, the effects are far from the expectations. Modern approaches to safety focus on three integrated elements: infrastructure measures, safety management and safety culture. Due to its complexity, the process of road safety management requires modern tools to help with identifying road user risks, assess and evaluate the safety of road infrastructure and select effective measures to improve road safety. One possible tool for tackling this problem is the risk-based method for road infrastructure safety management. European Union Directive 2008/96/EC regulates and proposes a list of tools for managing road infrastructure safety. Road safety tools look at two criteria: the life cycle of a road structure and the process of risk management. Risk can be minimized through the application of the proposed interventions during design process as reasonable. The proposed methods of risk management bring together two stages: risk assessment and risk response occurring within the analyzed road structure (road network, road stretch, road section, junction, etc.). The objective of the methods is to help road authorities to take rational decisions in the area of road safety and road infrastructure safety and understand the consequences occurring in the particular phases of road life cycle. To help with assessing the impact of a road project on the safety of related roads, a method was developed for long-term forecasts of accidents and accident cost estimation as well as a risk classification to identify risks that are not acceptable risks. With regard to road safety audits and road safety inspection, a set of principles was developed to identify risks and the basic classification of mistakes and omissions. This work has added to the Polish experience of preparing and implementing such tools within the competent road authorities.

Development and Optimisation of an In-Service Teacher Training Programme on Motivational Assessment in Physical Education

ERIC Educational Resources Information Center

Slingerland, Menno; Borghouts, Lars; Jans, Liesbeth; Weeldenburg, Gwen; van Dokkum, Gertjan; Vos, Steven; Haerens, Leen

2017-01-01

Although assessment practices are commonly part of the physical education (PE) curriculum they may often frustrate rather than support students' basic needs for autonomy, competence and relatedness. Nevertheless, assessment also provides various promising opportunities to support these basic needs and enhance learning in students. In order to…

Can an Integrated Approach Reduce Child Vulnerability to Anaemia? Evidence from Three African Countries

PubMed Central

Siekmans, Kendra; Receveur, Olivier; Haddad, Slim

2014-01-01

Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a “buffering” of risk associated with known causes of anaemia would be observed among children living in areas benefiting from a community-based health and nutrition program intervention. Cross-sectional data on the nutrition and health status of children 24–59 mo (N = 2405) were obtained in 2000 and 2004 from program evaluation surveys in Ghana, Malawi and Tanzania. Linear regression models estimated the association between haemoglobin and immediate, underlying and basic causes of child anaemia and variation in this association between years. Lower haemoglobin levels were observed in children assessed in 2000 compared to 2004 (difference -3.30 g/L), children from Tanzania (-9.15 g/L) and Malawi (-2.96 g/L) compared to Ghana, and the youngest (24–35 mo) compared to oldest age group (48–59 mo; -5.43 g/L). Children who were stunted, malaria positive and recently ill also had lower haemoglobin, independent of age, sex and other underlying and basic causes of anaemia. Despite ongoing morbidity, risk of lower haemoglobin decreased for children with malaria and recent illness, suggesting decreased vulnerability to their anaemia-producing effects. Stunting remained an independent and unbuffered risk factor. Reducing chronic undernutrition is required in order to further reduce child vulnerability and ensure maximum impact of anaemia control programs. Buffering the impact of child morbidity on haemoglobin levels, including malaria, may be achieved in certain settings. PMID:24598692

Can an integrated approach reduce child vulnerability to anaemia? Evidence from three African countries.

PubMed

Siekmans, Kendra; Receveur, Olivier; Haddad, Slim

2014-01-01

Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a "buffering" of risk associated with known causes of anaemia would be observed among children living in areas benefiting from a community-based health and nutrition program intervention. Cross-sectional data on the nutrition and health status of children 24-59 mo (N=2405) were obtained in 2000 and 2004 from program evaluation surveys in Ghana, Malawi and Tanzania. Linear regression models estimated the association between haemoglobin and immediate, underlying and basic causes of child anaemia and variation in this association between years. Lower haemoglobin levels were observed in children assessed in 2000 compared to 2004 (difference -3.30 g/L), children from Tanzania (-9.15 g/L) and Malawi (-2.96 g/L) compared to Ghana, and the youngest (24-35 mo) compared to oldest age group (48-59 mo; -5.43 g/L). Children who were stunted, malaria positive and recently ill also had lower haemoglobin, independent of age, sex and other underlying and basic causes of anaemia. Despite ongoing morbidity, risk of lower haemoglobin decreased for children with malaria and recent illness, suggesting decreased vulnerability to their anaemia-producing effects. Stunting remained an independent and unbuffered risk factor. Reducing chronic undernutrition is required in order to further reduce child vulnerability and ensure maximum impact of anaemia control programs. Buffering the impact of child morbidity on haemoglobin levels, including malaria, may be achieved in certain settings.

A systematic review of basic life support training targeted to family members of high-risk cardiac patients.

PubMed

Cartledge, Susie; Bray, Janet E; Leary, Marion; Stub, Dion; Finn, Judith

2016-08-01

Targeting basic life support (BLS) training to bystanders who are most likely to witness an out of hospital cardiac arrest (OHCA) is an important public health intervention. We performed a systematic review examining the evidence of the effectiveness of providing BLS training to family members of high-risk cardiac patients. A search of Ovid MEDLINE, CINAL, EMBASE, Informit, Cochrane Library, Web of Science, Scopus, ERIC and ProQuest Dissertations and Theses Global was conducted. We included all studies training adult family members of high-risk cardiac patients regardless of methods used for cardiopulmonary resuscitation (CPR) or BLS training. Two reviewers independently extracted data and evaluated the quality of evidence using GRADE (Grades of Recommendation, Assessment, Development and Evaluation). We included 26 of the 1172 studies identified. The majority of studies were non-randomised controlled trials (n=18), of very low to moderate quality. Currently, there is insufficient evidence to indicate a benefit of this intervention for patients; largely because of low numbers of OHCA events and high loss to follow-up. However, the majority of trained individuals were able to competently perform BLS skills, reported a willingness to use these skills and experienced lower anxiety. Whilst there is no current evidence for improvement in patient outcomes from targeted BLS training for family members, this group are willing and capable to learn these skills. Future research may need to examine longer periods of follow-up using alternate methods (e.g. cardiac arrest registries), and examine the effectiveness of training in the modern era. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Low Fruit/Vegetable Consumption in the Home: Cumulative Risk Factors in Early Childhood

ERIC Educational Resources Information Center

Ward, Wendy L.; Swindle, Taren M.; Kyzer, Angela L.; Whiteside-Mansell, Leanne

2015-01-01

Cumulative risk theory suggests that a variety of social risk factors would have an additive effect on obesity risk. Multiple studies have suggested that obesity is related to basic resources such as transportation and financial resources. Additional research points to parental engagement and parental monitoring as additional sources of risk. This…

Evaluation of biological methods for a future methodological implementation of the Hazard criterion H14 'ecotoxic' in the European waste list (2000/532/EC).

PubMed

Moser, Heidrun; Roembke, Joerg; Donnevert, Gerhild; Becker, Roland

2011-02-01

The ecotoxicological characterization of waste is part of its assessment as hazardous or non-hazardous according to the European Waste List. For this classification 15 hazard criteria are derived from the Council Directive 91/689/EEC on hazardous waste. Some of the hazard criteria are based on the content of dangerous substances. The criterion H14 'ecotoxic' lacks of an assessment and testing strategy and no specific threshold values have been defined so far. Based on the recommendations of CEN guideline 14735 (2005), an international round robin test (ring test) was organized by the German Federal Environment Agency in order to define suitable test methods for the biological assessment of waste and waste eluates. A basic test battery, consisting of three aquatic and three terrestrial tests, was compiled. In addition, data were submitted for ten additional tests (five aquatic (including a genotoxicity test) and five terrestrial ones). The tests were performed with three representative waste types: an ash from an incineration plant, a soil containing high concentrations of organic contaminants (polycyclic aromatic hydrocarbons) and a preserved wood waste. The results of this ring test confirm that a combination of a battery of biological tests and chemical residual analysis is needed for an ecotoxicological characterization of wastes. With small modifications the basic test battery is considered to be well suitable for the hazard and risk assessment of wastes and waste eluates. All results and documents are accessible via a web-based data bank application.

Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

PubMed Central

Kondo, Yutaka; Fukuda, Tatsuma; Uchimido, Ryo; Hifumi, Toru; Hayashida, Kei

2017-01-01

Introduction Advanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature. Methods and analysis We will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ2 test of homogeneity, and any observed heterogeneity will be quantified using the I2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence. Ethics and dissemination Our study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information. Trial registration number PROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389. PMID:29061611

The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993.

PubMed Central

Peña, R; Wall, S; Persson, L A

2000-01-01

OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality. PMID:10630139

Design and Implementation of an Assessment Model for Students Entering Vocational Education Programs in the State of Colorado. Automotive.

ERIC Educational Resources Information Center

University of Northern Colorado, Greeley.

This basic vocational related skills assessment module in automotive mechanics is one of sixteen modules designed to help teachers assess and identify some of the areas in which special needs students may encounter learning difficulties. The materials in the module allow for informal assessment in three basic areas: academic skills, motor skills,…

Design and Implementation of an Assessment Model for Students Entering Vocational Education Programs in the State of Colorado. Graphic Arts.

ERIC Educational Resources Information Center

Hartley, Nancy K.; And Others

This basic vocational related skills assessment module in graphic arts is one of sixteen modules designed to help teachers assess and identify some of the areas in which special needs students may encounter learning difficulties. The materials in the module allow for informal assessment in three basic areas: academic skills, motor skills, and…

Development and Validation of the Life Sciences Assessment: A Measure of Preschool Children's Conceptions of Basic Life Sciences

ERIC Educational Resources Information Center

Maherally, Uzma Nooreen

2014-01-01

The purpose of this study was to develop and validate a science assessment tool termed the Life Sciences Assessment (LSA) in order to assess preschool children's conceptions of basic life sciences. The hypothesis was that the four sub-constructs, each of which can be measured through a series of questions on the LSA, will make a significant…

Association Between Barracks Type and Acute Respiratory Infection in a Gender Integrated Army Basic Combat Training Population

PubMed Central

White, Duvel W.; Feigley, Charles E.; McKeown, Robert E.; Hout, Joseph J.; Hebert, James R.

2015-01-01

Background Acute respiratory infections (ARIs) are the leading cause of acute morbidity and lost work time in the United States. Few studies have looked at building design and transmission of ARIs. Objectives This study explores the association of ventilation design, room occupancy numbers, and training week with ARI rates in Army Basic Combat Training barracks. Methods This observational study captured the overall incidence of ARI in a cohort of 16,258 individuals attending basic combat training at Fort Jackson, South Carolina. Results ARI risk was higher among trainees living in the 60-person room barracks compared with those living in 8-person rooms, which increased rapidly for the first few weeks of training and then declined to baseline. Conclusions Findings support direct contact as primary ARI transmission mode in this study population based on observed lower ARI risk in smaller room barracks and similar risk in large room barracks despite heating, ventilation, and air conditioning system variability. PMID:21882781

The re-identification risk of Canadians from longitudinal demographics

PubMed Central

2011-01-01

Background The public is less willing to allow their personal health information to be disclosed for research purposes if they do not trust researchers and how researchers manage their data. However, the public is more comfortable with their data being used for research if the risk of re-identification is low. There are few studies on the risk of re-identification of Canadians from their basic demographics, and no studies on their risk from their longitudinal data. Our objective was to estimate the risk of re-identification from the basic cross-sectional and longitudinal demographics of Canadians. Methods Uniqueness is a common measure of re-identification risk. Demographic data on a 25% random sample of the population of Montreal were analyzed to estimate population uniqueness on postal code, date of birth, and gender as well as their generalizations, for periods ranging from 1 year to 11 years. Results Almost 98% of the population was unique on full postal code, date of birth and gender: these three variables are effectively a unique identifier for Montrealers. Uniqueness increased for longitudinal data. Considerable generalization was required to reach acceptably low uniqueness levels, especially for longitudinal data. Detailed guidelines and disclosure policies on how to ensure that the re-identification risk is low are provided. Conclusions A large percentage of Montreal residents are unique on basic demographics. For non-longitudinal data sets, the three character postal code, gender, and month/year of birth represent sufficiently low re-identification risk. Data custodians need to generalize their demographic information further for longitudinal data sets. PMID:21696636

"Now I see it, now I don't": Determining Threshold Levels of Facial Emotion Recognition for Use in Patient Populations.

PubMed

Chiu, Isabelle; Gfrörer, Regina I; Piguet, Olivier; Berres, Manfred; Monsch, Andreas U; Sollberger, Marc

2015-08-01

The importance of including measures of emotion processing, such as tests of facial emotion recognition (FER), as part of a comprehensive neuropsychological assessment is being increasingly recognized. In clinical settings, FER tests need to be sensitive, short, and easy to administer, given the limited time available and patient limitations. Current tests, however, commonly use stimuli that either display prototypical emotions, bearing the risk of ceiling effects and unequal task difficulty, or are cognitively too demanding and time-consuming. To overcome these limitations in FER testing in patient populations, we aimed to define FER threshold levels for the six basic emotions in healthy individuals. Forty-nine healthy individuals between 52 and 79 years of age were asked to identify the six basic emotions at different intensity levels (25%, 50%, 75%, 100%, and 125% of the prototypical emotion). Analyses uncovered differing threshold levels across emotions and sex of facial stimuli, ranging from 50% up to 100% intensities. Using these findings as "healthy population benchmarks", we propose to apply these threshold levels to clinical populations either as facial emotion recognition or intensity rating tasks. As part of any comprehensive social cognition test battery, this approach should allow for a rapid and sensitive assessment of potential FER deficits.

A rapid method for assessing the environmental performance of commercial farms in the Pampas of Argentina.

PubMed

Viglizzo, E F; Frank, F; Bernardos, J; Buschiazzo, D E; Cabo, S

2006-06-01

The generation of reliable updated information is critical to support the harmonization of socio-economic and environmental issues in a context of sustainable development. The agro-environmental assessment and management of agricultural systems often relies on indicators that are necessary to make sound decisions. This work aims to provide an approach to (a) assess the environmental performance of commercial farms in the Pampas of Argentina, and (b) propose a methodological framework to calculate environmental indicators that can rapidly be applied to practical farming. 120 commercial farms scattered across the Pampas were analyzed in this study during 2002 and 2003. Eleven basic indicators were identified and calculation methods described. Such indicators were fossil energy (FE) use, FE use efficiency, nitrogen (N) balance, phosphorus (P) balance, N contamination risk, P contamination risk, pesticide contamination risk, soil erosion risk, habitat intervention, changes in soil carbon stock, and balance of greenhouse gases. A model named Agro-Eco-Index was developed on a Microsoft-Excel support to incorporate on-farm collected data and facilitate the calculation of indicators by users. Different procedures were applied to validate the model and present the results to the users. Regression models (based on linear and non-linear models) were used to validate the comparative performance of the study farms across the Pampas. An environmental dashboard was provided to represent in a graphical way the behavior of farms. The method provides a tool to discriminate environmentally friendly farms from those that do not pay enough attention to environmental issues. Our procedure might be useful for implementing an ecological certification system to reward a good environmental behavior in society (e.g., through tax benefits) and generate a commercial advantage (e.g., through the allocation of green labels) for committed farmers.

Erectile dysfunction in fit and healthy young men: psychological or pathological?

PubMed Central

Rastrelli, Giulia

2017-01-01

Epidemiological studies consistently show that prevalence of erectile dysfunction (ED) increases with ageing. Nonetheless, complaints of ED even in younger men are becoming more and more frequent. Healthcare professionals working in Sexual Medicine but even those operating in different clinical contexts might be adequately prepared to answer this increasing requirement. ED in younger men is likely to be overlooked and dismissed without performing any medical assessment, even the most basic ones, such as collection of medical history and physical exam. This is due to the widespread assumption that ED in younger individuals is a self-limiting condition, which does not deserve any clinical evaluation or therapy and can be managed only with patient reassurance. However, evidence shows that, in younger subjects, organic, psychological and relational conditions can contribute to the pathogenesis of ED and all these conditions might be evaluated and treated, whenever necessary. Among the organic conditions contributing to the onset of ED, metabolic and cardiovascular (CV) risk factors are surprisingly of particular relevance in this age group. In fact, in younger men with ED, even more than in older ones, recognizing CV risk factors or conditions suggestive of cardio-metabolic derangements can help identifying men who, although at low absolute risk due to young age, carry a high relative risk for development of CV events. In this view, the assessment of a possible organic component of ED even in younger individuals acquires a pivotal importance, because it offers the unique opportunity to unearth the presence of CV risk factors, thus allowing effective and high quality preventive interventions. PMID:28217453

Tooth erosion and eating disorders: a systematic review and meta-analysis.

