The Keys to Successful Extended Missions

NASA Technical Reports Server (NTRS)

Seal, David A.; Manor-Chapman, Emily A.

2012-01-01

Many of NASA's successful missions of robotic exploration have gone on to highly productive mission extensions, from Voyager, Magellan, Ulysses, and Galileo, to the Mars Exploration Rovers Spirit and Opportunity, a variety of Mars orbiters, Spitzer, Deep Impact / EPOXI, and Cassini. These missions delivered not only a high science return during their prime science phase, but a wealth of opportunities during their extensions at a low incremental cost to the program. The success of such mission extensions can be traced to demonstration of new and unique science achievable during the extension; reduction in cost without significant increase in risk to spacecraft health; close inclusion of the science community and approval authorities in planning; intelligent design during the development and prime operations phase; and well crafted and conveyed extension proposals. This paper discusses lessons learned collected from a variety of project leaders which can be applied by current and future missions to maximize their chances of approval and success.

Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review.

PubMed

Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

2018-04-18

Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links.

Developing an integrated system for mechanical reduction of fuel loads at the wildland/urban interface in the southern United States

Treesearch

John A. Stanturf; Robert Rummer; M. Wimberly; Timothy G. Rials; Philip. A. Araman; Rodney Busby; James Granskog; Leslie Groom

2003-01-01

Prescribed fire is used routinely in the southern United States to reduce fuel loading and decrease the risk of catastrophic wildfires, improve forest health, and manage threatened and endangered species. With rapid human population growth, southern forests have become fragmented by an extensive road network and intertwined with urban uses in a wildland-urban interface...

Progress towards personalized therapeutics: biologic- and risk-directed therapy for neuroblastoma.

PubMed

Gustafson, William Clay; Matthay, Katherine K

2011-10-01

Neuroblastoma, a tumor of the developing peripheral sympathetic nervous system, is the most common and deadly extracranial solid tumor of childhood. Risk-stratification and risk-adapted therapy play a large role in the modern treatment of neuroblastoma. Recently, through extensive international collaboration, new guidelines for risk stratification have emerged that will aid in international cooperative studies, as well as clarifying therapeutic options for patients. Current therapies for low- and intermediate-risk neuroblastoma have resulted in excellent prognoses for these risk strata, and current efforts are concentrated on chemotherapy reduction. By contrast, much more gradual progress has been made in improving survival for high-risk neuroblastoma patients, despite significant chemotherapy intensification. Current investigations focus on overcoming resistance by elucidating the molecular/genetic causes of neuroblastoma tumorigenesis and progression, with the aim of developing more effective biologically targeted therapies for this disease.

RiskChanges Spatial Decision Support system for the analysis of changing multi-hazard risk

NASA Astrophysics Data System (ADS)

van Westen, Cees; Zhang, Kaixi; Bakker, Wim; Andrejchenko, Vera; Berlin, Julian; Olyazadeh, Roya; Cristal, Irina

2015-04-01

Within the framework of the EU FP7 Marie Curie Project CHANGES and the EU FP7 Copernicus project INCREO a spatial decision support system was developed with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. Central to the SDSS are the stakeholders. The envisaged users of the system are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analyzing spatial data at a municipal scale. The SDSS should be able to function in different countries with different legal frameworks and with organizations with different mandates. These could be subdivided into Civil protection organization with the mandate to design disaster response plans, Expert organizations with the mandate to design structural risk reduction measures (e.g. dams, dikes, check-dams etc), and planning organizations with the mandate to make land development plans. The SDSS can be used in different ways: analyzing the current level of risk, analyzing the best alternatives for risk reduction, the evaluation of the consequences of possible future scenarios to the risk levels, and the evaluation how different risk reduction alternatives will lead to risk reduction under different future scenarios. The SDSS is developed based on open source software and following open standards, for code as well as for data formats and service interfaces. Code development was based upon open source software as well. The architecture of the system is modular. The various parts of the system are loosely coupled, extensible, using standards for interoperability, flexible and web-based. The Spatial Decision Support System is composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to quantitative analysis (using different hazard types, temporal scenarios and vulnerability curves) resulting into risk curves. The platform does not include a component to calculate hazard maps, and existing hazard maps are used as input data for the risk component. The second component of the SDSS is a risk reduction planning component, which forms the core of the platform. This component includes the definition of risk reduction alternatives (related to disaster response planning, risk reduction measures and spatial planning) and links back to the risk assessment module to calculate the new level of risk if the measure is implemented, and a cost-benefit (or cost-effectiveness/ Spatial Multi Criteria Evaluation) component to compare the alternatives and make decision on the optimal one. The third component of the SDSS is a temporal scenario component, which allows to define future scenarios in terms of climate change, land use change and population change, and the time periods for which these scenarios will be made. The component doesn't generate these scenarios but uses input maps for the effect of the scenarios on the hazard and assets maps. The last component is a communication and visualization component, which can compare scenarios and alternatives, not only in the form of maps, but also in other forms (risk curves, tables, graphs)

Predation risk affects growth and reproduction of an invasive snail and its lethal effect depends on prey size

PubMed Central

Guo, Jing; Martín, Pablo R.; Zhang, Chunxia

2017-01-01

The behavior of invasive species under predation risk has been studied extensively, but their growth and reproductive responses have rarely been investigated. We conducted experiments with juveniles and adults of the invasive freshwater snail Pomacea canaliculata, and we observed changes in growth and reproduction in response to predation risk from a caged predator (Trachemys scripta elegans). P. canaliculata produced eggs earlier in the presence of predators and injured conspecifics compared with the control group (no risk), although the total number of egg masses laid by per female was exceeded by that of the controls after 15 days. Egg hatching success noticeably decreased under predation risk, and the incubation period was significantly prolonged; however, the oviposition height of the snails was not affected. A lethal effect of predation risk was detected in juvenile snails but not in adults. The growth of juvenile P. canaliculata was inhibited under predation risk, probably due to a reduction in food intake. Adult females exhibited a greater reduction in growth under predation risk than males, which likely resulted in part from the high reproductive investment of females in egg laying. These results indicate that P. canaliculata snails under predation risk face a trade-off between predator avoidance and growth and reproduction, where the lethal effect of predation risk is linked to the size of the prey. PMID:29136660

Age-related reduction of trunk muscle torque and prevalence of trunk sarcopenia in community-dwelling elderly: Validity of a portable trunk muscle torque measurement instrument and its application to a large sample cohort study

PubMed Central

Sasaki, Shizuka; Chiba, Daisuke; Yamamoto, Yuji; Nawata, Atsushi; Tsuda, Eiichi; Nakaji, Shigeyuki; Ishibashi, Yasuyuki

2018-01-01

Trunk muscle weakness and imbalance are risk factors for postural instability, low back pain, and poor postoperative outcomes. The association between trunk muscle strength and aging is poorly understood, and establishing normal reference values is difficult. We aimed to establish the validity of a novel portable trunk muscle torque measurement instrument (PTMI). We then estimated reference data for healthy young adults and elucidated age-related weakness in trunk muscle strength. Twenty-four university students were enrolled to validate values for PTMI, and 816 volunteers from the general population who were recruited to the Iwaki Health Promotion Project were included to estimate reference data for trunk muscle strength. Trunk flexion and extension torque were measured with PTMI and KinCom, and interclass correlation coefficients (ICC) were estimated to evaluate the reliability of PTMI values. Furthermore, from the young adult reference, the age-related reduction in trunk muscle torque and the prevalence of sarcopenia among age-sex groups were estimated. The ICC in flexion and extension torque were 0.807 (p<0.001) and 0.789 (p<0.001), respectively. The prevalence of sarcopenia increased with age, and the prevalence due to flexion torque was double that of extension torque. Flexion torque decreased significantly after 60 years of age, and extension torque decreased after 70 years of age. In males over age 80, trunk muscle torque decreased to 49.1% in flexion and 63.5% in extension. In females over age 80, trunk muscle torque decreased to 60.7% in flexion and 68.4% in extension. The validity of PTMI was confirmed by correlation with KinCom. PTMI produced reference data for healthy young adults, and demonstrated age-related reduction in trunk muscle torque. Trunk sarcopenia progressed with aging, and the loss of flexion torque began earlier than extension torque. At age 80, trunk muscle torque had decreased 60% compared with healthy young adults. PMID:29471310

Age-related reduction of trunk muscle torque and prevalence of trunk sarcopenia in community-dwelling elderly: Validity of a portable trunk muscle torque measurement instrument and its application to a large sample cohort study.

PubMed

Sasaki, Eiji; Sasaki, Shizuka; Chiba, Daisuke; Yamamoto, Yuji; Nawata, Atsushi; Tsuda, Eiichi; Nakaji, Shigeyuki; Ishibashi, Yasuyuki

2018-01-01

Trunk muscle weakness and imbalance are risk factors for postural instability, low back pain, and poor postoperative outcomes. The association between trunk muscle strength and aging is poorly understood, and establishing normal reference values is difficult. We aimed to establish the validity of a novel portable trunk muscle torque measurement instrument (PTMI). We then estimated reference data for healthy young adults and elucidated age-related weakness in trunk muscle strength. Twenty-four university students were enrolled to validate values for PTMI, and 816 volunteers from the general population who were recruited to the Iwaki Health Promotion Project were included to estimate reference data for trunk muscle strength. Trunk flexion and extension torque were measured with PTMI and KinCom, and interclass correlation coefficients (ICC) were estimated to evaluate the reliability of PTMI values. Furthermore, from the young adult reference, the age-related reduction in trunk muscle torque and the prevalence of sarcopenia among age-sex groups were estimated. The ICC in flexion and extension torque were 0.807 (p<0.001) and 0.789 (p<0.001), respectively. The prevalence of sarcopenia increased with age, and the prevalence due to flexion torque was double that of extension torque. Flexion torque decreased significantly after 60 years of age, and extension torque decreased after 70 years of age. In males over age 80, trunk muscle torque decreased to 49.1% in flexion and 63.5% in extension. In females over age 80, trunk muscle torque decreased to 60.7% in flexion and 68.4% in extension. The validity of PTMI was confirmed by correlation with KinCom. PTMI produced reference data for healthy young adults, and demonstrated age-related reduction in trunk muscle torque. Trunk sarcopenia progressed with aging, and the loss of flexion torque began earlier than extension torque. At age 80, trunk muscle torque had decreased 60% compared with healthy young adults.

The four Cs of HIV prevention with African Americans: crisis, condoms, culture, and community.

PubMed

Williams, John K; Wyatt, Gail E; Wingood, Gina

2010-11-01

HIV/AIDS continues to be a devastating epidemic with African American communities carrying the brunt of the impact. Despite extensive biobehavioral research, current strategies have not resulted in significantly decreasing HIV/AIDS cases among African Americans. The next generation of HIV prevention and risk reduction interventions must move beyond basic sex education and condom use and availability. Successful interventions targeting African Americans must optimize strategies that integrate socio-cultural factors and address institutional and historical barriers that hinder or support HIV risk reduction behaviors. Community-based participatory research to decrease the HIV/AIDS disparity by building community capacity and infrastructure and advocating for and distributing equitably, power and resources, must be promoted. Recommendations for paradigm shifts in using innovative theories and conceptual frameworks and for training researchers, clinicians, grant and journal reviewers, and community members are made so that culturally congruent interventions may be tested and implemented at the community level.

Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review

PubMed Central

Banwell, Nicola; Rutherford, Shannon; Mackey, Brendan; Chu, Cordia

2018-01-01

Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links. PMID:29670057

Biophysical risks to carbon sequestration and storage in Australian drylands.

PubMed

Nolan, Rachael H; Sinclair, Jennifer; Eldridge, David J; Ramp, Daniel

2018-02-15

Carbon abatement schemes that reduce land clearing and promote revegetation are now an important component of climate change policy globally. There is considerable potential for these schemes to operate in drylands which are spatially extensive. However, projects in these environments risk failure through unplanned release of stored carbon to the atmosphere. In this review, we identify factors that may adversely affect the success of vegetation-based carbon abatement projects in dryland ecosystems, evaluate their likelihood of occurrence, and estimate the potential consequences for carbon storage and sequestration. We also evaluate management strategies to reduce risks posed to these carbon abatement projects. Identified risks were primarily disturbances, including unplanned fire, drought, and grazing. Revegetation projects also risk recruitment failure, thereby failing to reach projected rates of sequestration. Many of these risks are dependent on rainfall, which is highly variable in drylands and susceptible to further variation under climate change. Resprouting vegetation is likely to be less vulnerable to disturbance and have faster recovery rates upon release from disturbance. We conclude that there is a strong impetus for identifying management strategies and risk reduction mechanisms for carbon abatement projects. Risk mitigation would be enhanced by effective co-ordination of mitigation strategies at scales larger than individual abatement project boundaries, and by implementing risk assessment throughout project planning and implementation stages. Reduction of risk is vital for maximising carbon sequestration of individual projects and for reducing barriers to the establishment of new projects entering the market. Copyright © 2017 Elsevier Ltd. All rights reserved.

A lifestyle intervention program for successfully addressing major cardiometabolic risks in persons with SCI: a three-subject case series.

PubMed

Bigford, Gregory E; Mendez, Armando J; Betancourt, Luisa; Burns-Drecq, Patricia; Backus, Deborah; Nash, Mark S

2017-01-01

This study is a prospective case series analyzing the effects of a comprehensive lifestyle intervention program in three patients with chronic paraplegia having major risks for the cardiometabolic syndrome (CMS). Individuals underwent an intense 6-month program of circuit resistance exercise, nutrition using a Mediterranean diet and behavioral support, followed by a 6-month extension (maintenance) phase involving minimal support. The primary goal was a 7% reduction of body mass. Other outcomes analyzed insulin resistance using the HOMA-IR model, and plasma levels of fasting triglycerides and high-density lipoprotein cholesterol. All participants achieved the goal for 7% reduction of body mass and maintained the loss after the MP. Improvements were observed in 2/3 subjects for HOMA-IR and high-density lipoprotein cholesterol. All participants improved their risk for plasma triglycerides. We conclude, in a three-person case series of persons with chronic paraplegia, a lifestyle intervention program involving circuit resistance training, a calorie-restrictive Mediterranean-style diet and behavioral support, results in clinically significant loss of body mass and effectively reduced component risks for CMS and diabetes. These results were for the most part maintained after a 6-month MP involving minimal supervision.

Colorectal anastomotic leakage: aspects of prevention, detection and treatment.

PubMed

Daams, Freek; Luyer, Misha; Lange, Johan F

2013-04-21

All colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years. New techniques of prevention, by innovative anastomotic techniques should improve results in the future, but standardization and "teachability" should be guaranteed. Risk scoring enables intra-operative decision-making whether to restore continuity or deviate. Early detection can lead to reduction in delay of diagnosis as long as a standard system is used. For treatment options, no firm evidence is available, but future studies could focus on repair and saving of the anastomosis on the one hand or anastomotical breakdown and definitive colostomy on the other hand.

School Health: an essential strategy in promoting community resilience and preparedness for natural disasters.

PubMed

Takahashi, Kenzo; Kodama, Mitsuya; Gregorio, Ernesto R; Tomokawa, Sachi; Asakura, Takashi; Waikagul, Jitra; Kobayashi, Jun

2015-01-01

The Third UN World Conference on Disaster Risk Reduction recommended the implementation of the Sendai Framework for Disaster Risk Reduction 2015-2030, which aims to achieve substantial risk reduction and to avoid various disaster-associated losses, including human lives and livelihoods, based on the lessons from the implementation of the Hyogo framework. However, the recommendations did not lay enough stress on the school and the Safe School Concept, which are the core components of a disaster response. To raise the issue of the importance of schools in disaster response. For human capacity building to avoid the damage caused by natural disasters, we should focus on the function of schools in the community and on school health framework. Schools perform a range of functions, which include being a landmark place for evacuation, acting as a participatory education hub among communities (students are usually from the surrounding communities), and being a sustainable source of current disaster-related information. In 2007, the Bangkok Action Agenda (BAA) on school education and disaster risk reduction (DRR) recommended the integration of DRR into education policy development, the enhancement of participatory mechanisms to improve DRR education, and the extension of DRR education from schools to communities. Based on our discussion and the recommendations of the BAA, we suggest that our existing challenges are to construct a repository of disaster-related lessons, develop training materials based on current information drawn from previous disasters, and disseminate the training to schools and communities. Schools linked with school health can provide good opportunities for DRR with a focus on development of school health policy and a community-oriented participatory approach.

Policies for Reducing Coastal Risk on the East and Gulf Coasts

NASA Astrophysics Data System (ADS)

Glickson, D.; Johnson, S.

2014-12-01

Hurricane- and coastal storm-related economic losses have increased substantially over the past century, largely due to expanding population and development in susceptible coastal areas. Concurrent with this growth, the federal government has assumed an increasing proportion of the financial responsibility associated with U.S. coastal storms, which may discourage state and local governments from taking appropriate actions to reduce risk and enhance resilience. Strategies to manage coastal storm risks fall into two categories: reducing the probability of flooding or wave impact (such as seawalls, storm surge barriers, beach nourishment, dune building, restoration/expansion of oyster reefs, salt marshes, and mangroves) and reducing the number or vulnerability of people or structures (such as relocation, land-use planning, and elevating or floodproofing buildings). Over the past century, most coastal risk management programs have emphasized coastal armoring, while doing little to decrease development in harm's way. This National Research Council report calls for the development of a national vision for managing coastal risks that includes a long-term view, regional solutions, and recognition of all benefits. A national coastal risk assessment is needed to identify high priority areas. Benefit-cost analysis provides a reasonable framework to evaluate national investments in coastal risk reduction, if constrained by other important environmental, social, and life-safety factors. Extensive collaboration and additional policy changes will be necessary to move from a nation that is primarily reactive to coastal disasters to one that invests wisely in coastal risk reduction and builds resilience among coastal communities.

Boom Rendezvous Alternative Docking Approach

NASA Technical Reports Server (NTRS)

Bonometti, Joseph A.

2006-01-01

Space rendezvous and docking has always been attempted with primarily one philosophic methodology. The slow matching of one vehicle's orbit by a second vehicle and then a final closing sequence that ends in matching the orbits with perfect precision and with near zero relative velocities. The task is time consuming, propellant intensive, risk inherent (plume impingement, collisions, fuel depletion, etc.) and requires substantial hardware mass. The historical background and rationale as to why this approach is used is discussed in terms of the path-not-taken and in light of an alternate methodology. Rendezvous and docking by boom extension is suggested to have inherent advantages that today s technology can readily exploit. Extension from the primary spacecraft, beyond its inherent large inertia, allows low inertia connections to be made rapidly and safely. Plume contamination issues are eliminated as well as the extra propellant mass and risk required for the final thruster (docking) operations. Space vehicle connection hardware can be significantly lightened. Also, docking sensors and controls require less fidelity; allowing them to be more robust and less sensitive. It is the potential safety advantage and mission risk reduction that makes this approach attractive, besides the prospect of nominal time and mass savings.

Assessing risks and preventing disease from environmental chemicals.

PubMed

Dunnette, D A

1989-01-01

In the last 25 years there has been considerable concern expressed about the extent to which chemical agents in the ambient and work environments are contributing to the causation of disease. This concern is a logical extension of our increased knowledge of the real and potential effects of environmental chemicals and the methodological difficulties in applying new knowledge that could help prevent environmentally induced disease. Chemical risk assessment offers an approach to estimating risks and involves consideration of relevant information including identification of chemical hazards, evaluation of the dose-response relationship, estimation of exposure and finally, risk characterization. Particularly significant uncertainties which are inherent in use of this and other risk models include animal-human and low dose-high dose extrapolation and estimation of exposure. Community public health risks from exposure to environmental chemicals appear to be small relative to other public health risks based on information related to cancer trends, dietary intake of synthetic chemicals, assessment data on substances such as DDT and "dioxin," public health effects of hazardous waste sites and contextual considerations. Because of inherent uncertainty in the chemical risk assessment process, however, we need to apply what methods are available in our efforts to prevent disease induced by environmental chemicals. There are a number of societal strategies which can contribute to overall reduction of risk from environmental chemicals. These include acquisition of information on environmental risk including toxicity, intensity and extensity of exposure, biological monitoring, disease surveillance, improvement in epidemiological methods, control of environmental chemical exposures, and dissemination of hazardous chemical information. Responsible environmental risk communication and information transfer appear to be among the most important of the available strategies for preventing disease induced by chemicals in the environment.

J-2X Upper Stage Engine: Hardware and Testing 2009

NASA Technical Reports Server (NTRS)

Buzzell, James C.

2009-01-01

Mission: Common upper stage engine for Ares I and Ares V. Challenge: Use proven technology from Saturn X-33, RS-68 to develop the highest Isp GG cycle engine in history for 2 missions in record time . Key Features: LOX/LH2 GG cycle, series turbines (2), HIP-bonded MCC, pneumatic ball-sector valves, on-board engine controller, tube-wall regen nozzle/large passively-cooled nozzle extension, TEG boost/cooling . Development Philosophy: proven hardware, aggressive schedule, early risk reduction, requirements-driven.

Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures.

PubMed

Lubowitz, James H; Elson, Wylie S; Guttmann, Dan

2005-01-01

Arthroscopic reduction and internal fixation (ARIF) of tibial intercondylar eminence fractures is the emerging state-of-the-art. ARIF is recommended for displaced type III fractures and should be considered for all cases of displaced type II fractures. Fractures without displacement after closed reduction require careful evaluation to rule out meniscal entrapment. Subjective results of ARIF are uniformly excellent, despite reports of objective anteroposterior laxity. Early range-of-motion exercises are essential to prevent loss of extension. Repair using nonabsorbable suture fixation, when of adequate strength to allow early range-of-motion, has the advantages of eliminating the risks of comminution of the fracture fragment, posterior neurovascular injury, and need for hardware removal, compared with ARIF using screws.

Housing arrangement and location determine the likelihood of housing loss due to wildfire

USGS Publications Warehouse

Syphard, Alexandra D.; Keeley, Jon E.; Massada, Avi Bar; Brennan, Teresa J.; Radeloff, Volker C.

2012-01-01

Surging wildfires across the globe are contributing to escalating residential losses and have major social, economic, and ecological consequences. The highest losses in the U.S. occur in southern California, where nearly 1000 homes per year have been destroyed by wildfires since 2000. Wildfire risk reduction efforts focus primarily on fuel reduction and, to a lesser degree, on house characteristics and homeowner responsibility. However, the extent to which land use planning could alleviate wildfire risk has been largely missing from the debate despite large numbers of homes being placed in the most hazardous parts of the landscape. Our goal was to examine how housing location and arrangement affects the likelihood that a home will be lost when a wildfire occurs. We developed an extensive geographic dataset of structure locations, including more than 5500 structures that were destroyed or damaged by wildfire since 2001, and identified the main contributors to property loss in two extensive, fire-prone regions in southern California. The arrangement and location of structures strongly affected their susceptibility to wildfire, with property loss most likely at low to intermediate structure densities and in areas with a history of frequent fire. Rates of structure loss were higher when structures were surrounded by wildland vegetation, but were generally higher in herbaceous fuel types than in higher fuel-volume woody types. Empirically based maps developed using housing pattern and location performed better in distinguishing hazardous from non-hazardous areas than maps based on fuel distribution. The strong importance of housing arrangement and location indicate that land use planning may be a critical tool for reducing fire risk, but it will require reliable delineations of the most hazardous locations.

A lifestyle intervention program for successfully addressing major cardiometabolic risks in persons with SCI: a three-subject case series

PubMed Central

Bigford, Gregory E; Mendez, Armando J; Betancourt, Luisa; Burns-Drecq, Patricia; Backus, Deborah; Nash, Mark S

2017-01-01

Introduction This study is a prospective case series analyzing the effects of a comprehensive lifestyle intervention program in three patients with chronic paraplegia having major risks for the cardiometabolic syndrome (CMS). Case presentation: Individuals underwent an intense 6-month program of circuit resistance exercise, nutrition using a Mediterranean diet and behavioral support, followed by a 6-month extension (maintenance) phase involving minimal support. The primary goal was a 7% reduction of body mass. Other outcomes analyzed insulin resistance using the HOMA-IR model, and plasma levels of fasting triglycerides and high-density lipoprotein cholesterol. All participants achieved the goal for 7% reduction of body mass and maintained the loss after the MP. Improvements were observed in 2/3 subjects for HOMA-IR and high-density lipoprotein cholesterol. All participants improved their risk for plasma triglycerides. Discussion: We conclude, in a three-person case series of persons with chronic paraplegia, a lifestyle intervention program involving circuit resistance training, a calorie-restrictive Mediterranean-style diet and behavioral support, results in clinically significant loss of body mass and effectively reduced component risks for CMS and diabetes. These results were for the most part maintained after a 6-month MP involving minimal supervision. PMID:28382218

Sexual tourism: implications for travelers and the destination culture.

PubMed

Marrazzo, Jeanne M

2005-03-01

Health care providers in a variety of settings need to improve their ability--along with the capabilities of supporting laboratories, surveillance systems, and services for sex partner management--to diagnose and treat STI. Whether the travel health care sector, as such, is willing to take on the additional burden of STI-related screening and risk reduction counseling has been raised by some authors. Currently, the burden of providing formalized STI care falls on the public sector; however, in the United States, most STI are actually diagnosed in the offices of private physicians. Given that the United States has the highest STI rates of any industrialized country, the undeniable synergy between STI and HIV acquisition, the failure of many American providers to screen for C trachomatis despite clear guidelines, the global resurgence of syphilis and extension of resistant N gonorrhoeae and of HIV, and the risk behaviors consistently reported by travelers, it is hard to argue against travel specialists' joining the daunting battle against these recalcitrant infections and their often devastating consequences. Most of the relevant diagnostic tests are relatively affordable, and patient-centered risk-reduction counseling, once mastered, can be brief and easily integrated into the overall conversation about protecting oneself during travel.

The extension of smoke-free areas and acute myocardial infarction mortality: before and after study.

PubMed

Villalbí, Joan R; Sánchez, Emília; Benet, Josep; Cabezas, Carmen; Castillo, Antonia; Guarga, Alex; Saltó, Esteve; Tresserras, Ricard

2011-05-18

Recent studies suggest that comprehensive smoking regulations to decrease exposure to second-hand smoke reduce the rates of acute myocardial infarction (AMI). The objective of this paper is to analyse if deaths due to AMI in Spain declined after smoking prevention legislation came into force in January 2006. Information was collected on deaths registered by the Instituto Nacional de Estadística for 2004-2007. Age- and sex-specific annual AMI mortality rates with 95% CIs were estimated, as well as age-adjusted annual AMI mortality rates by sex. Annual relative risks of death from AMI were estimated with an age-standardised Poisson regression model. Adjusted AMI mortality rates in 2004 and 2005 are similar, but in 2006 they show a 9% decline for men and a 8.7% decline for women, especially among those over 64 years of age. In 2007 there is a slower rate of decline, which reaches statistical significance for men (-4.8%) but not for women (-4%). The annual relative risk of AMI death decreased in both sexes (p < 0.001) from 1 to 0.90 in 2006, and to 0.86 in 2007. The extension of smoke-free regulations in Spain was associated with a reduction in AMI mortality, especially among the elderly. Although other factors may have played a role, this pattern suggests a likely influence of the reduction in population exposure to second-hand smoke on AMI deaths.

Salinity stress inhibits bean leaf expansion by reducing turgor, not wall extensibility

NASA Technical Reports Server (NTRS)

Neumann, P. M.; Van Volkenburgh, E.; Cleland, R. E.

1988-01-01

Treatment of bean (Phaseolus vulgaris L.) seedlings with low levels of salinity (50 or 100 millimolar NaCl) decreased the rate of light-induced leaf cell expansion in the primary leaves over a 3 day period. This decrease could be due to a reduction in one or both of the primary cellular growth parameters: wall extensibility and cell turgor. Wall extensibility was assessed by the Instron technique. Salinity did not decrease extensibility and caused small increases relative to the controls after 72 hours. On the other hand, 50 millimolar NaCl caused a significant reduction in leaf bulk turgor at 24 hours; adaptive decreases in leaf osmotic potential (osmotic adjustment) were more than compensated by parallel decreases in xylem tension potential and the leaf apoplastic solute potential, resulting in a decreased leaf water potential. It is concluded that in bean seedlings, mild salinity initially affects leaf growth rate by a decrease in turgor rather than by a reduction in wall extensibility. Moreover, long-term salinization (10 days) resulted in an apparent mechanical adjustment, i.e. an increase in wall extensibility, which may help counteract reductions in turgor and maintain leaf growth rates.

The Extension-Reduction Strategy: Activating Prior Knowledge

ERIC Educational Resources Information Center

Sloyer, Cliff W.

2004-01-01

A mathematical problem is solved using the extension-reduction or build it up-tear it down tactic. This technique is implemented in reviving students' earlier knowledge to enable them to apply this knowledge to solving new problems.

Extensive Intestinal Resection Triggers Behavioral Adaptation, Intestinal Remodeling and Microbiota Transition in Short Bowel Syndrome

PubMed Central

Mayeur, Camille; Gillard, Laura; Le Beyec, Johanne; Bado, André; Joly, Francisca; Thomas, Muriel

2016-01-01

Extensive resection of small bowel often leads to short bowel syndrome (SBS). SBS patients develop clinical mal-absorption and dehydration relative to the reduction of absorptive area, acceleration of gastrointestinal transit time and modifications of the gastrointestinal intra-luminal environment. As a consequence of severe mal-absorption, patients require parenteral nutrition (PN). In adults, the overall adaptation following intestinal resection includes spontaneous and complex compensatory processes such as hyperphagia, mucosal remodeling of the remaining part of the intestine and major modifications of the microbiota. SBS patients, with colon in continuity, harbor a specific fecal microbiota that we called “lactobiota” because it is enriched in the Lactobacillus/Leuconostoc group and depleted in anaerobic micro-organisms (especially Clostridium and Bacteroides). In some patients, the lactobiota-driven fermentative activities lead to an accumulation of fecal d/l-lactates and an increased risk of d-encephalopathy. Better knowledge of clinical parameters and lactobiota characteristics has made it possible to stratify patients and define group at risk for d-encephalopathy crises. PMID:27681910

Elucidating the impact of the pneumococcal conjugate vaccine programme on pneumonia, sepsis and otitis media hospital admissions in England using a composite control.

PubMed

Thorrington, Dominic; Andrews, Nick; Stowe, Julia; Miller, Elizabeth; van Hoek, Albert Jan

2018-02-08

The seven-valent pneumococcal conjugate vaccine (PCV) was introduced in England in September 2006, changing to the 13-valent vaccine in April 2010. PCV impact on invasive pneumococcal disease (IPD) has been extensively reported, but less described is its impact on the burden of pneumonia, sepsis and otitis media in the hospital. Using details on all admissions to hospitals in England, we compared the incidence of pneumococcal-specific and syndromic disease endpoints in a 24-month pre-PCV period beginning April 2004 to the 24-month period ending March 2015 to derive incidence rate ratios (IRRs). To adjust for possible secular trends in admission practice, IRRs were compared to the IRRs for five control conditions over the same period and the relative change assessed using the geometric mean of the five control IRRs as a composite, and individually for each control condition to give the min-max range. Relative changes were also compared with IRRs for IPD from the national laboratory database. The effect of stratifying cases into those with and without clinical risk factors for pneumococcal infection was explored. Relative reductions in pneumococcal pneumonia were seen in all age groups and in those with and without risk factors; in children under 15 years old reductions were similar in magnitude to reductions in IPD. For pneumonia of unspecified cause, relative reductions were seen in those under 15 years old (maximum reduction in children under 2 years of 34%, min-max: 11-49%) with a relative increase in 65+ year olds most marked in those with underlying risk conditions (41%, min-max: 0-82%). Reductions in pneumococcal sepsis were seen in all age groups, with the largest reduction in children younger than 2 years (67%, min-max 56-75%). Reductions in empyema and lung abscess were also seen in under 15 year olds. Results for other disease endpoints were varied. For disease endpoints showing an increase in raw IRR, the increase was generally reduced when expressed as a relative change. Use of a composite control and stratification by risk group status can help elucidate the impact of PCV on non-IPD disease endpoints and in vulnerable population groups. We estimate a substantial reduction in the hospitalised burden of pneumococcal pneumonia in all age groups and pneumonia of unspecified cause, empyema and lung abscess in children under 15 years of age since PCV introduction. The increase in unspecified pneumonia in high-risk 65+ year olds may in part reflect their greater susceptibility to develop pneumonia from less pathogenic serotypes that are replacing vaccine types in the nasopharynx.

Structuring Cooperative Nuclear RIsk Reduction Initiatives with China.

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

Brandt, Larry; Reinhardt, Jason Christian; Hecker, Siegfried

The Stanford Center for International Security and Cooperation engaged several Chinese nuclear organizations in cooperative research that focused on responses to radiological and nuclear terrorism. The objective was to identify joint research initiatives to reduce the global dangers of such threats and to pursue initial technical collaborations in several high priority areas. Initiatives were identified in three primary research areas: 1) detection and interdiction of smuggled nuclear materials; 2) nuclear forensics; and 3) radiological (“dirty bomb”) threats and countermeasures. Initial work emphasized the application of systems and risk analysis tools, which proved effective in structuring the collaborations. The extensive engagementsmore » between national security nuclear experts in China and the U.S. during the research strengthened professional relationships between these important communities.« less

Multivariate generalized multifactor dimensionality reduction to detect gene-gene interactions

PubMed Central

2013-01-01

Background Recently, one of the greatest challenges in genome-wide association studies is to detect gene-gene and/or gene-environment interactions for common complex human diseases. Ritchie et al. (2001) proposed multifactor dimensionality reduction (MDR) method for interaction analysis. MDR is a combinatorial approach to reduce multi-locus genotypes into high-risk and low-risk groups. Although MDR has been widely used for case-control studies with binary phenotypes, several extensions have been proposed. One of these methods, a generalized MDR (GMDR) proposed by Lou et al. (2007), allows adjusting for covariates and applying to both dichotomous and continuous phenotypes. GMDR uses the residual score of a generalized linear model of phenotypes to assign either high-risk or low-risk group, while MDR uses the ratio of cases to controls. Methods In this study, we propose multivariate GMDR, an extension of GMDR for multivariate phenotypes. Jointly analysing correlated multivariate phenotypes may have more power to detect susceptible genes and gene-gene interactions. We construct generalized estimating equations (GEE) with multivariate phenotypes to extend generalized linear models. Using the score vectors from GEE we discriminate high-risk from low-risk groups. We applied the multivariate GMDR method to the blood pressure data of the 7,546 subjects from the Korean Association Resource study: systolic blood pressure (SBP) and diastolic blood pressure (DBP). We compare the results of multivariate GMDR for SBP and DBP to the results from separate univariate GMDR for SBP and DBP, respectively. We also applied the multivariate GMDR method to the repeatedly measured hypertension status from 5,466 subjects and compared its result with those of univariate GMDR at each time point. Results Results from the univariate GMDR and multivariate GMDR in two-locus model with both blood pressures and hypertension phenotypes indicate best combinations of SNPs whose interaction has significant association with risk for high blood pressures or hypertension. Although the test balanced accuracy (BA) of multivariate analysis was not always greater than that of univariate analysis, the multivariate BAs were more stable with smaller standard deviations. Conclusions In this study, we have developed multivariate GMDR method using GEE approach. It is useful to use multivariate GMDR with correlated multiple phenotypes of interests. PMID:24565370

Sustained efficacy and safety of bazedoxifene in preventing fractures in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled study.