PubMed

Hermont, Ana Paula; Oliveira, Patrícia A D; Martins, Carolina C; Paiva, Saul M; Pordeus, Isabela A; Auad, Sheyla M

2014-01-01

Eating disorders are associated with the highest rates of morbidity and mortality of any mental disorders among adolescents. The failure to recognize their early signs can compromise a patient's recovery and long-term prognosis. Tooth erosion has been reported as an oral manifestation that might help in the early detection of eating disorders. The aim of this systematic review and meta-analysis was to search for scientific evidence regarding the following clinical question: Do eating disorders increase the risk of tooth erosion? An electronic search addressing eating disorders and tooth erosion was conducted in eight databases. Two independent reviewers selected studies, abstracted information and assessed its quality. Data were abstracted for meta-analysis comparing tooth erosion in control patients (without eating disorders) vs. patients with eating disorders; and patients with eating disorder risk behavior vs. patients without such risk behavior. Combined odds ratios (ORs) and a 95% confidence interval (CI) were obtained. Twenty-three papers were included in the qualitative synthesis and assessed by a modified version of the Newcastle-Ottawa Scale. Fourteen papers were included in the meta-analysis. Patients with eating disorders had more risk of tooth erosion (OR = 12.4, 95%CI = 4.1-37.5). Patients with eating disorders who self-induced vomiting had more risk of tooth erosion than those patients who did not self-induce vomiting (OR = 19.6, 95%CI = 5.6-68.8). Patients with risk behavior of eating disorder had more risk of tooth erosion than patients without such risk behavior (Summary OR = 11.6, 95%CI = 3.2-41.7). The scientific evidence suggests a causal relationship between tooth erosion and eating disorders and purging practices. Nevertheless, there is a lack of scientific evidence to fulfill the basic criteria of causation between the risk behavior for eating disorders and tooth erosion.

Knowledge, attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City, India.

PubMed

Somaraj, Vinej; Shenoy, Rekha P; Panchmal, Ganesh Shenoy; Jodalli, Praveen S; Sonde, Laxminarayan; Karkal, Ravichandra

2017-01-01

This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support (BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India. The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory (STAI) Questionnaire. Chi-square test was performed on SPSS 21.0 (IBM Statistics, 2012) to determine statistically significant differences ( P <0.05) between assessed knowledge and anxiety. Out of 183 interns, 39.89% had below average knowledge. A total of 123 (67.21%) reported unavailability of professional training. The majority (180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above high-stress level. Comparison of assessed knowledge and stress was found to be insignificant ( P =0.983). There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Comparing control strategies against foot-and-mouth disease: will vaccination be cost-effective in Denmark?

PubMed

Boklund, A; Halasa, T; Christiansen, L E; Enøe, C

2013-09-01

Recent outbreaks of foot-and-mouth disease (FMD) in Europe have highlighted the need for assessment of control strategies to optimise control of the spread of FMD. Our objectives were to assess the epidemiological and financial impact of simulated FMD outbreaks in Denmark and the effect of using ring depopulation or emergency vaccination to control these outbreaks. Two stochastic simulation models (InterSpreadPlus (ISP) and the modified Davis Animal Disease Simulation model (DTU-DADS)) were used to simulate the spread of FMD in Denmark using different control strategies. Each epidemic was initiated in one herd (index herd), and a total of 5000 index herds were used. Four types of control measures were investigated: (1) a basic scenario including depopulation of detected herds, 3 km protection and 10 km surveillance zones, movement tracing and a three-day national standstill, (2) the basic scenario plus depopulation in ring zones around detected herds (Depop), (3) the basic scenario plus protective vaccination within ring zones around detected herds, and (4) the basic scenario plus protective vaccination within ring zones around detected herds. Disease spread was simulated through direct animal movements, medium-risk contacts (veterinarians, artificial inseminators or milk controllers), low-risk contacts (animal feed and rendering trucks, technicians or visitors), market contacts, abattoir trucks, milk tanks, or local spread. The two simulation models showed different results in terms of the estimated numbers. However, the tendencies in terms of recommendations of strategies were similar for both models. Comparison of the different control strategies showed that, from an epidemiological point of view, protective vaccination would be preferable if the epidemic started in a cattle herd in an area with a high density of cattle, whereas if the epidemic started in an area with a low density of cattle or in other species, protective vaccination or depopulation would have almost the same preventive effect. Implementing additional control measures either 14 days after detection of the first infected herd or when 10 herds have been diagnosed would be more efficient than implementing additional control measures when more herds have been diagnosed. Protective vaccination scenarios would never be cost-effective, whereas depopulation or suppressive vaccination scenarios would most often be recommended. Looking at the median estimates of the cost-benefit analysis, depopulation in zones would most often be recommended, although, in extreme epidemics, suppressive vaccination scenarios could be less expensive. The vast majority of the costs and losses associated with a Danish epidemic could be attributed to export losses. Copyright © 2013 Elsevier B.V. All rights reserved.

Pretreatment Nomogram to Predict the Risk of Acute Urinary Retention After I-125 Prostate Brachytherapy

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

Roeloffzen, Ellen M., E-mail: e.m.a.roeloffzen@umcutrecht.nl; Vulpen, Marco van; Battermann, Jan J.

Purpose: Acute urinary retention (AUR) after iodine-125 (I-125) prostate brachytherapy negatively influences long-term quality of life and therefore should be prevented. We aimed to develop a nomogram to preoperatively predict the risk of AUR. Methods: Using the preoperative data of 714 consecutive patients who underwent I-125 prostate brachytherapy between 2005 and 2008 at our department, we modeled the probability of AUR. Multivariate logistic regression analysis was used to assess the predictive ability of a set of pretreatment predictors and the additional value of a new risk factor (the extent of prostate protrusion into the bladder). The performance of the finalmore » model was assessed with calibration and discrimination measures. Results: Of the 714 patients, 57 patients (8.0%) developed AUR after implantation. Multivariate analysis showed that the combination of prostate volume, IPSS score, neoadjuvant hormonal treatment and the extent of prostate protrusion contribute to the prediction of AUR. The discriminative value (receiver operator characteristic area, ROC) of the basic model (including prostate volume, International Prostate Symptom Score, and neoadjuvant hormonal treatment) to predict the development of AUR was 0.70. The addition of prostate protrusion significantly increased the discriminative power of the model (ROC 0.82). Calibration of this final model was good. The nomogram showed that among patients with a low sum score (<18 points), the risk of AUR was only 0%-5%. However, in patients with a high sum score (>35 points), the risk of AUR was more than 20%. Conclusion: This nomogram is a useful tool for physicians to predict the risk of AUR after I-125 prostate brachytherapy. The nomogram can aid in individualized treatment decision-making and patient counseling.« less

Evaluation of the Eological Management and Enhancement Alernative for Remediation of the K1007-P1 Pond

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

Peterson, M.J.

2005-10-31

An evaluation of the human and ecological risks associated with the P1 Pond and surrounding environs was conducted as part of the ETTP Site-Wide Remedial Investigation. The RI provides the basis for the focus on PCBs as the most important unacceptable risk to human and ecological health in the pond. Other P1 contaminants, media, or pathways of risk to receptors are identified in the RI, but are not addressed as a major risk reduction goal for the ETTP Site-Wide Feasibility Study. Therefore, the goal of the Ecological Management alternative is to reduce unacceptable risks associated with PCBs in fish. Manymore » of the actions proposed for this alternative, however, are likely to reduce risks associated with other contaminants and their pathways. The high PCB concentrations in fish from the P1 Pond are most certainly due in part to the current ecological condition of the pond that maximizes PCB biomagnification. This basic assumption and the factors contributing to it were evaluated by conducting an intensive field study of the P1 Pond in the summer of 2004 (for a thorough presentation of current P1 Pond biological conditions, see Peterson et al. 2005). Major hypotheses regarding the P1 Pond's current fish community, PCB fate and transport processes, pond vegetation, and limnological conditions that contribute to the high PCB levels in fish were validated by the study (Appendix A), The results of the 2004 ecological assessment, in concert with long-term datasets obtained as part of the ETTP Biological Monitoring and Abatement Program (BMAP) and recent abiotic sampling for the RI, provide the basis for the assessment of current conditions.« less

Trust and risk: a model for medical education.

PubMed

Damodaran, Arvin; Shulruf, Boaz; Jones, Philip

2017-09-01

Health care delivery, and therefore medical education, is an inherently risky business. Although control mechanisms, such as external audit and accreditation, are designed to manage risk in clinical settings, another approach is 'trust'. The use of entrustable professional activities (EPAs) represents a deliberate way in which this is operationalised as a workplace-based assessment. Once engaged with the concept, clinical teachers and medical educators may have further questions about trust. This narrative overview of the trust literature explores how risk, trust and control intersect with current thinking in medical education, and makes suggestions for potential directions of enquiry. Beyond EPAs, the importance of trust in health care and medical education is reviewed, followed by a brief history of trust research in the wider literature. Interpersonal and organisational levels of trust and a model of trust from the management literature are used to provide the framework with which to decipher trust decisions in health care and medical education, in which risk and vulnerability are inherent. In workplace learning and assessment, the language of 'trust' may offer a more authentic and practical vocabulary than that of 'competency' because clinical and professional risks are explicitly considered. There are many other trust relationships in health care and medical education. At the most basic level, it is helpful to clearly delineate who is the trustor, the trustee, and for what task. Each relationship has interpersonal and organisational elements. Understanding and considered utilisation of trust and control mechanisms in health care and medical education may lead to systems that maturely manage risk while actively encouraging trust and empowerment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

How meaningful are risk determinations in the absence of a complete dataset? Making the case for publishing standardized test guideline and 'no effect' studies for evaluating the safety of nanoparticulates versus spurious 'high effect' results from single investigative studies.

PubMed

Warheit, David B; Donner, E Maria

2015-06-01

A recent review article critically assessed the effectiveness of published research articles in nanotoxicology to meaningfully address health and safety issues for workers and consumers. The main conclusions were that, based on a number of flaws in study designs, the potential risk from exposures to nanomaterials is highly exaggerated, and that no 'nano-specific' adverse effects, different from exposures to bulk particles, have been convincingly demonstrated. In this brief editorial we focus on a related tangential issue which potentially compromises the integrity of basic risk science. We note that some single investigation studies report specious toxicity findings, which make the conclusions more alarming and attractive and publication worthy. In contrast, the standardized, carefully conducted, 'guideline study results' are often ignored because they can frequently report no adverse effects; and as a consequence are not considered as novel findings for publication purposes, and therefore they are never considered as newsworthy in the popular press. Yet it is the Organization for Economic Cooperation and Development (OECD) type test guideline studies that are the most reliable for conducting risk assessments. To contrast these styles and approaches, we present the results of a single study which reports high toxicological effects in rats following low-dose, short-term oral exposures to nanoscale titanium dioxide particles concomitant with selective investigative analyses. Alternatively, the findings of OECD test guideline 408, standardized guideline oral toxicity studies conducted for 90 days at much higher doses (1000 mg kg -1 ) in male and female rats demonstrated no adverse effects following a very thorough and complete clinical chemical, as well as histopathological evaluation of all of the relevant organs in the body. This discrepancy in study findings is not reconciled by the fact that several biokinetic studies in rats and humans demonstrate little or no uptake of nanoscale or pigment-grade TiO 2 particles following oral exposures. We conclude that to develop a competent risk assessment profile, results derived from standardized, guideline-type studies, and even 'no effect' study findings provide critically useful input for assessing safe levels of exposure; and should, in principle, be readily acceptable for publication in peer-reviewed toxicology journals. This is a necessary prerequisite for developing a complete dataset for risk assessment determinations.

[Platforms are needed for innovative basic research in ophthalmology].

PubMed

Wang, Yi-qiang

2012-07-01

Basic research poses the cornerstone of technical innovation in all lines including medical sciences. Currently, there are shortages of professional scientists as well as technical supporting teams and facilities in the field of basic research of ophthalmology and visual science in China. Evaluation system and personnel policies are not supportive for innovative but high-risk-of-failure research projects. Discussion of reasons and possible solutions are given here to address these problems, aiming at promoting buildup of platforms hosting novel and important basic research in eye science in this country.

Needs Assessment for the Construction Industry in B.C. & the Yukon. Skill Plan.

ERIC Educational Resources Information Center

Lewe, Glenda

A basic skills needs assessment developed a picture of the basic skills levels and needs of the construction industry in British Columbia and the Yukon. The three parts of the assessment were interviews with business managers and managers of other programs provided through joint labor/management initiatives, a questionnaire administered to…

20 CFR 628.515 - Objective assessment.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., work history, education, basic and occupational skills, interests, aptitudes (including interests and... assessment shall include an examination of the basic skills and supportive service needs of each participant... appropriate means to measure skills, abilities, attitudes, and interests of the participants. The methods used...

Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study.

PubMed

Gorski, Stanislaw; Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina; Grodzicki, Tomasz

2017-01-01

Purpose . Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods . Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards). Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization), received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results . 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion . Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

Nutritional Issues and Nutrition Support in Older Home Care Patients in the City of Zagreb.

PubMed

Vranešić Bender, Darija; Kovačević, Marta; Hanževački, Miro; Vrabec, Božena; Benković, Vanesa; Domislović, Viktor; Krznarić, Željko

2017-12-01

Population aging is a global demographic trend showing continuous growth and among its consequences is a rise in malnutrition that is characteristic for the elderly. The objective of this study was to evaluate nutritional status of elderly home care patients immediately after hospital discharge and to determine factors that affect nutritional status using questionnaires based on validated tools (NRS-2002, DETERMINE checklist) and basic medical history data. The study involved 76 elderly individuals (51.3% of them older than 70) living in the City of Zagreb. The nutritional status assessment using the NRS-2002 tool showed that 57.6% of the subjects were at nutritional risk. The findings of the assessment by use of the DETERMINE tool were also unfavorable, indicating that 82.1% of persons older than 70 were categorized as being at a high nutritional risk, while 17.9% were at moderate risk. The DETERMINE checklist elements (illness; reduced intake of fruits, vegetables or dairy products; alcohol consumption; oral health problems; and weight loss) were linked to a higher NRS score. The mean number of hospital days in subjects at nutritional risk was 14.27 (the mean number in the Republic of Croatia is 8.56 days). Although the study involved a small number of subjects, the results showed a substantial presence of malnutrition among the elderly. A timely -intervention by the healthcare system and training of healthcare personnel can be a step towards achieving a better nutritional status.

Back-to-the-Basics in English Teaching.

ERIC Educational Resources Information Center

Donelson, Ken, Ed.

1976-01-01

In this issue, the writers focus on the "basics" in English teaching, some offering suggestions on ways of altering present conditions, some commenting generally (in assessments, defenses, or attacks) cn the basics, and some presenting specific discussions of basics in teaching the various language arts components. A few of the articales and…

Can households earning minimum wage in Nova Scotia afford a nutritious diet?

PubMed

Williams, Patricia L; Johnson, Christine P; Kratzmann, Meredith L V; Johnson, C Shanthi Jacob; Anderson, Barbara J; Chenhall, Cathy

2006-01-01

To assess the affordability of a nutritious diet for households earning minimum wage in Nova Scotia. Food costing data were collected in 43 randomly selected grocery stores throughout NS in 2002 using the National Nutritious Food Basket (NNFB). To estimate the affordability of a nutritious diet for households earning minimum wage, average monthly costs for essential expenses were subtracted from overall income to see if enough money remained for the cost of the NNFB. This was calculated for three types of household: 1) two parents and two children; 2) lone parent and two children; and 3) single male. Calculations were also made for the proposed 2006 minimum wage increase with expenses adjusted using the Consumer Price Index (CPI). The monthly cost of the NNFB priced in 2002 for the three types of household was 572.90 dollars, 351.68 dollars, and 198.73 dollars, respectively. Put into the context of basic living, these data showed that Nova Scotians relying on minimum wage could not afford to purchase a nutritious diet and meet their basic needs, placing their health at risk. These basic expenses do not include other routine costs, such as personal hygiene products, household and laundry cleaners, and prescriptions and costs associated with physical activity, education or savings for unexpected expenses. People working at minimum wage in Nova Scotia have not had adequate income to meet basic needs, including a nutritious diet. The 2006 increase in minimum wage to 7.15 dollars/hr is inadequate to ensure that Nova Scotians working at minimum wage are able to meet these basic needs. Wage increases and supplements, along with supports for expenses such as childcare and transportation, are indicated to address this public health problem.