PubMed

Silverman, S L; Chines, A A; Kendler, D L; Kung, A W C; Teglbjærg, C S; Felsenberg, D; Mairon, N; Constantine, G D; Adachi, J D

2012-01-01

In this 2-year extension of a 3-year study, bazedoxifene showed sustained efficacy in preventing new vertebral fractures in postmenopausal women with osteoporosis and in preventing non-vertebral fractures in higher-risk women. Bazedoxifene significantly increased bone mineral density and reduced bone turnover versus placebo and was generally safe and well tolerated. This study evaluated the efficacy and safety of bazedoxifene for the treatment of postmenopausal osteoporosis over 5 years. A total of 4,216 postmenopausal women with osteoporosis were enrolled in this 2-year extension of a 3-year, randomized, double-blind, placebo-controlled, phase 3 trial. In the core study (N = 7,492), subjects received bazedoxifene 20 or 40 mg/day, raloxifene 60 mg/day, or placebo. The raloxifene arm was discontinued after 3 years; subjects receiving bazedoxifene 40 mg were transitioned to bazedoxifene 20 mg after 4 years. Five-year findings are reported for bazedoxifene 20 and 40/20 mg and placebo. Endpoints included incidence of new vertebral fractures (primary) and non-vertebral fractures, and changes in bone mineral density (BMD) and bone turnover markers. At 5 years, the incidence of new vertebral fractures in the intent-to-treat population was significantly lower with bazedoxifene 20 mg (4.5%) and 40/20 mg (3.9%) versus placebo (6.8%; P < 0.05), with relative risk reductions of 35% and 40%, respectively. Non-vertebral fracture incidence was similar among groups. In a subgroup of higher-risk women (n = 1,324; femoral neck T-score ≤-3.0 and/or ≥ 1 moderate or severe or ≥ 2 mild vertebral fracture[s]), bazedoxifene 20 mg reduced non-vertebral fracture risk versus placebo (37%; P = 0.06); combined data for bazedoxifene 20 and 40/20 mg reached statistical significance (34% reduction; P < 0.05). Bazedoxifene significantly increased BMD and reduced bone turnover versus placebo (P < 0.05) and was generally safe and well tolerated. The findings support a sustained anti-fracture effect of bazedoxifene on new vertebral fractures in postmenopausal osteoporotic women and on non-vertebral fractures in the higher-risk subgroup of women.

Anterior cervical distraction and screw elevating–pulling reduction for traumatic cervical spine fractures and dislocations

PubMed Central

Li, Haoxi; Yong, Zhiyao; Chen, Zhaoxiong; Huang, Yufeng; Lin, Zhoudan; Wu, Desheng

2017-01-01

Abstract Treatment of cervical fracture and dislocation by improving the anterior cervical technique. Anterior cervical approach has been extensively used in treating cervical spine fractures and dislocations. However, when this approach is used in the treatment of locked facet joints, an unsatisfactory intraoperative reduction and prying reduction increases the risk of secondary spinal cord injury. Thus, herein, the cervical anterior approach was improved. With distractor and screw elevation therapy during surgery, the restoration rate is increased, and secondary injury to the spinal cord is avoided. To discuss the feasibility of the surgical method of treating traumatic cervical spine fractures and dislocations and the clinical application. This retrospective study included the duration of patients’ hospitalization from January 2005 to June 2015. The potential risks of surgery (including death and other surgical complications) were explained clearly, and written consents were obtained from all patients before surgery. The study was conducted on 86 patients (54 males and 32 females, average age of 40.1 ± 5.6 years) with traumatic cervical spine fractures and dislocations, who underwent one-stage anterior approach treatment. The effective methods were evaluated by postoperative follow-up. The healing of the surgical incision was monitored in 86 patients. The follow-up duration was 18 to 36 (average 26.4 ± 7.1) months. The patients achieved bones grafted fusion and restored spine stability in 3 to 9 (average 6) months after the surgery. Statistically, significant improvement was observed by Frankel score, visual analog scale score, Japanese Orthopedic Association score, and correction rate of the cervical spine dislocation pre- and postoperative (P < .01). The modified anterior cervical approach is simple with a low risk but a good effect in reduction. In addition, it can reduce the risk of iatrogenic secondary spinal cord injury and maintain optimal cervical spine stability as observed during follow-ups. Therefore, it is suitable for clinical promotion and application. PMID:28658125

Consumption of new psychoactive substances in a Spanish sample of research chemical users.

PubMed

González, Débora; Ventura, Mireia; Caudevilla, Fernando; Torrens, Marta; Farre, Magi

2013-07-01

To know the pattern of use of new psychoactive substances (NPSs) in a Spanish sample of research chemical (RC) users and to deepen the RC user profile and risk reduction strategies employed. This study is a cross-sectional survey by means of a specific questionnaire. Recruitment was carried out at music festivals, at non-governmental organizations (NGOs), and through announcements on an online forum. Two RC user profiles were defined, according to whether they search information through online forums. A total of 230 users participated. The most frequent RCs were hallucinogenic phenethylamines (2C-B 80.0%, 2C-I 39.6%) and cathinones (methylone 40.1%, mephedrone 35.2%). The most frequent combination of RC with other illegal drugs was with cannabis (68.6%) and 2C-B with MDMA (28.3%). Subjects who are consulting drug forums (group 1) use more RC, obtain RC by Internet, and use more frequently risk prevention strategies. Regarding the risk-reduction strategies in this group, users sought information concerning RC before consuming them (100%), used precision scales to calculate dosage (72.3%), and analyzed the contents before consumption (68.8%). There is a specific RC user profile with extensive knowledge and consumption of substances, using different strategies to reduce risks associated to its consumption. Copyright © 2013 John Wiley & Sons, Ltd.

Risk assessment by percolation leaching tests of extensive green roofs with fine fraction of mixed recycled aggregates from construction and demolition waste.

PubMed

López-Uceda, Antonio; Galvín, Adela P; Ayuso, Jesús; Jiménez, José Ramón; Vanwalleghem, Tom; Peña, Adolfo

2018-03-19

Extensive green roofs are urban construction systems that provide thermal regulation and sound proofing for the buildings involved, in addition to providing an urban heat island mitigation or water retention. On the other hand, policies towards reduction of energy consumption, a circular economy and sustainability are core in the European Union. Motivated by this, an experimental study was carried out to evaluate the environmental risk assessment according to release levels of polluting elements on leachates of different green roof substrate mixtures based on recycled aggregates from construction and demolition waste through (i) the performance in laboratory of two procedures: compliance and percolation tests and (ii) an upscaled experimental leaching test for long-term on-site prediction. Four plots were built on a building roof and covered with autochthonous Mediterranean plants in Córdoba, South of Spain. As growing substrate, four mixtures were used of a commercial growing substrate with different proportions of a fine mixed recycled aggregate ranging from 0 to 75% by volume. The results show that these mixtures were classified as non-hazardous materials according to legal limits of the Landfill Directive 2003/33/CE. The release levels registered in extensive green roofs were lower compared to the laboratory test data. This shows how laboratory conditions can overestimate the potential pollutant effect of these materials compared to actual conditions.

Five Years of Cenosumab Exposure in Women With Postmenopausal Osteoporosis: Results From the First Two Years of the FREEDOM Extension

PubMed Central

Papapoulos, Socrates; Chapurlat, Roland; Libanati, Cesar; Brandi, Maria Luisa; Brown, Jacques P; Czerwiński, Edward; Krieg, Marc-Antoine; Man, Zulema; Mellström, Dan; Radominski, Sebastião C; Reginster, Jean-Yves; Resch, Heinrich; Ivorra, José A Román; Roux, Christian; Vittinghoff, Eric; Austin, Matthew; Daizadeh, Nadia; Bradley, Michelle N; Grauer, Andreas; Cummings, Steven R; Bone, Henry G

2012-01-01

The 3-year FREEDOM trial assessed the efficacy and safety of 60 mg denosumab every 6 months for the treatment of postmenopausal women with osteoporosis. Participants who completed the FREEDOM trial were eligible to enter an extension to continue the evaluation of denosumab efficacy and safety for up to 10 years. For the extension results presented here, women from the FREEDOM denosumab group had 2 more years of denosumab treatment (long-term group) and those from the FREEDOM placebo group had 2 years of denosumab exposure (cross-over group). We report results for bone turnover markers (BTMs), bone mineral density (BMD), fracture rates, and safety. A total of 4550 women enrolled in the extension (2343 long-term; 2207 cross-over). Reductions in BTMs were maintained (long-term group) or occurred rapidly (cross-over group) following denosumab administration. In the long-term group, lumbar spine and total hip BMD increased further, resulting in 5-year gains of 13.7% and 7.0%, respectively. In the cross-over group, BMD increased at the lumbar spine (7.7%) and total hip (4.0%) during the 2-year denosumab treatment. Yearly fracture incidences for both groups were below rates observed in the FREEDOM placebo group and below rates projected for a “virtual untreated twin” cohort. Adverse events did not increase with long-term denosumab administration. Two adverse events in the cross-over group were adjudicated as consistent with osteonecrosis of the jaw. Five-year denosumab treatment of women with postmenopausal osteoporosis maintained BTM reduction and increased BMD, and was associated with low fracture rates and a favorable risk/benefit profile. © 2012 American Society for Bone and Mineral Research PMID:22113951

Empirical extensions of the lasso penalty to reduce the false discovery rate in high-dimensional Cox regression models.

PubMed

Ternès, Nils; Rotolo, Federico; Michiels, Stefan

2016-07-10

Correct selection of prognostic biomarkers among multiple candidates is becoming increasingly challenging as the dimensionality of biological data becomes higher. Therefore, minimizing the false discovery rate (FDR) is of primary importance, while a low false negative rate (FNR) is a complementary measure. The lasso is a popular selection method in Cox regression, but its results depend heavily on the penalty parameter λ. Usually, λ is chosen using maximum cross-validated log-likelihood (max-cvl). However, this method has often a very high FDR. We review methods for a more conservative choice of λ. We propose an empirical extension of the cvl by adding a penalization term, which trades off between the goodness-of-fit and the parsimony of the model, leading to the selection of fewer biomarkers and, as we show, to the reduction of the FDR without large increase in FNR. We conducted a simulation study considering null and moderately sparse alternative scenarios and compared our approach with the standard lasso and 10 other competitors: Akaike information criterion (AIC), corrected AIC, Bayesian information criterion (BIC), extended BIC, Hannan and Quinn information criterion (HQIC), risk information criterion (RIC), one-standard-error rule, adaptive lasso, stability selection, and percentile lasso. Our extension achieved the best compromise across all the scenarios between a reduction of the FDR and a limited raise of the FNR, followed by the AIC, the RIC, and the adaptive lasso, which performed well in some settings. We illustrate the methods using gene expression data of 523 breast cancer patients. In conclusion, we propose to apply our extension to the lasso whenever a stringent FDR with a limited FNR is targeted. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

75 FR 71072 - Extension of the Patent Application Backlog Reduction Stimulus Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-22

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office [Docket No.: PTO-P-2010-0087] Extension of the Patent Application Backlog Reduction Stimulus Plan AGENCY: United States Patent and Trademark Office, Commerce. ACTION: Notice. SUMMARY: The United States Patent and Trademark Office (USPTO...

Alzheimer's disease, cerebrovascular dysfunction and the benefits of exercise: from vessels to neurons.

PubMed

Lange-Asschenfeldt, Christian; Kojda, Georg

2008-06-01

Exercise training promotes extensive cardiovascular changes and adaptive mechanisms in both the peripheral and cerebral vasculature, such as improved organ blood flow, induction of antioxidant pathways, and enhanced angiogenesis and vascular regeneration. Clinical studies have demonstrated a reduction of morbidity and mortality from cardiovascular disease among exercising individuals. However, evidence from recent large clinical trials also suggests a substantial reduction of dementia risk - particularly regarding Alzheimer's disease (AD) - with regular exercise. Enhanced neurogenesis and improved synaptic plasticity have been implicated in this beneficial effect. However, recent research has revealed that vascular and specifically endothelial dysfunction is essentially involved in the disease process and profoundly aggravates underlying neurodegeneration. Moreover, vascular risk factors (VRFs) are probably determinants of incidence and course of AD. In this review, we emphasize the interconnection between AD and VRFs and the impact of cerebrovascular and endothelial dysfunction on AD pathophysiology. Furthermore, we describe the molecular mechanisms of the beneficial effects of exercise on the vasculature such as activation of the vascular nitric oxide (NO)/endothelial NO synthase (eNOS) pathway, upregulation of antioxidant enzymes, and angiogenesis. Finally, recent prospective clinical studies dealing with the effect of exercise on the risk of incident AD are briefly reviewed. We conclude that, next to upholding neuronal plasticity, regular exercise may counteract AD pathophysiology by building a vascular reserve.

Robotic Lunar Landers for Science and Exploration

NASA Technical Reports Server (NTRS)

Cohen, B. A.; Hill, L. A.; Bassler, J. A.; Chavers, D. G.; Hammond, M. S.; Harris, D. W.; Kirby, K. W.; Morse, B. J.; Mulac, B. D.; Reed, C. L. B.

2010-01-01

NASA Marshall Space Flight Center and The Johns Hopkins University Applied Physics Laboratory has been conducting mission studies and performing risk reduction activities for NASA s robotic lunar lander flight projects. In 2005, the Robotic Lunar Exploration Program Mission #2 (RLEP-2) was selected as a Exploration Systems Mission Directorate precursor robotic lunar lander mission to demonstrate precision landing and definitively determine if there was water ice at the lunar poles; however, this project was canceled. Since 2008, the team has been supporting NASA s Science Mission Directorate designing small lunar robotic landers for diverse science missions. The primary emphasis has been to establish anchor nodes of the International Lunar Network (ILN), a network of lunar science stations envisioned to be emplaced by multiple nations. This network would consist of multiple landers carrying instruments to address the geophysical characteristics and evolution of the moon. Additional mission studies have been conducted to support other objectives of the lunar science community and extensive risk reduction design and testing has been performed to advance the design of the lander system and reduce development risk for flight projects. This paper describes the current status of the robotic lunar mission studies that have been conducted by the MSFC/APL Robotic Lunar Lander Development team, including the ILN Anchor Nodes mission. In addition, the results to date of the lunar lander development risk reduction efforts including high pressure propulsion system testing, structure and mechanism development and testing, long cycle time battery testing and combined GN&C and avionics testing will be addressed. The most visible elements of the risk reduction program are two autonomous lander test articles: a compressed air system with limited flight durations and a second version using hydrogen peroxide propellant to achieve significantly longer flight times and the ability to more fully exercise flight sensors and algorithms. Robotic Lunar Lander design and development will have significant feed-forward to other missions to the Moon and, indeed, to other airless bodies such as Mercury, asteroids, and Europa, to which similar science and exploration objectives are applicable.

75 FR 36063 - Expansion and Extension of the Patent Application Backlog Reduction Stimulus Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office [Docket No.: PTO-P-2010-0048] Expansion and Extension of the Patent Application Backlog Reduction Stimulus Plan AGENCY: United States Patent and Trademark Office, Commerce. ACTION: Notice. SUMMARY: The United States Patent and Trademark...

75 FR 5041 - Extension of the Patent Application Backlog Reduction Stimulus Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... DEPARTMENT OF COMMERCE Patent and Trademark Office [Docket No.: PTO-P-2010-0003] Extension of the Patent Application Backlog Reduction Stimulus Plan AGENCY: United States Patent and Trademark Office, Commerce. ACTION: Notice. SUMMARY: The United States Patent and Trademark Office (USPTO) published a notice...

Quantifying the risk of deforestation in Latin America and the Caribbean.

NASA Astrophysics Data System (ADS)

Manners, Rhys; Varela-Ortega, Consuelo

2015-04-01

Latin American and Caribbean countries have seen considerable deforestation due to a complex web of interconnected and interdependent causes, which include agricultural expansion, infrastructure development, social demographics and governmental policies and activity. It is necessary for successful and efficient policy development to understand how variability in these causes can potentially result in increased or decreased deforestation. The purpose of this study is to develop a tool that can quantify the risk, as in the threat or pressure, of potential deforestation, whilst identifying the key indicators that contribute to this risk. This tool will take the form of a composite index that will provide spatial and temporal trends of deforestation risk across Latin America and the Caribbean. The development of the Deforestation Risk Index (DRI) was based upon work performed in the EU project ROBIN1. Indicators of deforestation included in the index were identified based upon the multi-scalar approach adopted in ROBIN- nationally from principal component analysis and econometric modelling, provincially from extensive interviews with experts and farmers (subsistence and commercial) in Amazonian regions of Bolivia and Brazil, and locally from stakeholder workshops in Bolivia, Brazil and Mexico. The identification process was supported by an extensive literature review. In total, 11 indicators were identified and grouped into four components (biophysical, economic, governance and social) capable of explaining the risk of deforestation in Latin America and Caribbean countries. The DRI was calculated for 24 Latin American and Caribbean countries in the years 2000, 2005 and 2010 using national-level data collected from open access databases (FAOStat, WorldBank and UNDP). The DRI was subjected to two weighting schemes; the first based upon the opinions of experts from ROBIN (weighted biophysical and governance components heavily), and the second developed from the results of the ROBIN stakeholder workshops (heavily weighted the governance component). The results from the DRI were categorised as; low risk, moderate risk, at risk, elevated risk, high risk and extreme risk. The DRI demonstrated that in over 60% of countries, the risk of deforestation reduced between 2000-2010 with Belize, Costa Rica, Guyana and Venezuela being notable exceptions. Countries that saw reductions in their risk did so through economic growth (per capita GDP), institutional development (governmental effectiveness and regulatory quality), as well reductions in the scale of agricultural expansion. Despite the general trend towards lower risk, Amazonian countries were still found to be subject to potential deforestation. Bolivia, Ecuador, Guyana and Suriname were estimated to have an elevated risk of deforestation, with Brazil, Colombia and Peru considered to be at risk in 2010. The DRI provides an innovative, potentially multi-scalar tool, that can be used by national policy makers to identify where policies should be developed and directed, where specific measures in international programs such as REDD/+ could be most effectively pursued, and for international policy makers to identify and to tailor development or aid packages that reduce rather than contribute to deforestation.

Significant reduction in risk of falls and back pain in osteoporotic-kyphotic women through a Spinal Proprioceptive Extension Exercise Dynamic (SPEED) program.

PubMed

Sinaki, Mehrsheed; Brey, Robert H; Hughes, Christine A; Larson, Dirk R; Kaufman, Kenton R

2005-07-01

To determine the outcome of intervention with a spinal weighted kypho-orthosis (WKO) and a spinal proprioceptive extension exercise dynamic (SPEED) program on the risk of falls in ambulatory community-dwelling persons older than 60 years with osteoporosis-kyphosis at risk for falls. The study had 3 stages. At stage 1 (baseline), the 12 women in the kyphotic group were compared with 13 healthy controls to assess the risk of falls and balance disorder in the kyphotic group. At stage 2, the 12 kyphotic women began the SPEED program with a WKO (2 supervised sessions in an outpatient clinic and a 4-week, daily home-based training program). At stage 3, baseline and follow-up data of the kyphotic group were compared to determine the effect of intervention. At baseline, there were significant differences between the osteoporotic-kyphotic group and the control group in balance (P=.002), gait (P<.05), and strength (P<.05). After a 4-week intervention, comparison of the kyphotic group's baseline and follow-up results showed a significant change in balance (P=.003) and several gait parameters (P<.05). Mean back extensor strength improved significantly from baseline (144.0-46.5 N) to follow-up (198.6+/-55.2 N; P<.001). Lower extremity muscle strength was not changed significantly, except for improved left ankle plantar flexors (P=.02). Back pain decreased significantly (P=.001). Balance, gait, and risk of falls improved significantly with the 4-week SPEED program.

The good, the bad, and the ugly: weighing the risks and benefits of seafood consumption.

PubMed

Morrissey, Michael T

2006-01-01

The health benefits that long chain omega-3 fatty acids contribute in the reduction of coronary heart disease are well established through a number of scientific publications. A number of studies are also examining their potential role in mitigating other diseases and health conditions such as Alzheimer's and mental disorders. Some of the latest research have shown the importance of omega-3 fatty acids such as docosahexaenoic acid in cognitive development in infants. Extensive scientific research and recommendations to consume fish regularly from professional societies, health organizations, and government agencies consistently support dietary guidance to consume fish regularly. Nevertheless, increasingly consumers are being warned to eliminate or minimize their consumption of certain species. The warnings, which have been issued due to risks associated with chemical contaminates such as mercury, PCB, and dioxin in fish, have received extensive coverage in news articles and stories in popular magazines. There have been a series of mixed messages to the consumer about the benefits or risks in eating seafood. In some cases, the warnings have been issued by government agencies such as the Food and Drug Administration and Environmental Protection Agency's Joint Fish Advisory on methylmercury. In other cases, the warnings have come from advocacy groups and others. Unfortunately, the advice is often miscommunicated and misunderstood by consumers. The emerging news about the benefits and risks of fish consumption will be discussed in the context of their impacts on consumer's health and well-being.

Austerity and health: the impact in the UK and Europe

PubMed Central

Stuckler, David; Reeves, Aaron; Loopstra, Rachel; Karanikolos, Marina; McKee, Martin

2017-01-01

Abstract Austerity measures—reducing social spending and increasing taxation—hurts deprived groups the most. Less is known about the impact on health. In this short review, we evaluate the evidence of austerity’s impact on health, through two main mechanisms: a ‘social risk effect’ of increasing unemployment, poverty, homelessness and other socio-economic risk factors (indirect), and a ‘healthcare effect’ through cuts to healthcare services, as well as reductions in health coverage and restricting access to care (direct). We distinguish those impacts of economic crises from those of austerity as a response to it. Where possible, data from across Europe will be drawn upon, as well as more extensive analysis of the UK’s austerity measures performed by the authors of this review. PMID:29028245

SAVY-4000 Surveillance and Life Extension Program Fiscal Year 2013 Annual Report

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

Stone, Timothy A.; Blair, Michael W.; Weis, Eric

2014-03-03

The Packaging Surveillance Program section of the DOE M441.1-1 /sup>1, Nuclear Material Packaging Manual (DOE, 2008) requires DOE contractors to “ensure that a surveillance program is established and implemented to ensure the nuclear material storage package continues to meet its design criteria.” In order to ensure continuing safe storage of nuclear material and the maximization of risk reduction, TA-55 has established a Surveillance Program to ensure storage container integrity for operations within its specified design life. The LANL SAVY-4000 Field Surveillance Plan2 defines the near-term field surveillance plan for SAVY-4000 containers as required by the Manual. A long-term surveillance planmore » will be established based on the results of the first several years of surveillance and the results of the lifetime extension studies as defined in the Accelerated Aging Plan3. This report details progress in positioning the Surveillance Program for successful implementation in FY14 and status of the Design Life Extension Program in terms of its implementation and data collection for FY13.« less

Reduction Osteotomy vs Pie-Crust Technique as Possible Alternatives for Medial Release in Total Knee Arthroplasty and Compared in a Prospective Randomized Controlled Trial.

PubMed

Ahn, Ji Hyun; Yang, Tae Yeong; Lee, Jang Yun

2016-07-01

To compare the gap change between the pie-crust technique and reduction osteotomy to determine their effects on flexion and extension gaps and their success rates in achieving ligament balancing during total knee arthroplasty. In a prospective randomized controlled trial, 106 total knee arthroplasties were allocated to each group with 53 cases. If there was a narrow medial gap with an imbalance of ≥3 mm after the initial limited medial release, either reduction osteotomy or pie-crust technique was performed. The changes of extension and flexion medial gaps along with the success rate of mediolateral balancing were compared. There was a significant difference in the change of medial gap in knee extension with mean changes of 3.5 ± 0.5 mm and 2.3 ± 0.8 mm in the reduction osteotomy and pie-crust groups, respectively (P < .001). For flexion gap, greater change was found in the pie-crust group compared with the reduction osteotomy group; the mean medial gap changes in knee flexion were 1.1 ± 0.5 mm and 2.3 ± 1.2 mm in the reduction osteotomy and pie-crust groups, respectively. The success rates were 90.6% and 67.9% in reduction osteotomy and pie-crust groups, respectively (P = .007). As an alternative medial release method, reduction osteotomy was more effective in extension gap balancing, and pie-crust technique was more effective in flexion gap balancing. The overall success rate of mediolateral ligament balancing was higher in the reduction osteotomy group than in the pie-crust group. Copyright © 2016 Elsevier Inc. All rights reserved.

Extension through Partnerships: Research and Education Center Teams with County Extension to Deliver Programs

ERIC Educational Resources Information Center

Mullahey, J. Jeffrey

2011-01-01

Budget reductions have severely affected resources available to deliver agriculture and natural resource Extension programs in Florida. University of Florida/Institute of Food and Agricultural Sciences delivers Extension programming through a unique partnership between research and education centers and county Extension. Science-based information…

Robust Derivation of Risk Reduction Strategies

NASA Technical Reports Server (NTRS)

Richardson, Julian; Port, Daniel; Feather, Martin

2007-01-01

Effective risk reduction strategies can be derived mechanically given sufficient characterization of the risks present in the system and the effectiveness of available risk reduction techniques. In this paper, we address an important question: can we reliably expect mechanically derived risk reduction strategies to be better than fixed or hand-selected risk reduction strategies, given that the quantitative assessment of risks and risk reduction techniques upon which mechanical derivation is based is difficult and likely to be inaccurate? We consider this question relative to two methods for deriving effective risk reduction strategies: the strategic method defined by Kazman, Port et al [Port et al, 2005], and the Defect Detection and Prevention (DDP) tool [Feather & Cornford, 2003]. We performed a number of sensitivity experiments to evaluate how inaccurate knowledge of risk and risk reduction techniques affect the performance of the strategies computed by the Strategic Method compared to a variety of alternative strategies. The experimental results indicate that strategies computed by the Strategic Method were significantly more effective than the alternative risk reduction strategies, even when knowledge of risk and risk reduction techniques was very inaccurate. The robustness of the Strategic Method suggests that its use should be considered in a wide range of projects.

Assessment of NHTSA’s Report “Relationships Between Fatality Risk, Mass, and Footprint in Model Year 2004-2011 Passenger Cars and LTVs” (LBNL Phase 1)

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

Wenzel, Tom P.

In its 2012 report NHTSA simulated the effect four fleetwide mass reduction scenarios would have on the change in annual fatalities. NHTSA estimated that the most aggressive of these scenarios (reducing mass 5.2% in heavier light trucks and 2.6% in all other vehicles types except lighter cars) would result in a small reduction in societal fatalities. LBNL replicated the methodology NHTSA used to simulate six mass reduction scenarios, including the mass reductions recommended in the 2015 NRC committee report, and estimated in 2021 and 2025 by EPA in the TAR, using the updated data through 2012. The analysis indicates thatmore » the estimated x change in fatalities under each scenario based on the updated analysis is comparable to that in the 2012 analysis, but less beneficial or more detrimental than that in the 2016 analysis. For example, an across the board 100-lb reduction in mass would result in an estimated 157 additional annual fatalities based on the 2012 analysis, but would result in only an estimated 91 additional annual fatalities based on the 2016 analysis, and an additional 87 fatalities based on the current analysis. The mass reductions recommended by the 2015 NRC committee report6 would result in a 224 increase in annual fatalities in the 2012 analysis, a 344 decrease in annual fatalities in the 2016 analysis, and a 141 increase in fatalities in the current analysis. The mass reductions EPA estimated for 2025 in the TAR7 would result in a 203 decrease in fatalities based on the 2016 analysis, but an increase of 39 fatalities based on the current analysis. These results support NHTSA’s conclusion from its 2012 study that, when footprint is held fixed, “no judicious combination of mass reductions in the various classes of vehicles results in a statistically significant fatality increase and many potential combinations are safety-neutral as point estimates.”Like the previous NHTSA studies, this updated report concludes that the estimated effect of mass reduction while maintaining footprint on societal U.S. fatality risk is small, and not statistically significant at the 95% or 90% confidence level for all vehicle types based on the jack-knife method NHTSA used. This report also finds that the estimated effects of other control variables, such as vehicle type, specific safety technologies, and crash conditions such as whether the crash occurred at night, in a rural county, or on a high-speed road, on risk are much larger, in some cases two orders of magnitude larger, than the estimated effect of mass or footprint reduction on risk. Finally, this report shows that after accounting for the many vehicle, driver, and crash variables NHTSA used in its regression analyses, there remains a wide variation in risk by vehicle make and model, and this variation is unrelated to vehicle mass. Although the purpose of the NHTSA and LBNL reports is to estimate the effect of vehicle mass reduction on societal risk, this is not exactly what the regression models are estimating. Rather, they are estimating the recent historical relationship between mass and risk, after accounting for most measurable differences between vehicles, drivers, and crash times and locations. In essence, the regression models are comparing the risk of a 2600-lb Dodge Neon with that of a 2500-lb Honda Civic, after attempting to account for all other differences between the two vehicles. The models are not estimating the effect of literally removing 100 pounds from the Neon, leaving everything else unchanged. In addition, the analyses are based on the relationship of vehicle mass and footprint on risk for recent vehicle designs (model year 2004 to 2011). These relationships may or may not continue into the future as manufacturers utilize new vehicle designs and incorporate new technologies, such as more extensive use of strong lightweight materials and specific safety technologies. Therefore, throughout this report we use the phrase “the estimated effect of mass (or footprint) reduction on risk” as shorthand for “the estimated change in risk as a function of its relationship to mass (or footprint) for vehicle models of recent design.”« less

USING THE DELPHI TECHNIQUE TO DEVELOP EFFECTIVENESS INDICATORS FOR SOCIAL MARKETING COMMUNICATION TO REDUCE HEALTH-RISK BEHAVIORS AMONG YOUTH.

PubMed

Vantamay, Nottakrit

2015-09-01

This study aimed to develop effectiveness indicators for social marketing communication to reduce health-risk behaviors among Thai youth by using the Delphi technique. The Delphi technique is a research approach used to gain consensus through a series of two or more rounds of questionnaire surveys where information and results are fed back to panel members between each round and it has been extensively used to generate many indicators relevant to health behaviors. The Delphi technique was conducted in 3 rounds by consulting a panel of 15 experts in the field of social marketing communication for public health campaigns in Thailand. We found forty-nine effectiveness indicators in eight core components reached consensus. These components were: 1) attitude about health-risk behavior reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge about the dangers and impact of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These effectiveness indicators could be applied by health promotion organizations for evaluating the effectiveness of social marketing communication to effectively reduce health-risk behaviors among youth.

Volar plate fixation failure for volar shearing distal radius fractures with small lunate facet fragments.

PubMed

Beck, John D; Harness, Neil G; Spencer, Hillard T

2014-04-01

To determine the percentage of AO B3 distal radius fractures that lose reduction after operative fixation and to see whether fracture morphology, patient factors, or fixation methods predict failure. We hypothesized that initial fracture displacement, amount of lunate facet available for fixation, plate position, and screw fixation would be significant risk factors for loss of reduction. A prospective, observational review was conducted of 51 patients (52 fractures) with AO B3 (volar shearing) distal radius fractures treated operatively between January 2007 and June 2012. We reviewed a prospective distal radius registry to determine demographic data, medical comorbidities, and physical examination findings. Radiographs were evaluated for AO classification, loss of reduction, length of volar cortex available for fixation, and adequacy of stabilization of the lunate facet fragment with a volar plate. Preoperative data were compared between patients who maintained radiographic alignment and those with loss of reduction. A multivariate logistic regression analysis was completed to determine significant predictors of loss of reduction. Volar shearing fractures with separate scaphoid and lunate facet fragments (AO B3.3), preoperative lunate subsidence distance, and length of volar cortex available for fixation were significant predictors for loss of reduction; the latter was significant in multivariate analysis. Plate position and number of screws used to stabilize the lunate facet were not statistically different between groups. Patients with AO B3.3 fractures with less than 15 mm of lunate facet available for fixation, or greater than 5 mm of initial lunate subsidence, are at risk for failure even if a volar plate is properly placed. In these cases, we recommend additional fixation to maintain reduction of the small volar lunate facet fracture fragments in the form of plate extensions, pins, wires, suture, wire forms, or mini screws. Therapeutic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans.

PubMed

Duraimani, Shanthi; Schneider, Robert H; Randall, Otelio S; Nidich, Sanford I; Xu, Shichen; Ketete, Muluemebet; Rainforth, Maxwell A; Gaylord-King, Carolyn; Salerno, John W; Fagan, John

2015-01-01

African Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans. Forty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes. Both groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors. In this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP observed in this high-risk population suggest hypotheses that telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP. ClinicalTrials.gov NCT00681200.

Effects of Lifestyle Modification on Telomerase Gene Expression in Hypertensive Patients: A Pilot Trial of Stress Reduction and Health Education Programs in African Americans

PubMed Central

Duraimani, Shanthi; Schneider, Robert H.; Randall, Otelio S.; Nidich, Sanford I.; Xu, Shichen; Ketete, Muluemebet; Rainforth, Maxwell A.; Gaylord-King, Carolyn; Salerno, John W.; Fagan, John

2015-01-01

Background African Americans suffer from disproportionately high rates of hypertension and cardiovascular disease. Psychosocial stress, lifestyle and telomere dysfunction contribute to the pathogenesis of hypertension and cardiovascular disease. This study evaluated effects of stress reduction and lifestyle modification on blood pressure, telomerase gene expression and lifestyle factors in African Americans. Methods Forty-eight African American men and women with stage I hypertension who participated in a larger randomized controlled trial volunteered for this substudy. These subjects participated in either stress reduction with the Transcendental Meditation technique and a basic health education course (SR) or an extensive health education program (EHE) for 16 weeks. Primary outcomes were telomerase gene expression (hTERT and hTR) and clinic blood pressure. Secondary outcomes included lifestyle-related factors. Data were analyzed for within-group and between-group changes. Results Both groups showed increases in the two measures of telomerase gene expression, hTR mRNA levels (SR: p< 0.001; EHE: p< 0.001) and hTERT mRNA levels (SR: p = 0.055; EHE: p< 0.002). However, no statistically significant between-group changes were observed. Both groups showed reductions in systolic BP. Adjusted changes were SR = -5.7 mm Hg, p< 0.01; EHE = -9.0 mm Hg, p < 0.001 with no statistically significant difference between group difference. There was a significant reduction in diastolic BP in the EHE group (-5.3 mm Hg, p< 0.001) but not in SR (-1.2 mm Hg, p = 0.42); the between-group difference was significant (p = 0.04). The EHE group showed a greater number of changes in lifestyle behaviors. Conclusion In this pilot trial, both stress reduction (Transcendental Meditation technique plus health education) and extensive health education groups demonstrated increased telomerase gene expression and reduced BP. The association between increased telomerase gene expression and reduced BP observed in this high-risk population suggest hypotheses that telomerase gene expression may either be a biomarker for reduced BP or a mechanism by which stress reduction and lifestyle modification reduces BP. Trial Registration ClinicalTrials.gov NCT00681200 PMID:26571023

78 FR 9901 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: Department of Energy. ACTION... Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

75 FR 4055 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-26

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: Department of Energy. ACTION... Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

78 FR 38305 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: Department of Energy. ACTION... Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

The Evidence for α-Linolenic Acid and Cardiovascular Disease Benefits: Comparisons with Eicosapentaenoic Acid and Docosahexaenoic Acid12

PubMed Central

Fleming, Jennifer A.; Kris-Etherton, Penny M.