Assessing the risks of genotoxicity in the therapeutic development of induced pluripotent stem cells.

PubMed

Hong, So Gun; Dunbar, Cynthia E; Winkler, Thomas

2013-02-01

Induced pluripotent stem cells (iPSCs) have great potential for regenerative medicine as well as for basic and translational research. However, following the initial excitement over the enormous prospects of this technology, several reports uncovered serious concerns regarding its safety for clinical applications and reproducibility for laboratory applications such as disease modeling or drug screening. In particular, the genomic integrity of iPSCs is the focus of extensive research. Epigenetic remodeling, aberrant expression of reprogramming factors, clonal selection, and prolonged in vitro culture are potential pathways for acquiring genomic alterations. In this review, we will critically discuss current reprogramming technologies particularly in the context of genotoxicity, and the consequences of these alternations for the potential applications of reprogrammed cells. In addition, current strategies of genetic modification of iPSCs, as well as applicable suicide strategies to control the risk of iPSC-based therapies will be introduced.

[Safety in the Microbiology laboratory].

PubMed

Rojo-Molinero, Estrella; Alados, Juan Carlos; de la Pedrosa, Elia Gómez G; Leiva, José; Pérez, José L

2015-01-01

The normal activity in the laboratory of microbiology poses different risks - mainly biological - that can affect the health of their workers, visitors and the community. Routine health examinations (surveillance and prevention), individual awareness of self-protection, hazard identification and risk assessment of laboratory procedures, the adoption of appropriate containment measures, and the use of conscientious microbiological techniques allow laboratory to be a safe place, as records of laboratory-acquired infections and accidents show. Training and information are the cornerstones for designing a comprehensive safety plan for the laboratory. In this article, the basic concepts and the theoretical background on laboratory safety are reviewed, including the main legal regulations. Moreover, practical guidelines are presented for each laboratory to design its own safety plan according its own particular characteristics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Assessment and management of dental erosion.

PubMed

Wang, Xiaojie; Lussi, Adrian

2010-07-01

Studies have shown a growing trend toward increasing prevalence of dental erosion, associated with the declining prevalence of caries disease in industrialized countries. Erosion is an irreversible chemical process that results in tooth substance loss and leaves teeth susceptible to damage as a result of wear over the course of an individual's lifetime. Therefore, early diagnosis and adequate prevention are essential to minimize the risk of tooth erosion. Clinical appearance is the most important sign to be used to diagnose erosion. The Basic Erosive Wear Examination (BEWE) is a simple method to fulfill this task. The determination of a variety of risk and protective factors (patient-dependent and nutrition-dependent factors) as well as their interplay are necessary to initiate preventive measures tailored to the individual. When tooth loss caused by erosive wear reaches a certain level, oral rehabilitation becomes necessary. Copyright 2010 Elsevier Inc. All rights reserved.

Safe teleradiology: information assurance as project planning methodology.

PubMed

Collmann, Jeff; Alaoui, Adil; Nguyen, Dan; Lindisch, David

2005-01-01

The Georgetown University Medical Center Department of Radiology used a tailored version of OCTAVE, a self-directed information security risk assessment method, to design a teleradiology system that complied with the regulation implementing the security provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The system addressed threats to and vulnerabilities in the privacy and security of protected health information. By using OCTAVE, Georgetown identified the teleradiology program's critical assets, described threats to the assurance of those assets, developed and ran vulnerability scans of a system pilot, evaluated the consequences of security breaches, and developed a risk management plan to mitigate threats to program assets, thereby implementing good information assurance practices. This case study illustrates the basic point that prospective, comprehensive planning to protect the privacy and security of an information system strategically benefits program management as well as system security.

Proton-Nucleus Elastic Cross Sections Using Two-Body In-Medium Scattering Amplitudes

NASA Technical Reports Server (NTRS)

Tripathi, R. K.; Wilson, John W.; Cucinotta, Francis A.

2001-01-01

Recently, a method was developed of extracting nucleon-nucleon (NN) cross sections in the medium directly from experiment. The in-medium NN cross sections form the basic ingredients of several heavy-ion scattering approaches including the coupled-channel approach developed at the Langley Research Center. The ratio of the real to the imaginary part of the two-body scattering amplitude in the medium was investigated. These ratios are used in combination with the in-medium NN cross sections to calculate elastic proton-nucleus cross sections. The agreement is excellent with the available experimental data. These cross sections are needed for the radiation risk assessment of space missions.

Summer Undergraduate Research Program: Environmental studies

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

McMillan, J.

1994-12-31

The purpose of the summer undergraduate internship program for research in environmental studies is to provide an opportunity for well-qualified students to undertake an original research project as an apprentice to an active research scientist in basic environmental research. The students are offered research topics at the Medical University in the scientific areas of pharmacology and toxicology, epidemiology and risk assessment, environmental microbiology, and marine sciences. Students are also afforded the opportunity to work with faculty at the University of Charleston, SC, on projects with an environmental theme. Ten well-qualified students from colleges and universities throughout the eastern United Statesmore » were accepted into the program.« less

Total Dose Effects in Conventional Bipolar Transistors

NASA Technical Reports Server (NTRS)

Johnston, A. H.; Swift, G. W.; Rax, B. G.

1994-01-01

This paper examines various factors in bipolar device construction and design, and discusses their impact on radiation hardness. The intent of the paper is to improve understanding of the underlying mechanisms for practical devices without special test structures, and to provide (1) guidance in ways to select transistor designs that are more resistant to radiation damage, and (2) methods to estimate the maximum amount of damage that might be expected from a basic transistor design. The latter factor is extremely important in assessing the risk that future lots of devices will be substantially below design limits, which are usually based on test data for older devices.

Social cognition and neurocognition as independent domains in psychosis.

PubMed

van Hooren, S; Versmissen, D; Janssen, I; Myin-Germeys, I; à Campo, J; Mengelers, R; van Os, J; Krabbendam, L

2008-08-01

Patients with psychosis display alterations in social cognition as well as in the realm of neurocognition. It is unclear, however, to what degree these cognitive domains represent two separate dimensions of liability or the pleiotropic expression of a single deficit. The purpose of the present study was to investigate (i) to what extent alterations in social cognition represent an independent area of vulnerability to psychosis, separate from neurocognitive deficits and (ii) whether social cognition is one construct or can be divided into several subcomponents. Five social cognition and three neurocognitive tasks were completed by 186 participants with different levels of vulnerability for psychosis: 44 patients with psychotic disorder; 47 subjects at familial risk; 41 subjects at psychometric risk and 54 control subjects. The social cognition tasks covered important basic subcomponents of social cognition, i.e. mentalisation (or theory of mind), data gathering bias (jumping to conclusions), source monitoring and attribution style. Neurocognitive tasks assessed speed of information processing, inhibition, cognitive shifting and strategy-driven retrieval from semantic memory. The results of factor analysis suggested that neurocognition and social cognition are two separate areas of vulnerability in psychosis. Furthermore, the social cognition measures lacked significant overlap, suggesting a multidimensional construct. Cognitive liabilities to psychosis are manifold, and include key processes underlying basic person-environment interactions in daily life, independent of cognition quantified by neuropsychological tests.

Analysis of Critical Infrastructure Dependencies and Interdependencies

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

Petit, Frederic; Verner, Duane; Brannegan, David

2015-06-01

The report begins by defining dependencies and interdependencies and exploring basic concepts of dependencies in order to facilitate a common understanding and consistent analytical approaches. Key concepts covered include; Characteristics of dependencies: upstream dependencies, internal dependencies, and downstream dependencies; Classes of dependencies: physical, cyber, geographic, and logical; and Dimensions of dependencies: operating environment, coupling and response behavior, type of failure, infrastructure characteristics, and state of operations From there, the report proposes a multi-phase roadmap to support dependency and interdependency assessment activities nationwide, identifying a range of data inputs, analysis activities, and potential products for each phase, as well as keymore » steps needed to progress from one phase to the next. The report concludes by outlining a comprehensive, iterative, and scalable framework for analyzing dependencies and interdependencies that stakeholders can integrate into existing risk and resilience assessment efforts.« less

[The concept of risk and its estimation].