2014-01-01

Our understanding of the cardiovascular disease (CVD) benefits of α-linolenic acid (ALA, 18:3n–3) has advanced markedly during the past decade. It is now evident that ALA benefits CVD risk. The expansion of the ALA evidence base has occurred in parallel with ongoing research on eicosapentaenoic acid (EPA, 20:5n–3) and docosahexaenoic acid (DHA, 22:6n–3) and CVD. The available evidence enables comparisons to be made for ALA vs. EPA + DHA for CVD risk reduction. The epidemiologic evidence suggests comparable benefits of plant-based and marine-derived n–3 (omega-3) PUFAs. The clinical trial evidence for ALA is not as extensive; however, there have been CVD event benefits reported. Those that have been reported for EPA + DHA are stronger because only EPA + DHA differed between the treatment and control groups, whereas in the ALA studies there were diet differences beyond ALA between the treatment and control groups. Despite this, the evidence suggests many comparable CVD benefits of ALA vs. EPA + DHA. Thus, we believe that it is time to revisit what the contemporary dietary recommendation should be for ALA to decrease the risk of CVD. Our perspective is that increasing dietary ALA will decrease CVD risk; however, randomized controlled clinical trials are necessary to confirm this and to determine what the recommendation should be. With a stronger evidence base, the nutrition community will be better positioned to revise the dietary recommendation for ALA for CVD risk reduction. PMID:25398754

40 CFR 63.78 - Early reduction demonstration evaluation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Early reduction demonstration... Regulations Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.78 Early reduction demonstration evaluation. (a) The permitting authority will evaluate an early reduction...

40 CFR 63.78 - Early reduction demonstration evaluation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Early reduction demonstration... Regulations Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.78 Early reduction demonstration evaluation. (a) The permitting authority will evaluate an early reduction...

77 FR 23469 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-19

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has submitted an information collection request to OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

75 FR 38091 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

77 FR 44602 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has submitted an information collection request to OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

75 FR 54859 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

76 FR 53887 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

76 FR 31598 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has submitted an information collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The information collection requests a three-year extension...

78 FR 66909 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-07

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Department of Energy (DOE) has previously published its Agency Information Collection Extension request in... collection request to the OMB for extension under the provisions of the Paperwork Reduction Act of 1995. The...

Barrage fishponds: Reduction of pesticide concentration peaks and associated risk of adverse ecological effects in headwater streams.

PubMed

Gaillard, Juliette; Thomas, Marielle; Iuretig, Alain; Pallez, Christelle; Feidt, Cyril; Dauchy, Xavier; Banas, Damien

2016-03-15

Constructed wetlands have been suggested as pesticide risk mitigation measures. Yet, in many agricultural areas, ponds or shallow lakes are already present and may contribute to the control of non-point source contamination by pesticides. In order to test this hypothesis, we investigated the influence of extensively managed barrage fishponds (n = 3) on the dissolved concentrations of 100 pesticides in headwater streams over the course of a year. Among the 100 pesticides, 50 different substances were detected upstream and 48 downstream. Highest measured concentration upstream was 26.5 μg/L (2-methyl-4-chlorophenoxyacetic acid, MCPA) and 5.19 μg/L (isoproturon) downstream. Fishponds were found to reduce peak exposure levels as high pesticide concentrations (defined here as ≥ 1 μg/L) generally decreased by more than 90% between upstream and downstream sampling sites. The measured concentrations in the investigated streams were compared to laboratory toxicity data for standard test organisms (algae, invertebrates and fish) using the toxic unit approach. When considering the threshold levels set by the European Union within the first tier risk assessment procedure for pesticide registration (commission regulation (EU) N° 546/2011), regulatory threshold exceedances were observed for 22 pesticides upstream from fishponds and for 9 pesticides downstream. Therefore, the investigated barrage fishponds contributed to the reduction of pesticide peak concentrations and potential risk of adverse effects for downstream ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Afghanistan Multi-Risk Assessment to Natural Hazards

NASA Astrophysics Data System (ADS)

Diermanse, Ferdinand; Daniell, James; Pollino, Maurizio; Glover, James; Bouwer, Laurens; de Bel, Mark; Schaefer, Andreas; Puglisi, Claudio; Winsemius, Hessel; Burzel, Andreas; Ammann, Walter; Aliparast, Mojtaba; Jongman, Brenden; Ranghieri, Federica; Fallesen, Ditte

2017-04-01

The geographical location of Afghanistan and years of environmental degradation in the country make Afghanistan highly prone to intense and recurring natural hazards such as flooding, earthquakes, snow avalanches, landslides, and droughts. These occur in addition to man-made disasters resulting in the frequent loss of live, livelihoods, and property. Since 1980, disasters caused by natural hazards have affected 9 million people and caused over 20,000 fatalities in Afghanistan. The creation, understanding and accessibility of hazard, exposure, vulnerability and risk information is key for effective management of disaster risk. This is especially true in Afghanistan, where reconstruction after recent natural disasters and military conflicts is on-going and will continue over the coming years. So far, there has been limited disaster risk information produced in Afghanistan, and information that does exist typically lacks standard methodology and does not have uniform geo-spatial coverage. There are currently no available risk assessment studies that cover all major natural hazards in Afghanistan, which can be used to assess the costs and benefits of different resilient reconstruction and disaster risk reduction strategies. As a result, the Government of Afghanistan has limited information regarding current and future disaster risk and the effectiveness of policy options on which to base their reconstruction and risk reduction decisions. To better understand natural hazard and disaster risk, the World Bank and Global Facility for Disaster Reduction and Recovery (GFDRR) are supporting the development of new fluvial flood, flash flood, drought, landslide, avalanche and seismic risk information in Afghanistan, as well as a first-order analysis of the costs and benefits of resilient reconstruction and risk reduction strategies undertaken by the authors. The hazard component is the combination of probability and magnitude of natural hazards. Hazard analyses were carried out separately for each peril. Several models were implemented used to simulate the relevant processes involved. These models were fed by global and local climate data and geological data like elevation, slope, land use, soil characteristics etc. Exposure is a measure of the assets and population at risk. An extensive data collection and processing effort was carried out to derive nation-wide exposure data. Vulnerability is a measure of potential exposure losses if a hazardous event occurs. Vulnerability analyses were carried out separately for each peril, because of differences in impact characteristics. Damage functions were derived from asset characteristics and/or experiences from (international) literature. The main project output consists of tables and (GIS-) maps of hazard, exposure and risk. Tables present results at the nation-wide level (admin0), province level (admin1) and district level (admin2). Hazard maps are provided for various return periods, including 10, 20, 50, 100, 250, 500 and 1000 years. All maps are stored in a Web-based GIS-platform. This platform contains four separate directories with [1] generic data (catchment boundaries, rivers etc), [2] hazard maps, [3] exposure maps and [4] risk maps for each of the considered perils.

Polysubstance use profiles among electronic dance music party attendees in New York City and their relation to use of new psychoactive substances.

PubMed

Fernández-Calderón, Fermín; Cleland, Charles M; Palamar, Joseph J

2018-03-01

Electronic Dance Music (EDM) party attendees are often polysubstance users and are at high risk for use of new psychoactive substances (NPS). We sought to identify patterns of use of common illegal drugs among EDM party attendees, sociodemographic correlates, and use of NPS as a function of patterns of use of more common drugs to inform prevention and harm reduction. Using time-space-sampling, 1045 individuals aged 18-40 were surveyed entering EDM parties in New York City. We queried past-year use of common illegal drugs and 98 NPS. We conducted latent class analysis to identify polysubstance use profiles of use of eight common drugs (i.e., ecstasy, ketamine, LSD, mushrooms, powder cocaine, marijuana, amphetamine, benzodiazepines). Relationships between drug classification membership and sociodemographics and use of drugs within six NPS categories were examined. We identified four profiles of use of common drugs: non-polysubstance use (61.1%), extensive polysubstance use (19.2%), moderate polysubstance use/stimulants (12.8%), and moderate polysubstance use/psychedelics (6.7%). Those in the moderate/psychedelic group were at higher odds of using NPS with psychedelic-type effects (2C, tryptamines, and other "new" psychedelics; Ps<0.05). Extensive polysubstance users were at increased odds of reporting use of 2C drugs, synthetic cathinones ("bath salts"), tryptamines, other new (non-phenethylamine) psychedelics, new dissociatives, and synthetic cannabinoids (Ps<0.05). NPS preference is linked to the profile of use of common drugs among individuals in the EDM scene. Most participants were identified as non-polysubstance users, but findings may help inform preventive and harm reduction interventions among those at risk in this scene. Copyright © 2017 Elsevier Ltd. All rights reserved.

Austerity and health: the impact in the UK and Europe.

PubMed

Stuckler, David; Reeves, Aaron; Loopstra, Rachel; Karanikolos, Marina; McKee, Martin

2017-10-01

Austerity measures-reducing social spending and increasing taxation-hurts deprived groups the most. Less is known about the impact on health. In this short review, we evaluate the evidence of austerity's impact on health, through two main mechanisms: a 'social risk effect' of increasing unemployment, poverty, homelessness and other socio-economic risk factors (indirect), and a 'healthcare effect' through cuts to healthcare services, as well as reductions in health coverage and restricting access to care (direct). We distinguish those impacts of economic crises from those of austerity as a response to it. Where possible, data from across Europe will be drawn upon, as well as more extensive analysis of the UK's austerity measures performed by the authors of this review. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

An Extensible Information Grid for Risk Management

NASA Technical Reports Server (NTRS)

Maluf, David A.; Bell, David G.

2003-01-01

This paper describes recent work on developing an extensible information grid for risk management at NASA - a RISK INFORMATION GRID. This grid is being developed by integrating information grid technology with risk management processes for a variety of risk related applications. To date, RISK GRID applications are being developed for three main NASA processes: risk management - a closed-loop iterative process for explicit risk management, program/project management - a proactive process that includes risk management, and mishap management - a feedback loop for learning from historical risks that escaped other processes. This is enabled through an architecture involving an extensible database, structuring information with XML, schemaless mapping of XML, and secure server-mediated communication using standard protocols.

Extended thromboprophylaxis in the acutely ill medical patient after hospitalization - a paradigm shift in post-discharge thromboprophylaxis.

PubMed

Mahan, Charles E; Burnett, Allison E; Fletcher, Meghan L; Spyropoulos, Alex C

2018-02-01

Venous thromboembolism (VTE) is a significant healthcare burden with approximately 900,000 events annually in the United States, over half of which are healthcare-associated. This number is anticipated to double by 2050. Group prophylaxis strategies confined to the inpatient setting appear to have minimal impact on the reduction of post-discharge VTE in medically ill patients due to shortened lengths of stay and a heterogenous population that includes patients at low risk for VTE. In accordance with current guideline recommendations, very few (<5%) medically ill patients are discharged with extended prophylaxis, which potentially creates a clinical gap for at-risk patients as VTE risk has been shown to persist for up to 90 days. Initial studies of extended thromboprophylaxis in acutely ill medical patients with enoxaparin, rivaroxaban and apixaban showed little to no benefit towards VTE reduction that was consistently outweighed by increased bleeding. The more recent APEX study that compared betrixaban to enoxaparin in an enriched patient population at high-risk for VTE was the first study of extended thromboprophylaxis that showed similar efficacy in VTE prevention without an increase in major bleeding. Based on the APEX results, betrixaban recently gained FDA approval for extended thromboprophylaxis in acutely ill medical patients. Recognition that up to half of medically ill patients are not at sufficient risk to warrant thromboprophylaxis has driven extensive research towards development of scientifically derived and validated VTE risk assessment models intended to identify patients who do not warrant prophylaxis, as well as those at high risk who may derive benefit from extended thromboprophylaxis. This article will review prior and ongoing extended thromboprophylaxis studies, VTE and bleed risk assessment models, incorporation of biomarkers in VTE risk assessment and key issues in the paradigm shift towards individualized VTE prophylaxis in acutely ill medical patients.

Willingness to pay for a reduction in mortality risk after a myocardial infarction: an application of the contingent valuation method to the case of eplerenone.

PubMed

Pinto-Prades, Jose-Luis; Farreras, Veronica; de Bobadilla, Jaime Fernandez

2008-02-01

In order to allocate health care resources more efficiently, it is necessary to relate health improvements provided by new medicines to their cost. It is necessary to ascertain when the additional cost of introducing a new health technology is justified by the additional health gain produced. Eplerenone is a new medicine that reduces the risk of death after myocardial infarction (MI) but produces additional cost to the health system. The contingent valuation approach can be used to measure the monetary value of this risk reduction and to estimate society's willingness to pay (WTP) for a new medicine that reduces the risk of death after MI by 2% points. We used a contingent valuation approach to evaluate WTP amongst members of the general population. We used the ex-ante and the ex-post approach. In the ex-ante approach, subjects are asked if they would accept an increase in their taxes in order to have access to eplerenone should they need it in the future. In the ex-post approach, subjects are asked if they would pay a certain amount of money as co-payment per month during 5 years if they suffered an MI. We used the dichotomous choice method, using five bids in each approach. The WTP was estimated using both single-bound and double-bound dichotomous choice (SBDC, DBDC). Extensive piloting (n = 187) preceded the final survey (n = 350). The WTP in the ex-ante case was euro 58 per year under both SBDC and DBDC. In the ex-post case, monthly WTP was euro 141 for the SBDC and euro 85 for the DBDC. Subjects with higher income and subjects with a higher perception of risk showed a higher WTP (P 0.05). Society is willing to pay an additional amount of money in order to give eplerenone to present and future patients. We estimate that euro 85 per month is a conservative estimate of the monetary value of a 2% risk reduction in mortality after MI and to spend this additional amount of money in Eplerenone can be considered an efficient policy.

Managing wetlands for disaster risk reduction: A case study of the eastern Free State, South Africa

PubMed Central

Collins, Nacelle

2018-01-01

This article investigated the knowledge and practice of a nature-based solution to reduce disaster risks of drought, veld fires and floods using wetlands in the eastern Free State, South Africa. A mixed research method approach was used to collect primary data using three data collection tools, namely questionnaires, interviews and field observations. Ninety-five wetlands under communal and private ownership as well as a few in protected areas were sampled, with their users completing questionnaires. The study showed that communal wetlands were more degraded, while wetlands in protected areas and in private commercial farms were in a good ecological state. An extensive literature review reveals that healthy wetlands are effective buffers in reducing disaster risks such as drought, veld fires and floods which are recurrent in the study area. Therefore, through better land-use and management practices, backed by education and awareness, wetlands could be good instruments to mitigate recurrent natural hazards in the agriculturally dominated eastern Free State in South Africa.

Purpose-driven public sector reform: the need for within-government capacity build for the management of slope stability in communities in the Caribbean.

PubMed

Anderson, Malcolm; Holcombe, Liz

2006-01-01

This article stresses the importance of within-government capacity build as the optimal approach to minimizing landslide risk to the most vulnerable communities in the developing world. Landslide risk is an integrated issue that demands strong managerial leadership and multidisciplinary inclusion to develop structures that deliver sustainable improvements in the reduction of risk. The tension between projects demanding international technical and financial intervention and those capable of "within-country" solutions are examined. More particularly, the challenges of developing a management methodology capable of energizing inter-ministry collaboration to achieve community-level action is examined in the context of a recently established program of slope stability management in St. Lucia. The program, Management of Slope Stability in Communities (MoSSaiC), is shown to have successfully fostered not only extensive technical collaboration within government but also to have energized local communities in the shared mission of capacity build through their direct involvement in the management process.

Bayes and empirical Bayes methods for reduced rank regression models in matched case-control studies.

PubMed

Satagopan, Jaya M; Sen, Ananda; Zhou, Qin; Lan, Qing; Rothman, Nathaniel; Langseth, Hilde; Engel, Lawrence S

2016-06-01

Matched case-control studies are popular designs used in epidemiology for assessing the effects of exposures on binary traits. Modern studies increasingly enjoy the ability to examine a large number of exposures in a comprehensive manner. However, several risk factors often tend to be related in a nontrivial way, undermining efforts to identify the risk factors using standard analytic methods due to inflated type-I errors and possible masking of effects. Epidemiologists often use data reduction techniques by grouping the prognostic factors using a thematic approach, with themes deriving from biological considerations. We propose shrinkage-type estimators based on Bayesian penalization methods to estimate the effects of the risk factors using these themes. The properties of the estimators are examined using extensive simulations. The methodology is illustrated using data from a matched case-control study of polychlorinated biphenyls in relation to the etiology of non-Hodgkin's lymphoma. © 2015, The International Biometric Society.

Purpose-Driven Public Sector Reform: The Need for Within-Government Capacity Build for the Management of Slope Stability in Communities in the Caribbean

NASA Astrophysics Data System (ADS)

Anderson, Malcolm; Holcombe, Liz

2006-01-01

This article stresses the importance of within-government capacity build as the optimal approach to minimizing landslide risk to the most vulnerable communities in the developing world. Landslide risk is an integrated issue that demands strong managerial leadership and multidisciplinary inclusion to develop structures that deliver sustainable improvements in the reduction of risk. The tension between projects demanding international technical and financial intervention and those capable of “within-country” solutions are examined. More particularly, the challenges of developing a management methodology capable of energizing inter-ministry collaboration to achieve community-level action is examined in the context of a recently established program of slope stability management in St. Lucia. The program, Management of Slope Stability in Communities (MoSSaiC), is shown to have successfully fostered not only extensive technical collaboration within government but also to have energized local communities in the shared mission of capacity build through their direct involvement in the management process.

Cost-effectiveness analysis of risk-reduction measures to reach water safety targets.

PubMed

Lindhe, Andreas; Rosén, Lars; Norberg, Tommy; Bergstedt, Olof; Pettersson, Thomas J R

2011-01-01

Identifying the most suitable risk-reduction measures in drinking water systems requires a thorough analysis of possible alternatives. In addition to the effects on the risk level, also the economic aspects of the risk-reduction alternatives are commonly considered important. Drinking water supplies are complex systems and to avoid sub-optimisation of risk-reduction measures, the entire system from source to tap needs to be considered. There is a lack of methods for quantification of water supply risk reduction in an economic context for entire drinking water systems. The aim of this paper is to present a novel approach for risk assessment in combination with economic analysis to evaluate risk-reduction measures based on a source-to-tap approach. The approach combines a probabilistic and dynamic fault tree method with cost-effectiveness analysis (CEA). The developed approach comprises the following main parts: (1) quantification of risk reduction of alternatives using a probabilistic fault tree model of the entire system; (2) combination of the modelling results with CEA; and (3) evaluation of the alternatives with respect to the risk reduction, the probability of not reaching water safety targets and the cost-effectiveness. The fault tree method and CEA enable comparison of risk-reduction measures in the same quantitative unit and consider costs and uncertainties. The approach provides a structured and thorough analysis of risk-reduction measures that facilitates transparency and long-term planning of drinking water systems in order to avoid sub-optimisation of available resources for risk reduction. Copyright © 2010 Elsevier Ltd. All rights reserved.

75 FR 45563 - Terrorism Risk Insurance Program; Final Netting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... DEPARTMENT OF THE TREASURY 31 CFR Part 50 RIN 1505-AC24 Terrorism Risk Insurance Program; Final... Title I of the Terrorism Risk Insurance Act of 2002 (``TRIA'' or ``the Act''), as amended by the Terrorism Risk Insurance Extension Act of 2005 (``Extension Act'') and the Terrorism Risk Insurance Program...

Data Model for Multi Hazard Risk Assessment Spatial Support Decision System

NASA Astrophysics Data System (ADS)

Andrejchenko, Vera; Bakker, Wim; van Westen, Cees

2014-05-01

The goal of the CHANGES Spatial Decision Support System is to support end-users in making decisions related to risk reduction measures for areas at risk from multiple hydro-meteorological hazards. The crucial parts in the design of the system are the user requirements, the data model, the data storage and management, and the relationships between the objects in the system. The implementation of the data model is carried out entirely with an open source database management system with a spatial extension. The web application is implemented using open source geospatial technologies with PostGIS as the database, Python for scripting, and Geoserver and javascript libraries for visualization and the client-side user-interface. The model can handle information from different study areas (currently, study areas from France, Romania, Italia and Poland are considered). Furthermore, the data model handles information about administrative units, projects accessible by different types of users, user-defined hazard types (floods, snow avalanches, debris flows, etc.), hazard intensity maps of different return periods, spatial probability maps, elements at risk maps (buildings, land parcels, linear features etc.), economic and population vulnerability information dependent on the hazard type and the type of the element at risk, in the form of vulnerability curves. The system has an inbuilt database of vulnerability curves, but users can also add their own ones. Included in the model is the management of a combination of different scenarios (e.g. related to climate change, land use change or population change) and alternatives (possible risk-reduction measures), as well as data-structures for saving the calculated economic or population loss or exposure per element at risk, aggregation of the loss and exposure using the administrative unit maps, and finally, producing the risk maps. The risk data can be used for cost-benefit analysis (CBA) and multi-criteria evaluation (SMCE). The data model includes data-structures for CBA and SMCE. The model is at the stage where risk and cost-benefit calculations can be stored but the remaining part is currently under development. Multi-criteria information, user management and the relation of these with the rest of the model is our next step. Having a carefully designed data model plays a crucial role in the development of the whole system for rapid development, keeping the data consistent, and in the end, support the end-user in making good decisions in risk-reduction measures related to multiple natural hazards. This work is part of the EU FP7 Marie Curie ITN "CHANGES"project (www.changes-itn.edu)

Alendronate for fracture prevention in postmenopause.

PubMed

Holder, Kathryn K; Kerley, Sara Shelton

2008-09-01

Osteoporosis is an abnormal reduction in bone mass and bone deterioration leading to increased fracture risk. Alendronate (Fosamax) belongs to the bisphosphonate class of drugs, which act to inhibit bone resorption by interfering with the activity of osteoclasts. To assess the effectiveness of alendronate in the primary and secondary prevention of osteoporotic fractures in postmenopausal women. The authors searched Central, Medline, and EMBASE for relevant randomized controlled trials published from 1966 to 2007. The authors undertook study selection and data abstraction in duplicate. The authors performed meta-analysis of fracture outcomes using relative risks, and a relative change greater than 15 percent was considered clinically important. The authors assessed study quality through reporting of allocation concealment, blinding, and withdrawals. Eleven trials representing 12,068 women were included in the review. Relative and absolute risk reductions for the 10-mg dose were as follows. For vertebral fractures, a 45 percent relative risk reduction was found (relative risk [RR] = 0.55; 95% confidence interval [CI], 0.45 to 0.67). This was significant for primary prevention, with a 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.38 to 0.80) and 2 percent absolute risk reduction; and for secondary prevention, with 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.43 to 0.69) and 6 percent absolute risk reduction. For nonvertebral fractures, a 16 percent relative risk reduction was found (RR = 0.84; 95% CI, 0.74 to 0.94). This was significant for secondary prevention, with a 23 percent relative risk reduction (RR = 0.77; 95% CI, 0.64 to 0.92) and a 2 percent absolute risk reduction, but not for primary prevention (RR = 0.89; 95% CI, 0.76 to 1.04). There was a 40 percent relative risk reduction in hip fractures (RR = 0.60; 95% CI, 0.40 to 0.92), but only secondary prevention was significant, with a 53 percent relative risk reduction (RR = 0.47; 95% CI, 0.26 to 0.85) and a 1 percent absolute risk reduction. The only significance found for wrist fractures was in secondary prevention, with a 50 percent relative risk reduction (RR = 0.50; 95% CI, 0.34 to 0.73) and a 2 percent absolute risk reduction. For adverse events, the authors found no statistically significant difference in any included study. However, observational data raise concerns about potential risk for upper gastrointestinal injury and, less commonly, osteonecrosis of the jaw. At 10 mg of alendronate per day, clinically important and statistically significant reductions in vertebral, nonvertebral, hip, and wrist fractures were observed for secondary prevention. The authors found no statistically significant results for primary prevention, with the exception of vertebral fractures, for which the reduction was clinically important.

41 CFR 102-80.50 - Are Federal agencies responsible for identifying/estimating risks and for appropriate risk...

Code of Federal Regulations, 2010 CFR

2010-07-01

... identify and estimate safety and environmental management risks and appropriate risk reduction strategies... responsible for identifying/estimating risks and for appropriate risk reduction strategies? 102-80.50 Section... Environmental Management Risks and Risk Reduction Strategies § 102-80.50 Are Federal agencies responsible for...

Extensive arsenic contamination in high-pH unconfined aquifers in the Indus Valley

PubMed Central

Podgorski, Joel E.; Eqani, Syed Ali Musstjab Akber Shah; Khanam, Tasawar; Ullah, Rizwan; Shen, Heqing; Berg, Michael

2017-01-01

Arsenic-contaminated aquifers are currently estimated to affect ~150 million people around the world. However, the full extent of the problem remains elusive. This is also the case in Pakistan, where previous studies focused on isolated areas. Using a new data set of nearly 1200 groundwater quality samples throughout Pakistan, we have created state-of-the-art hazard and risk maps of arsenic-contaminated groundwater for thresholds of 10 and 50 μg/liter. Logistic regression analysis was used with 1000 iterations, where surface slope, geology, and soil parameters were major predictor variables. The hazard model indicates that much of the Indus Plain is likely to have elevated arsenic concentrations, although the rest of the country is mostly safe. Unlike other arsenic-contaminated areas of Asia, the arsenic release process in the arid Indus Plain appears to be dominated by elevated-pH dissolution, resulting from alkaline topsoil and extensive irrigation of unconfined aquifers, although pockets of reductive dissolution are also present. We estimate that approximately 50 million to 60 million people use groundwater within the area at risk, with hot spots around Lahore and Hyderabad. This number is alarmingly high and demonstrates the urgent need for verification and testing of all drinking water wells in the Indus Plain, followed by appropriate mitigation measures. PMID:28845451

76 FR 52945 - Chlorpyrifos Registration Review; Preliminary Human Health Risk Assessment; Extension of Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-24

... Review; Preliminary Human Health Risk Assessment; Extension of Comment Period AGENCY: Environmental... chlorpyrifos registration review; preliminary human health risk assessment. This document extends the comment... review, preliminary human health risk assessment, established in the Federal Register of Wednesday, July...

76 FR 82296 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... Cumulative Risk Assessment; Extension of Comment Period AGENCY: Environmental Protection Agency (EPA). ACTION..., 2011, concerning the availability of EPA's cumulative risk assessment for the naturally occurring... cumulative risk assessment for the pyrethroids. Based on this assessment, the EPA concluded that the...

40 CFR 63.74 - Demonstration of early reduction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 9 2011-07-01 2011-07-01 false Demonstration of early reduction. 63.74... Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.74 Demonstration of early reduction. (a) An owner or operator applying for an alternative emission limitation shall...

Squamous cell carcinoma – similarities and differences among anatomical sites

PubMed Central

Yan, Wusheng; Wistuba, Ignacio I; Emmert-Buck, Michael R; Erickson, Heidi S

2011-01-01

Squamous cell carcinoma (SCC) is an epithelial malignancy involving many anatomical sites and is the most common cancer capable of metastatic spread. Development of early diagnosis methods and novel therapeutics are important for prevention and mortality reduction. In this effort, numerous molecular alterations have been described in SCCs. SCCs share many phenotypic and molecular characteristics, but they have not been extensively compared. This article reviews SCC as a disease, including: epidemiology, pathology, risk factors, molecular characteristics, prognostic markers, targeted therapy, and a new approach to studying SCCs. Through this comparison, several themes are apparent. For example, HPV infection is a common risk factor among the four major SCCs (NMSC, HNSC, ESCC, and NSCLC) and molecular abnormalities in cell-cycle regulation and signal transduction predominate. These data reveal that the molecular insights, new markers, and drug targets discovered in individual SCCs may shed light on this type of cancer as a whole. PMID:21938273

[Crespi d'Adda: psychosocial risk factors in a late 19th century company town].

PubMed

Punzi, S

2012-01-01

Crespi d'Adda is a late 19th century company town established around a textile factory by Cristoforo Benigno Crespi and his son Silvio. It was an ideal model of company residency being a self-sufficient microcosm equipped with all the services needed by a community where the life of workers and their families was revolving around the factory and the working requirements. It was the expression of philanthropic and patronizing enlightened entrepreneurs at that time, committed in protecting workers' life inside and outside the factory, resulting into a more affectionate and productive manpower. Silvio Benigno Crespi developed an extensive activity to improve working conditions, with special reference to accident prevention and work-related diseases, as well as night work in factories, weekly day off, reduction of working hours: we can say that in some ways he was concerned also with psychosocial risks.

Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania.

PubMed

Hanger, Susanne; Linnerooth-Bayer, Joanne; Surminski, Swenja; Nenciu-Posner, Cristina; Lorant, Anna; Ionescu, Radu; Patt, Anthony

2018-04-01

In light of increasing losses from floods, many researchers and policymakers are looking for ways to encourage flood risk reduction among communities, business, and households. In this study, we investigate risk-reduction behavior at the household level in three European Union Member States with fundamentally different insurance and compensation schemes. We try to understand if and how insurance and public assistance influence private risk-reduction behavior. Data were collected using a telephone survey (n = 1,849) of household decisionmakers in flood-prone areas. We show that insurance overall is positively associated with private risk-reduction behavior. Warranties, premium discounts, and information provision with respect to risk reduction may be an explanation for this positive relationship in the case of structural measures. Public incentives for risk-reduction measures by means of financial and in-kind support, and particularly through the provision of information, are also associated with enhancing risk reduction. In this study, public compensation is not negatively associated with private risk-reduction behavior. This does not disprove such a relationship, but the negative effect may be mitigated by factors related to respondents' capacity to implement measures or social norms that were not included in the analysis. The data suggest that large-scale flood protection infrastructure creates a sense of security that is associated with a lower level of preparedness. Across the board there is ample room to improve both public and private policies to provide effective incentives for household-level risk reduction. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Warmer is healthier: effects on mortality rates of changes in average fine particulate matter (PM2.5) concentrations and temperatures in 100 U.S. cities.

PubMed

Cox, Louis A; Popken, Douglas A; Ricci, Paolo F

2013-08-01

Recent studies have indicated that reducing particulate pollution would substantially reduce average daily mortality rates, prolonging lives, especially among the elderly (age ≥ 75). These benefits are projected by statistical models of significant positive associations between levels of fine particulate matter (PM2.5) levels and daily mortality rates. We examine the empirical correspondence between changes in average PM2.5 levels and temperatures from 1999 to 2000, and corresponding changes in average daily mortality rates, in each of 100 U.S. cities in the National Mortality and Morbidity Air Pollution Study (NMMAPS) data base, which has extensive PM2.5, temperature, and mortality data for those 2 years. Increases in average daily temperatures appear to significantly reduce average daily mortality rates, as expected from previous research. Unexpectedly, reductions in PM2.5 do not appear to cause any reductions in mortality rates. PM2.5 and mortality rates are both elevated on cold winter days, creating a significant positive statistical relation between their levels, but we find no evidence that reductions in PM2.5 concentrations cause reductions in mortality rates. For all concerned, it is crucial to use causal relations, rather than statistical associations, to project the changes in human health risks due to interventions such as reductions in particulate air pollution. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence of Neutralizing Antibodies to Japanese Encephalitis Virus among High-Risk Age Groups in South Korea, 2010

PubMed Central

Ju, Young Ran; Han, Myung Guk; Lee, Won-Ja; Jeong, Young Eui

2016-01-01

After an extensive vaccination policy, Japanese encephalitis (JE) was nearly eliminated since the mid-1980s in South Korea. Vaccination in children shifted the affected age of JE patients from children to adults. However, an abrupt increase in JE cases occurred in 2010, and this trend has continued. The present study aimed to investigate the prevalence of neutralizing antibodies to the JE virus (JEV) among high-risk age groups (≥40 years) in South Korea. A plaque reduction neutralization test was conducted to evaluate the prevalence of neutralizing antibodies to JEV in 945 subjects within four age groups (30–39, 40–49, 50–59, and 60–69 years) in 10 provinces. Of the 945 enrolled subjects, 927 (98.1%) exhibited antibodies against JEV. No significant differences were found in the prevalence of neutralizing antibodies according to sex, age, or occupation. However, there were significant differences in the plaque reduction rate according to age and occupation; oldest age group had a higher reduction rate, and subjects who were employed in agriculture or forestry also had a higher value than the other occupations. We also found that three provinces (Gangwon, Jeonnam, and Gyeongnam) had a relatively lower plaque reduction rate than the other locations. In addition, enzyme-linked immunosorbent assays were conducted to determine recent viral infections and 12 (2.2%) subjects were found to have been recently infected by the virus. In conclusion, the present study clearly indicated that the prevalence of neutralizing antibodies has been maintained at very high levels among adult age groups owing to vaccination or natural infections, or both. In the future, serosurveillance should be conducted periodically using more representative samples to better understand the population-level immunity to JE in South Korea. PMID:26807709

Adaptation to walking with an exoskeleton that assists ankle extension.

PubMed

Galle, S; Malcolm, P; Derave, W; De Clercq, D

2013-07-01

The goal of this study was to investigate adaptation to walking with bilateral ankle-foot exoskeletons with kinematic control that assisted ankle extension during push-off. We hypothesized that subjects would show a neuromotor and metabolic adaptation during a 24min walking trial with a powered exoskeleton. Nine female subjects walked on a treadmill at 1.36±0.04ms(-1) during 24min with a powered exoskeleton and 4min with an unpowered exoskeleton. Subjects showed a metabolic adaptation after 18.5±5.0min, followed by an adapted period. Metabolic cost, electromyography and kinematics were compared between the unpowered condition, the beginning of the adaptation and the adapted period. In the beginning of the adaptation (4min), a reduction in metabolic cost of 9% was found compared to the unpowered condition. This reduction was accompanied by reduced muscular activity in the plantarflexor muscles, as the powered exoskeleton delivered part of the necessary ankle extension moment. During the adaptation this metabolic reduction further increased to 16%, notwithstanding a constant exoskeleton assistance. This increased reduction is the result of a neuromotor adaptation in which subjects adapt to walking with the exoskeleton, thereby reducing muscular activity in all leg muscles. Because of the fast adaptation and the significant reductions in metabolic cost we want to highlight the potential of an ankle-foot exoskeleton with kinematic control that assists ankle extension during push-off. Copyright © 2013 Elsevier B.V. All rights reserved.

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

PubMed

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

2012-08-01

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

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

PubMed Central

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

2012-01-01

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

Reducing risks from hazardous glacier lakes in the Cordillera Blanca (Peru): Six decades of experience and perspectives for the future

NASA Astrophysics Data System (ADS)

Portocarrero, Cesar; Cochachin, Alejo; Frey, Holger; González, Cesar; Haeberli, Wilfried; Huggel, Christian

2016-04-01

Outbursts from glacier lakes at various spatial and temporal scales have had marked geomorphological effects in many mountain ranges. In many glacierized Andean mountain regions substrates of human settlements made out of flood and debris-flow deposits are testimonies of such events. Examples in the Cordillera Blanca, Peru, are the towns of Caraz, Carhuaz or parts of Huaraz. Continued glacier shrinking since the end of the Little Ice Age caused the formation or enlargement of numerous lakes. The outburst of Laguna Palcacocha, destroying the centre of Huaraz and causing more than 1800 losses of life in December 1941, marked the beginning of systematic risk reduction work in Peru. Corresponding efforts included glacier and lake inventories, hazard assessments, definition of high-risk situations, and completion of engineering work for lake-level lowering in more than 30 cases. The latter comprises outlet reinforcements on morainic dams as well as artificial tunnels in bedrock thresholds. This work has been remarkably efficient as documented in the latest case of the Laguna Huallcacocha (Carhuaz-Ancash), where the earlier made installations withstood the erosive power of an impact wave from an ice avalanche in 2015. In the case of the Laguna 513, the impact wave and far-reaching flood caused by a rock/ice avalanche from Nevado Hualcán in April 2010 showed that the risk had been essentially reduced by the preventive lake-level lowering in the early 1990s but not to zero. Risk assessments, planning, construction and non-structural risk reduction efforts continue. Work is in progress to increase the safety of Laguna Palcacocha where extensive assessments and model calculations had been carried out. Risks related to rock/ice avalanches into lakes from steep icy slopes and related to de-buttressing processes as well as long-term permafrost degradation increases. Based on morphological indications and numerical modelling (GlabTop) an inventory of possible future lakes likely to form with continued atmospheric warming and glacier retreat has been compiled. The possibility of monitoring the stability of slopes around lakes using satellite-based radar interferometry techniques has been tested in the case of Laguna Parón and a number of other lakes. Hence risk reduction measures applied to critical glacier lakes is based on rigorous science and research progress. For the future it is essential to integrate risk reduction with water resource management because shrinking glaciers reduce water availability during the dry season when various economic sectors depend on melt water. First experiences with development of multi-purpose projects combining risk and water resource management have shown the associated scientific, technical, social and legal challenges. A multi-disciplinary process involving multiple institutions and actors is necessary to secure sustainable development in the Andes of Peru, and related experiences are valuable for other high-mountain regions as well.

The wicked problem of earthquake hazard in developing countries: the example of Bangladesh

NASA Astrophysics Data System (ADS)

Steckler, M. S.; Akhter, S. H.; Stein, S.; Seeber, L.

2017-12-01

Many developing nations in earthquake-prone areas confront a tough problem: how much of their limited resources to use mitigating earthquake hazards? This decision is difficult because it is unclear when an infrequent major earthquake may happen, how big it could be, and how much harm it may cause. This issue faces nations with profound immediate needs and ongoing rapid urbanization. Earthquake hazard mitigation in Bangladesh is a wicked problem. It is the world's most densely populated nation, with 160 million people in an area the size of Iowa. Complex geology and sparse data make assessing a possibly-large earthquake hazard difficult. Hence it is hard to decide how much of the limited resources available should be used for earthquake hazard mitigation, given other more immediate needs. Per capita GDP is $1200, so Bangladesh is committed to economic growth and resources are needed to address many critical challenges and hazards. In their subtropical environment, rural Bangladeshis traditionally relied on modest mud or bamboo homes. Their rapidly growing, crowded capital, Dhaka, is filled with multistory concrete buildings likely to be vulnerable to earthquakes. The risk is compounded by the potential collapse of services and accessibility after a major temblor. However, extensive construction as the population shifts from rural to urban provides opportunity for earthquake-risk reduction. While this situation seems daunting, it is not hopeless. Robust risk management is practical, even for developing nations. It involves recognizing uncertainties and developing policies that should give a reasonable outcome for a range of the possible hazard and loss scenarios. Over decades, Bangladesh has achieved a thousandfold reduction in risk from tropical cyclones by building shelters and setting up a warning system. Similar efforts are underway for earthquakes. Smart investments can be very effective, even if modest. Hence, we suggest strategies consistent with high uncertainty and limited resources. The most crucial steps are enforcing building codes and public education on earthquake risk reduction. Requiring moderate investments that increases building costs by 5-10% can substantially improve safety and is a cost effective strategy. Over time, natural building turnover will make communities more resilient.

Risk-adapted monitoring is not inferior to extensive on-site monitoring: Results of the ADAMON cluster-randomised study.

PubMed

Brosteanu, Oana; Schwarz, Gabriele; Houben, Peggy; Paulus, Ursula; Strenge-Hesse, Anke; Zettelmeyer, Ulrike; Schneider, Anja; Hasenclever, Dirk

2017-12-01

Background According to Good Clinical Practice, clinical trials must protect rights and safety of patients and make sure that the trial results are valid and interpretable. Monitoring on-site has an important role in achieving these objectives; it controls trial conduct at trial sites and informs the sponsor on systematic problems. In the past, extensive on-site monitoring with a particular focus on formal source data verification often lost sight of systematic problems in study procedures that endanger Good Clinical Practice objectives. ADAMON is a prospective, stratified, cluster-randomised, controlled study comparing extensive on-site monitoring with risk-adapted monitoring according to a previously published approach. Methods In all, 213 sites from 11 academic trials were cluster-randomised between extensive on-site monitoring (104) and risk-adapted monitoring (109). Independent post-trial audits using structured manuals were performed to determine the frequency of major Good Clinical Practice findings at the patient level. The primary outcome measure is the proportion of audited patients with at least one major audit finding. Analysis relies on logistic regression incorporating trial and monitoring arm as fixed effects and site as random effect. The hypothesis was that risk-adapted monitoring is non-inferior to extensive on-site monitoring with a non-inferiority margin of 0.60 (logit scale). Results Average number of monitoring visits and time spent on-site was 2.1 and 2.7 times higher in extensive on-site monitoring than in risk-adapted monitoring, respectively. A total of 156 (extensive on-site monitoring: 76; risk-adapted monitoring: 80) sites were audited. In 996 of 1618 audited patients, a total of 2456 major audit findings were documented. Depending on the trial, findings were identified in 18%-99% of the audited patients, with no marked monitoring effect in any of the trials. The estimated monitoring effect is -0.04 on the logit scale with two-sided 95% confidence interval (-0.40; 0.33), demonstrating that risk-adapted monitoring is non-inferior to extensive on-site monitoring. At most, extensive on-site monitoring could reduce the frequency of major Good Clinical Practice findings by 8.2% compared with risk-adapted monitoring. Conclusion Compared with risk-adapted monitoring, the potential benefit of extensive on-site monitoring is small relative to overall finding rates, although risk-adapted monitoring requires less than 50% of extensive on-site monitoring resources. Clusters of findings within trials suggest that complicated, overly specific or not properly justified protocol requirements contributed to the overall frequency of findings. Risk-adapted monitoring in only a sample of patients appears sufficient to identify systematic problems in the conduct of clinical trials. Risk-adapted monitoring has a part to play in quality control. However, no monitoring strategy can remedy defects in quality of design. Monitoring should be embedded in a comprehensive quality management approach covering the entire trial lifecycle.

Risk-adapted monitoring is not inferior to extensive on-site monitoring: Results of the ADAMON cluster-randomised study

PubMed Central

Brosteanu, Oana; Schwarz, Gabriele; Houben, Peggy; Paulus, Ursula; Strenge-Hesse, Anke; Zettelmeyer, Ulrike; Schneider, Anja; Hasenclever, Dirk

2017-01-01

Background According to Good Clinical Practice, clinical trials must protect rights and safety of patients and make sure that the trial results are valid and interpretable. Monitoring on-site has an important role in achieving these objectives; it controls trial conduct at trial sites and informs the sponsor on systematic problems. In the past, extensive on-site monitoring with a particular focus on formal source data verification often lost sight of systematic problems in study procedures that endanger Good Clinical Practice objectives. ADAMON is a prospective, stratified, cluster-randomised, controlled study comparing extensive on-site monitoring with risk-adapted monitoring according to a previously published approach. Methods In all, 213 sites from 11 academic trials were cluster-randomised between extensive on-site monitoring (104) and risk-adapted monitoring (109). Independent post-trial audits using structured manuals were performed to determine the frequency of major Good Clinical Practice findings at the patient level. The primary outcome measure is the proportion of audited patients with at least one major audit finding. Analysis relies on logistic regression incorporating trial and monitoring arm as fixed effects and site as random effect. The hypothesis was that risk-adapted monitoring is non-inferior to extensive on-site monitoring with a non-inferiority margin of 0.60 (logit scale). Results Average number of monitoring visits and time spent on-site was 2.1 and 2.7 times higher in extensive on-site monitoring than in risk-adapted monitoring, respectively. A total of 156 (extensive on-site monitoring: 76; risk-adapted monitoring: 80) sites were audited. In 996 of 1618 audited patients, a total of 2456 major audit findings were documented. Depending on the trial, findings were identified in 18%–99% of the audited patients, with no marked monitoring effect in any of the trials. The estimated monitoring effect is −0.04 on the logit scale with two-sided 95% confidence interval (−0.40; 0.33), demonstrating that risk-adapted monitoring is non-inferior to extensive on-site monitoring. At most, extensive on-site monitoring could reduce the frequency of major Good Clinical Practice findings by 8.2% compared with risk-adapted monitoring. Conclusion Compared with risk-adapted monitoring, the potential benefit of extensive on-site monitoring is small relative to overall finding rates, although risk-adapted monitoring requires less than 50% of extensive on-site monitoring resources. Clusters of findings within trials suggest that complicated, overly specific or not properly justified protocol requirements contributed to the overall frequency of findings. Risk-adapted monitoring in only a sample of patients appears sufficient to identify systematic problems in the conduct of clinical trials. Risk-adapted monitoring has a part to play in quality control. However, no monitoring strategy can remedy defects in quality of design. Monitoring should be embedded in a comprehensive quality management approach covering the entire trial lifecycle. PMID:28786330

Lung cancer risk among construction workers in California, 1988-2007.

PubMed

Calvert, Geoffrey M; Luckhaupt, Sara; Lee, Soo-Jeong; Cress, Rosemary; Schumacher, Pam; Shen, Rui; Tak, SangWoo; Deapen, Dennis

2012-05-01

Although lung cancer risks can vary by race/ethnicity and by construction occupation, these risks have not been examined extensively. This study analyzed 110,937 lung cancer cases identified from the California Cancer Registry between 1988 and 2007. Mean age at diagnosis, proportion diagnosed at an advanced stage, and proportion with 3-year survival were calculated for lung cancer cases employed in the construction industry. Case-control methodology was also used to assess the risk of lung cancer. Morbidity odds ratios (MORs) were estimated by conditional logistic regression. Construction workers were found to have a significantly elevated risk for all lung cancer combined (MOR = 1.57) and for each lung cancer histologic subtype examined. All construction occupations, except managers/engineers and supervisors, had a significantly elevated risk for all lung cancer combined. Roofers and welders had the highest risks for total lung cancer and for each of the histologic subtypes. Construction workers in each of the four race/ethnicity groups also had significantly increased lung cancer risks. Compared to non-construction workers, construction workers were diagnosed at an earlier age, at a more advanced stage, and had significantly lower 3-year survival, though differences were modest. These findings justify additional reductions in carcinogenic exposures in construction, and increased support for smoking cessation programs at construction sites. Copyright © 2012 Wiley Periodicals, Inc.

Regulatory Approval of Cancer Risk-reducing (Chemopreventive) Drugs: Moving What We Have Learned into the Clinic

PubMed Central

Meyskens, Frank L.; Curt, Gregory A.; Brenner, Dean E.; Gordon, Gary; Herberman, Ronald B.; Finn, Olivera; Kelloff, Gary J.; Khleif, Samir N.; Sigman, Caroline C.; Szabo, Eva

2010-01-01

This paper endeavors to clarify the current requirements and status of regulatory approval for chemoprevention (risk reduction) drugs and discusses possible improvements to the regulatory pathway for chemoprevention. Covering a wide range of topics in as much depth as space allows, this report is written in a style to facilitate the understanding of non-scientists and to serve as a framework for informing the directions of experts engaged more deeply with this issue. Key topics we cover here are as follows: a history of definitive cancer chemoprevention trials and their influence on the evolution of regulatory assessments; a brief review of the long-standing success of pharmacologic risk reduction of cardiovascular diseases and its relevance to approval for cancer risk reduction drugs; the use and limitations of biomarkers for developing and the approval of cancer risk reduction drugs; the identification of individuals at a high(er) risk for cancer and who are appropriate candidates for risk reduction drugs; business models that should incentivize pharmaceutical-industry investment in cancer risk reduction; a summary of scientific and institutional barriers to development of cancer risk reduction drugs; and a summary of major recommendations that should help facilitate the pathway to regulatory approval for pharmacologic cancer risk reduction drugs. PMID:21372031

Examining the impact of case management in Vancouver's downtown community court: a quasi-experimental design.

PubMed

Somers, Julian M; Moniruzzaman, Akm; Rezansoff, Stefanie N; Patterson, Michelle

2014-01-01

Problem solving courts (PSC) have been implemented internationally, with a common objective to prevent reoffending by addressing criminogenic needs and strengthening social determinants of health. There has been no empirical research on the effectiveness of community courts, which are a form of PSC designed to harness community resources and inter-disciplinary expertise to reduce recidivism in a geographic catchment area. We used the propensity score matching method to examine the effectiveness of Vancouver's Downtown Community Court (DCC). We focused on the subset of DCC participants who were identified as having the highest criminogenic risk and were assigned to a case management team (CMT). A comparison group was derived using one-to-one matching on a large array variables including static and dynamic criminogenic factors, geography, and time. Reductions in offences (one year pre minus one year post) were compared between CMT and comparison groups. Compared to other DCC offenders, those triaged to CMT (9.5% of the DCC population) had significantly higher levels of healthcare, social service use, and justice system involvement over the ten years prior to the index offence. Compared to matched offenders who received traditional court outcomes, those assigned to CMT (n=249) exhibited significantly greater reductions in overall offending (p<0.001), primarily comprised of significant reductions in property offences (p<0.001). Our findings indicate that CMT achieved significantly greater reductions in recidivism than traditional court among offenders with complex needs and high numbers of previous offences. Limitations of this research include a non-experimental design and one year follow up. Strengths include a robust matching process and extensive client level data spanning multiple sectors. Further research is needed to replicate the observed outcomes, to investigate the extension of community courts to settings with divergent offender needs and local resources, and to estimate potential cost avoidance attributable to this intervention.

Research on Liquidity Risk Evaluation of Chinese A-Shares Market Based on Extension Theory

NASA Astrophysics Data System (ADS)

Bai-Qing, Sun; Peng-Xiang, Liu; Lin, Zhang; Yan-Ge, Li

This research defines the liquidity risk of stock market in matter-element theory and affair-element theory, establishes the indicator system of the forewarning for liquidity risks,designs the model and the process of early warning using the extension set method, extension dependent function and the comprehensive evaluation model. And the paper studies empirically A-shares market through the data of 1A0001, which prove that the model can better describe liquidity risk of China’s A-share market. At last, it gives the corresponding policy recommendations.

Synthesis of Triamino Acid Building Blocks with Different Lipophilicities

PubMed Central

Maity, Jyotirmoy; Honcharenko, Dmytro; Strömberg, Roger

2015-01-01

To obtain different amino acids with varying lipophilicity and that can carry up to three positive charges we have developed a number of new triamino acid building blocks. One set of building blocks was achieved by aminoethyl extension, via reductive amination, of the side chain of ortnithine, diaminopropanoic and diaminobutanoic acid. A second set of triamino acids with the aminoethyl extension having hydrocarbon side chains was synthesized from diaminobutanoic acid. The aldehydes needed for the extension by reductive amination were synthesized from the corresponding Fmoc-L-2-amino fatty acids in two steps. Reductive amination of these compounds with Boc-L-Dab-OH gave the C4-C8 alkyl-branched triamino acids. All triamino acids were subsequently Boc-protected at the formed secondary amine to make the monomers appropriate for the N-terminus position when performing Fmoc-based solid-phase peptide synthesis. PMID:25876040

Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding.

PubMed

Rippe, James M; Angelopoulos, Theodore J

2016-11-04

Added sugars are a controversial and hotly debated topic. Consumption of added sugars has been implicated in increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers. Support for these putative associations has been challenged, however, on a variety of fronts. The purpose of the current review is to summarize high impact evidence including systematic reviews, meta-analyses, and randomized controlled trials (RCTs), in an attempt to provide an overview of current evidence related to added sugars and health considerations. This paper is an extension of a symposium held at the Experimental Biology 2015 conference entitled "Sweeteners and Health: Current Understandings, Controversies, Recent Research Findings and Directions for Future Research". We conclude based on high quality evidence from randomized controlled trials (RCT), systematic reviews and meta-analyses of cohort studies that singling out added sugars as unique culprits for metabolically based diseases such as obesity, diabetes and cardiovascular disease appears inconsistent with modern, high quality evidence and is very unlikely to yield health benefits. While it is prudent to consume added sugars in moderation, the reduction of these components of the diet without other reductions of caloric sources seems unlikely to achieve any meaningful benefit.

Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding

PubMed Central

Rippe, James M.; Angelopoulos, Theodore J.

2016-01-01

Added sugars are a controversial and hotly debated topic. Consumption of added sugars has been implicated in increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers. Support for these putative associations has been challenged, however, on a variety of fronts. The purpose of the current review is to summarize high impact evidence including systematic reviews, meta-analyses, and randomized controlled trials (RCTs), in an attempt to provide an overview of current evidence related to added sugars and health considerations. This paper is an extension of a symposium held at the Experimental Biology 2015 conference entitled “Sweeteners and Health: Current Understandings, Controversies, Recent Research Findings and Directions for Future Research”. We conclude based on high quality evidence from randomized controlled trials (RCT), systematic reviews and meta-analyses of cohort studies that singling out added sugars as unique culprits for metabolically based diseases such as obesity, diabetes and cardiovascular disease appears inconsistent with modern, high quality evidence and is very unlikely to yield health benefits. While it is prudent to consume added sugars in moderation, the reduction of these components of the diet without other reductions of caloric sources seems unlikely to achieve any meaningful benefit. PMID:27827899

[Coffee consumption in depressive disorders: it's not one size fits all].

PubMed

Rusconi, Anna Carlotta; Valeriani, Giuseppe; Carluccio, Giuseppe Mattia; Majorana, Michele; Carlone, Cristiano; Raimondo, Pasquale; Ripà, Stefano; Marino, Pietropaolo; Coccanari de Fornari, Maria Antonietta; Biondi, Massimo

2014-01-01

Caffeine is considered the world's most popular psychoactive substance. Its actions on the central nervous system, mainly mediated by antagonism of adenosine receptors and subsequent modulation of dopaminergic activity, would be particularly sought by depressed patients, as an attempt of self-medication. However, published data suggested that coffee consumption may worsen psychopathological conditions in mood disorders. Thus, we reviewed available evidence in the literature that investigated the effects of coffee consumption on clinical development of underlying psychopathology. Literature research was done by typing on Medline/PubMed and PsychINFO the key words "coffee AND major depression", "coffee AND dysthymia". The research was limited to English language publications and to studies conducted exclusively on humans. Although literature data are conflicting, extensive follow-up studies indicate a significant caffeine effect on risk reduction of developing clinical depression symptoms. Clinical worsening was observed mainly in cases of postpartum depression and comorbid panic disorder. Taking in account the study limitations, we observed a biphasic profile in caffeine psychostimulant effect: low to moderate doses may correlate with a reduction in depressive risk in healthy subjects and an improvement of many clinical symptoms (attention, arousal, psychomotor performance) in depressed patients, whereas the assumption of high doses may result in thymic dysregulation, favor mixed affective states and worsen circadian profiles and anxiety symptoms.

78 FR 32233 - Notice of Request for Extension of Approval of an Information Collection; Importation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

...] Notice of Request for Extension of Approval of an Information Collection; Importation of Artificially... an information collection; comment request. SUMMARY: In accordance with the Paperwork Reduction Act... an extension of approval of an information collection associated with the regulations for the...

77 FR 15370 - General Services Administration Acquisition Regulation; Information Collection; Price Reductions...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-15

... Services Administration Acquisition Regulation; Information Collection; Price Reductions Clause; Extension... notice of request for comments regarding OMB Control No. 3090-0235, Price Reductions Clause, published in... 16, 2012. ADDRESSES: Submit comments identified by Information Collection 3090- 0235, Price...

Radiographic diagnosis of sagittal plane rotational displacement in pelvic fractures: a cadaveric model and clinical case study.

PubMed

Shui, Xiaolong; Ying, Xiaozhou; Kong, Jianzhong; Feng, Yongzeng; Hu, Wei; Guo, Xiaoshan; Wang, Gang

2015-08-01

Our objective was to measure the sagittal plane rotational (flexion and extension) displacement of hemipelvis radiologically and analyze the ratio of flexion and extension displacement of unstable pelvic fractures. We used 8 cadaveric models to study the radiographic evidence of pelvic fractures in the sagittal plane. We performed pelvic osteotomy on 8 cadavers to simulate anterior and posterior pelvic ring injury. Radiological data were measured in the flexion and extension group under different angles (5°, 10°, 15°, 20°, and 25°). We retrospectively reviewed 164 patients who were diagnosed with a unilateral fracture of the pelvis. Pelvic ring displacement was identified and recorded radiographically in cadaveric models. The flexion and extension displacement of pelvic fractures was measured in terms of the vertical distance of fracture from the top of iliac crest to the pubic tubercle (CD) or from the top of iliac crest to the lowest point of ischial tuberosity (AB). Fifty-seven pelves showed flexion displacement and 15 showed extension displacement. Closed reduction including internal fixation and external fixation was successfully used in 141 cases (86.0 %). The success rates of closed reduction in flexion and extension displacement groups were 77 and 73 %, respectively, which were lower than in unstable pelvic ring fractures. The sagittal plane rotation (flexion and extension) displacement of pelvic fractures could be measured by special points and lines on the radiographs. Minimally invasive reduction should be based on clearly identified differences between the sagittal plane rotation and the vertical displacement of pelvic fractures.

Near-field acoustical holography of military jet aircraft noise

NASA Astrophysics Data System (ADS)

Wall, Alan T.; Gee, Kent L.; Neilsen, Tracianne; Krueger, David W.; Sommerfeldt, Scott D.; James, Michael M.

2010-10-01

Noise radiated from high-performance military jet aircraft poses a hearing-loss risk to personnel. Accurate characterization of jet noise can assist in noise prediction and noise reduction techniques. In this work, sound pressure measurements were made in the near field of an F-22 Raptor. With more than 6000 measurement points, this is the most extensive near-field measurement of a high-performance jet to date. A technique called near-field acoustical holography has been used to propagate the complex pressure from a two- dimensional plane to a three-dimensional region in the jet vicinity. Results will be shown and what they reveal about jet noise characteristics will be discussed.

Examination and treatment of a professional ballet dancer with a suspected acetabular labral tear: A case report.

PubMed

Khoo-Summers, Lynnette; Bloom, Nancy J

2015-08-01

Dancers are at risk for developing groin pain that is due to acetabular labral tears. Although surgical management of labral tears has been reported extensively, conservative management has been poorly described. This case report describes the examination, diagnosis, and treatment of groin pain in a professional ballet dancer with a suspected acetabular labral tear. Treatment focused on decreasing anterior hip joint stresses and improving the precision of hip motion through correction of alignment and movement impairments noted during functional activities and dance. Successful outcomes included a reduction in pain and return to professional ballet dancing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Rigorous Model Reduction for a Damped-Forced Nonlinear Beam Model: An Infinite-Dimensional Analysis

NASA Astrophysics Data System (ADS)

Kogelbauer, Florian; Haller, George

2018-06-01

We use invariant manifold results on Banach spaces to conclude the existence of spectral submanifolds (SSMs) in a class of nonlinear, externally forced beam oscillations. SSMs are the smoothest nonlinear extensions of spectral subspaces of the linearized beam equation. Reduction in the governing PDE to SSMs provides an explicit low-dimensional model which captures the correct asymptotics of the full, infinite-dimensional dynamics. Our approach is general enough to admit extensions to other types of continuum vibrations. The model-reduction procedure we employ also gives guidelines for a mathematically self-consistent modeling of damping in PDEs describing structural vibrations.

Nation-Based Occurrence and Endogenous Biological Reduction of Mycotoxins in Medicinal Herbs and Spices.

PubMed

Do, Kee Hun; An, Tae Jin; Oh, Sang-Keun; Moon, Yuseok

2015-10-14

Medicinal herbs have been increasingly used for therapeutic purposes against a diverse range of human diseases worldwide. Moreover, the health benefits of spices have been extensively recognized in recent studies. However, inevitable contaminants, including mycotoxins, in medicinal herbs and spices can cause serious problems for humans in spite of their health benefits. Along with the different nation-based occurrences of mycotoxins, the ultimate exposure and toxicities can be diversely influenced by the endogenous food components in different commodities of the medicinal herbs and spices. The phytochemicals in these food stuffs can influence mold growth, mycotoxin production and biological action of the mycotoxins in exposed crops, as well as in animal and human bodies. The present review focuses on the occurrence of mycotoxins in medicinal herbs and spices and the biological interaction between mold, mycotoxin and herbal components. These networks will provide insights into the methods of mycotoxin reduction and toxicological risk assessment of mycotoxin-contaminated medicinal food components in the environment and biological organisms.

Nation-Based Occurrence and Endogenous Biological Reduction of Mycotoxins in Medicinal Herbs and Spices

PubMed Central

Do, Kee Hun; An, Tae Jin; Oh, Sang-Keun; Moon, Yuseok

2015-01-01

Medicinal herbs have been increasingly used for therapeutic purposes against a diverse range of human diseases worldwide. Moreover, the health benefits of spices have been extensively recognized in recent studies. However, inevitable contaminants, including mycotoxins, in medicinal herbs and spices can cause serious problems for humans in spite of their health benefits. Along with the different nation-based occurrences of mycotoxins, the ultimate exposure and toxicities can be diversely influenced by the endogenous food components in different commodities of the medicinal herbs and spices. The phytochemicals in these food stuffs can influence mold growth, mycotoxin production and biological action of the mycotoxins in exposed crops, as well as in animal and human bodies. The present review focuses on the occurrence of mycotoxins in medicinal herbs and spices and the biological interaction between mold, mycotoxin and herbal components. These networks will provide insights into the methods of mycotoxin reduction and toxicological risk assessment of mycotoxin-contaminated medicinal food components in the environment and biological organisms. PMID:26473926

[Significance of a life style change in arterial hypertension].

PubMed

Müller, J F; Franz, I W

1998-12-10

Changes in lifestyle represent a rational, promising and low side effect means of lowering the blood pressure and reducing the cardiovascular risk in many hypertensives. The first measure in all over-weight hypertensives is weight reduction. Even when the ideal weight is not reached, this measure leads to a lasting decrease in blood pressure. Beyond a threshold of 30 mg alcohol per day in men (approximately three glasses of beer or two glasses of wine) and 20 mg alcohol per day in women, the consumption of alcohol leads to an increase in blood pressure. Although only some hypertensives respond to a restriction of salt, all hypertensives should limit their salt intake to 5 to 6 g daily. Endurance training is an important pillar of lifestyle change. That relaxation techniques lower blood pressure has not been confirmed by the results of relevant studies. What has been confirmed, however, is the benefit of extensive changes in lifestyle, including information on health, daily endurance training, healthy eating habits and reduction of alcohol intake.

Taking stock of decentralized disaster risk reduction in Indonesia

NASA Astrophysics Data System (ADS)

Grady, Anthony; Gersonius, Berry; Makarigakis, Alexandros

2016-09-01

The Sendai Framework, which outlines the global course on disaster risk reduction until 2030, places strong importance on the role of local government in disaster risk reduction. An aim of decentralization is to increase the influence and authority of local government in decision making. Yet, there is limited empirical evidence of the extent, character and effects of decentralization in current disaster risk reduction implementation, and of the barriers that are most critical to this. This paper evaluates decentralization in relation to disaster risk reduction in Indonesia, chosen for its recent actions to decentralize governance of DRR coupled with a high level of disaster risk. An analytical framework was developed to evaluate the various dimensions of decentralized disaster risk reduction, which necessitated the use of a desk study, semi-structured interviews and a gap analysis. Key barriers to implementation in Indonesia included: capacity gaps at lower institutional levels, low compliance with legislation, disconnected policies, issues in communication and coordination and inadequate resourcing. However, any of these barriers are not unique to disaster risk reduction, and similar barriers have been observed for decentralization in other developing countries in other public sectors.

Enamel formation and growth in non-mammalian cynodonts

PubMed Central

Dirks, Wendy; Martinelli, Agustín G.

2018-01-01

The early evolution of mammals is associated with the linked evolutionary origin of diphyodont tooth replacement, rapid juvenile growth and determinate adult growth. However, specific relationships among these characters during non-mammalian cynodont evolution require further exploration. Here, polarized light microscopy revealed incremental lines, resembling daily laminations of extant mammals, in histological sections of enamel in eight non-mammalian cynodont species. In the more basal non-probainognathian group, enamel extends extremely rapidly from cusp to cervix. By contrast, the enamel of mammaliamorphs is gradually accreted, with slow rates of crown extension, more typical of the majority of non-hypsodont crown mammals. These results are consistent with the reduction in dental replacement rate across the non-mammalian cynodont lineage, with greater rates of crown extension required in most non-probainognathians, and slower crown extension rates permitted in mammaliamorphs, which have reduced patterns of dental replacement in comparison with many non-probainognathians. The evolution of mammal-like growth patterns, with faster juvenile growth and more abruptly terminating adult growth, is linked with this reduction in dental replacement rates and may provide an additional explanation for the observed pattern in enamel growth rates. It is possible that the reduction in enamel extension rates in mammaliamorphs reflects an underlying reduction in skeletal growth rates at the time of postcanine formation, due to a more abruptly terminating pattern of adult growth in these more mammal-like, crownward species. PMID:29892415

40 CFR 76.12 - Phase I NOX compliance extension.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.12 Phase I NOX compliance extension. (a... outage. (iii) Fuel and energy balance summaries and power and other consumption requirements (including...

40 CFR 76.12 - Phase I NOX compliance extension.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.12 Phase I NOX compliance extension. (a... outage. (iii) Fuel and energy balance summaries and power and other consumption requirements (including...

40 CFR 76.12 - Phase I NOX compliance extension.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.12 Phase I NOX compliance extension. (a... outage. (iii) Fuel and energy balance summaries and power and other consumption requirements (including...

40 CFR 76.12 - Phase I NOX compliance extension.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.12 Phase I NOX compliance extension. (a... outage. (iii) Fuel and energy balance summaries and power and other consumption requirements (including...

40 CFR 76.12 - Phase I NOX compliance extension.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.12 Phase I NOX compliance extension. (a... outage. (iii) Fuel and energy balance summaries and power and other consumption requirements (including...

40 CFR 63.74 - Demonstration of early reduction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 10 2012-07-01 2012-07-01 false Demonstration of early reduction. 63.74 Section 63.74 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.74 Demonstration of...

40 CFR 63.74 - Demonstration of early reduction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 10 2013-07-01 2013-07-01 false Demonstration of early reduction. 63.74 Section 63.74 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.74 Demonstration of...

40 CFR 63.74 - Demonstration of early reduction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 10 2014-07-01 2014-07-01 false Demonstration of early reduction. 63.74 Section 63.74 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Governing Compliance Extensions for Early Reductions of Hazardous Air Pollutants § 63.74 Demonstration of...

11 CFR 116.3 - Extensions of credit by commercial vendors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of credit to nonpolitical debtors that are of similar risk and size of obligation. (b) Incorporated... similar to extensions of credit to nonpolitical debtors that are of similar risk and size of obligation... 11 Federal Elections 1 2010-01-01 2010-01-01 false Extensions of credit by commercial vendors. 116...

76 FR 40320 - Risk Reduction Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

... identifying and analyzing applicable hazards and (2) develops plans to mitigate that risk. Each RRP is...-2009-0038] RIN 2130-AC11 Risk Reduction Program AGENCY: Federal Railroad Administration (FRA... certain railroads to develop a Risk Reduction Program (RRP). The Rail Safety Improvement Act of 2008...

78 FR 61322 - Notice of Request for Extension of Approval of an Information Collection; Importation of Fresh...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

...] Notice of Request for Extension of Approval of an Information Collection; Importation of Fresh Baby Kiwi... an information collection; comment request. SUMMARY: In accordance with the Paperwork Reduction Act... an extension of approval of an information collection associated with the regulations for the...

47 CFR 63.505 - Contents of applications for any type of discontinuance, reduction, or impairment of telephone...

Code of Federal Regulations, 2010 CFR

2010-10-01

... discontinuance, reduction, or impairment of telephone service not specifically provided for in this part. 63.505... (CONTINUED) EXTENSION OF LINES, NEW LINES, AND DISCONTINUANCE, REDUCTION, OUTAGE AND IMPAIRMENT OF SERVICE BY...; Examples § 63.505 Contents of applications for any type of discontinuance, reduction, or impairment of...

Dietary lignan intakes in relation to survival among women with breast cancer: the Western New York Exposures and Breast Cancer (WEB) Study.

PubMed

McCann, Susan E; Thompson, Lilian U; Nie, Jing; Dorn, Joan; Trevisan, Maurizio; Shields, Peter G; Ambrosone, Christine B; Edge, Stephen B; Li, Hsin-Fang; Kasprzak, Christina; Freudenheim, Jo L

2010-07-01

Dietary lignan intakes have been associated with reduced breast cancer risks; however, no previous studies have investigated whether lignan intake might be associated with breast cancer survival. We examined the association of dietary lignan intakes with survival in 1122 women with primary, incident, histologically confirmed breast cancer identified between 1996 and 2001, and with vital status determined through December 31, 2006. Diet in the 12-24 months before diagnosis was assessed with an extensive food frequency questionnaire, and potential confounders assessed from an extensive epidemiologic interview and abstracted clinical data. Lignan intake was calculated using published food composition data. Hazard ratios (HR), and 95% confidence intervals (CIs) for dietary lignan intakes with all cause, and breast cancer mortality were estimated using Cox proportional hazards adjusting for age, education, race, total energy intake, tumor stage, and body mass index. Of the 1122 women with complete dietary data, 160 had died by the end of follow-up. Among postmenopausal women only, those in the highest versus lowest quartile of lignan intakes had a statistically significant reduction in the risk of all cause mortality (HR 0.49, 95% CI 0.26-0.91) and a significantly reduced risk of breast cancer mortality (HR 0.29, 95% CI 0.11-0.76). Higher intakes of dried beans (HR 0.61, 95% CI 0.36-1.03), but not fruits, vegetables, or grains, were also weakly associated with overall mortality. In summary, our results suggest that higher lignan intakes may be associated with improved survival among postmenopausal women with breast cancer.

Effect of ezetimibe add-on therapy over 52 weeks extension analysis of prospective randomized trial (RESEARCH study) in type 2 diabetes subjects.

PubMed

Sakamoto, Kentaro; Kawamura, Mitsunobu; Watanabe, Takayuki; Ashidate, Keiko; Kohro, Takahide; Tanaka, Akira; Mori, Yasumichi; Tagami, Motoki; Hirano, Tsutomu; Yamazaki, Tsutomu; Shiba, Teruo

2017-06-24

Lowering cholesterol levels decreases the risk of atherosclerotic diseases. Effective ways to stably reduce LDL-C level are warranted in type 2 diabetic patients, a high-risk population for CVD, with various anti-diabetic therapeutic background. The RESEARCH study focuses on LDL-C reduction in this population along with modifications of the lipid profiles. We evaluated long-term ezetimibe add-on therapy in T2DM patients with hypercholesterolemia. In a randomized, multicenter, open-label, prospective study, a total of 109 T2DM patients not attaining LDL-C target value despite first-line dose statin (10 mg of atorvastatin or 1 mg of pitavastatin) therapy in Japan were recruited. We investigated the difference in cholesterol lowering effect between ezetimibe (10 mg) add-on statin (EAT) group and double-dose statin (DST) group. Changes of parameters related to atherosclerotic event risks were assessed. The reduction of LDL-C was larger in the EAT group (28.3%) than in the DST group (9.2%) at 52 weeks as well as the primary endpoint of 12 weeks. EAT achieved significant lower levels of TC and apo B, respectively. Both treatments attained significant reduction in sd-LDL-C or hsCRP on this long-term basis. Notably, sd-LDL-C in EAT reduced as low as 36.1 ± 14.9 mg/dl to reach near the threshold (35.0 mg/dl) for atherosclerosis with significantly higher achievement rate (55.6%) than DST treatment. Simultaneously, hsCRP reduction by EAT attained as low value as 0.52 ± 0.43 mg/l. In the present 52-week long-term period, ezetimibe add-on therapy showed a robust advantage in lowering LDL-C and in attaining target LDL-C values compared with the doubling of statin dose. Moreover, it's meaningful that sd-LDL, powerfully atherogenic lipoprotein, exhibited prominent decrease consistently prominently by ezetimibe add-on therapy. DM patients with hypercholesterolemia are at high risk for CAD, and adding ezetimibe onto usual-dose statin treatment in Japan has been suggested as the first-line therapy for those DM patients who failed to attain the target LDL-C value (UMIN000002593).