PubMed

Zocchetti, C; Della Foglia, M; Colombi, A

1996-01-01

The concept of risk, in relation to human health, is a topic of primary interest for occupational health professionals. A new legislation recently established in Italy (626/94) according to European Community directives in the field of Preventive Medicine, called attention to this topic, and in particular to risk assessment and evaluation. Motivated by this context and by the impression that the concept of risk is frequently misunderstood, the present paper has two aims: the identification of the different meanings of the term "risk" in the new Italian legislation and the critical discussion of some commonly used definitions; and the proposal of a general definition, with the specification of a mathematical expression for quantitative risk estimation. The term risk (and risk estimation, assessment, or evaluation) has mainly referred to three different contexts: hazard identification, exposure assessment, and adverse health effects occurrence. Unfortunately, there are contexts in the legislation in which it is difficult to identify the true meaning of the term. This might cause equivocal interpretations and erroneous applications of the law because hazard evaluation, exposure assessment, and adverse health effects identification are completely different topics that require integrated but distinct approaches to risk management. As far as a quantitative definition of risk is of concern, we suggest an algorithm which connects the three basic risk elements (hazard, exposure, adverse health effects) by means of their probabilities of occurrence: the probability of being exposed (to a definite dose) given that a specific hazard is present (Pr(e[symbol: see text]p)), and the probability of occurrence of an adverse health effect as a consequence of that exposure (Pr(d[symbol: see text]e)). Using these quantitative components, risk can be defined as a sequence of measurable events that starts with hazard identification and terminates with disease occurrence; therefore, the following formal definition of risk is proposed: the probability of occurrence, in a given period of time, of an adverse health effect as a consequence of the existence of an hazard. In formula: R(d[symbol: see text]p) = Pr(e[symbol: see text]p) x Pr(d[symbol: see text]e). While Pr(e[symbol: see text]p) (exposure given hazard) must be evaluated in the situation under study, two alternatives exist for the estimation of the occurrence of adverse health effects (Pr(d[symbol: see text]e)): a "direct" estimation of the damage (Pr(d[symbol: see text]e) through formal epidemiologic studies conducted in the situation under observation; and an "indirect" estimation of Pr(d[symbol: see text]e) using information taken from the scientific literature (epidemiologic evaluations, dose-response relationships, extrapolations, ...). Both conditions are presented along with their respective advantages, disadvantages, and uncertainties. The usefulness of the proposed algorithm is discussed with respect to commonly used applications of risk assessment in occupational medicine; the relevance of time for risk estimation (both in the term of duration of observation, duration of exposure, and latency of effect) is briefly explained; and how the proposed algorithm takes into account (in terms of prevention and public health) both the etiologic relevance of the exposure and the consequences of exposure removal is highlighted. As a last comment, it is suggested that the diffuse application of good work practices (technical, behavioral, organizational, ...), or the exhaustive use of check lists, can be relevant in terms of improvement of prevention efficacy, but does not represent any quantitative procedure of risk assessment which, in any circumstance, must be considered the elective approach to adverse health effect prevention.

Geographical BSE risk assessment and its impact on disease detection and dissemination.

PubMed

Salman, Mo; Silano, Vittorio; Heim, Dagmar; Kreysa, Joachim

2012-08-01

Bovine Spongiform Encephalopathy (BSE) rapidly evolved into an issue of major public concern particularly when, in 1996, evidence was provided that this disease had crossed the species barrier and infected humans in the UK with what has become known as "variant Creutzfeldt Jakob Disease" (vCJD). The aim of this paper is to describe the European Geographical BSE risk assessment (GBR) that was successfully used for assessing the qualitative likelihood that BSE could be present in a country where it was not yet officially recognized. It also discusses how this can lead to risk-based and therefore preventive management of BSE at national and international levels. The basic assumption of the GBR method is that the BSE agent is initially introduced into a country's domestic cattle production system through the importation of contaminated feedstuffs or live cattle. This is referred to as an "external challenge". The ability of the system to cope with such a challenge is, in turn, referred to as its "stability": a stable system will not allow the BSE agent to propagate and amplify following its introduction, while an unstable system will. The BSE-status of a country assessed by this system was used by the European Commission as the basis for trade legislation rules for cattle and their products. The GBR was an invaluable tool in evaluating the potential global spread of BSE as it demonstrated how a disease could be transferred through international trade. This was shown to be a critical factor to address in reducing the spread and amplification of BSE throughout the world. Furthermore, GBR resulted in the implementation of additional measures and management activities both to improve surveillance and to prevent transmission within the cattle population. Copyright © 2012 Elsevier B.V. All rights reserved.

“SHOUT” to improve the quality of care delivered to patients with acute kidney injury at Great Western Hospital

PubMed Central

Brady, Paul; Gorham, James; Kosti, Angeliki; Seligman, William; Courtney, Alona; Mazan, Karolina; Paterson, Stuart; Ramcharitar, Steve; Chandrasekaran, Badri; Juniper, Mark; Greamspet, Mala; Daniel, Jessica; Chalstrey, Sue; Ahmed, Ijaz; Dasgupta, Tanaji

2015-01-01

Acute kidney injury (AKI) affects up to 20% of all patients admitted to hospital, and is associated with a higher risk of adverse clinical outcomes, increased healthcare costs, as well as long term risks of chronic kidney disease and end stage renal failure. The aim of this project was to improve the quality of care for patients with AKI admitted to the acute medical unit (AMU) at the Great Western Hospital (GWH). We assessed awareness and self reported confidence among physicians in our Trust, in addition to basic aspects of care relevant to AKI on our AMU. A multifaceted quality improvement strategy was developed, which included measures to improve awareness such as a Trust wide AKI awareness day, and reconfiguring the admission proforma on our AMU in order to enhance risk assessment, staging, and early response to AKI. Ancillary measures such as the dissemination of flashcards for lanyards containing core information were also used. Follow up assessments showed that foundation year one (FY1) doctors’ self reported confidence in managing AKI increased from 2.8 to 4.2, as measured on a five point Likert scale (P=0.0003). AKI risk assessment increased from 13% to 57% (P=0.07) following a change in the admission proforma. Documentation of the diagnosis of AKI increased from 66% to 95% (P=0.038) among flagged patients. Documentation of urine dip results increased from 33% to 73% (P=0.01), in addition to a rise in appropriate referral for specialist input, although this was not statistically significant. Our results suggest that using the twin approaches of improving awareness, and small changes to systemic factors such as modification of the admission proforma, can lead to significant enhancements in the quality of care of patients with AKI. PMID:26734401

A mission to preserve the Geostationary Region (ROGER)

NASA Astrophysics Data System (ADS)

Smith, D.; Martin, K. C.; Petersen, H.; Shaw, A.; Skidmore, B.; Smith, D.; Stokes, H.; Willig, A.

The high strategic and commercial value of the geostationary region is unquestioned. It is known that many satellites are not re-orbited at the end of their mission for a number of reasons. Previous studies have investigated the possibility of rendezvous and docking with an uncontrolled target and concluded a basic technical plausibility. Thus the possibility exists that spent satellites could be removed from the operational region by one or more shuttle vehicles. This is the basis for the European Space Agency (ESA/ESTEC) study entitled Robotic Geostationary Orbit Restorer (ROGER). In full, the ROGER study will address the collision risk in GEO, identify workable economic and technical mission scenarios and propose a solution. To enable an accurate quantification of the risk in the operational GEO region a detailed assessment of the current and future status has been performed. This paper will present the results of this analysis, which includes a breakdown of the current utilisation of the GEO ring and an assessment of the satellite failures that have afflicted GEO satellites. Also considered are the general trends in the GEO market and the tendencies of satellite operators to remove their assets from the operational GEO region at the end of their useful life. All of these analyses are brought together in a GEO Simulator, which is designed to determine the collision risk in GEO and the effect that satellite failures, future launch traffic and re-orbiting trends have on this risk. Drawing on this assessment of current and future GEO utilisation, a list of potential ROGER mission scenarios has been generated. For each case the major technical issues are assessed with respect to the available technology, and cost and schedule implications are compared with economic issues such as sources of funding. In this way, cases for government and commercial funding of a ROGER mission are examined. This paper will present examples of such analyses and discuss the rationale behind a possible solution.

Prediction of pH dependent absorption using in vitro, in silico, and in vivo rat models: Early liability assessment during lead optimization.

PubMed

Saxena, Ajay; Shah, Devang; Padmanabhan, Shweta; Gautam, Shashyendra Singh; Chowan, Gajendra Singh; Mandlekar, Sandhya; Desikan, Sridhar

2015-08-30

Weakly basic compounds which have pH dependent solubility are liable to exhibit pH dependent absorption. In some cases, a subtle change in gastric pH can significantly modulate the plasma concentration of the drug and can lead to sub-therapeutic exposure of the drug. Evaluating the risk of pH dependent absorption and potential drug-drug interaction with pH modulators are important aspects of drug discovery and development. In order to assess the risk around the extent of decrease in the systemic exposure of drugs co-administered with pH modulators in the clinic, a pH effect study is carried out, typically in higher species, mostly dog. The major limitation of a higher species pH effect study is the resource and material requirement to assess this risk. Hence, these studies are mostly restricted to promising or advanced leads. In our current work, we have used in vitro aqueous solubility, in silico simulations using GastroPlus™ and an in vivo rat pH effect model to provide a qualitative assessment of the pH dependent absorption liability. Here, we evaluate ketoconazole and atazanavir with different pH dependent solubility profiles and based on in vitro, in silico and in vivo results, a different extent of gastric pH effect on absorption is predicted. The prediction is in alignment with higher species and human pH effect study results. This in vitro, in silico and in vivo (IVISIV) correlation is then extended to assess pH absorption mitigation strategy. The IVISIV predicts pH dependent absorption for BMS-582949 whereas its solubility enhancing prodrug, BMS-751324 is predicted to mitigate this liability. Overall, the material requirement for this assessment is substantially low which makes this approach more practical to screen multiple compounds during lead optimization. Copyright © 2015 Elsevier B.V. All rights reserved.

Analysis of risk factors for post-operative complications and prognostic predictors of disease recurrence following definitive treatment of patients with esophageal cancer from two medical centers in Northwest China

PubMed Central

Wang, Jichang; Zhang, Boxiang; Meng, Jinying; Xiao, Guodong; Li, Xiang; Li, Gang; Qin, Sida; Du, Ning; Zhang, Jia; Zhang, Jing; Xu, Chongwen; Tang, Shou-Ching; Liang, Rui; Ren, Hong; Sun, Xin

2017-01-01

Evaluating the clinicopathological features of patients receiving definitive treatment for esophageal cancer may facilitate the identification of patterns and factors associated with post-operative complications, and enable the development of a surveillance strategy for surviving patients at a higher risk of disease recurrence. In the present study, clinical data from 579 patients with esophageal cancer that underwent radical resection of esophagus were collected. These patients were admitted to two medical centers in Northwest China, and information regarding the presence or absence of basic chronic diseases and post-operative results were retrospectively analyzed. The level of selected stem cell markers, including aldehyde dehydrogenase 1, CD133, integrin subunit α 6, integrin subunit β 4 and T-cell factor-4, were determined in esophageal cancer tissue samples in order to determine whether these markers may be useful predictors of disease prognosis and recurrence. Post-operative complications in patients receiving radical resection of the esophagus included respiratory system complications, cardiovascular abnormalities and esophageal anastomotic fistulae. Diabetes, basic respiratory disease and lower pre-surgical serum albumin levels were observed to be individual risk factors associated with post-operative complications, including respiratory system complications of acute respiratory failure and pulmonary infection, cardiovascular abnormalities of atrial fibrillation and arrhythmia, as well as the development of esophageal anastomotic fistulae. Diagnosis of esophageal cancer at later stage was significantly correlated with anastomotic fistula. Molecular detection of stem cell markers for prognosis prediction was achieved by immunohistochemical and immunofluorescence staining assays. The results demonstrated that the presence of stem-like cells in cancer tissues was associated with poor disease prognosis and a high recurrence ratio. In conclusion, the results of the current study suggested that post-operative complications were more likely to occur in patients with diabetes, basic respiratory disease or lower serum albumin levels prior to surgery. Therefore, sufficient intensive peri-operative care, rigorous operative risk assessments, and the selection of the patients with early or mid-stage esophageal cancer, may decrease the risk of post-surgical complications in patients receiving radical resection of the esophagus. In addition, a high ratio of esophageal cancer stem-like cells was associated with cancer recurrence. These results suggest that an intensive surveillance strategy should be implemented in order to facilitate early detection of disease recurrence and improve the clinical management of these patients post-surgery. PMID:28962198

The Predictive Validity of the Assessment of Basic Learning Abilities versus Parents' Predictions with Children with Autism

ERIC Educational Resources Information Center

Murphy, Colleen; Martin, Garry L.; Yu, C. T.

2014-01-01

The Assessment of Basic Learning Abilities (ABLA) is an empirically validated clinical tool for assessing the learning ability of persons with intellectual disabilities and children with autism. An ABLA tester uses standardized prompting and reinforcement procedures to attempt to teach, individually, each of six tasks, called levels, to a testee,…

Assessment of the Implementation of the Reading Component of the English Language Curriculum for Basic Education in Nigeria

ERIC Educational Resources Information Center

Yusuf, Hanna Onyi

2014-01-01

This study assessed the implementation of the reading component of the Junior Secondary School English Language Curriculum for Basic Education in Nigeria. Ten (10) randomly selected public and private secondary schools from Kaduna metropolis in Kaduna State of Nigeria were used for the study. Among the factors assessed in relation to the…

Neural responses to exclusion predict susceptibility to social influence.

PubMed

Falk, Emily B; Cascio, Christopher N; O'Donnell, Matthew Brook; Carp, Joshua; Tinney, Francis J; Bingham, C Raymond; Shope, Jean T; Ouimet, Marie Claude; Pradhan, Anuj K; Simons-Morton, Bruce G

2014-05-01

Social influence is prominent across the lifespan, but sensitivity to influence is especially high during adolescence and is often associated with increased risk taking. Such risk taking can have dire consequences. For example, in American adolescents, traffic-related crashes are leading causes of nonfatal injury and death. Neural measures may be especially useful in understanding the basic mechanisms of adolescents' vulnerability to peer influence. We examined neural responses to social exclusion as potential predictors of risk taking in the presence of peers in recently licensed adolescent drivers. Risk taking was assessed in a driving simulator session occurring approximately 1 week after the neuroimaging session. Increased activity in neural systems associated with the distress of social exclusion and mentalizing during an exclusion episode predicted increased risk taking in the presence of a peer (controlling for solo risk behavior) during a driving simulator session outside the neuroimaging laboratory 1 week later. These neural measures predicted risky driving behavior above and beyond self-reports of susceptibility to peer pressure and distress during exclusion. These results address the neural bases of social influence and risk taking; contribute to our understanding of social and emotional function in the adolescent brain; and link neural activity in specific, hypothesized, regions to risk-relevant outcomes beyond the neuroimaging laboratory. Results of this investigation are discussed in terms of the mechanisms underlying risk taking in adolescents and the public health implications for adolescent driving. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Neural responses to exclusion predict susceptibility to social influence

PubMed Central

Falk, Emily B.; Cascio, Christopher N.; O’Donnell, Matthew Brook; Carp, Joshua; Tinney, Francis J.; Bingham, C. Raymond; Shope, Jean T.; Ouimet, Marie Claude; Pradhan, Anuj K.; Simons-Morton, Bruce G.

2014-01-01

Purpose Social influence is prominent across the lifespan, but sensitivity to influence is especially high during adolescence, and is often associated with increased risk taking. Such risk taking can have dire consequences. For example, in American teens, traffic-related crashes are leading causes of non-fatal injury and death. Neural measures may be especially useful in understanding the basic mechanisms of adolescents’ vulnerability to peer influence. Methods We examined neural responses to social exclusion as potential predictors of risk taking in the presence of peers in recently-licensed adolescent drivers. Risk taking was assessed in a driving simulator session occurring approximately one week after the neuroimaging session. Results Increased activity in neural systems associated with the distress of social exclusion and mentalizing during an exclusion episode predicted increased risk taking in the presence of a peer (controlling for solo risk behavior) during a driving simulator session outside of the neuroimaging lab one week later. These neural measures predicted risky driving behavior above and beyond self-reports of susceptibility to peer pressure and distress during exclusion. Conclusions These results speak to the neural bases of social influence and risk taking; contribute to our understanding of social and emotional function in the adolescent brain; and link neural activity in specific, hypothesized, regions to risk-relevant outcomes beyond the neuroimaging lab. Results of this investigation are discussed in terms of the mechanisms underlying risk taking in adolescents and the public health implications for adolescent driving. PMID:24759437

Novice Users' Misconceptions of BASIC Programming Statements. Report No. 82-1.