Spatial patterns of methylmercury risks to common loons and piscivorous fish in Canada.

PubMed

Depew, David C; Burgess, Neil M; Campbell, Linda M

2013-11-19

Deposition of inorganic mercury (Hg) from the atmosphere remains the principle source of Hg contamination for most aquatic ecosystems. Inorganic Hg is readily converted to toxic methylmercury (MeHg) that bioaccumulates in aquatic food webs and may pose a risk to piscivorous fish and wildlife. We conducted a screening-level risk assessment to evaluate the extent of risk to top aquatic piscivores: the common loon (Gavia immer), walleye (Sander vitreus), and northern pike (Esox lucius). Risk quotients (RQs) were calculated on the basis of a dietary Hg exposure indicator (HgPREY) modeled from over 230,000 observations of fish Hg concentrations at over 1900 locations across Canada and dietary Hg exposure screening benchmarks derived specifically for this assessment. HgPREY exceeded benchmark thresholds related to impaired productivity and behavior in adult loons at 10% and 36% of sites, respectively, and exceeded benchmark thresholds for impaired reproduction and health in fishes at 82% and 73% of sites, respectively. The ecozones of southeastern Canada characterized by extensive forest cover, elevated Hg deposition, and poorly buffered soils had the greatest proportion of RQs > 1.0. Results of this assessment suggest that common loons and piscivorous fishes would likely benefit from reductions in Hg deposition, especially in southeastern Canada.

Primary stroke prevention and hypertension treatment: which is the first-line strategy?

PubMed

Ravenni, Roberta; Jabre, Joe F; Casiglia, Edoardo; Mazza, Alberto

2011-07-05

Hypertension (HT) is considered the main classic vascular risk factor for stroke and the importance of lowering blood pressure (BP) is well established. However, not all the benefit of antihypertensive treatment is due to BP reduction per se, as the effect of reducing the risk of stroke differs among classes of antihypertensive agents. Extensive evidences support that angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), dihydropyridine calcium channel blockers (CCB) and thiazide diuretics each reduced risk of stroke compared with placebo or no treatment. Therefore, when combination therapy is required, a combination of these antihypertensive classes represents a logical approach. Despite the efficacy of antihypertensive therapy a large proportion of the population, still has undiagnosed or inadequately treated HT, and remain at high risk of stroke. In primary stroke prevention current guidelines recommend a systolic/diastolic BP goal of <140/<90 mmHg in the general population and <130/80 mmHg in diabetics and in subjects with high cardiovascular risk and renal disease. The recent release in the market of the fixed-dose combination (FDC) of ACEI or ARB and CCB should provide a better control of BP. However to confirm the efficacy of the FDC in primary stroke prevention, clinical intervention trials are needed.

Revealing the underlying drivers of disaster risk: a global analysis

NASA Astrophysics Data System (ADS)

Peduzzi, Pascal

2017-04-01

Disasters events are perfect examples of compound events. Disaster risk lies at the intersection of several independent components such as hazard, exposure and vulnerability. Understanding the weight of each component requires extensive standardisation. Here, I show how footprints of past disastrous events were generated using GIS modelling techniques and used for extracting population and economic exposures based on distribution models. Using past event losses, it was possible to identify and quantify a wide range of socio-politico-economic drivers associated with human vulnerability. The analysis was applied to about nine thousand individual past disastrous events covering earthquakes, floods and tropical cyclones. Using a multiple regression analysis on these individual events it was possible to quantify each risk component and assess how vulnerability is influenced by various hazard intensities. The results show that hazard intensity, exposure, poverty, governance as well as other underlying factors (e.g. remoteness) can explain the magnitude of past disasters. Analysis was also performed to highlight the role of future trends in population and climate change and how this may impacts exposure to tropical cyclones in the future. GIS models combined with statistical multiple regression analysis provided a powerful methodology to identify, quantify and model disaster risk taking into account its various components. The same methodology can be applied to various types of risk at local to global scale. This method was applied and developed for the Global Risk Analysis of the Global Assessment Report on Disaster Risk Reduction (GAR). It was first applied on mortality risk in GAR 2009 and GAR 2011. New models ranging from global assets exposure and global flood hazard models were also recently developed to improve the resolution of the risk analysis and applied through CAPRA software to provide probabilistic economic risk assessments such as Average Annual Losses (AAL) and Probable Maximum Losses (PML) in GAR 2013 and GAR 2015. In parallel similar methodologies were developed to highlitght the role of ecosystems for Climate Change Adaptation (CCA) and Disaster Risk Reduction (DRR). New developments may include slow hazards (such as e.g. soil degradation and droughts), natech hazards (by intersecting with georeferenced critical infrastructures) The various global hazard, exposure and risk models can be visualized and download through the PREVIEW Global Risk Data Platform.

Using risk elasticity to prioritize risk reduction strategies for geographical areas and industry sectors.

PubMed

Li, Pei-Chiun; Ma, Hwong-Wen

2016-01-25

The total quantity of chemical emissions does not take into account their chemical toxicity, and fails to be an accurate indicator of the potential impact on human health. The sources of released contaminants, and therefore, the potential risk, also differ based on geography. Because of the complexity of the risk, there is no integrated method to evaluate the effectiveness of risk reduction. Therefore, this study developed a method to incorporate the spatial variability of emissions into human health risk assessment to evaluate how to effectively reduce risk using risk elasticity analysis. Risk elasticity analysis, the percentage change in risk in response to the percentage change in emissions, was adopted in this study to evaluate the effectiveness and efficiency of risk reduction. The results show that the main industry sectors are different in each area, and that high emission in an area does not correspond to high risk. Decreasing the high emissions of certain sectors in an area does not result in efficient risk reduction in this area. This method can provide more holistic information for risk management, prevent the development of increased risk, and prioritize the risk reduction strategies. Copyright © 2015 Elsevier B.V. All rights reserved.

77 FR 62496 - Federal Acquisition Regulation; Submission for OMB Review; Incentive Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... Management and Budget (OMB) a request to review and approve an extension of a previously approved information... extension of the information collection would violate the fundamental purposes of the Paperwork Reduction...

Valuing Drinking Water Risk Reductions Using the Contingent Valuation Method: A Methodological Study of Risks from THM and Giardia (1986)

EPA Pesticide Factsheets

This study develops contingent valuation methods for measuring the benefits of mortality and morbidity drinking water risk reductions. The major effort was devoted to developing and testing a survey instrument to value low-level risk reductions.

Assessment of methods used to determine the safety of the topical insect repellent N,N-diethyl-m-toluamide (DEET).

PubMed

Chen-Hussey, Vanessa; Behrens, Ron; Logan, James G

2014-06-03

N,N-diethyl-m-toluamide (DEET) has been registered for commercial use as an insect repellent for over five decades, and is used widely across the world. Concerns over the safety of DEET first emerged during the 1980s after reports of encephalopathy following DEET exposure, particularly in children. However, the role of DEET in either the illness or deaths was and remains purely speculative. In response to these cases a number of reviews and investigations of DEET safety were carried out. Here we examine the methods used and information available to determine the safety of DEET in humans. Animal testing, observational studies and intervention trials have found no evidence of severe adverse events associated with recommended DEET use. Minor adverse effects noted in animal trials were associated with very large doses and were not replicated between different test species. The safety surveillance from extensive humans use reveals no association with severe adverse events. This review compares the toxicity assessment using three different models to define the risk assessment and safety threshold for DEET use in humans and discusses the clinical consequences of the thresholds derived from the models.The theoretical risks associated with wearing an insect repellent should be weighed against the reduction or prevention of the risk of fatal or debilitating diseases including malaria, dengue, yellow fever and filariasis. With over 48 million European residents travelling to regions where vector borne diseases are a threat in 2009, restricting the concentration of DEET containing repellents to 15% or less, as modelled in the 2010 EU directive, is likely to result in extensive sub-therapeutic activity where repellents are infrequently applied. Future European travellers, as a consequence of inadequate personal protection, could potentially be at increased risk of vector borne diseases. Risk assessments of repellents should take these factors into account when setting safe limits.

Space Launch System NASA Research Announcement Advanced Booster Engineering Demonstration and/or Risk Reduction

NASA Technical Reports Server (NTRS)

Crumbly, Christopher M.; Craig, Kellie D.

2011-01-01

The intent of the Advanced Booster Engineering Demonstration and/or Risk Reduction (ABEDRR) effort is to: (1) Reduce risks leading to an affordable Advanced Booster that meets the evolved capabilities of SLS (2) Enable competition by mitigating targeted Advanced Booster risks to enhance SLS affordability. Key Concepts (1) Offerors must propose an Advanced Booster concept that meets SLS Program requirements (2) Engineering Demonstration and/or Risk Reduction must relate to the Offeror s Advanced Booster concept (3) NASA Research Announcement (NRA) will not be prescriptive in defining Engineering Demonstration and/or Risk Reduction

Modified anterior-only reduction and fixation for traumatic cervical facet dislocation (AO type C injuries).

PubMed

Kanna, Rishi M; Shetty, Ajoy P; Rajasekaran, S

2018-06-01

Surgical reduction of uni and bi-facetal dislocations of the cervical spine (AO type C injuries) can be performed by posterior, anterior or combined approaches. Ease of access, low infection rates and less risks of neurological worsening has popularized anterior approach. However, the reduction of locked cervical facets can be intricate through anterior approach. We analyzed the safety, efficacy and outcomes at a minimum 1 year, of a novel anterior reduction technique for consecutively treated cervical facet dislocations. Patients with single level traumatic sub-axial cervical dislocation (n = 39) treated by this modified anterior technique were studied. The technique involved standard Smith-Robinson approach, discectomy beyond PLL, use of inter-laminar distracter to distract while Caspar pins were used as "joysticks" (either flexion-extension or lateral rotation moments are provided), to reduce the sub-luxed facets. Among 51 patients with cervical type C injury treated during the study period, 4 patients who had spontaneous reduction and 8 treated by planned global fusion were excluded. 39 patients of mean age 49.9 years were studied. The levels of injury included (C3-4 = 2, C4-5 = 5, C5-6 = 20, C6-7 = 12). 18 were bi-facetal and 21 were uni-facetal dislocation. One facet was fractured in 17 and both in 5 patients. 30% (n = 13) had a concomitant disc prolapse. The neurological status was as follows: 9 ASIA A, 9 ASIA C, 13 ASIA D and 8 ASIA E. All the patients were successfully reduced by this technique and fixed with anterior locking cervical locking plates. No supplemental posterior surgery was performed. 22 patients with incomplete deficit showed recovery. The mean follow-up was 14.3 months and there was no implant failure except one patient who had partial loss of the reduction. Patients with traumatic sub-axial cervical dislocation (AO type C injuries) can be safely and effectively reduced by this technique. Other advantages include minimal blood loss, less risks of infection, shorted fusion zone, good fusion rate and neurological recovery.

Environmental risk factors for dementia: a systematic review.

PubMed

Killin, Lewis O J; Starr, John M; Shiue, Ivy J; Russ, Tom C

2016-10-12

Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia. We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed. We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields. Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations.

Statistics for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater runoff best management practices (BMPs)

USGS Publications Warehouse

Granato, Gregory E.

2014-01-01

The U.S. Geological Survey (USGS) developed the Stochastic Empirical Loading and Dilution Model (SELDM) in cooperation with the Federal Highway Administration (FHWA) to indicate the risk for stormwater concentrations, flows, and loads to be above user-selected water-quality goals and the potential effectiveness of mitigation measures to reduce such risks. SELDM models the potential effect of mitigation measures by using Monte Carlo methods with statistics that approximate the net effects of structural and nonstructural best management practices (BMPs). In this report, structural BMPs are defined as the components of the drainage pathway between the source of runoff and a stormwater discharge location that affect the volume, timing, or quality of runoff. SELDM uses a simple stochastic statistical model of BMP performance to develop planning-level estimates of runoff-event characteristics. This statistical approach can be used to represent a single BMP or an assemblage of BMPs. The SELDM BMP-treatment module has provisions for stochastic modeling of three stormwater treatments: volume reduction, hydrograph extension, and water-quality treatment. In SELDM, these three treatment variables are modeled by using the trapezoidal distribution and the rank correlation with the associated highway-runoff variables. This report describes methods for calculating the trapezoidal-distribution statistics and rank correlation coefficients for stochastic modeling of volume reduction, hydrograph extension, and water-quality treatment by structural stormwater BMPs and provides the calculated values for these variables. This report also provides robust methods for estimating the minimum irreducible concentration (MIC), which is the lowest expected effluent concentration from a particular BMP site or a class of BMPs. These statistics are different from the statistics commonly used to characterize or compare BMPs. They are designed to provide a stochastic transfer function to approximate the quantity, duration, and quality of BMP effluent given the associated inflow values for a population of storm events. A database application and several spreadsheet tools are included in the digital media accompanying this report for further documentation of methods and for future use. In this study, analyses were done with data extracted from a modified copy of the January 2012 version of International Stormwater Best Management Practices Database, designated herein as the January 2012a version. Statistics for volume reduction, hydrograph extension, and water-quality treatment were developed with selected data. Sufficient data were available to estimate statistics for 5 to 10 BMP categories by using data from 40 to more than 165 monitoring sites. Water-quality treatment statistics were developed for 13 runoff-quality constituents commonly measured in highway and urban runoff studies including turbidity, sediment and solids; nutrients; total metals; organic carbon; and fecal coliforms. The medians of the best-fit statistics for each category were selected to construct generalized cumulative distribution functions for the three treatment variables. For volume reduction and hydrograph extension, interpretation of available data indicates that selection of a Spearman’s rho value that is the average of the median and maximum values for the BMP category may help generate realistic simulation results in SELDM. The median rho value may be selected to help generate realistic simulation results for water-quality treatment variables. MIC statistics were developed for 12 runoff-quality constituents commonly measured in highway and urban runoff studies by using data from 11 BMP categories and more than 167 monitoring sites. Four statistical techniques were applied for estimating MIC values with monitoring data from each site. These techniques produce a range of lower-bound estimates for each site. Four MIC estimators are proposed as alternatives for selecting a value from among the estimates from multiple sites. Correlation analysis indicates that the MIC estimates from multiple sites were weakly correlated with the geometric mean of inflow values, which indicates that there may be a qualitative or semiquantitative link between the inflow quality and the MIC. Correlations probably are weak because the MIC is influenced by the inflow water quality and the capability of each individual BMP site to reduce inflow concentrations.

Preventing brachial plexus injury during shoulder surgery: a real-time cadaveric study.

PubMed

Kam, Andrew W; Lam, Patrick H; Haen, Pieter S W A; Tan, Martin; Shamsudin, Aminudin; Murrell, George A C

2018-05-01

Brachial plexopathy is not uncommon after shoulder surgery. Although thought to be due to stretch neuropathy, its etiology is poorly understood. This study aimed to identify arm positions and maneuvers that may risk causing brachial plexopathy during shoulder arthroplasty. Tensions in the cords of the brachial plexuses of 6 human cadaveric upper limbs were measured using load cells while each limb was placed in different arm positions and while they underwent shoulder hemiarthroplasty and revision reverse arthroplasty. Arthroplasty procedures in 4 specimens were performed with standard limb positioning (unsupported), and 2 specimens were supported from under the elbow (supported). Each cord then underwent biomechanical testing to identify tension corresponding to 10% strain (the stretch neuropathy threshold in animal models). Tensions exceeding 15 N, 11 N, and 9 N in the lateral, medial, and posterior cords, respectively, produced 10% strain. Shoulder abduction >70° and combined external rotation >60° with extension >50° increased medial cord tension above the 10% strain threshold. Medial cord tensions (mean ± standard error of the mean) in unsupported specimens increased over baseline during hemiarthroplasty (sounder insertion [4.7 ± 0.6 N, P = .04], prosthesis impaction [6.1 ± 0.8 N, P = .04], and arthroplasty reduction [5.0 ± 0.7 N, P = .04]) and revision reverse arthroplasty (retractor positioning [7.2 ± 0.8 N, P = .02]). Supported specimens experienced lower tensions than unsupported specimens. Shoulder abduction >70°, combined external rotation >60° with extension >50°, and downward forces on the humeral shaft may risk causing brachial plexopathy. Retractor placement, sounder insertion, humeral prosthesis impaction, and arthroplasty reduction increase medial cord tensions during shoulder arthroplasty. Supporting the arm from under the elbow protected the brachial plexus in this cadaveric model. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Reductive dehalogenation of 3,5-dibromo-4-hydroxybenzoate by an aerobic strain of Delftia sp. EOB-17.

PubMed

Chen, Kai; Jian, Shanshan; Huang, Linglong; Ruan, Zhepu; Li, Shunpeng; Jiang, Jiandong

2015-12-01

To confirm the reductive dehalogenation ability of the aerobic strain of Delftia sp. EOB-17, finding more evidences to support the hypothesis that reductive dehalogenation may occur extensively in aerobic bacteria. Delftia sp. EOB-17, isolated from terrestrial soil contaminated with halogenated aromatic compounds, completely degraded 0.2 mM DBHB in 28 h and released two equivalents of bromides under aerobic conditions in the presence of sodium succinate. LC-MS analysis revealed that DBHB was transformed to 4-hydroxybenzoate via 3-bromo-4-hydroxybenzoate by successive reductive dehalogenation. Highly conserved DBHB-degrading genes, including reductive dehalogenase gene (bhbA3) and the extra-cytoplasmic binding receptor gene (bhbB3), were also found in strain EOB-17 by genome sequencing. The optimal temperature and pH for DBHB reductive dehalogenation activity are 30 °C and 8, respectively, and 0.1 mM Cd(2+), Cu(2+), Hg(2+) and Zn(2+) strongly inhibited dehalogenation activity. The aerobic strain of Delftia sp. EOB-17 was confirmed to reductively dehalogenate DBHB under aerobic conditions, providing another evidence to support the hypothesis that reductive dehalogenation occurs extensively in aerobic bacteria.

75 FR 31787 - Agency Information Collection Activities: Existing Collection; Emergency Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

... EQUAL EMPLOYMENT OPPORTUNITY COMMISSION Agency Information Collection Activities: Existing Collection; Emergency Extension AGENCY: Equal Employment Opportunity Commission. ACTION: Notice of... Paperwork Reduction Act, the Equal Employment Opportunity Commission (EEOC or Commission) announces that it...

How long do centenarians survive? Life expectancy and maximum lifespan.

PubMed

Modig, K; Andersson, T; Vaupel, J; Rau, R; Ahlbom, A

2017-08-01

The purpose of this study was to explore the pattern of mortality above the age of 100 years. In particular, we aimed to examine whether Scandinavian data support the theory that mortality reaches a plateau at particularly old ages. Whether the maximum length of life increases with time was also investigated. The analyses were based on individual level data on all Swedish and Danish centenarians born from 1870 to 1901; in total 3006 men and 10 963 women were included. Birth cohort-specific probabilities of dying were calculated. Exact ages were used for calculations of maximum length of life. Whether maximum age changed over time was analysed taking into account increases in cohort size. The results confirm that there has not been any improvement in mortality amongst centenarians in the past 30 years and that the current rise in life expectancy is driven by reductions in mortality below the age of 100 years. The death risks seem to reach a plateau of around 50% at the age 103 years for men and 107 years for women. Despite the rising life expectancy, the maximum age does not appear to increase, in particular after accounting for the increasing number of individuals of advanced age. Mortality amongst centenarians is not changing despite improvements at younger ages. An extension of the maximum lifespan and a sizeable extension of life expectancy both require reductions in mortality above the age of 100 years. © 2017 The Association for the Publication of the Journal of Internal Medicine.

The relationship between health risks and health and productivity costs among employees at Pepsi Bottling Group.

PubMed

Henke, Rachel M; Carls, Ginger S; Short, Meghan E; Pei, Xiaofei; Wang, Shaohung; Moley, Susan; Sullivan, Mark; Goetzel, Ron Z

2010-05-01

To evaluate relationships between modifiable health risks and costs and measure potential cost savings from risk reduction programs. Health risk information from active Pepsi Bottling Group employees who completed health risk assessments between 2004 and 2006 (N = 11,217) were linked to medical care, workers' compensation, and short-term disability cost data. Ten health risks were examined. Multivariate analyses were performed to estimate costs associated with having high risk, holding demographics, and other risks constant. Potential savings from risk reduction were estimated. High risk for weight, blood pressure, glucose, and cholesterol had the greatest impact on total costs. A one-percentage point annual reduction in the health risks assessed would yield annual per capita savings of $83.02 to $103.39. Targeted programs that address modifiable health risks are expected to produce substantial cost reductions in multiple benefit categories.

Method and apparatus for steam mixing a nuclear fueled electricity generation system

DOEpatents

Tsiklauri, Georgi V.; Durst, Bruce M.

1996-01-01

A method and apparatus for improving the efficiency and performance of a nuclear electrical generation system that comprises the addition of steam handling equipment to an existing plant that results in a surprising increase in plant performance. More particularly, a gas turbine electrical generation system with heat recovery boiler is installed along with a micro-jet high pressure and a low pressure mixer superheater. Depending upon plant characteristics, the existing moisture separator reheater (MSR) can be either augmented or done away with. The instant invention enables a reduction in T.sub.hot without a derating of the reactor unit, and improves efficiency of the plant's electrical conversion cycle. Coupled with this advantage is a possible extension of the plant's fuel cycle length due to an increased electrical conversion efficiency. The reduction in T.sub.hot further allows for a surprising extension of steam generator life. An additional advantage is the reduction in erosion/corrosion of secondary system components including turbine blades and diaphragms. The gas turbine generator used in the instant invention can also replace or augment existing peak or emergency power needs. Another benefit of the instant invention is the extension of plant life and the reduction of downtime due to refueling.

Integrated risk reduction framework to improve railway hazardous materials transportation safety.

PubMed

Liu, Xiang; Saat, M Rapik; Barkan, Christopher P L

2013-09-15

Rail transportation plays a critical role to safely and efficiently transport hazardous materials. A number of strategies have been implemented or are being developed to reduce the risk of hazardous materials release from train accidents. Each of these risk reduction strategies has its safety benefit and corresponding implementation cost. However, the cost effectiveness of the integration of different risk reduction strategies is not well understood. Meanwhile, there has been growing interest in the U.S. rail industry and government to best allocate resources for improving hazardous materials transportation safety. This paper presents an optimization model that considers the combination of two types of risk reduction strategies, broken rail prevention and tank car safety design enhancement. A Pareto-optimality technique is used to maximize risk reduction at a given level of investment. The framework presented in this paper can be adapted to address a broader set of risk reduction strategies and is intended to assist decision makers for local, regional and system-wide risk management of rail hazardous materials transportation. Copyright © 2013 Elsevier B.V. All rights reserved.

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...

Direct potable reuse microbial risk assessment methodology: Sensitivity analysis and application to State log credit allocations.

PubMed

Soller, Jeffrey A; Eftim, Sorina E; Nappier, Sharon P

2018-01-01

Understanding pathogen risks is a critically important consideration in the design of water treatment, particularly for potable reuse projects. As an extension to our published microbial risk assessment methodology to estimate infection risks associated with Direct Potable Reuse (DPR) treatment train unit process combinations, herein, we (1) provide an updated compilation of pathogen density data in raw wastewater and dose-response models; (2) conduct a series of sensitivity analyses to consider potential risk implications using updated data; (3) evaluate the risks associated with log credit allocations in the United States; and (4) identify reference pathogen reductions needed to consistently meet currently applied benchmark risk levels. Sensitivity analyses illustrated changes in cumulative annual risks estimates, the significance of which depends on the pathogen group driving the risk for a given treatment train. For example, updates to norovirus (NoV) raw wastewater values and use of a NoV dose-response approach, capturing the full range of uncertainty, increased risks associated with one of the treatment trains evaluated, but not the other. Additionally, compared to traditional log-credit allocation approaches, our results indicate that the risk methodology provides more nuanced information about how consistently public health benchmarks are achieved. Our results indicate that viruses need to be reduced by 14 logs or more to consistently achieve currently applied benchmark levels of protection associated with DPR. The refined methodology, updated model inputs, and log credit allocation comparisons will be useful to regulators considering DPR projects and design engineers as they consider which unit treatment processes should be employed for particular projects. Published by Elsevier Ltd.

What's wrong with hazard-ranking systems? An expository note.

PubMed

Cox, Louis Anthony Tony

2009-07-01

Two commonly recommended principles for allocating risk management resources to remediate uncertain hazards are: (1) select a subset to maximize risk-reduction benefits (e.g., maximize the von Neumann-Morgenstern expected utility of the selected risk-reducing activities), and (2) assign priorities to risk-reducing opportunities and then select activities from the top of the priority list down until no more can be afforded. When different activities create uncertain but correlated risk reductions, as is often the case in practice, then these principles are inconsistent: priority scoring and ranking fails to maximize risk-reduction benefits. Real-world risk priority scoring systems used in homeland security and terrorism risk assessment, environmental risk management, information system vulnerability rating, business risk matrices, and many other important applications do not exploit correlations among risk-reducing opportunities or optimally diversify risk-reducing investments. As a result, they generally make suboptimal risk management recommendations. Applying portfolio optimization methods instead of risk prioritization ranking, rating, or scoring methods can achieve greater risk-reduction value for resources spent.

The Community-based Participatory Intervention Effect of “HIV-RAAP”

PubMed Central

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

The community-based participatory intervention effect of "HIV-RAAP".

PubMed

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

Effects of the "plate model" as part of dietary intervention on modification of selected cardiometabolic risk factors in post-myocardial infarction patients: study protocol for a randomized controlled trial.

PubMed

Jayawardena, Ranil; Fernando, Pasindu; Lokunarangoda, Niroshan; Pathirana, Anidu Keerthi

2017-07-10

Cardiovascular disease remains the leading cause of morbidity and mortality worldwide, and there is a rising global burden. The effects of diet on cardiometabolic risk factors have been studied extensively. Healthy eating as a cost-effective approach to risk reduction in post-myocardial infarction patients is proven to be beneficial, and the "plate model" is one of the practical methods to achieve this objective. The study will be conducted as a randomized, single-blind, controlled clinical trial for a period of 3 months. A total of 120 overweight (body mass index >23 kg/m 2 ) inpatients (aged 20-70 years) with a history of troponin-positive acute coronary syndrome (ACS) within the 1 month preceding the study will be recruited. Simple randomization will be used in participant allocation. The intervention group will receive the model plate diet. The control group will be provided with routine dietary advice. Other domains, such as advice on exercise and lifestyle modification, will be equalized among patients in both the groups. The visits and evaluations will be done at recruitment (visit 0), 4 weeks, and 12 weeks after the intervention. The primary outcome will be a mean body weight reduction of 10%, and the secondary outcomes will include mean reduction of systolic and diastolic blood pressure, improvement of anthropometric parameters, and improvement of lipid profile and liver enzymes in the test group compared with the control group at 12 weeks following the plate model diet. This study protocol is designed to establish the effects of the plate model diet on modification of cardiometabolic risk factors in patients with ACS. This will also be a pioneering study designed to investigate the practicality of the model plate in local settings and in the South Asian region. Sri Lanka Clinical Trials Registry identifier: SLCTR/2016/22. Registered on 22 September 2016 ( http://www.slctr.lk/trials/483 ).

Polarimetry Data Reduction at the Joint Astronomy Centre

NASA Astrophysics Data System (ADS)

Cavanagh, B.; Jenness, T.; Currie, M. J.

2005-12-01

ORAC-DR is an automated data-reduction pipeline that has been used for on-line data reduction for infrared imaging, spectroscopy, and integral-field-unit data at UKIRT; sub-millimetre imaging at JCMT; and infrared imaging at AAT. It allows for real-time automated infrared and submillmetre imaging polarimetry and spectropolarimetry data reduction. This paper describes the polarimetry data-reduction pipelines used at the Joint Astronomy Centre, highlighting their flexibility and extensibility.

Estimated cardiovascular relative risk reduction from fixed-dose combination pill (polypill) treatment in a wide range of patients with a moderate risk of cardiovascular disease.

PubMed

Lafeber, Melvin; Webster, Ruth; Visseren, Frank Lj; Bots, Michiel L; Grobbee, Diederick E; Spiering, W; Rodgers, Anthony

2016-08-01

Recent data indicate that fixed-dose combination (FDC) pills, polypills, can produce sizeable risk factor reductions. There are very few published data on the consistency of the effects of a polypill in different patient populations. It is unclear for example whether the effects of the polypill are mainly driven by the individuals with high individual risk factor levels. The aim of the present study is to examine whether baseline risk factor levels modify the effect of polypill treatment on low-density lipoprotein (LDL)-cholesterol, blood pressure (BP), calculated cardiovascular relative risk reduction and adverse events. This paper describes a post-hoc analysis of a randomised, placebo-controlled trial of a polypill (containing aspirin 75 mg, simvastatin 20 mg, lisinopril 10 mg and hydrochlorothiazide 12.5 mg) in 378 individuals without an indication for any component of the polypill, but who had an estimated five-year risk for cardiovascular disease ≥7.5%. The outcomes considered were effect modification by baseline risk factor levels on change in LDL-cholesterol, systolic BP, calculated cardiovascular relative risk reduction and adverse events. The mean LDL-cholesterol in the polypill group was 0.9 mmol/l (95% confidence interval (CI): 0.8-1.0) lower compared with the placebo group during follow-up. Those with a baseline LDL-cholesterol >3.6 mmol/l achieved a greater absolute LDL-cholesterol reduction with the polypill compared with placebo, than patients with an LDL-cholesterol ≤3.6 mmol/l (-1.1 versus -0.6 mmol/l, respectively). The mean systolic BP was 10 mm Hg (95% CI: 8-12) lower in the polypill group. In participants with a baseline systolic BP >135 mm Hg the polypill resulted in a greater absolute systolic BP reduction with the polypill compared with placebo, than participants with a systolic BP ≤ 135 mm Hg (-12 versus -7 mm Hg, respectively). Calculated from individual risk factor reductions, the mean cardiovascular relative risk reduction was 48% (95% CI: 43-52) in the polypill group. Both baseline LDL-cholesterol and estimated cardiovascular risk were significant modifiers of the estimated cardiovascular relative risk reduction caused by the polypill. Adverse events did not appear to be related to baseline risk factor levels or the estimated cardiovascular risk. This study demonstrated that the effect of a cardiovascular polypill on risk factor levels is modified by the level of these risk factors. Groups defined by baseline LDL-cholesterol or systolic BP had large differences in risk factor reductions but only moderate differences in estimated cardiovascular relative risk reduction, suggesting also that patients with mildly increased risk factor levels but an overall raised cardiovascular risk benefit from being treated with a polypill. © The European Society of Cardiology 2016.

Juvenile Angiofibroma: Evolution of Management

PubMed Central

Nicolai, Piero; Schreiber, Alberto; Bolzoni Villaret, Andrea

2012-01-01

Juvenile angiofibroma is a rare benign lesion originating from the pterygopalatine fossa with distinctive epidemiologic features and growth patterns. The typical patient is an adolescent male with a clinical history of recurrent epistaxis and nasal obstruction. Although the use of nonsurgical therapies is described in the literature, surgery is currently considered the ideal treatment for juvenile angiofibroma. Refinement in preoperative embolization has provided significant reduction of complications and intraoperative bleeding with minimal risk of residual disease. During the last decade, an endoscopic technique has been extensively adopted as a valid alternative to external approaches in the management of small-intermediate size juvenile angiofibromas. Herein, we review the evolution in the management of juvenile angiofibroma with particular reference to recent advances in diagnosis and treatment. PMID:22164185

76 FR 12967 - Agency Information Collection Activities; Proposed Collection; Comment Request; Channels of Trade...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-09

...The Food and Drug Administration (FDA) is announcing an opportunity for public comment on the proposed collection of certain information by the Agency. Under the Paperwork Reduction Act of 1995 (the PRA), Federal Agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension of an existing collection of information, and to allow 60 days for public comment in response to the notice. This notice solicits comments on the information collection provisions of FDA's guidance for industry entitled ``Channels of Trade Policy for Commodities With Residues of Pesticide Chemicals, for Which Tolerances Have Been Revoked, Suspended, or Modified by the Environmental Protection Agency Pursuant to Dietary Risk Considerations.''

Hyper-X Program Status

NASA Technical Reports Server (NTRS)

McClinton, Charles R.; Rausch, Vincent L.; Sitz, Joel; Reukauf, Paul

2001-01-01

This paper provides an overview of the objectives and status of the Hyper-X program, which is tailored to move hypersonic, airbreathing vehicle technology from the laboratory environment to the flight environment. The first Hyper-X research vehicle (HXRV), designated X-43, is being prepared at the Dryden Flight Research Center for flight at Mach 7. Extensive risk reduction activities for the first flight are completed, and non-recurring design activities for the Mach 10 X-43 (3rd flight) are nearing completion. The Mach 7 flight of the X-43, in the spring of 2001, will be the first flight of an airframe-integrated scramjet-powered vehicle. The Hyper-X program is continuing to plan follow-on activities to focus an orderly continuation of hypersonic technology development through flight research.

Hyper-X Program Status

NASA Technical Reports Server (NTRS)

McClinton, Charles R.; Reubush, David E.; Sitz, Joel; Reukauf, Paul

2001-01-01

This paper provides an overview of the objectives and status of the Hyper-X program, which is tailored to move hypersonic, airbreathing vehicle technology from the laboratory environment to the flight environment. The first Hyper-X research vehicle (HXRV), designated X-43, is being prepared at the Dryden Flight Research Center for flight at Mach 7. Extensive risk reduction activities for the first flight are completed, and non-recurring design activities for the Mach 10 X-43 (third flight) are nearing completion. The Mach 7 flight of the X-43, in the spring of 2001, will be the first flight of an airframe-integrated scramjet-powered vehicle. The Hyper-X program is continuing to plan follow-on activities to focus an orderly continuation of hypersonic technology development through flight research.

Continuous Spinal Anesthesia for Obstetric Anesthesia and Analgesia

PubMed Central

Veličković, Ivan; Pujic, Borislava; Baysinger, Charles W.; Baysinger, Curtis L.

2017-01-01

The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used. Small doses of drug can be administered and extension of labor analgesia for emergency cesarean delivery may occur more rapidly compared to continuous epidural techniques. PMID:28861414

Adaptation and Refinement of the HIV Knowledge Questionnaire for Use With Adolescent Girls

PubMed Central

Volpe, Ellen M.; Nelson, LaRon E.; Kraus, Rachel A.; Morrison-Beedy, Dianne

2008-01-01

The number of adolescent girls becoming infected with HIV has dramatically escalated to the point where they now represent one of the groups most at risk for this infection. As a component of addressing this pandemic, there is a need for psychometrically sound, tailored measures to assess an adolescent girl's level of knowledge regarding transmission and prevention of HIV. The purpose of this research was to modify an existing HIV knowledge measure used in the general adult population (brief HIV Knowledge Questionnaire [HIV-KQ]) and increase its utility by making it developmentally- and gender-specific for adolescent girls. The revised version with additional items underwent item and scale analysis to confirm psychometric properties with a sample of 62 adolescent girls. HIV-related knowledge is assessed extensively in clinical practice and educational settings and is an important component for monitoring change in successful HIV risk-reduction interventions. The final HIV-KQ for adolescent girls is a practical, specific, and appropriate instrument for use with adolescent girls in these settings. PMID:17889326

Randomized controlled trial of a cognitive-behavioral intervention for HIV-positive persons: an investigation of treatment effects on psychosocial adjustment.