ERIC Educational Resources Information Center

Bayman, Piraye; Mayer, Richard E.

The nature of novice programmers' mental models for BASIC statements following preliminary BASIC instruction was assessed with 30 undergraduates who were taught BASIC through a self-paced, mastery manual and who were simultaneously given hands-on access to an Apple II microcomputer. Following instruction, the students were tested to determine…

Risk to civilization: A planetary science perspective

NASA Technical Reports Server (NTRS)

Chapman, Clark R.; Morrison, David

1988-01-01

One of the most profound changes in our perspective of the solar system resulting from the first quarter century of planetary exploration by spacecraft is the recognition that planets, including Earth, were bombarded by cosmic projectiles for 4.5 aeons and continue to be bombarded today. Although the planetary cratering rate is much lower now than it was during the first 0.5 aeons, sizeable Earth-approaching asteroids and comets continue to hit the Earth at a rate that poses a finite risk to civilization. The evolution of this planetary perspective on impact cratering is gradual over the last two decades. It took explorations of Mars and Mercury by early Mariner spacecraft and of the outer solar system by the Voyagers to reveal the significance of asteroidal and cometary impacts in shaping the morphologies and even chemical compositions of the planets. An unsettling implication of the new perspective is addressed: the risk to human civilization. Serious scientific attention was given to this issue in July 1981 at a NASA-sponsored Spacewatch Workshop in Snowmass, Colorado. The basic conclusion of the 1981 NASA sponsored workshop still stands: the risk that civilization might be destroyed by impact with an as-yet-undiscovered asteroid or comet exceeds risk levels that are sometimes deemed unacceptable by modern societies in other contexts. Yet these impact risks have gone almost undiscussed and undebated. The tentative quantitative assessment by some members of the 1981 workshop was that each year, civilization is threatened with destruction with a probability of about 1 in 100,000. The enormous spread in risk levels deemed by the public to be at the threshold of acceptability derives from a host of psychological factors that were widely discussed in the risk assessment literature. Slovic shows that public fears of hazards are greatest for hazards that are uncontrollable, involuntary, fatal, dreadful, globally catastrophic, and which have consequences that seem inequitable, especially if they affect future generations.

Large-scale derived flood frequency analysis based on continuous simulation

NASA Astrophysics Data System (ADS)

Dung Nguyen, Viet; Hundecha, Yeshewatesfa; Guse, Björn; Vorogushyn, Sergiy; Merz, Bruno

2016-04-01

There is an increasing need for spatially consistent flood risk assessments at the regional scale (several 100.000 km2), in particular in the insurance industry and for national risk reduction strategies. However, most large-scale flood risk assessments are composed of smaller-scale assessments and show spatial inconsistencies. To overcome this deficit, a large-scale flood model composed of a weather generator and catchments models was developed reflecting the spatially inherent heterogeneity. The weather generator is a multisite and multivariate stochastic model capable of generating synthetic meteorological fields (precipitation, temperature, etc.) at daily resolution for the regional scale. These fields respect the observed autocorrelation, spatial correlation and co-variance between the variables. They are used as input into catchment models. A long-term simulation of this combined system enables to derive very long discharge series at many catchment locations serving as a basic for spatially consistent flood risk estimates at the regional scale. This combined model was set up and validated for major river catchments in Germany. The weather generator was trained by 53-year observation data at 528 stations covering not only the complete Germany but also parts of France, Switzerland, Czech Republic and Australia with the aggregated spatial scale of 443,931 km2. 10.000 years of daily meteorological fields for the study area were generated. Likewise, rainfall-runoff simulations with SWIM were performed for the entire Elbe, Rhine, Weser, Donau and Ems catchments. The validation results illustrate a good performance of the combined system, as the simulated flood magnitudes and frequencies agree well with the observed flood data. Based on continuous simulation this model chain is then used to estimate flood quantiles for the whole Germany including upstream headwater catchments in neighbouring countries. This continuous large scale approach overcomes the several drawbacks reported in traditional approaches for the derived flood frequency analysis and therefore is recommended for large scale flood risk case studies.

A framework and a set of tools called Nutting models to estimate retention capacities and loads of nitrogen and phosphorus in rivers at catchment and national level (France)

NASA Astrophysics Data System (ADS)

Legeay, Pierre-Louis; Moatar, Florentina; Dupas, Rémi; Gascuel-Odoux, Chantal

2016-04-01

The Nutting-N and Nutting-P models (Dupas et al., 2013, 2015) have been developed to estimate Nitrogen and Phosphorus nonpoint-source emissions to surface water, using readily available data. These models were inspired from US model SPARROW (Smith al., 1997) and European model GREEN (Grizzetti et al., 2008), i.e. statistical approaches consisting of linking nitrogen and phosphorus surplus to catchment's land and rivers characteristics to find the catchment relative retention capacities. The nutrient load (L) at the outlet of each catchment is expressed as: L=R*(B*DS+PS) [1] where DS is diffuse sources (i.e. surplus in kg.ha-1/yr-1 for N, P storage in soil for P), PS is point sources from domestic and industrial origin (kg.ha-1.yr-1), R and B are the river system and basin reduction factor, respectively and they combine observed variables and calibrated parameters. The model was calibrated on independent catchments for the 2005-2009 and 2008-2012 periods. Variables were selected according to Bayesian Information Criterion (BIC) in order to optimize the predictive performance of the models. From these basic models, different improvements have been realized to build a framework and a set of tools: 1) a routing module has been added in order to improve estimations on 4 or 5 stream order, i.e. upscaling the basic Nutting approach; 2) a territorial module, in order to test the models at local scale (from 500 to 5000 km²); 3) a seasonal estimation has been investigated. The basic approach as well territorial application will be illustrated. These tools allow water manager to identify areas at risk where high nutrients loads are estimated, as well areas where retention is potentially high and can buffer high nutrient sources. References Dupas R., Curie F., Gascuel-Odoux C., Moatar F., Delmas M., Parnaudeau, V., Durand P., 2013. Assessing N emissions in surface water at the national level: Comparison of country-wide vs. regionalized models. Science of the Total Environment 443, 152-162 Dupas R., Delmas M., Dorioz J.M., Garnier J., Moatar F., Gascuel-Odoux C., 2015. Assessing the impact of agricultural pressures on N and P loads andeutrophication risk. Ecological Indicators 48, 396-407. Grizzetti B., Bouraoui F., De Marsily G., 2008. Assessing nitrogen pressures on European surface water. Global Biogeochemical Cycles; 22. Smith R.A., Schwarz G.E., Alexander R.B., 1997. Regional interpretation of water-quality monitoring data. Water Resources Research 1997; 33: 2781-2798.

Obesity, type 2 diabetes mellitus and cardiovascular disease risk: an uptodate in the management of polycystic ovary syndrome.

PubMed

Orio, Francesco; Muscogiuri, Giovanna; Nese, Cinar; Palomba, Stefano; Savastano, Silvia; Tafuri, Domenico; Colarieti, Giorgio; La Sala, Giovanbattista; Colao, Annamaria; Yildiz, Bulent O

2016-12-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women and is characterized by two of the following three features: oligoovulation or anovulation, clinical and/or biochemical signs of hyperandrogenism, or polycystic ovaries. It has been demonstrated that PCOS includes a complex number of systemic symptoms in addition to symptoms related to the reproductive apparatus. It has been associated with obesity, metabolic syndrome, type 2 diabetes and an increased risk of cardiovascular disease. Several clinical and basic studies have investigated the link between PCOS and the cardiovascular disease risk, which seems to be due to blunted lipid/glucose metabolism, hypertension, and systemic inflammatory and coagulation disorders. Therefore, the current manuscript aims to review the main findings on PCOS and obesity/obesity-related disease (glucose derangements and cardiovascular disease risk factors). Although there are no long-term data on the morbidity and mortality for cardiovascular disease in PCOS, it is advisable to perform a careful metabolic and cardiovascular assessment in women with PCOS in order to tailor the most suitable strategy to prevent cardiovascular disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Travel medicine

PubMed Central

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599