PubMed

Carrico, Adam W; Chesney, Margaret A; Johnson, Mallory O; Morin, Stephen F; Neilands, Torsten B; Remien, Robert H; Rotheram-Borus, Mary Jane; Lennie Wong, F

2009-06-01

Questions remain regarding the clinical utility of psychological interventions for HIV-positive persons because randomized controlled trials have utilized stringent inclusion criteria and focused extensively on gay men. The present randomized controlled trial examined the efficacy of a 15-session, individually delivered cognitive-behavioral intervention (n = 467) compared to a wait-list control (n = 469) in a diverse sample of HIV-positive persons who reported HIV transmission risk behavior. Five intervention sessions that dealt with executing effective coping responses were delivered between baseline and the 5 months post-randomization. Additional assessments were completed through 25 months post-randomization. Despite previously documented reductions in HIV transmission risk, no intervention-related changes in psychosocial adjustment were observed across the 25-month investigation period. In addition, there were no intervention effects on psychosocial adjustment among individuals who presented with mild to moderate depressive symptoms. More intensive mental health interventions may be necessary to improve psychosocial adjustment among HIV-positive individuals.

A regulatory perspective on the radiological impact of NORM industries: the case of the Spanish phosphate industry.

PubMed

García-Talavera, M; Matarranz, J L M; Salas, R; Ramos, L

2011-01-01

Radioactive and chemical risks coexist in NORM industries although they are usually addressed separately by regulations. The European Union (EU) has developed extensive legislation concerning both matters, which has been diversely reflected in national policies. We consider the case of the Spanish phosphate industry and analyse to which extent regulatory mandates have reduced the historical and ongoing radiological impact on the environment of phosphate facilities. Although no specific radiological constraints on effluent monitoring and release or on waste disposal have yet been imposed on NORM industries in Spain, other environmental regulations have achieved a substantial reduction on the phosphate industry impact. Nevertheless, a more efficient control could be established by eliminating the current conceptual and practical separation of chemical and radioactive risks in NORM industries. We highlight research needs to accomplish so and propose shorter-term measures that require active cooperation among the regulatory bodies involved. Copyright © 2010. Published by Elsevier Ltd.

Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders.

PubMed

Flodgren, G; Heiden, M; Lyskov, E; Crenshaw, A G

2007-03-01

In the present study, we assessed the wrist kinetics (range of motion, mean position, velocity and mean power frequency in radial/ulnar deviation, flexion/extension, and pronation/supination) associated with performing a mouse-operated computerized task involving painting rectangles on a computer screen. Furthermore, we evaluated the effects of the painting task on subjective perception of fatigue and wrist position sense. The results showed that the painting task required constrained wrist movements, and repetitive movements of about the same magnitude as those performed in mouse-operated design tasks. In addition, the painting task induced a perception of muscle fatigue in the upper extremity (Borg CR-scale: 3.5, p<0.001) and caused a reduction in the position sense accuracy of the wrist (error before: 4.6 degrees , error after: 5.6 degrees , p<0.05). This standardized painting task appears suitable for studying relevant risk factors, and therefore it offers a potential for investigating the pathophysiological mechanisms behind musculoskeletal disorders related to computer mouse use.

Safety in the SEM laboratory--1981 update

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

Bance, G.N.; Barber, V.C.; Sholdice, J.A.

1981-01-01

The article reviews recent information on hazards as they relate to safety in SEM laboratories. The first section lists the safety equipment that should be available in a SEM laboratory. Flammable and combustible liquids are discussed, and particular warnings are given concerning the fire and explosion risks associated with diethyl ether and diisopropyl ether. The possible hazards associated with electrical equipment, and the risk of X-ray emissions from EM's are briefly outlined. The hazards associated with acute and chronic toxicity of chemicals used in the EM laboratory are discussed. The need to reduce exposure to a growing list of recognizablemore » hazardous chemicals is emphasized. This reduction can be accomplished by more extensive use of functioning fume hoods, and the use of more appropriate and effective protective gloves. Allergies and the hazards of dangerous pathogens in the SEM laboratory are discussed. The explosion and other hazards associated with cryogens, vacuum evaporators, critical point dryers, and compressed gas cylinders are emphasized.« less

Major Cereal Grain Fibers and Psyllium in Relation to Cardiovascular Health

PubMed Central

Bernstein, Adam M.; Titgemeier, Brigid; Kirkpatrick, Kristin; Golubic, Mladen; Roizen, Michael F.

2013-01-01

Numerous studies reveal the cardiovascular benefits of consuming dietary fiber and, especially, cereal fiber. Cereal fiber is associated with cardiovascular risk reduction through multiple mechanisms and consuming a variety of cereal fiber sources offers health benefits specific to the source. Certain cereal fibers have been studied more extensively than others and provide greater support for their incorporation into a healthful diet. β-glucan from oats or barley, or a combination of whole oats and barley, and soluble fiber from psyllium reduces the risk of coronary heart disease; inulin-type fructans added to foods and beverages may modestly decrease serum triacylglycerols; arabinoxylan and resistant starch may improve glycemic control. Individuals with low cereal fiber intake should increase their intake of whole grains in order to receive the benefits of whole grains in addition to fiber. For those adjusting to the texture and palatability of whole grains, turning to added-fiber products rich in β-glucan and psyllium may allow them to reach their fiber goals without increasing caloric intake. PMID:23628720

76 FR 54453 - Request for Comments on the Notice of Intent To Prepare a Draft Environmental Impact Statement...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

... Investigation Study (Previously Advertised as the Skagit River Flood Damage Reduction Study), Skagit County, WA... advertised as the Skagit River Flood Damage Reduction Study), Skagit County, Washington. This extension will... Investigation Study (previously advertised as the Skagit River Flood Damage Reduction Study), Skagit County...

Succession Planning for the 1862 Institutions in the Southern Region States of the Cooperative Extension System

ERIC Educational Resources Information Center

Kelly, Tammy Denise

2015-01-01

The purpose of this study was to explore and describe succession plans and components of importance as perceived by the organizational leadership within the Southern Region of the Cooperative Extension System. Cooperative Extension Systems across the United States, continue to be faced with a reduction in force, primarily due to retirement, budget…

Development of risk reduction behavioral counseling for Ebola virus disease survivors enrolled in the Sierra Leone Ebola Virus Persistence Study, 2015-2016.

PubMed

Abad, Neetu; Malik, Tasneem; Ariyarajah, Archchun; Ongpin, Patricia; Hogben, Matthew; McDonald, Suzanna L R; Marrinan, Jaclyn; Massaquoi, Thomas; Thorson, Anna; Ervin, Elizabeth; Bernstein, Kyle; Ross, Christine; Liu, William J; Kroeger, Karen; Durski, Kara N; Broutet, Nathalie; Knust, Barbara; Deen, Gibrilla F

2017-09-01

During the 2014-2016 West Africa Ebola Virus Disease (EVD) epidemic, the public health community had concerns that sexual transmission of the Ebola virus (EBOV) from EVD survivors was a risk, due to EBOV persistence in body fluids of EVD survivors, particularly semen. The Sierra Leone Ebola Virus Persistence Study was initiated to investigate this risk by assessing EBOV persistence in numerous body fluids of EVD survivors and providing risk reduction counseling based on test results for semen, vaginal fluid, menstrual blood, urine, rectal fluid, sweat, tears, saliva, and breast milk. This publication describes implementation of the counseling protocol and the key lessons learned. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol was developed from a framework used to prevent transmission of HIV and other sexually transmitted infections. The framework helped to identify barriers to risk reduction and facilitated the development of a personalized risk-reduction plan, particularly around condom use and abstinence. Pre-test and post-test counseling sessions included risk reduction guidance, and post-test counseling was based on the participants' individual test results. The behavioral counseling protocol enabled study staff to translate the study's body fluid test results into individualized information for study participants. The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol provided guidance to mitigate the risk of EBOV transmission from EVD survivors. It has since been shared with and adapted by other EVD survivor body fluid testing programs and studies in Ebola-affected countries.

Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

PubMed

Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

2002-03-01

To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

78 FR 76628 - Draft Risk Profile on Pathogens and Filth in Spices: Availability; Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

...] Draft Risk Profile on Pathogens and Filth in Spices: Availability; Extension of Comment Period AGENCY... Profile on Pathogens and Filth in Spices: Availability'' that appeared in the Federal Register of November... Risk Profile on Pathogens and Filth in Spices: Availability.'' The notice provided a 60-day comment...

Nature-based solutions for hydro-meteorological risk reduction and nutrient removal in the Nordic and Arctic regions

NASA Astrophysics Data System (ADS)

Bring, Arvid; Kalantari, Zahra

2017-04-01

Natural ecological functions provide essential and fundamental benefits to mankind, but can also be actively employed in nature-based solutions to specific challenges in society. For example, water-related ecosystem services have a role in such societal benefits as flood protection, erosion control, and excess nutrient removal. Ecosystem services may be produced and consumed in different locations, and research has recently attempted to formalize this discrepancy in identifying service providing areas (SPAs), service benefitting areas (SBAs), and service connecting areas (SCAs). However, in terms of water-related services, there is a lack of formal evaluation of how SPAs, SBAs, and SCAs are related to hydrological measures such as discharge, flood recurrence, excess nutrient removal, etc. We seek to map SPAs, SBAs and SCAs for a number of key ecosystem services in the Nordic and Arctic region though established ecological definitions (typically, based on land use) and evaluate the findings alongside metrics of hydrological connectivity (river networks), provisioning areas (runoff generating areas), and benefitting areas (river stretches where water flow is moderated). We make use of extensive GIS analysis using both high-resolution land cover data and river network maps. In the end, the results are expected to contribute to identifying how water-related ecosystem services can be employed as nature-based solutions for hydro-meteorological risk reduction and nutrient removal in a changing climate in the Nordic and Arctic regions.

Fish consumption as a driver of risk-management decisions and human health-based water quality criteria.

PubMed

Judd, Nancy; Lowney, Yvette; Anderson, Paul; Baird, Suzanne; Bay, Steven M; Breidt, Jay; Buonanduci, Michele; Dong, Zhao; Essig, Don; Garry, Michael R; Jim, Rebecca C; Kirkwood, Gemma; Moore, Shelly; Niemi, Cheryl; O'Rourke, Rory; Ruffle, Betsy; Schaider, Laurel A; Vidal-Dorsch, Doris E

2015-11-01

The use and interpretation of fish consumption surveys and interviews, the application of fish consumption rates for sediment evaluation and cleanup, and the development of human health water quality criteria (HH WQC) are complex and interrelated issues. The present article focuses on these issues using examples from the United States, although the issues may be relevant for other countries. Some key considerations include the fact that there are many types of fish consumption surveys (e.g., 24-h recall surveys, food frequency questionnaires, creel surveys), and these surveys have different advantages and limitations. Identification of target populations for protection, identification of the species and quantities of fish consumed, and determination of bioaccumulation assumptions are important factors when developing water quality and sediment screening levels and standards. Accounting for the cultural importance of fish consumption for some populations is an even more complex element. Discussions about HH WQC often focus only on the fish consumption rate and may not have broad public input. Some states are trying to change this through extensive public participation efforts and use of probabilistic approaches to derive HH WQC. Finally, there are limits to what WQC can achieve. Solutions beyond the establishment of WQC that target toxics reduction from other sources may provide the greatest improvements to water quality and reductions in human health risks in the future. © 2015 SETAC.

Effects of Sodium Glucose Cotransporter-2 Inhibitors on Serum Uric Acid in Type 2 Diabetes Mellitus.

PubMed

Ahmadieh, Hala; Azar, Sami

2017-09-01

Hyperuricemia has been linked to metabolic syndrome, cardiovascular disease, and chronic kidney disease. Hyperuricemia and type 2 diabetes mellitus were inter-related, type 2 diabetes mellitus was more at risk of having a higher serum uric acid level, and also individuals with higher serum uric acid had higher risk of developing type 2 diabetes in the future. Insulin resistance seems to play an important role in the causal relationship between metabolic syndrome, type 2 diabetes, and hyperuricemia. Oral diabetic drugs that would have additional beneficial effects on reducing serum uric acid levels are of importance. Selective SGLT2 inhibitors were extensively studied in type 2 diabetes mellitus and were found to have improvement of glycemic control, in addition to their proven metabolic effects on weight and blood pressure. Additional beneficial effect of SGLT2 inhibitors on serum uric acid level reduction is investigated. Recently, data have been accumulating showing that they have additional beneficial effects on serum uric acid reduction. As for the postulated mechanism, serum uric acid decreased in SGLT2 inhibitor users as a result of the increase in the urinary excretion rate of uric acid, due to the inhibition of uric acid reabsorption mediated by the effect of the drug on the GLUT9 isoform 2, located at the collecting duct of the renal tubule.

[Listeria monocytogenes outbreaks: a review of the routes that favor bacterial presence].

PubMed

Rossi, M Laura; Paiva, Analía; Tornese, Mariela; Chianelli, Sabrina; Troncoso, Alcides

2008-10-01

Listeria monocytogenes is a foodborne pathogen that causes serious invasive illness, mainly in certain well-defined high-risk groups, including immunocompromised patients, pregnant women and neonates. L. monocytogenes primarily causes abortion, septicaemia or infections of the central nervous systems. Listeriosis outbreaks have mostly been linked to consumption of raw milk or cheese made of unpasteurized milk. Previous outbreaks of listeriosis have been linked to a variety of foods especially processed meats (such as hot dogs, deli meats, and páté). The public health importance of listeriosis is not always recognized, particularly since listeriosis is a relatively rare disease compared with other common foodborne illnesses such as salmonellosis or botulism. However, because of its high case fatality rate, listeriosis ranks among the most frequent causes of death due to foodborne illness: second after salmonellosis. Changes in the manner food is produced, distributed and stored have created the potential for widespread outbreaks involving many countries. The pasteurization of raw milk, which destroys L. monocytogenes, does not eliminate later risk of L. monocytogenes contamination in dairy products. Extensive work has been ongoing in many countries during the last decade to prevent outbreaks and decrease the incidence of listeriosis. A marked reduction has occurred in its incidence in some of these countries during the 1990s, suggesting a relationship between preventive measures and reduction on human cases listeriosis.

77 FR 70742 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

... DEPARTMENT OF ENERGY U.S. Energy Information Administration Agency Information Collection Extension AGENCY: U.S. Energy Information Administration (EIA), Department of Energy (DOE). ACTION: Notice..., under the provisions of the Paperwork Reduction Act of 1995, an information collection request to the...

78 FR 14520 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... DEPARTMENT OF ENERGY Energy Information Administration Agency Information Collection Extension AGENCY: U.S. Energy Information Administration (EIA), Department of Energy. ACTION: Notice and Request... information collection request to the OMB under the provisions of the Paperwork Reduction Act of 1995 for a...

41 CFR 102-80.55 - Are Federal agencies responsible for managing the execution of risk reduction projects?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Risks and Risk Reduction Strategies § 102-80.55 Are Federal agencies responsible for managing the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Are Federal agencies responsible for managing the execution of risk reduction projects? 102-80.55 Section 102-80.55 Public...

Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

ERIC Educational Resources Information Center

Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

2005-01-01

Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research.

PubMed

Fielden, Hannah G; Brown, Stephen L; Saini, Pooja; Beesley, Helen; Salmon, Peter

2017-09-01

Risk-reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk-reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction. Synthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception-June 2015). Women did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk-reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk-reducing procedures without such deliberation. Reasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically-based ethical reflection is required to determine whether and when it is appropriate to provide risk-reduction procedures to alleviate worry. © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

Using a relative health indicator (RHI) metric to estimate health risk reductions in drinking water.

PubMed

Alfredo, Katherine A; Seidel, Chad; Ghosh, Amlan; Roberson, J Alan

2017-03-01

When a new drinking water regulation is being developed, the USEPA conducts a health risk reduction and cost analysis to, in part, estimate quantifiable and non-quantifiable cost and benefits of the various regulatory alternatives. Numerous methodologies are available for cumulative risk assessment ranging from primarily qualitative to primarily quantitative. This research developed a summary metric of relative cumulative health impacts resulting from drinking water, the relative health indicator (RHI). An intermediate level of quantification and modeling was chosen, one which retains the concept of an aggregated metric of public health impact and hence allows for comparisons to be made across "cups of water," but avoids the need for development and use of complex models that are beyond the existing state of the science. Using the USEPA Six-Year Review data and available national occurrence surveys of drinking water contaminants, the metric is used to test risk reduction as it pertains to the implementation of the arsenic and uranium maximum contaminant levels and quantify "meaningful" risk reduction. Uranium represented the threshold risk reduction against which national non-compliance risk reduction was compared for arsenic, nitrate, and radium. Arsenic non-compliance is most significant and efforts focused on bringing those non-compliant utilities into compliance with the 10 μg/L maximum contaminant level would meet the threshold for meaningful risk reduction.

77 FR 13313 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-06

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Paperwork Reduction Act of 1995, intends to reinstate and extend for three years, an information collection request with the Office of Management and Budget (OMB). The information collection request, Historic...

Reduction in Sexual Risk Behaviors among College Students Following a Comprehensive Health Education Intervention.

ERIC Educational Resources Information Center

Turner, James C.; And Others

1993-01-01

Researchers studied college students' sexual behavior and the association of a comprehensive health education program with subsequent sexual risk behavior modifications. Pre- and postintervention surveys indicated the intervention created short-term reduction in sexual risk behaviors, but the reduction varied according to gender. (SM)

Striving to Reduce Vulnerability:Lessons from the Poor Community Livelihoodsin the Jakarta Bay Facing High Risk of Rapid Urbanization and Climate Changes

NASA Astrophysics Data System (ADS)

Hidayati, D.; Delinom, R. M.; Abdurachim, A. Y.; Dalimunthe, S.; Haba, J.; Pawitan, H.

2014-12-01

This paper discusses water-food issues in relation to how livelihoods of the poor community in Jakarta Bayarein high risk ofrapid urbanization and climate changes. As a part of the capital city of Indonesia, this area has experienced rapid increase in populationand extensive developments causing significant increase in the built up area. This city is unable to keep with demand on sewers, water and solid waste management, leading to settlement with concentrated slum pockets areas and widespread of flooding. The community is mostly poor people of productive group, live with urban pressure in fragile home and livelihoods.The situation becomes much worse due to the impact of climate change with flooding as the greatest climate and disaster risk. With lack of basic services, coastal water inundation (BanjirRob)commonly occursand floods the community housing areaswithout patternanymore. The community has lack of fresh and clean water sources and facedeconomic problem, particularly significant reduction of fishing activities. Coastal reclamation and water pollution from nearby industries are blamed as the main reason for these problems. Strategies therefore have to be developed, especially increasing community awareness and preparedness, and poverty alleviation, to sustain their livelihoods in this high risk urban area.

47 CFR 63.66 - Closure of or reduction of hours of service at telephone exchanges at military establishments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Closure of or reduction of hours of service at telephone exchanges at military establishments. 63.66 Section 63.66 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) EXTENSION OF LINES, NEW LINES, AND DISCONTINUANCE, REDUCTION, OUTAGE AND...

Estimating risk reduction required to break even in a health promotion program.

PubMed

Ozminkowski, Ronald J; Goetzel, Ron Z; Santoro, Jan; Saenz, Betty-Jo; Eley, Christine; Gorsky, Bob

2004-01-01

To illustrate a formula to estimate the amount of risk reduction required to break even on a corporate health promotion program. A case study design was implemented. Base year (2001) health risk and medical expenditure data from the company, along with published information on the relationships between employee demographics, health risks, and medical expenditures, were used to forecast demographics, risks, and expenditures for 2002 through 2011 and estimate the required amount of risk reduction. Motorola. 52,124 domestic employees. Demographics included age, gender, race, and job type. Health risks for 2001 were measured via health risk appraisal. Risks were noted as either high or low and related to exercise/eating habits, body weight, blood pressure, blood sugar levels, cholesterol levels, depression, stress, smoking/drinking habits, and seat belt use. Medical claims for 2001 were used to calculate medical expenditures per employee. Assuming a dollar 282 per employee program cost, Motorola employees would need to reduce their lifestyle-related health risks by 1.08% to 1.42% per year to break even on health promotion programming, depending upon the discount rate. Higher or lower program investments would change the risk reduction percentages. Employers can use information from published studies, along with their own data, to estimate the amount of risk reduction required to break even on their health promotion programs.

Positive youth development programmes to reduce substance use in young people: Systematic review.

PubMed

Melendez-Torres, G J; Dickson, Kelly; Fletcher, Adam; Thomas, James; Hinds, Kate; Campbell, Rona; Murphy, Simon; Bonell, Chris

2016-10-01

Substance use has detrimental short-term and long-term consequences for young people. Positive youth development (PYD) interventions, which favour promotion of positive assets over traditional risk reduction, have received attention recently as a possible intervention to prevent adolescent substance use. We aimed to synthesise the evidence on PYD interventions for reduction in substance use in young people. We searched 21 databases, including MEDLINE, PsycINFO, CINAHL and CENTRAL, and hand-searched key journals and websites. We included studies with more than half of participants aged 11-18 years where interventions meeting a pre-specified definition of PYD were delivered in community settings outside of normal school hours and did not target parents or young people with pre-defined conditions. Two reviewers screened records, assessed full-text studies for inclusion, and extracted data. A modified Cochrane risk of bias tool was used for quality assessment. Ten studies reported in 13 reports were included in our synthesis. PYD interventions did not have an effect of statistical or public health significance on any substance use, illicit drug use or alcohol outcomes in young people. Interventions were diverse in content and delivery. Our review suggests that existing PYD interventions subject to evaluation do not appear to have produced reductions in substance use of public health significance. However, these interventions may not be the best exemplars of a PYD approach. Therefore, our findings should not be taken as evidence for the ineffectiveness of PYD as a theory of change for reducing substance use among young people. Additional rigorous evaluation of PYD interventions is key before further investment. Evaluations were of highly variable quality. Though searches were extensive, we were unable to test for publication bias. Copyright © 2016 Elsevier B.V. All rights reserved.

Managing iliofemoral deep venous thrombosis of pregnancy with a strategy of thrombus removal is safe and avoids post-thrombotic morbidity.

PubMed

Herrera, Santiago; Comerota, Anthony J; Thakur, Subhash; Sunderji, Shiraz; DiSalle, Robert; Kazanjian, Sahira N; Assi, Zakaria

2014-02-01

Extensive deep venous thrombosis (DVT) during pregnancy is usually treated with anticoagulation alone, risking significant post-thrombotic syndrome (PTS) in young patients. Catheter-directed thrombolysis (CDT) and operative venous thrombectomy have been safely and effectively used in nonpregnant patients, demonstrating significant reduction in post-thrombotic morbidity. This report reviews short- and long-term outcomes of 13 patients with extensive DVT of pregnancy treated with a strategy of thrombus removal. From 1999 to 2013, 13 patients with iliofemoral DVT during pregnancy were offered CDT, pharmacomechanical thrombolysis (PMT), and/or venous thrombectomy. Gestational age ranged from 8 to 34 weeks. Fetal monitoring was performed throughout hospitalization. Radiation exposure was minimized with pelvic lead shields, focal fluoroscopy, and limited angiographic runs. Follow-up included objective vein evaluation using venous duplex and PTS assessment using the Villalta scale. CDT and/or PMT were used in 11 patients. Two patients underwent venous thrombectomy alone, and one patient had operative thrombectomy as an adjunct to CDT and PMT. Each patient had complete or near-complete thrombus resolution and rapid improvement in clinical symptoms. Eight of 11 having CDT or PMT underwent venoplasty and stenting of the involved iliac veins. Twelve of the 13 delivered healthy infants at term. One patient opted for termination of her pregnancy. Mean patient and gestational ages were 26 years and 26 weeks, respectively. Mean follow-up was 1.3 years, with only one recurrence. Duplex ultrasonography demonstrated patent veins in all but one patient and normal valve function in 10 patients. Eleven patients had Villalta scores <5 (considered normal), with a mean score of 0.7. Extensive DVT of pregnancy can be effectively and safely treated with a strategy of thrombus removal, resulting in a patent venous system, normal valve function in many, prevention of PTS, and reduction in recurrence. Copyright © 2014. Published by Mosby, Inc.

Conversion of external fixation to open reduction and internal fixation for complex distal radius fractures.

PubMed

Natoli, R M; Baer, M R; Bednar, M S

2016-05-01

Distal radius fractures are common injuries treated in a multitude of ways. One treatment paradigm not extensively studied is initial treatment by external fixation (EF) followed by conversion to open reduction internal fixation (ORIF). Such a paradigm may be beneficial in damage control situations, when there is extensive soft tissue injury, or when appropriate personnel/hospital resources are not available for immediate internal fixation. There is no increased risk of infection when converting EF to ORIF in the treatment of complex distal radius fractures when conversion occurs early or if EF pin sites are overlapped by the definitive fixation. Using an IRB approved protocol, medical records over nine years were queried to identify patients with distal radius fractures that had undergone initial EF and were later converted to ORIF. Charts were reviewed for demographic data, injury characteristics, operative details, time to conversion from EF to ORIF, assessment of whether the EF pin sites overlapped the definitive fixation, presence of infection after ORIF, complications, and occupational therapy measurements of range of motion and strength. In total, 16 patients were identified, only one of which developed an infection following conversion to ORIF. Fisher's exact testing showed that infection did not depend on open fracture, time to conversion of one week or less, presence of EF pin sites overlapping definitive fixation, fracture classification, high energy mechanism of injury, or concomitant injury to the DRUJ. Planned staged conversion from EF to ORIF for complex distal radius fractures does not appear to result in an increased rate of infection if conversion occurs early or if the EF pin sites are overlapped by definitive fixation. This treatment paradigm may be reasonable for treating complex distal radius fractures in damage control situations, when there is extensive soft tissue injury, or when appropriate personnel/hospital resources are not available for immediate internal fixation. IV, retrospective case series. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Development of risk reduction behavioral counseling for Ebola virus disease survivors enrolled in the Sierra Leone Ebola Virus Persistence Study, 2015-2016

PubMed Central

Malik, Tasneem; Ariyarajah, Archchun; Ongpin, Patricia; Hogben, Matthew; McDonald, Suzanna L. R.; Marrinan, Jaclyn; Massaquoi, Thomas; Thorson, Anna; Ervin, Elizabeth; Bernstein, Kyle; Ross, Christine; Liu, William J.; Kroeger, Karen; Durski, Kara N.; Broutet, Nathalie; Knust, Barbara; Deen, Gibrilla F.

2017-01-01

Background During the 2014–2016 West Africa Ebola Virus Disease (EVD) epidemic, the public health community had concerns that sexual transmission of the Ebola virus (EBOV) from EVD survivors was a risk, due to EBOV persistence in body fluids of EVD survivors, particularly semen. The Sierra Leone Ebola Virus Persistence Study was initiated to investigate this risk by assessing EBOV persistence in numerous body fluids of EVD survivors and providing risk reduction counseling based on test results for semen, vaginal fluid, menstrual blood, urine, rectal fluid, sweat, tears, saliva, and breast milk. This publication describes implementation of the counseling protocol and the key lessons learned. Methodology/Principal findings The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol was developed from a framework used to prevent transmission of HIV and other sexually transmitted infections. The framework helped to identify barriers to risk reduction and facilitated the development of a personalized risk-reduction plan, particularly around condom use and abstinence. Pre-test and post-test counseling sessions included risk reduction guidance, and post-test counseling was based on the participants’ individual test results. The behavioral counseling protocol enabled study staff to translate the study’s body fluid test results into individualized information for study participants. Conclusions/Significance The Ebola Virus Persistence Risk Reduction Behavioral Counseling Protocol provided guidance to mitigate the risk of EBOV transmission from EVD survivors. It has since been shared with and adapted by other EVD survivor body fluid testing programs and studies in Ebola-affected countries. PMID:28892490

A review of ADM1 extensions, applications, and analysis: 2002-2005.

PubMed

Batstone, D J; Keller, J; Steyer, J P

2006-01-01

Since publication of the Scientific and Technical Report (STR) describing the ADM1, the model has been extensively used, and analysed in both academic and practical applications. Adoption of the ADM1 in popular systems analysis tools such as the new wastewater benchmark (BSM2), and its use as a virtual industrial system can stimulate modelling of anaerobic processes by researchers and practitioners outside the core expertise of anaerobic processes. It has been used as a default structural element that allows researchers to concentrate on new extensions such as sulfate reduction, and new applications such as distributed parameter modelling of biofilms. The key limitations for anaerobic modelling originally identified in the STR were: (i) regulation of products from glucose fermentation, (ii) parameter values, and variability, and (iii) specific extensions. Parameter analysis has been widespread, and some detailed extensions have been developed (e.g., sulfate reduction). A verified extension that describes regulation of products from glucose fermentation is still limited, though there are promising fundamental approaches. This is a critical issue, given the current interest in renewable hydrogen production from carbohydrate-type waste. Critical analysis of the model has mainly focused on model structure reduction, hydrogen inhibition functions, and the default parameter set recommended in the STR. This default parameter set has largely been verified as a reasonable compromise, especially for wastewater sludge digestion. One criticism of note is that the ADM1 stoichiometry focuses on catabolism rather than anabolism. This means that inorganic carbon can be used unrealistically as a carbon source during some anabolic reactions. Advances and novel applications have also been made in the present issue, which focuses on the ADM1. These papers also explore a number of novel areas not originally envisaged in this review.

Method and apparatus for improving the performance of a steam driven power system by steam mixing

DOEpatents

Tsiklauri, Georgi V.; Durst, Bruce M.; Prichard, Andrew W.; Reid, Bruce D.; Burritt, James

1998-01-01

A method and apparatus for improving the efficiency and performance of a steam driven power plant wherein addition of steam handling equipment to an existing plant results in a surprising increase in plant performance. For Example, a gas turbine electrical generation system with heat recovery boiler may be installed along with a micro-jet high pressure and a low pressure mixer superheater. Depending upon plant characteristics, the existing moisture separator reheater (MSR) can be either augmented or done away with. The instant invention enables a reduction in T.sub.hot without a derating of the reactor unit, and improves efficiency of the plant's electrical conversion cycle. Coupled with this advantage is a possible extension of the plant's fuel cycle length due to an increased electrical conversion efficiency. The reduction in T.sub.hot further allows for a surprising extension of steam generator life. An additional advantage is the reduction in erosion/corrosion of secondary system components including turbine blades and diaphragms. The gas turbine generator used in the instant invention can also replace or augment existing peak or emergency power needs. Another benefit of the instant invention is the extension of plant life and the reduction of downtime due to refueling.

Changes in diet, cardiovascular risk factors and modelled cardiovascular risk following diagnosis of diabetes: 1-year results from the ADDITION-Cambridge trial cohort.

PubMed

Savory, L A; Griffin, S J; Williams, K M; Prevost, A T; Kinmonth, A-L; Wareham, N J; Simmons, R K

2014-02-01

To describe change in self-reported diet and plasma vitamin C, and to examine associations between change in diet and cardiovascular disease risk factors and modelled 10-year cardiovascular disease risk in the year following diagnosis of Type 2 diabetes. Eight hundred and sixty-seven individuals with screen-detected diabetes underwent assessment of self-reported diet, plasma vitamin C, cardiovascular disease risk factors and modelled cardiovascular disease risk at baseline and 1 year (n = 736) in the ADDITION-Cambridge trial. Multivariable linear regression was used to quantify the association between change in diet and cardiovascular disease risk at 1 year, adjusting for change in physical activity and cardio-protective medication. Participants reported significant reductions in energy, fat and sodium intake, and increases in fruit, vegetable and fibre intake over 1 year. The reduction in energy was equivalent to an average-sized chocolate bar; the increase in fruit was equal to one plum per day. There was a small increase in plasma vitamin C levels. Increases in fruit intake and plasma vitamin C were associated with small reductions in anthropometric and metabolic risk factors. Increased vegetable intake was associated with an increase in BMI and waist circumference. Reductions in fat, energy and sodium intake were associated with reduction in HbA1c , waist circumference and total cholesterol/modelled cardiovascular disease risk, respectively. Improvements in dietary behaviour in this screen-detected population were associated with small reductions in cardiovascular disease risk, independently of change in cardio-protective medication and physical activity. Dietary change may have a role to play in the reduction of cardiovascular disease risk following diagnosis of diabetes. © 2013 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Relative risk perception for terrorism: implications for preparedness and risk communication.

PubMed

Caponecchia, Carlo

2012-09-01

Terrorism presents a significant risk that is often approached at public policy, infrastructure, or emergency management level. Public perceptions of the likelihood of terrorist events, and how this may relate to individual preparedness, are not always extensively examined. The tendency to think that negative events are less likely to happen to oneself than to the average person is known as optimism bias. Optimism bias is relevant to perceptions of terrorism, because it is thought to be related to a reduction in precaution use. Using an online survey of 164 participants, this study aimed to determine whether Sydney residents thought they had a lower likelihood of experiencing terrorist events than other Australians. Significant optimism bias was observed for witnessing terrorist events, but not for personally experiencing terrorist events. In addition, Sydney residents tended to think that terrorist attacks were more likely to occur in Sydney than another major Australian city in the next five years. At the same time, household and workplace preparedness for terrorism was quite low, as was awareness of emergency strategies in the central business district. Perceptions of high likelihood of terrorism happening in one's own city, yet low preparedness present a challenge for risk communication and emergency management strategies. The diversity of possible terrorist targets, and the simple plans that can moderate the effects of a disaster may need to be emphasized in future anti-terrorism initiatives. © 2012 Society for Risk Analysis.

Impact of Soy Foods on the Development of Breast Cancer and the Prognosis of Breast Cancer Patients.

PubMed

Messina, Mark

2016-01-01

The relationship between soy food intake and breast cancer has been rigorously investigated for more than 25 years. The identification of isoflavones as possible chemopreventive agents helped fuel this line of investigation. These diphenolic compounds, which are found in uniquely-rich amounts in soy beans, possess both estrogen-dependent and -independent properties that potentially inhibit the development of breast cancer. Observational studies show that among Asian women higher soy consumption is associated with an approximate 30% reduction in risk of developing breast cancer. However, evidence suggests that for soy to reduce breast cancer risk consumption must occur early in life, that is during childhood and/or adolescence. Despite the interest in the role of soy in reducing breast cancer risk concerns have arisen that soy foods, because they contain isoflavones, may increase the likelihood of high-risk women developing breast cancer and worsen the prognosis of breast cancer patients. However, extensive clinical and epidemiologic data show these concerns to be unfounded. Clinical trials consistently show that isoflavone intake does not adversely affect markers of breast cancer risk, including mammographic density and cell proliferation. Furthermore, prospective epidemiologic studies involving over 11,000 women from the USA and China show that postdiagnosis soy intake statistically significantly reduces recurrence and improves survival. © 2016 S. Karger GmbH, Freiburg.

Occipital Neuralgia from C2 Cavernous Malformation

PubMed Central

Ha, Sang-woo; Choi, Jin-gyu; Son, Byung-chul

2018-01-01

A unique case is presented of chronic occipital neuralgia (ON) caused by cavernous malformation (CM) in the intramedullary C2 spinal cord and subsequent pain relief and remodeling of allodynic pain following dorsal root rhizotomy. A 53-year-old male presented with a 30-year history of chronic allodynic, paroxysmal lancinating pain in the greater and lesser occipital nerves. Typically, the pain was aggravated with neck extension and head movement. Magnetic resonance imaging showed a CM in the right posterolateral side of the intramedullary C2 cord. Considering potential risks associated with removal of the lesion, intradural C1-3 dorsal root rhizotomy with dentate ligament resection was performed. The paroxysmal lancinating pain of ON was significantly alleviated, and the remodeling of the extent of allodynic pain was noted after C1-3 dorsal root rhizotomy. These changes gradually occurred during the second postoperative month, and this effect was maintained for 24 months postoperatively. Significant reduction in chronic allodynic pain of secondary ON caused by cervicomedullary CM involving central sensitization in the trigeminocervical complex was observed with reduction of irritating, afferent input with C1-C3 dorsal root rhizotomy. PMID:29682056

Occipital Neuralgia from C2 Cavernous Malformation.

PubMed

Ha, Sang-Woo; Choi, Jin-Gyu; Son, Byung-Chul

2018-01-01

A unique case is presented of chronic occipital neuralgia (ON) caused by cavernous malformation (CM) in the intramedullary C2 spinal cord and subsequent pain relief and remodeling of allodynic pain following dorsal root rhizotomy. A 53-year-old male presented with a 30-year history of chronic allodynic, paroxysmal lancinating pain in the greater and lesser occipital nerves. Typically, the pain was aggravated with neck extension and head movement. Magnetic resonance imaging showed a CM in the right posterolateral side of the intramedullary C2 cord. Considering potential risks associated with removal of the lesion, intradural C1-3 dorsal root rhizotomy with dentate ligament resection was performed. The paroxysmal lancinating pain of ON was significantly alleviated, and the remodeling of the extent of allodynic pain was noted after C1-3 dorsal root rhizotomy. These changes gradually occurred during the second postoperative month, and this effect was maintained for 24 months postoperatively. Significant reduction in chronic allodynic pain of secondary ON caused by cervicomedullary CM involving central sensitization in the trigeminocervical complex was observed with reduction of irritating, afferent input with C1-C3 dorsal root rhizotomy.

Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species.

PubMed

Davidson, Alisha D; Hewitt, Chad L; Kashian, Donna R

2015-01-01

Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources.

Guidelines for contingency planning NASA (National Aeronautics and Space Administration) ADP security risk reduction decision studies

NASA Technical Reports Server (NTRS)

Tompkins, F. G.

1984-01-01

Guidance is presented to NASA Computer Security Officials for determining the acceptability or unacceptability of ADP security risks based on the technical, operational and economic feasibility of potential safeguards. The risk management process is reviewed as a specialized application of the systems approach to problem solving and information systems analysis and design. Reporting the results of the risk reduction analysis to management is considered. Report formats for the risk reduction study are provided.

78 FR 13657 - Commission Information Collection Activities (FERC-577); Comment Request; Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. IC13-12-000] Commission Information Collection Activities (FERC-577); Comment Request; Extension AGENCY: Federal Energy Regulatory...: In compliance with the requirements of the Paperwork Reduction Act of 1995, the Federal Energy...

Money 2000: A Model Extension Program.

ERIC Educational Resources Information Center

Porter, Nancy M.; Christenbury, Joyce H.

1999-01-01

Money 2000 is a South Carolina program that educates participants in personal savings and debt reduction. It is marketed through state-local government agency collaboration, promotional items, and extensive media coverage. It targets a diversified audience, including youth, rural farm families, and families with limited resources. (SK)

76 FR 63289 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Paperwork Reduction Act of 1995, intends to extend for three years, an information collection request with... collection of information is necessary for the proper performance of the functions of the agency, including...

78 FR 19695 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... to the Paperwork Reduction Act of 1995, intends to extend for three years an information collection... collection of information is necessary for the proper performance of the functions of the agency, including...

75 FR 54859 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Paperwork Reduction Act of 1995, intends to extend for three years, an information collection request (ICR... Safety and Health Policy uses the information collected from the contractors to evaluate the adequacy of...

78 FR 62609 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Paperwork Reduction Act of 1995, intends to extend for three years, an information collection request (ICR... Safety and Health Policy uses the information collected from the contractors to evaluate the adequacy of...

77 FR 34367 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-11

... DEPARTMENT OF ENERGY Agency Information Collection Extension AGENCY: U.S. Department of Energy... Paperwork Reduction Act of 1995), intends to extend for three years, an information collection request with... collection of information is necessary for the proper performance of the functions of the agency, including...

77 FR 55478 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-10

... Examination Survey (NHANES)-- (0920-0237, Expiration 11/30/2012)--Extension--National Center for Health... health of the population of the United States. The National Health and Nutrition Examination Survey... of the survey. This extension requests generic clearance for all activities needed to successfully...

Obesity and metabolic syndrome in COPD: Is exercise the answer?

PubMed

James, Benjamin D; Jones, Amy V; Trethewey, Ruth E; Evans, Rachael A

2018-05-01

Approximately half of all patients with chronic obstructive pulmonary disease (COPD) attending pulmonary rehabilitation (PR) programmes are overweight or obese which negatively impacts upon dyspnoea and exercise tolerance particularly when walking. Within the obese population (without COPD), the observed heterogeneity in prognosis is in part explained by the variability in the risk of developing cardiovascular disease or diabetes (cardiometabolic risk) leading to the description of metabolic syndrome. In obesity alone, high-intensity aerobic training can support healthy weight loss and improve the constituent components of metabolic syndrome. Those with COPD, obesity and/or metabolic syndrome undergoing PR appear to do as well in traditional outcomes as their normal-weight metabolically healthy peers in terms of improvement of symptoms, health-related quality of life and exercise performance, and should therefore not be excluded. To broaden the benefit of PR, for this complex population, we should learn from the extensive literature examining the effects of exercise in obesity and metabolic syndrome discussed in this review and optimize the exercise strategy to improve these co-morbid conditions. Standard PR outcomes could be expanded to include cardiometabolic risk reduction to lower future morbidity and mortality; to this end exercise may well be the answer.

Obesity and metabolic syndrome in COPD: Is exercise the answer?

PubMed Central

James, Benjamin D; Jones, Amy V; Trethewey, Ruth E; Evans, Rachael A

2017-01-01

Approximately half of all patients with chronic obstructive pulmonary disease (COPD) attending pulmonary rehabilitation (PR) programmes are overweight or obese which negatively impacts upon dyspnoea and exercise tolerance particularly when walking. Within the obese population (without COPD), the observed heterogeneity in prognosis is in part explained by the variability in the risk of developing cardiovascular disease or diabetes (cardiometabolic risk) leading to the description of metabolic syndrome. In obesity alone, high-intensity aerobic training can support healthy weight loss and improve the constituent components of metabolic syndrome. Those with COPD, obesity and/or metabolic syndrome undergoing PR appear to do as well in traditional outcomes as their normal-weight metabolically healthy peers in terms of improvement of symptoms, health-related quality of life and exercise performance, and should therefore not be excluded. To broaden the benefit of PR, for this complex population, we should learn from the extensive literature examining the effects of exercise in obesity and metabolic syndrome discussed in this review and optimize the exercise strategy to improve these co-morbid conditions. Standard PR outcomes could be expanded to include cardiometabolic risk reduction to lower future morbidity and mortality; to this end exercise may well be the answer. PMID:29117797

Reduction by symmetries in singular quantum-mechanical problems: General scheme and application to Aharonov-Bohm model

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

Smirnov, A. G., E-mail: smirnov@lpi.ru

2015-12-15

We develop a general technique for finding self-adjoint extensions of a symmetric operator that respects a given set of its symmetries. Problems of this type naturally arise when considering two- and three-dimensional Schrödinger operators with singular potentials. The approach is based on constructing a unitary transformation diagonalizing the symmetries and reducing the initial operator to the direct integral of a suitable family of partial operators. We prove that symmetry preserving self-adjoint extensions of the initial operator are in a one-to-one correspondence with measurable families of self-adjoint extensions of partial operators obtained by reduction. The general scheme is applied to themore » three-dimensional Aharonov-Bohm Hamiltonian describing the electron in the magnetic field of an infinitely thin solenoid. We construct all self-adjoint extensions of this Hamiltonian, invariant under translations along the solenoid and rotations around it, and explicitly find their eigenfunction expansions.« less

Active patient decision making regarding nerve sparing during radical prostatectomy: a novel approach.

PubMed

Lavery, Hugh J; Prall, David N; Abaza, Ronney

2011-08-01

The motivation to preserve sexual function can vary widely among patients before prostatectomy. Increasing patient involvement may allow a more personalized experience and may improve satisfaction. We assessed a strategy of surgeon deference to patient choice in regard to nerve sparing to determine to what degree patients are rational actors and capable of active decision making. A total of 150 patients treated with prostatectomy participated in a standardized preoperative discussion regarding the concept of nerve sparing, extracapsular extension and the potential need for adjuvant radiation in the event of local recurrence. Each patient was given his nomogram predicted risk of extracapsular extension and then elected nerve sparing or nonnerve sparing. The corresponding procedure was performed unless grossly invasive disease was encountered. Of the 150 patients 109 chose nerve sparing (73%) and 41 chose nonnerve sparing (27%). In patients with a nomogram predicted risk of extracapsular extension less than 20%, 20% to 50% and greater than 50%, nerve sparing was elected by 88%, 41% and 25%, respectively. Patients with lower risks of extracapsular extension electing nonnerve sparing were older and had higher rates of erectile dysfunction. Empowering patients to decide on their nerve sparing status is a reasonable strategy that did not lead to a high rate of patients with a high risk of extracapsular extension electing nerve sparing. With proper counseling informed patients made reasonable decisions, and appeared to be conservative, prioritizing cancer control in the majority of instances where extracapsular extension risk was high. In addition, they may have been overly conservative in electing nonnerve sparing when the risk was low. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Is mosquito larval source management appropriate for reducing malaria in areas of extensive flooding in The Gambia? A cross-over intervention trial.

PubMed

Majambere, Silas; Pinder, Margaret; Fillinger, Ulrike; Ameh, David; Conway, David J; Green, Clare; Jeffries, David; Jawara, Musa; Milligan, Paul J; Hutchinson, Robert; Lindsay, Steven W

2010-02-01

Larviciding to control malaria was assessed in rural areas with extensive seasonal flooding. Larval and adult mosquitoes and malaria incidence were surveyed routinely in four 100-km(2) areas either side of the Gambia River. Baseline data were collected in 2005. Microbial larvicide was applied to all water bodies by hand application with water-dispersible granular formulations and corn granules weekly from May to November in two areas in 2006 and in the other two areas in 2007 in a cross-over design. The intervention was associated with a reduction in habitats with late stage anopheline larvae and an 88% reduction in larval densities (P < 0.001). The effect of the intervention on mosquito densities was not pronounced and was confounded by the distance of villages to the major breeding sites and year (P = 0.002). There was no reduction in clinical malaria or anemia. Ground applications of non-residual larvicides with simple equipment are not effective in riverine areas with extensive flooding, where many habitats are poorly demarcated, highly mobile, and inaccessible on foot.

Minimally invasive reduction and fixation of displaced calcaneal fractures: surgical technique and radiographic analysis.

PubMed

Arastu, Mateen; Sheehan, Brendan; Buckley, Richard

2014-03-01

The optimal treatment of calcaneal fractures is controversial. A specific subgroup of healthy patients has good outcomes with open reduction and internal fixation using an extensile lateral approach. However, there are many patients who do not fit into this category. Consequently, they are either denied surgical intervention or put at significant risk of developing complications as a result of open surgical intervention. Minimally invasive reduction and fixation (MIRF) of calcaneal fractures can restore the height, width, length and shape of the hindfoot in addition to restoring the orientation of the posterior facet of the calcaneus (Böhler's angle). We present a series of 31 patients treated with minimally invasive reduction and fixation technique using threaded K wires and Steinmann pins as an alternative treatment method in patients who are not suitable for open reduction and internal fixation. The mean time to surgery from injury was six days (range one to ten days). The mean duration of surgery was 35 minutes (range 11-52 minutes). The mean followup was 14.9 months (range of seven to 30 months). The mean change in Böhler's angle and length of the calcaneus from intra-operative fixation to final followup were 18.7° and 4.7 mm, respectively. The complication rate was low and there was one case of a superficial wound infection and no cases of deep infection or peroneal impingement in this series. The MIRF technique with the use of threaded K wires has not been previously described in the literature. In our experience, the operative time is short and can be safely performed even in the presence of extensive soft tissue swelling in the immediate period following injury. The infection risk is low and calcaneal morphology was improved and maintained in terms of Böhler's angle. This technique is suitable to be considered in patients who have significant medical co-morbidities (smokers, diabetics, peripheral vascular disease) and in those patients who are not suitable for an extensile lateral approach and internal fixation.

Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

PubMed Central

Rodu, Brad; Godshall, William T

2006-01-01

According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in public policy, and to assist consumers in distinguishing real health threats from spurious health claims. As this report documents, there is a strong scientific and medical foundation for tobacco harm reduction, and it shows great potential as a public health strategy to help millions of smokers. PMID:17184539

Relationship among Food-Safety Knowledge, Beliefs, and Risk-Reduction Behavior in University Students in Japan

ERIC Educational Resources Information Center

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

2011-01-01

Objective: To identify whether university students who have both food-safety knowledge and beliefs perform risk-reduction behaviors. Design: 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…

Modifiable Prostate Cancer Risk Reduction and Early Detection Behaviors in Black Men

ERIC Educational Resources Information Center

Odedina, Folakemi T.; Scrivens, John J., Jr.; Larose-Pierre, Margareth; Emanuel, Frank; Adams, Angela Denise; Dagne, Getachew A.; Pressey, Shannon Alexis; Odedina, Oladapo

2011-01-01

Objective: To explore the personal factors related to modifiable prostate cancer risk-reduction and detection behaviors among black men. Methods: Three thousand four hundred thirty (3430) black men were surveyed and structural equation modeling employed to test study hypotheses. Results: Modifiable prostate cancer risk-reduction behavior was found…

Patterns of shading tolerance determined from experimental light reduction studies of seagrasses

EPA Science Inventory

An extensive review of the experimental literature on seagrass shading evaluated the relationship between experimental light reductions, duration of experiment and seagrass response metrics to determine whether there were consistent statistical patterns. There were highly signif...

75 FR 69049 - Expansion and Extension of the Green Technology Pilot Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... environmental quality, energy conservation, development of renewable energy resources, and greenhouse gas... including greenhouse gas reduction (applications pertaining to environmental quality, energy conservation, development of renewable energy resources or greenhouse gas emission reduction) and met other requirements...

Benthic iron cycling in a high-oxygen environment: Implications for interpreting the Archean sedimentary iron isotope record.

PubMed

McCoy, V E; Asael, D; Planavsky, N

2017-09-01

The most notable trend in the sedimentary iron isotope record is a shift at the end of the Archean from highly variable δ 56 Fe values with large negative excursions to less variable δ 56 Fe values with more limited negative values. The mechanistic explanation behind this trend has been extensively debated, with two main competing hypotheses: (i) a shift in marine redox conditions and the transition to quantitative iron oxidation; and (ii) a decrease in the signature of microbial iron reduction in the sedimentary record because of increased bacterial sulfate reduction (BSR). Here, we provide new insights into this debate and attempt to assess these two hypotheses by analyzing the iron isotope composition of siderite concretions from the Carboniferous Mazon Creek fossil site. These concretions precipitated in an environment with water column oxygenation, extensive sediment pile dissimilatory iron reduction (DIR) but limited bacterial sulfate reduction (BSR). Most of the concretions have slightly positive iron isotope values, with a mean of 0.15‰ and limited iron isotope variability compared to the Archean sedimentary record. This limited variability in an environment with high DIR and low BSR suggests that these conditions alone are insufficient to explain Archean iron isotope compositions. Therefore, these results support the idea that the unusually variable and negative iron isotope values in the Archean are due to dissimilatory iron reduction (DIR) coupled with extensive water column iron cycling. © 2017 John Wiley & Sons Ltd.

The financial attractiveness assessment of large waste management projects registered as clean development mechanism

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

Bufoni, André Luiz, E-mail: bufoni@facc.ufrj.br; Oliveira, Luciano Basto; Rosa, Luiz Pinguelli

Highlights: • Projects are not financially attractive without registration as CDMs. • WM benchmarks and indicators are converging and reducing in variance. • A sensitivity analysis reveal that revenue has more of an effect on the financial results. • Results indicate that an extensive database would reduce WM project risk and capital costs. • Disclosure standards would make information more comparable worldwide. - Abstract: This study illustrates the financial analyses for demonstration and assessment of additionality presented in the project design (PDD) and enclosed documents of the 431 large Clean Development Mechanisms (CDM) classified as the ‘waste handling and disposalmore » sector’ (13) over the past ten years (2004–2014). The expected certified emissions reductions (CER) of these projects total 63.54 million metric tons of CO{sub 2}eq, where eight countries account for 311 projects and 43.36 million metric tons. All of the projects declare themselves ‘not financially attractive’ without CER with an estimated sum of negative results of approximately a half billion US$. The results indicate that WM benchmarks and indicators are converging and reducing in variance, and the sensitivity analysis reveals that revenues have a greater effect on the financial results. This work concludes that an extensive financial database with simple standards for disclosure would greatly diminish statement problems and make information more comparable, reducing the risk and capital costs of WM projects.« less

The marketing of responsible drinking: competing voices and interests.

PubMed

Wettlaufer, Ashley; Cukier, Samantha; Giesbrecht, Norman; Greenfield, Thomas K

2012-03-01

This paper contrasts health-oriented low-risk drinking guidelines (LRDGs) with social drinking marketing and popular advice on the amount of alcohol to be provided for social occasions. The questions addressed include:What is the underlying evidence base and rationale for health-oriented versus socially oriented drinking guidelines?What are the recommended amounts of alcohol per person from the LRDGs and from popular advice? This paper draws on existing research, archival data, websites, print media and key informant interviews. The focus is on recent information on LRDGs and social drinking indicators in Canada, the USA, Australia and the UK. There is extensive epidemiological research indicating the associations between drinking pattern and risk for chronic disease and trauma as well as certain potential health benefits from drinking small amounts regularly. This body of evidence is one resource for government or medically sanctioned LRDGs in many jurisdictions. In contrast, for those planning social events where liquor is served, information is available from the hospitality industry, retailers and liquor control boards.While some overlap exists between these two sources of information, in some contexts normative recommendations support drinking at potentially dangerous levels. The inconsistency among the different guidelines highlights one of the challenges of conveying health information on a drug that is integrated into social life and used extensively. It also reflects a siloed approach to alcohol policy—where retailing and harm reduction practices are managed by different sectors of government that seldom reflect a coordinated response.

The Marketing of Responsible Drinking: Competing Voices and Interests

PubMed Central

Wettlaufer, Ashley; Cukier, Samantha; Giesbrecht, Norman; Greenfield, Thomas K.

2011-01-01

Aim This paper contrasts health-oriented low-risk drinking guidelines (LRDG) with social drinking marketing and popular advice on the amount of alcohol to be provided for social occasions. The questions addressed include: What is the underlying evidence base and rationale for health-oriented vs. socially-oriented drinking guidelines? What are the recommended amounts of alcohol per person from the LRDGs and from popular advice? Method This paper draws on existing research, archival data, web sites, print media, and key informant interviews. The focus is on recent information on LRDGs and social drinking indicators in Canada, the U.S., Australia, and the U.K. Results There is extensive epidemiological research indicating the associations between drinking pattern and risk for chronic disease and trauma as well as certain potential health benefits from drinking small amounts regularly. This body of evidence is one resource for government or medically-sanctioned LRDGs in many jurisdictions. In contrast, for those planning social events where liquor is served, information is available from the hospitality industry, retailers, and liquor control boards. While some overlap exists between these two sources of information, in some contexts normative recommendations support drinking at potentially dangerous levels. Discussion The inconsistency among the different guidelines highlights one of the challenges of conveying health information on a drug that is integrated into social life and used extensively. It also reflects a siloed approach to alcohol policy – where retailing and harm reduction practices are managed by different sectors of government that seldom reflect a coordinated response. PMID:22489309

A randomized controlled trial targeting alcohol use and sexual assault risk among college women at high risk for victimization.

PubMed

Gilmore, Amanda K; Lewis, Melissa A; George, William H

2015-11-01

Sexual assault risk reduction programs do not target alcohol use despite the widespread knowledge that alcohol use is a risk factor for being victimized. The current study assessed the effectiveness of a web-based combined sexual assault risk and alcohol use reduction program using a randomized control trial. A total of 207 college women between the ages of 18 and 20 who engaged in heavy episodic drinking were randomized to one of five conditions: full assessment only control condition, sexual assault risk reduction condition, alcohol use reduction condition, combined sexual assault risk and alcohol use reduction condition, and a minimal assessment only condition. Participants completed a 3-month follow-up survey on alcohol-related sexual assault outcomes, sexual assault outcomes, and alcohol use outcomes. Significant interactions revealed that women with higher severity of sexual assault at baseline experienced less incapacitated attempted or completed rapes, less severity of sexual assaults, and engaged in less heavy episodic drinking compared to the control condition at the 3-month follow-up. Web-based risk reduction programs targeting both sexual assault and alcohol use may be the most effective way to target the highest risk sample of college students for sexual assault: those with a sexual assault history and those who engage in heavy episodic drinking. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Randomized Controlled Trial Targeting Alcohol Use and Sexual Assault Risk among College Women at High Risk for Victimization

PubMed Central

Gilmore, Amanda K.; Lewis, Melissa A.; George, William H.

2015-01-01

Current sexual assault risk reduction programs do not target alcohol use despite the widespread knowledge that alcohol use is a risk factor for being victimized. The current study assessed the effectiveness of a web-based combined sexual assault risk and alcohol use reduction program using a randomized control trial. A total of 207 college women between the ages of 18 and 20 who engaged in heavy episodic drinking were randomized to one of five conditions: full assessment only control condition, sexual assault risk reduction condition, alcohol use reduction condition, combined sexual assault risk and alcohol use reduction condition, and a minimal assessment only condition. Participants completed a 3-month follow-up survey on alcohol-related sexual assault outcomes, sexual assault outcomes, and alcohol use outcomes. Significant interactions revealed that women with higher incidence and severity of sexual assault at baseline experienced less incapacitated attempted or completed rapes, less incidence/severity of sexual assaults, and engaged in less heavy episodic drinking compared to the control condition at the 3-month follow-up. Web-based risk reduction programs targeting both sexual assault and alcohol use may be the most effective way to target the highest risk sample of college students for sexual assault: those with a sexual assault history and those who engage in heavy episodic drinking. PMID:26408290

Actuarial Models for Assessing Prison Violence Risk: Revisions and Extensions of the Risk Assessment Scale for Prison (RASP)

ERIC Educational Resources Information Center

Cunningham, Mark D.; Sorensen, Jon R.

2006-01-01

An investigation and extension of the Risk Assessment Scale for Prison (RASP-Potosi), an actuarially derived scale for the assessment of prison violence, was undertaken through a retrospective review of the disciplinary records of the first 12 months of confinement of a cohort of inmates entering the Florida Department of Corrections in 2002 and…

76 FR 44301 - Information Collection; Homeowner Risk Reduction Behaviors Concerning Wildfire Risks and Climate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-25

... Behaviors Concerning Wildfire Risks and Climate Change Impacts AGENCY: Forest Service, USDA. ACTION: Notice... collection, Homeowner Risk Reduction Behaviors Concerning Wildfire Risks and Climate Change Impacts. The... undertake, and factors that influence these choices, particularly factors related to climate change impacts...

Meteorological risks as drivers of innovation for agroecosystem management

NASA Astrophysics Data System (ADS)

Gobin, Anne; Van de Vyver, Hans; Zamani, Sepideh; Curnel, Yannick; Planchon, Viviane; Verspecht, Ann; Van Huylenbroeck, Guido

2015-04-01

Devastating weather-related events recorded in recent years have captured the interest of the general public in Belgium. The MERINOVA project research hypothesis is that meteorological risks act as drivers of environmental innovation in agro-ecosystem management which is being tested using a "chain of risk" approach. The major objectives are to (1) assess the probability of extreme meteorological events by means of probability density functions; (2) analyse the extreme events impact of on agro-ecosystems using process-based bio-physical modelling methods; (3) identify the most vulnerable agro-ecosystems using fuzzy multi-criteria and spatial analysis; (4) uncover innovative risk management and adaptation options using actor-network theory and economic modelling; and, (5) communicate to research, policy and practitioner communities using web-based techniques. Generalized Extreme Value (GEV) theory was used to model annual rainfall maxima based on location-, scale- and shape-parameters that determine the centre of the distribution, the deviation of the location-parameter and the upper tail decay, respectively. Likewise the distributions of consecutive rainy days, rainfall deficits and extreme 24-hour rainfall were modelled. Spatial interpolation of GEV-derived return levels resulted in maps of extreme precipitation, precipitation deficits and wet periods. The degree of temporal overlap between extreme weather conditions and sensitive periods in the agro-ecosystem was determined using a bio-physically based modelling framework that couples phenological models, a soil water balance, crop growth and environmental models. 20-year return values were derived for frost, heat stress, drought, waterlogging and field access during different sensitive stages for different arable crops. Extreme yield values were detected from detrended long term arable yields and relationships were found with soil moisture conditions, heat stress or other meteorological variables during the season. A methodology for identifying agro-ecosystem vulnerability was developed using spatially explicit information and was tested for arable crop production in Belgium. The different components of vulnerability for a region include spatial information on meteorology, soil available water content, soil erosion, the degree of waterlogging, crop share and the diversity of potato varieties. The level of vulnerability and resilience of an agro-ecosystem is also determined by risk management. The types of agricultural risk and their relative importance differ across sectors and farm types. Risk types are further distinguished according to production, market, institutional, financial and liability risks. Strategies are often combined in the risk management strategy of a farmer and include reduction and prevention, mitigation, coping and impact reduction. Based on an extensive literature review, a portfolio of potential strategies was identified at farm, market and policy level. Research hypotheses were tested using an on-line questionnaire on knowledge of agricultural risk, measuring the general risk aversion of the farmer and risk management strategies. The "chain of risk" approach adopted as a research methodology allows for investigating the hypothesis that meteorological risks act as drivers for agricultural innovation. Risks related to extreme weather events in Belgium are mainly caused by heat, frost, excess rainfall, drought and storms, and their impact is predominantly felt by arable, horticultural and extensive dairy farmers. Quantification of the risk is evaluated in terms of probability of occurrence, magnitude, frequency and extent of impact on several agro-ecosystems services. The spatial extent of vulnerability is developed by integrating different layers of geo-information, while risk management is analysed using questionnaires and economic modelling methods. Future work will concentrate on the further development and testing of the currently developed modelling methodologies. https://merinova.vito.be The research is funded by the Belgian Science Policy Organisation (Belspo) under contract nr SD/RI/03A.

Extension Resources for International Trade

ERIC Educational Resources Information Center

Seal, Susan D.

2016-01-01

With the opening of additional trade partnerships, the reduction of global transportation and communication costs, and the increase in demand for U.S. agricultural products and services, international trade is an area of great importance to more and more Extension clients and stakeholders. This article provides information about the primary…

77 FR 63799 - Proposed Extension of Approval of Information Collection; Comment Request-Children's Sleepwear

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... CONSUMER PRODUCT SAFETY COMMISSION Proposed Extension of Approval of Information Collection; Comment Request--Children's Sleepwear AGENCY: Consumer Product Safety Commission. ACTION: Notice; correction. SUMMARY: As required by the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35), the Consumer...

77 FR 59590 - Notice of Request for Extension of Approval of an Information Collection; National Animal Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-28

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request an extension of approval of an information collection associated with the National Animal Health Reporting System.

Alcohol expectancies pre-and post-alcohol use disorder treatment: Clinical implications.

PubMed

Coates, Jason M; Gullo, Matthew J; Feeney, Gerald F X; Young, Ross McD; Dingle, Genevieve A; Connor, Jason P

2018-05-01

Modification of elevated positive expectations of alcohol consumption (alcohol outcome expectancies; AOEs) is a key feature of Cognitive Behaviour Therapy (CBT) approaches to Alcohol Use Disorders (AUDs). Despite extensive research supporting the efficacy of CBT for AUD, few studies have examined AOE change. This study aimed to assess AOE change following completion of CBT for AUD and its association with drinking behaviour. One-hundred and seventy-five patients who completed a 12-week CBT program for AUD were administered the Drinking Expectancy Questionnaire (DEQ) at pre-treatment assessment and upon completion of treatment. Abstinence was achieved by 108 (61.7%) of completing patients. For patients who lapsed, the mean proportion of abstinent days was 93%. DEQ scales assessing expectations of positive alcohol effects on tension reduction, assertiveness, and cognitive enhancement were significantly lower post-treatment (p<0.001). Expectations of negative effects on mood were higher post-treatment (p<0.001). The largest AOE change occurred on the tension reduction scale. Greater percentage of abstinent days over treatment was associated with lower pre-and post-treatment tension reduction expectancy scores (p<0.05). Drinking during treatment was associated with smaller changes in expectations of negative effects of alcohol on mood (p<0.05). Individuals who completed CBT treatment for AUD showed significant AOE change. Tension reduction and affective change expectancies may be particularly important for abstinence and useful markers of lapse risk. Copyright © 2018 Elsevier Ltd. All rights reserved.

Climate change air toxic co-reduction in the context of macroeconomic modelling.

PubMed

Crawford-Brown, Douglas; Chen, Pi-Cheng; Shi, Hsiu-Ching; Chao, Chia-Wei

2013-08-15

This paper examines the health implications of global PM reduction accompanying greenhouse gas emissions reductions in the 180 national economies of the global macroeconomy. A human health effects module based on empirical data on GHG emissions, PM emissions, background PM concentrations, source apportionment and human health risk coefficients is used to estimate reductions in morbidity and mortality from PM exposures globally as co-reduction of GHG reductions. These results are compared against the "fuzzy bright line" that often underlies regulatory decisions for environmental toxics, and demonstrate that the risk reduction through PM reduction would usually be considered justified in traditional risk-based decisions for environmental toxics. It is shown that this risk reduction can be on the order of more than 4 × 10(-3) excess lifetime mortality risk, with global annual cost savings of slightly more than $10B, when uniform GHG reduction measures across all sectors of the economy form the basis for climate policy ($2.2B if only Annex I nations reduce). Consideration of co-reduction of PM-10 within a climate policy framework harmonized with other environmental policies can therefore be an effective driver of climate policy. An error analysis comparing results of the current model against those of significantly more spatially resolved models at city and national scales indicates errors caused by the low spatial resolution of the global model used here may be on the order of a factor of 2. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cost-benefit analysis of using sewage sludge as alternative fuel in a cement plant: a case study.

PubMed

Nadal, Martí; Schuhmacher, Marta; Domingo, José L

2009-05-01

To enforce the implementation of the Kyoto Protocol targets, a number of governmental/international institutions have launched emission trade schemes as an approach to specify CO(2) caps and to regulate the emission trade in recent years. These schemes have been basically applied for large industrial sectors, including energy producers and energy-intensive users. Among them, cement plants are included among the big greenhouse gas (GHG) emitters. The use of waste as secondary fuel in clinker kilns is currently an intensive practice worldwide. However, people living in the vicinity of cement plants, where alternative fuels are being used, are frequently concerned about the potential increase in health risks. In the present study, a cost-benefit analysis was applied after substituting classical fuel for sewage sludge as an alternative fuel in a clinker kiln in Catalonia, Spain. The economical benefits resulting in the reduction of CO(2) emissions were compared with the changes in human health risks due to exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and carcinogenic metals (As, Cd, Co, and Cr) before and after using sewage sludge to generate 20% of the thermal energy needed for pyro-processing. The exposure to PCDD/Fs and metals through air inhalation, soil ingestion and dermal absorption was calculated according to the environmental levels in soil. The carcinogenic risks were assessed, and the associated cost for the population was estimated by considering the DG Environment's recommended value for preventing a statistical fatality (VPF). In turn, the amount of CO(2) emitted was calculated, and the economical saving, according to the market prices, was evaluated. The use of sewage sludge as a substitute of conventional energy meant a probability cancer decrease of 4.60 for metals and a cancer risk increase of 0.04 for PCDD/Fs. Overall, a net reduction of 4.56 cancers for one million people can be estimated. The associated economical evaluation due to the decreasing cancer for 60,000 people, the current population living near the cement plant, would be of 0.56 million euros (US$ 0.83 million). In turn, a reduction of 144,000 tons of CO(2) emitted between 2003 and 2006 was estimated. Considering a cost of 20 euros per ton of CO(2), the global saving would be 2.88 million euros (US$ 4.26 million). After the partial substitution of the fuel, the current environmental exposure to metals and PCDD/Fs would even mean a potential decrease of health risks for the individuals living in the vicinity of the cement plant. The total benefit of using sewage sludge as an alternative fuel was calculated in 3.44 million euros (US$ 5.09 million). Environmental economics is becoming an interesting research field to convert environmental benefits (i.e., reduction of health risks, emission of pollutants, etc.) into economical value. The results show, that while the use of sewage sludge as secondary fuel is beneficial for the reduction in GHG emissions, no additional health risks for the population derived from PCDD/F and metal emissions are estimated. Cost-benefit analysis seems to be a suitable tool to estimate the environmental damage and benefit associated to industrial processes. Therefore, this should become a generalized practice, mainly for those more impacting sectors such as power industries. On the other hand, the extension of the study could vastly be enlarged by taking into account other potentially emitted GHGs, such as CH(4) and N(2)O, as well as other carcinogenic and non-carcinogenic micropollutants.

Research and Development Project Summaries, October 1991

DTIC Science & Technology

1991-10-01

delivery methods, training cost reduction, demonstration of technology’ effectiveness, and the reduction of acquisition risk . The majority of the work...demonstrations, risk reduction developments, and cost-effectiveness investigations in simulator and training technologzv. This advanced development program is a...systems. The program is organized around specific demonstration tasks that target critical technical risks that confront future weapons system

Reducing intimate and paying partner violence against women who exchange sex in Mongolia: results from a randomized clinical trial.

PubMed

Carlson, Catherine E; Chen, Jiehua; Chang, Mingway; Batsukh, Altantsetseg; Toivgoo, Aira; Riedel, Marion; Witte, Susan S

2012-07-01

Women who exchange sex for money or other goods, that is, female sex workers, are at increased risk of experiencing physical and sexual violence from both paying and intimate partners. Exposure to violence can be exacerbated by alcohol use and HIV/STI risk. The purpose of this study is to examine the efficacy of a HIV/STI risk reduction and enhanced HIV/STI risk reduction intervention at decreasing paying and intimate partner violence against Mongolian women who exchange sex and engage in harmful alcohol use. Women are recruited and randomized to either (a) four sessions of a relationship-based HIV/STI risk reduction intervention (n = 49), (b) the same HIV/STI risk reduction intervention plus two additional motivational interviewing sessions (n = 58), or (c) a four session control condition focused on wellness promotion (n = 59). All the respondents complete assessments at baseline (preintervention) as well as at immediate posttest, 3 and 6 months postintervention. A multilevel logistic model finds that women who participated in the HIV/STI risk reduction group (OR = 0.14, p < .00), HIV/STI risk reduction and motivational interview group (OR = 0.46, p = .02), and wellness (OR = 0.20, p < .00) group reduced their exposure to physical and sexual violence in the past 90 days. No significant differences in effects are observed between conditions. This study demonstrates the efficacy of a relationship-based HIV/STI risk reduction intervention, a relationship-based HIV/STI risk reduction intervention combined with motivational interviewing, and a wellness promotion intervention in reducing intimate and paying partner violence against women who exchange sex in Mongolia. The findings have significant implications for the impact of minimal intervention and the potential role of peer networks and social support in reducing women's experiences of violence in resource poor settings.

Experiences on the development of a Community Based Early Warning System for mountain risks in northern Italy

NASA Astrophysics Data System (ADS)

Garcia, Carolina; Sterlacchini, Simone; de Amicis, Mattia; Fontana, Michele; Trozzi, Arianna; Frigerio, Ivan

2010-05-01

In the framework of the European project Mountain Risks (http://mountain-risks.eu/), one of the projects currently developed is a methodology to integrate risk management and evacuation emergency plans, focused on prevention as a key element for disaster risk reduction, applied in the Mountain Community Valtellina of Tirano, an area recurrently affected by several mountain hazards. Taking into account the actual state of disaster risk reduction initiatives in the study area, including the existence of a real time emergency plan based on GIS (Geographical Information Systems), DSS (Decision Support Systems), and ICT (Information & Communication Technology), but knowing the lack involvement of the general community in any of the preparation activities developed until the present and the lack of divulgation of the current emergency plan, it was decided that the methodology that could better adapt to the actual conditions of the study area would be a non structural Community Based Early Warning System (CBEWS). A CBEWS has been recognized by institutions as the UN and the INSDR, as an effective and important strategy for disaster risk reduction. This strategy is broadly used especially in developing countries and has proved its effectiveness in many disasters crisis all over the world. In spite of that, possibly for political and social reasons, there are really few applications of CBEWS in developed countries which has made the elaboration of this research project a particularly difficult process due to the lack of previous references with similar conditions to the one in the study area. Difficulties related to any multidisciplinary work which also involves the general community have been faced during the development of the project such as the differences in language (both the technical jargon of the different disciplines and the native language), time restrictions, the process of learning and adapting to different social structures, the process of contacting several institutions and persons looking to co-involve them in the project. The development of the CBEWS involves several phases: hazard and risk assessment including the analysis of the legal framework and the application of an extensive social survey to evaluate the levels of risk perception, awareness, preparation and information desires of the community; the development of prevention and monitoring strategies and preparedness activities, including the development of a communication campaign developed by an interdisciplinary group to inform and educate the community and practitioner stakeholders. Preliminary results of the survey show, among others, low levels of risk perception and preparedness, and lack of knowledge and information related to natural hazards. All the results confirm the necessity of develop the communication and education campaign. The aim of the CBEWS is not only to increase the level of preparedness of the community and decrease its vulnerability, but also to strengthen institutional collaboration, in particular local institutions, in order to assure a continuity of the efforts.

The efficacy of serostatus disclosure for HIV Transmission risk reduction.

PubMed

O'Connell, Ann A; Reed, Sandra J; Serovich, Julianne A

2015-02-01

Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698-705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed.

The Efficacy of Serostatus Disclosure for HIV Transmission Risk Reduction

PubMed Central

O’Connell, Ann A.; Serovich, Julianne A.

2015-01-01

Interventions to assist HIV+ persons in disclosing their serostatus to sexual partners can play an important role in curbing rates of HIV transmission among men who have sex with men (MSM). Based on the methods of Pinkerton and Galletly (AIDS Behav 11:698–705, 2007), we develop a mathematical probability model for evaluating effectiveness of serostatus disclosure in reducing the risk of HIV transmission and extend the model to examine the impact of serosorting. In baseline data from 164 HIV+ MSM participating in a randomized controlled trial of a disclosure intervention, disclosure is associated with a 45.0 % reduction in the risk of HIV transmission. Accounting for serosorting, a 61.2 % reduction in risk due to disclosure was observed in serodisconcordant couples. The reduction in risk for seroconcordant couples was 38.4 %. Evidence provided supports the value of serostatus disclosure as a risk reduction strategy in HIV+ MSM. Interventions to increase serostatus disclosure and that address serosorting behaviors are needed. PMID:25164375

Communication about melanoma and risk reduction after melanoma diagnosis.

PubMed

Rodríguez, Vivian M; Berwick, Marianne; Hay, Jennifer L

2017-12-01

Melanoma patients are advised to perform regular risk-reduction practices, including sun protection as well as skin self-examinations (SSEs) and physician-led examinations. Melanoma-specific communication regarding family risk and screening may promote such behaviors. To this end, associations between patients' melanoma-specific communication and risk reduction were examined. Melanoma patients (N = 169) drawn from a population-based cancer registry reported their current risk-reduction practices, perceived risk of future melanoma, and communication with physicians and relatives about melanoma risk and screening. Patients were, on average, 56 years old and 6.7 years' post diagnosis; 51% were male, 93% reported "fair/very fair" skin color, 75% completed at least some college, and 22% reported a family history of melanoma. Patients reported varying levels of regular (always/nearly always) sun protection: sunscreen use (79%), shade seeking (60%), hat use (54%), and long-sleeve shirt use (30%). Only 28% performed thorough SSE regularly, whereas 92% reported undergoing physician-led skin examinations within the past year. Participants who were female, younger, and had a higher perceived risk of future melanoma were more likely to report past communication. In adjusted analyses, communication remained uniquely associated with increased sunscreen use and SSE. Encouraging melanoma patients to have a more active role in discussions concerning melanoma risk and screening with relatives and physicians alike may be a useful strategy to promote 2 key risk-reduction practices post melanoma diagnosis and treatment. Future research is needed to identify additional strategies to improve comprehensive risk reduction in long-term melanoma patients. Copyright © 2016 John Wiley & Sons, Ltd.

Chemoembolic Hepatopulmonary Shunt Reduction to Allow Safe Yttrium-90 Radioembolization Lobectomy of Hepatocellular Carcinoma

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

Gaba, Ron C., E-mail: rgaba@uic.edu; VanMiddlesworth, Kyle A.

2012-12-15

Yttrium-90 ({sup 90}Y) radioembolization represents an emerging transcatheter treatment option for the management of hepatocellular carcinoma (HCC). Elevation of the hepatopulmonary shunt fraction risks nontarget radiation to the lungs and may limit the use of {sup 90}Y therapy in patients with locally advanced disease with vascular invasion, who often demonstrate increased shunting. We present two cases in which patients with HCC and portal vein invasion resulting in elevated hepatopulmonary shunt fractions underwent chemoembolic shunt closure to allow safe {sup 90}Y radioembolization. Both patients demonstrated excellent tumor response and patient survival. On this basis, we propose a role for chemoembolic reductionmore » of the lung shunt fraction before {sup 90}Y radioembolization in patients with extensive tumor-related hepatopulmonary shunting.« less

Prospects, Promise and Problems on the Road to Effective Vaccines and Related Therapies for Substance Abuse

PubMed Central

Brimijoin, Stephen; Shen, Xiaoyun; Orson, Frank; Kosten, Thomas

2013-01-01

EXECUTIVE SUMMARY This review addresses potential new treatments for stimulant drugs of abuse, especially cocaine. Clinical trials of vaccines against cocaine and nicotine have been completed with the generally encouraging result that subjects showing high titers of anti-drug antibody experience a reduction in drug reward, which may aid in cessation. New vaccine technologies including gene transfer of highly optimized monoclonal antibodies are likely to improve such outcomes further. In the special case of cocaine abuse, a metabolic enzyme is emerging as an alternative or added therapeutic intervention, which would also involve gene transfer. Such approaches still require extensive studies of safety and efficacy, but they may eventually contribute to a robust form of in vivo drug interception that greatly reduces risks of addiction relapse. PMID:23496671

Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

PubMed Central

Bichsel, Ursina; Nyffeler, Richard Walter

2015-01-01

Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally. PMID:26558125

NASA's Hyper-X Program

NASA Technical Reports Server (NTRS)

Rausch, Vincent L.; McClinton, Charles R.; Sitz, Joel; Reukauf, Paul

2000-01-01

This paper provides an overview of the objectives and status of the Hyper-X program which is tailored to move hypersonic, airbreathing vehicle technology from the laboratory environment to the flight environment, the last stage preceding prototype development. The first Hyper-X research vehicle (HXRV), designated X-43, is being prepared at the Dryden Flight Research Center for flight at Mach 7 in the near future. In addition, the associated booster and vehicle-to-booster adapter are being prepared for flight and flight test preparations are well underway. Extensive risk reduction activities for the first flight and non-recurring design for the Mach 10 X-43 (3rd flight) are nearing completion. The Mach 7 flight of the X-43 will be the first flight of an airframe-integrated scramjet-powered vehicle.

The social value of mortality risk reduction: VSL versus the social welfare function approach.

PubMed

Adler, Matthew D; Hammitt, James K; Treich, Nicolas

2014-05-01

We examine how different welfarist frameworks evaluate the social value of mortality risk reduction. These frameworks include classical, distributively unweighted cost-benefit analysis--i.e., the "value per statistical life" (VSL) approach-and various social welfare functions (SWFs). The SWFs are either utilitarian or prioritarian, applied to policy choice under risk in either an "ex post" or "ex ante" manner. We examine the conditions on individual utility and on the SWF under which these frameworks display sensitivity to wealth and to baseline risk. Moreover, we discuss whether these frameworks satisfy related properties that have received some attention in the literature, namely equal value of risk reduction, preference for risk equity, and catastrophe aversion. We show that the particular manner in which VSL ranks risk-reduction measures is not necessarily shared by other welfarist frameworks. Copyright © 2014 Elsevier B.V. All rights reserved.

Effects of a cardiovascular risk reduction intervention with psychobehavioral strategies for Korean adults with type 2 diabetes and metabolic syndrome.

PubMed

Kim, Chun-Ja; Kim, Dae-Jung; Park, Hyung-Ran

2011-01-01

Type 2 diabetes mellitus (DM) and metabolic syndrome are associated with high risk of cardiovascular disease (CVD) and depression. Although lifestyle modifications including regular exercise and weight control are recommended as a primary approach to glycemic control and CVD risk reduction for people with DM and/or metabolic syndrome, little is known concerning the effects of CVD risk reduction interventions using psychobehavioral strategies in this population. This pilot study investigated the effects of a 16-week CVD risk reduction intervention in Korean adults with type 2 DM and metabolic syndrome. A prospective, pretest and posttest, controlled, quasi-experimental design enrolled a convenience sample of 43 Korean adults with type 2 DM and metabolic syndrome at a university hospital. The adults in the intervention group participated in a 16-week CVD risk reduction intervention consisting of 150 minutes of regular exercise per week; 200- to 300-kcal reduced daily diet for weight control; one-on-one psychobehavioral counseling based on constructs from the Transtheoretical Model such as processes of change, self-efficacy, and decisional balance; and telephone coaching for behavioral modification. Participants in the control group received a booklet with basic diabetic education as part of their routine care. Repeated-measures analysis of variance was used for analyzing the effects of the CVD risk reduction intervention on cardiometabolic risk factors including the UK Prospective Diabetes Study score for 10-year CVD risk, glycated hemoglobin (HbA1c), and depression. The intervention group showed significant reductions (P < .05) at 16 weeks, compared with the control group on the UK Prospective Diabetes Study fatal risk scale (-1.73% vs -0.04%), triglycerides (-38.5 vs -15.1 mg/dL), fasting plasma glucose (-29.24 vs +1.77 mg/dL), HbA1c (-0.37% vs +0.17%), and depression (score, -3.24 vs 1.40) measurements. This pilot study yielded evidence for the beneficial impact of the CVD risk reduction intervention for Korean adults with type 2 DM and metabolic syndrome on improved glycemic control, reduced CVD risk, and depression.

Long-Term Benefit of Mesalamine Granules for Patients Who Achieved Corticosteroid-Induced Ulcerative Colitis Remission.

PubMed

Lichtenstein, Gary R; Gordon, Glenn L; Zakko, Salam; Murthy, Uma; Sedghi, Shahriar; Pruitt, Ron; Barrett, Andrew C; Bortey, Enoch; Paterson, Craig; Forbes, William P

2016-01-01

Patients with ulcerative colitis (UC) who achieve remission with corticosteroids often relapse after tapering or discontinuation; alternative treatments limiting steroid exposure and UC relapse would be beneficial. It remains uncertain whether patients with corticosteroid-induced remission experience benefit with mesalamine granules (MG), a locally acting aminosalicylate extended-release capsule formulation for maintenance of UC remission in adults. Efficacy and safety of MG 1.5 g once daily was evaluated in patients with UC in corticosteroid-induced remission. Data from patients with previous corticosteroid use to achieve baseline UC remission were analyzed from two 6-month randomized, double-blind, placebo-controlled trials and a 24-month open-label extension (OLE). Six-month relapse-free rates were assessed using the revised Sutherland Disease Activity Index. UC-related adverse events (AEs) were recorded during the 30 months. Included were 158 steroid-treated patients in UC remission (MG, n = 105; placebo, n = 53) and 74/105 MG-treated patients who continued MG in the OLE. A significantly larger percentage of patients remained relapse-free at 6 months with MG (77.1 %) versus placebo (54.7 %; P = 0.006), with a 55 % reduction in relapse risk (hazard ratio [HR] 0.45; 95 % CI 0.25-0.79). There was a similar (49.2 %) reduction in risk of UC-related AEs at 6 months (HR 0.51; 95 % CI 0.31-0.84; P = 0.009) that was sustained during the OLE. MG 1.5 g once daily administered for maintenance of corticosteroid-induced remission was associated with low risk of relapse and UC-related AEs. CLINICALTRIALS.GOV: NCT00744016, NCT00767728, and NCT00326209.

Health Hazard Appraisal Counseling—Continuing Evaluation

PubMed Central

LaDou, Joseph; Sherwood, John N.; Hughes, Lewis

1979-01-01

A program of annual health examinations was expanded to include counseling based on a computerized appraisal of individual patients' specific health risk factors. Data obtained from a specially designed questionnaire, laboratory tests and a physical examination yielded a health hazard appraisal showing a number of weighted risk factors and their relation to ten leading causes of death as determined for that patient. From all of this information, a “risk age” was developed which could then be compared with the patient's “true age.” The results were reviewed with each patient, and methods of correcting health hazards were stressed. The first annual retesting of a group of 107 examinees showed a net risk age reduction of 1.4 years (formerly reported in this journal). The longer term follow-up reported in this paper showed a net risk reduction of 2.38 years in a group of 26 examinees. The net risk age reduction in the two groups represented 32 and 40 percent, respectively, of the achievable risk age reduction when patients comply with suggestions made during risk reduction counseling. These findings indicate that health hazard appraisal counseling is an effective method of altering priorities of health practices. PMID:425518

78 FR 26618 - Collection of Information; Proposed Extension of Approval; Comment Request-Follow-Up Activities...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... CONSUMER PRODUCT SAFETY COMMISSION [Docket No. CPSC-2009-0102] Collection of Information; Proposed Extension of Approval; Comment Request--Follow-Up Activities for Product-Related Injuries AGENCY: Consumer Product Safety Commission. ACTION: Notice. SUMMARY: As required by the Paperwork Reduction Act of 1995...

75 FR 31748 - Notice of Request for Extension of Approval of an Information Collection; Importation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request an extension of approval of an information collection associated with regulations for the importation of artificially dwarfed plants.

78 FR 32230 - Notice of Request for Extension of Approval of an Information Collection; Federally Recognized...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2013-0030... Managed Phytosanitary Program AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Extension... Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to...

77 FR 47029 - Notice of Intent To Request Revision and Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... DEPARTMENT OF AGRICULTURE National Agricultural Statistics Service Notice of Intent To Request Revision and Extension of a Currently Approved Information Collection AGENCY: National Agricultural... Reduction Act of 1995 this notice announces the intention of the National Agricultural Statistics Service...

75 FR 77611 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-13

... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-TM-10-0106] Notice of Request for Extension of a Currently Approved Information Collection AGENCY: Agricultural Marketing... Reduction Act of 1995 (44 U.S.C. chapter 35), this notice announces the Agricultural Marketing Service's...

75 FR 68315 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-LS-10-0085] Notice of Request for Extension of a Currently Approved Information Collection AGENCY: Agricultural Marketing... Reduction Act of 1995 (44 U.S.C. Chapter 35), this notice announces the Agricultural Marketing Service's...

75 FR 29306 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-25

... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-LS-10-0035] Notice of Request for Extension of a Currently Approved Information Collection AGENCY: Agricultural Marketing... Reduction Act of 1995 (44 U.S.C. Chapter 35), this notice announces the Agricultural Marketing Service's...

77 FR 4574 - Agency Information Collection Activities: USCIS Case Status Online; Extension of an Existing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-30

... Collection Activities: USCIS Case Status Online; Extension of an Existing Information Collection; Comment Request ACTION: 60-Day Notice of Information Collection Under Review: USCIS Case Status Online. The... following information collection request for review and clearance in accordance with the Paperwork Reduction...

77 FR 60686 - Proposed Extension of Approval of Information Collection; Comment Request-Safety Standard for...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... CONSUMER PRODUCT SAFETY COMMISSION [Docket No. CPSC-2013-0001] Proposed Extension of Approval of... AGENCY: Consumer Product Safety Commission. ACTION: Notice. SUMMARY: As required by the Paperwork Reduction Act (44 U.S.C. chapter 35), the Consumer Product Safety Commission (CPSC or Commission) requests...

75 FR 38456 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... Paperwork Reduction Act of 1995, this notice announces the Commodity Credit Corporations (CCC) intention to request an extension for a currently approved information collection in support of the CCC Facility...: CCC Facility Guarantee Program. OMB Number: 0551-0032. Expiration Date of Approval: November 30, 2010...

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.

Themes in the literature related to cardiovascular disease risk reduction.

PubMed

Cohen, Shannon Munro; Kataoka-Yahiro, Merle

2009-01-01

This article aimed to identify themes in the literature related to patient-healthcare provider beliefs, barriers to adherence, and interventions pertaining to cardiovascular disease risk reduction. Twenty quantitative and qualitative primary research studies including 2 meta-analyses published between 1995 and 2008 were analyzed for themes and practice implications to synthesize existing research on cardiovascular disease risk reduction. Databases searched included EBSCO, CINAHL, MEDLINE, ScienceDirect, HealthSource, and PsychLit using the search terms patient- provider adherence, adherence and shared decision making, adherence and decision support, patient- provider goal setting, and cardiovascular disease risk reduction. The emergent themes found in this literature review included (1) complex medication regimens; (2) risk perception, quality of life, and competing priorities; (3) motivation for change; (4) provider clinical inertia; and (5) goal setting, feedback, and reminders. Studies reporting the highest rates of adherence to cardiovascular disease risk reduction recommendations incorporated patient-provider goal setting and decision support, self-management techniques, and personalized printed communication. Goal setting in cardiovascular disease risk reduction is a relatively unexplored area and is an important component of shared decision making and adherence to cardiovascular disease health recommendations. The following review will address the 5 themes identified in more detail and provide a basis for improved clinical practice.

Epidural volume extension: A novel technique and its efficacy in high risk cases

PubMed Central

Tiwari, Akhilesh Kumar; Singh, Rajeev Ratan; Anupam, Rudra Pratap; Ganguly, S.; Tomar, Gaurav Singh

2012-01-01

We present a unique case series restricting ourselves only to the high-risk case of different specialities who underwent successful surgery in our Institute by using epidural volume extension's technique using 1 mL of 0.5% ropivacaine and 25 μg of fentanyl. PMID:25885627

The Nernst equation applied to oxidation-reduction reactions in myoglobin and hemoglobin. Evaluation of the parameters.

PubMed

Saroff, Harry A

Analyses of the binding of oxygen to monomers such as myoglobin employ the Mass Action equation. The Mass Action equation, as such, is not directly applicable for the analysis of the binding of oxygen to oligomers such as hemoglobin. When the binding of oxygen to hemoglobin is analyzed, models incorporating extensions of mass action are employed. Oxidation-reduction reactions of the heme group in myoglobin and hemoglobin involve the binding and dissociation of electrons. This reaction is described with the Nernst equation. The Nernst equation is applicable only to a monomeric species even if the number of electrons involved is greater than unity. To analyze the oxidation-reduction reaction in a molecule such as hemoglobin a model is required which incorporates extensions of the Nernst equation. This communication develops models employing the Nernst equation for oxidation-reduction reactions analogous to those employed for hemoglobin in the analysis of the oxygenation (binding of oxygen) reaction.

11 CFR 100.55 - Extension of credit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... substantially similar to extensions of credit to nonpolitical debtors that are of similar risk and size of... 11 Federal Elections 1 2010-01-01 2010-01-01 false Extension of credit. 100.55 Section 100.55... Contribution (2 U.S.C. 431(8)) § 100.55 Extension of credit. The extension of credit by any person is a...

Quantitative risk assessment using empirical vulnerability functions from debris flow event reconstruction

NASA Astrophysics Data System (ADS)

Luna, Byron Quan; Blahut, Jan; Camera, Corrado; van Westen, Cees; Sterlacchini, Simone; Apuani, Tiziana; Akbas, Sami

2010-05-01

For a quantitative risk assessment framework it is essential to assess not only the hazardous process itself but to perform an analysis of their consequences. This quantitative assessment should include the expected monetary losses as the product of the probability of occurrence of a hazard with a given magnitude and its vulnerability. A quantifiable integrated approach of both hazard and risk is becoming a required practice in risk reduction management. Dynamic run-out models for debris flows are able to calculate physical outputs (extension, depths, velocities, impact pressures) and to determine the zones where the elements at risk could suffer an impact. These results are then applied for vulnerability and risk calculations. The risk assessment has been conducted in the Valtellina Valley, a typical Italian alpine valley lying in northern Italy (Lombardy Region). On 13th July 2008, after more than two days of intense rainfall, several debris and mud flows were released in the central part of valley between Morbegno and Berbenno. One of the largest debris flows occurred in Selvetta. The debris flow event was reconstructed after extensive field work and interviews with local inhabitants and civil protection teams. Also inside the Valtellina valley, between the 22nd and the 23rd of May 1983, two debris flows happened in Tresenda (Teglio municipality), causing casualties and considerable economic damages. On the same location, during the 26th of November 2002, another debris flow occurred that caused significant damage. For the quantification of a new scenario, the outcome results obtained from the event of Selvetta were applied in Tresenda. The Selvetta and Tresenda event were modelled with the FLO2D program. FLO2D is an Eulerian formulation with a finite differences numerical scheme that requires the specification of an input hydrograph. The internal stresses are isotropic and the basal shear stresses are calculated using a quadratic model. The significance of calculated values of pressure and velocity were investigated in terms of the resulting damage to the affected buildings. The physical damage was quantified for each affected structure within the context of physical vulnerability, which is defined as the ratio between the monetary loss and the reconstruction value. Two different empirical vulnerability curves were obtained, which are functions of debris flow velocity and pressure, respectively. Prospective economic direct losses were estimated.

Transcriptome dynamics along axolotl regenerative development are consistent with an extensive reduction in gene expression heterogeneity in dedifferentiated cells

PubMed Central

2017-01-01

Although in recent years the study of gene expression variation in the absence of genetic or environmental cues or gene expression heterogeneity has intensified considerably, many basic and applied biological fields still remain unaware of how useful the study of gene expression heterogeneity patterns might be for the characterization of biological systems and/or processes. Largely based on the modulator effect chromatin compaction has for gene expression heterogeneity and the extensive changes in chromatin compaction known to occur for specialized cells that are naturally or artificially induced to revert to less specialized states or dedifferentiate, I recently hypothesized that processes that concur with cell dedifferentiation would show an extensive reduction in gene expression heterogeneity. The confirmation of the existence of such trend could be of wide interest because of the biomedical and biotechnological relevance of cell dedifferentiation-based processes, i.e., regenerative development, cancer, human induced pluripotent stem cells, or plant somatic embryogenesis. Here, I report the first empirical evidence consistent with the existence of an extensive reduction in gene expression heterogeneity for processes that concur with cell dedifferentiation by analyzing transcriptome dynamics along forearm regenerative development in Ambystoma mexicanum or axolotl. Also, I briefly discuss on the utility of the study of gene expression heterogeneity dynamics might have for the characterization of cell dedifferentiation-based processes, and the engineering of tools that afforded better monitoring and modulating such processes. Finally, I reflect on how a transitional reduction in gene expression heterogeneity for dedifferentiated cells can promote a long-term increase in phenotypic heterogeneity following cell dedifferentiation with potential adverse effects for biomedical and biotechnological applications. PMID:29134148

Routine brief risk-reduction counseling with biannual STD testing reduces STD incidence among HIV-infected men who have sex with men in care.

PubMed

Patel, Pragna; Bush, Tim; Mayer, Kenneth; Milam, Joel; Richardson, Jean; Hammer, John; Henry, Keith; Overton, Turner; Conley, Lois; Marks, Gary; Brooks, John T

2012-06-01

We evaluated whether routine biannual sexually transmitted disease (STD) testing coupled with brief risk-reduction counseling reduces STD incidence and high-risk behaviors. The SUN study is a prospective observational HIV cohort study conducted in 4 US cities. At enrollment and every 6 months thereafter, participants completed a behavioral survey and were screened for STDs, and if diagnosed, were treated. Medical providers conducted brief risk-reduction counseling with all patients. Among men who have sex with men (MSM), we examined trends in STD incidence and rates of self-reported risk behaviors before and after exposure to the risk-reduction intervention. The "preintervention" visit was the study visit that was at least 6 months after enrollment STD screening and treatment and at which the participant was first exposed to the intervention. The "postintervention" visit was 12 months later. Among 216 MSM with complete STD and behavioral data, median age was 44.5 years; 77% were non-Hispanic white; 83% were on highly active antiretroviral treatment; 84% had an HIV RNA level <400 copies/mL and the median CD4 (cluster of differentiation 4) count was 511 cells/mm. Twelve months after first exposure to the risk-reduction intervention, STD incidence declined from 8.8% to 4.2% (P = 0.041). Rates of unprotected receptive or insertive anal intercourse with HIV-positive partners increased (19% to 25%, P = 0.024), but did not change with HIV-negative partners or partners of unknown HIV status (24% to 22%, P = 0.590). STD incidence declined significantly among HIV-infected MSM after implementing frequent, routine STD testing coupled with risk-reduction counseling. These findings support adoption of routine STD screening and risk-reduction counseling for HIV-infected MSM.

Comparative Effectiveness of Personalized Lifestyle Management Strategies for Cardiovascular Disease Risk Reduction.

PubMed

Chu, Paula; Pandya, Ankur; Salomon, Joshua A; Goldie, Sue J; Hunink, M G Myriam

2016-03-29

Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year cardiovascular disease risk. We computed risks using the American College of Cardiology/American Heart Association Pooled Cohort Equations for a variety of individual profiles. Using published literature on risk factor reductions through diverse lifestyle interventions-group therapy for stopping smoking, Mediterranean diet, aerobic exercise (walking), and yoga-we calculated the risk reduction through each of these interventions to determine the strategy associated with the maximum benefit for each profile. Sensitivity analyses were conducted to test the robustness of the results. In the base-case analysis, yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If the individual was a current smoker and successfully quit smoking (ie, achieved complete smoking cessation), then stopping smoking yielded the largest reduction. Probabilistic and 1-way sensitivity analysis confirmed the demonstrated trend. This study reports the comparative effectiveness of several forms of lifestyle modifications and found smoking cessation and yoga to be the most effective forms of cardiovascular disease prevention. Future research should focus on patient adherence to personalized therapies, cost-effectiveness of these strategies, and the potential for enhanced benefit when interventions are performed simultaneously rather than as single measures. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Graph embedding and extensions: a general framework for dimensionality reduction.

PubMed

Yan, Shuicheng; Xu, Dong; Zhang, Benyu; Zhang, Hong-Jiang; Yang, Qiang; Lin, Stephen

2007-01-01

Over the past few decades, a large family of algorithms - supervised or unsupervised; stemming from statistics or geometry theory - has been designed to provide different solutions to the problem of dimensionality reduction. Despite the different motivations of these algorithms, we present in this paper a general formulation known as graph embedding to unify them within a common framework. In graph embedding, each algorithm can be considered as the direct graph embedding or its linear/kernel/tensor extension of a specific intrinsic graph that describes certain desired statistical or geometric properties of a data set, with constraints from scale normalization or a penalty graph that characterizes a statistical or geometric property that should be avoided. Furthermore, the graph embedding framework can be used as a general platform for developing new dimensionality reduction algorithms. By utilizing this framework as a tool, we propose a new supervised dimensionality reduction algorithm called Marginal Fisher Analysis in which the intrinsic graph characterizes the intraclass compactness and connects each data point with its neighboring points of the same class, while the penalty graph connects the marginal points and characterizes the interclass separability. We show that MFA effectively overcomes the limitations of the traditional Linear Discriminant Analysis algorithm due to data distribution assumptions and available projection directions. Real face recognition experiments show the superiority of our proposed MFA in comparison to LDA, also for corresponding kernel and tensor extensions.

The contribution of indigenous knowledge to disaster risk reduction activities in Zimbabwe: A big call to practitioners

PubMed Central

Munsaka, Edson

2018-01-01

This article examined the contribution of indigenous knowledge to disaster risk reduction activities in Zimbabwe. The current discourse underrates the use of indigenous knowledge of communities by practitioners when dealing with disasters’, as the knowledge is often viewed as outdated and primitive. This study, which was conducted in 2016, sought to examine this problem through analysing the potential contribution of indigenous knowledge as a useful disaster risk reduction intervention. Tsholotsho district in Matabeleland, North province of Zimbabwe, which frequently experiences perennial devastating floods, was used as a case study. Interviews and researcher observations were used to gather data from 40 research participants. The findings were that communities understand weather patterns and could predict imminent flooding after studying trees and clouds, and the behaviours of certain animal species. Local communities also use available local resources to put structural measures in place as part of disaster risk reduction interventions. Despite this important potential, the study found that the indigenous knowledge of disaster risk reduction of the communities is often shunned by practitioners. The practitioners claim that indigenous knowledge lacks documentation, it is not found in all generational classes, it is contextualised to particular communities and the knowledge cannot be scientifically validated. The study concluded that both local communities and disaster risk reduction practitioners can benefit from the indigenous knowledge of communities. This research has the potential to benefit communities, policymakers and disaster risk reduction practitioners.

The effect of recent trends in vehicle design on U.S. societal fatality risk per vehicle mile traveled, and their projected future relationship with vehicle mass.

PubMed

Wenzel, Tom

2013-07-01

The National Highway Traffic Safety Administration (NHTSA) recently updated its 2003 and 2010 logistic regression analyses of the effect of a reduction in light-duty vehicle mass on US fatality risk per vehicle mile traveled (VMT). The current NHTSA analysis is the most thorough investigation of this issue to date. LBNL's assessment of the analysis indicates that the estimated effect of mass reduction on risk is smaller than in the previous studies, and statistically non-significant for all but the lightest cars. The effects three recent trends in vehicle designs and technologies have on societal fatality risk per VMT are estimated, and whether these changes might affect the relationship between vehicle mass and fatality risk in the future. Side airbags are found to reduce fatality risk in cars, but not necessarily light trucks or CUVs/minivans, struck in the side by another light-duty vehicle; reducing the number of fatalities in cars struck in the side is predicted to reduce the estimated detrimental effect of footprint reduction, but increase the detrimental effect of mass reduction, in cars on societal fatality risk. Better alignment of light truck bumpers with those of other vehicles appears to result in a statistically significant reduction in risk imposed on car occupants; however, reducing this type of fatality will likely have little impact on the estimated effect of mass or footprint reduction on risk. Finally, shifting light truck drivers into safer, car-based vehicles, such as sedans, CUVs, and minivans, would result in larger reductions in societal fatalities than expected from even substantial reductions in the masses of light trucks. A strategy of shifting drivers from truck-based to car-based vehicles would reduce fuel use and greenhouse gas emissions, while improving societal safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

Can I Count on Getting Better? Association between Math Anxiety and Poorer Understanding of Medical Risk Reductions.

PubMed

Rolison, Jonathan J; Morsanyi, Kinga; O'Connor, Patrick A

2016-10-01

Lower numerical ability is associated with poorer understanding of health statistics, such as risk reductions of medical treatment. For many people, despite good numeracy skills, math provokes anxiety that impedes an ability to evaluate numerical information. Math-anxious individuals also report less confidence in their ability to perform math tasks. We hypothesized that, independent of objective numeracy, math anxiety would be associated with poorer responding and lower confidence when calculating risk reductions of medical treatments. Objective numeracy was assessed using an 11-item objective numeracy scale. A 13-item self-report scale was used to assess math anxiety. In experiment 1, participants were asked to interpret the baseline risk of disease and risk reductions associated with treatment options. Participants in experiment 2 were additionally provided a graphical display designed to facilitate the processing of math information and alleviate effects of math anxiety. Confidence ratings were provided on a 7-point scale. Individuals of higher objective numeracy were more likely to respond correctly to baseline risks and risk reductions associated with treatment options and were more confident in their interpretations. Individuals who scored high in math anxiety were instead less likely to correctly interpret the baseline risks and risk reductions and were less confident in their risk calculations as well as in their assessments of the effectiveness of treatment options. Math anxiety predicted confidence levels but not correct responding when controlling for objective numeracy. The graphical display was most effective in increasing confidence among math-anxious individuals. The findings suggest that math anxiety is associated with poorer medical risk interpretation but is more strongly related to confidence in interpretations. © The Author(s) 2015.

Research and Evaluations of the Health Aspects of Disasters, Part IX: Risk-Reduction Framework.

PubMed

Birnbaum, Marvin L; Daily, Elaine K; O'Rourke, Ann P; Loretti, Alessandro

2016-06-01

A disaster is a failure of resilience to an event. Mitigating the risks that a hazard will progress into a destructive event, or increasing the resilience of a society-at-risk, requires careful analysis, planning, and execution. The Disaster Logic Model (DLM) is used to define the value (effects, costs, and outcome(s)), impacts, and benefits of interventions directed at risk reduction. A Risk-Reduction Framework, based on the DLM, details the processes involved in hazard mitigation and/or capacity-building interventions to augment the resilience of a community or to decrease the risk that a secondary event will develop. This Framework provides the structure to systematically undertake and evaluate risk-reduction interventions. It applies to all interventions aimed at hazard mitigation and/or increasing the absorbing, buffering, or response capacities of a community-at-risk for a primary or secondary event that could result in a disaster. The Framework utilizes the structure provided by the DLM and consists of 14 steps: (1) hazards and risks identification; (2) historical perspectives and predictions; (3) selection of hazard(s) to address; (4) selection of appropriate indicators; (5) identification of current resilience standards and benchmarks; (6) assessment of the current resilience status; (7) identification of resilience needs; (8) strategic planning; (9) selection of an appropriate intervention; (10) operational planning; (11) implementation; (12) assessments of outputs; (13) synthesis; and (14) feedback. Each of these steps is a transformation process that is described in detail. Emphasis is placed on the role of Coordination and Control during planning, implementation of risk-reduction/capacity building interventions, and evaluation. Birnbaum ML , Daily EK , O'Rourke AP , Loretti A . Research and evaluations of the health aspects of disasters, part IX: Risk-Reduction Framework. Prehosp Disaster Med. 2016;31(3):309-325.

Moral Hazard: How The National Flood Insurance Program Is Limiting Risk Reduction

DTIC Science & Technology

2016-12-01

Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE December...assessment, floodplain management , and flood insurance. A study of the NFIP concludes that aspects of the program limit risk reduction...floodplain management , risk assessment, disaster recovery, flood insurance claim, pre-flood insurance rate map 15. NUMBER OF PAGES 123 16. PRICE CODE

Risk avoidance versus risk reduction: a framework and segmentation profile for understanding adolescent sexual activity.

PubMed

Hopkins, Christopher D; Tanner, John F; Raymond, Mary Anne

2004-01-01

The teen birthrate in the United States is twice that of other industrialized nations. Adolescents in the U.S. are among high-risk groups for HIV/AIDS and other sexually transmitted diseases. As a result, the Department of Health and Human Services changed its policy on the promotion of abstinence to teenagers from a focus on a risk reduction strategy to a focus on a risk avoidance strategy. In order to create more effective risk avoidance as well as risk reduction campaigns, this study proposes a framework to illustrate the distinction that teens make between spontaneous sexual activity and planned sexual activity, as well as those teens that make a commitment to abstinence versus abstinence by default. Furthermore, this study classifies teens into three behavior segments (abstemious, promiscuous and monogamous) and then assesses specific differences that exist within these groups relative to their attitudes and perceptions concerning abstinence, sexual activity, contraception, fear and norms. This change in focus from a risk reduction to a risk avoidance strategy has important implications for social marketing, public policy and marketing theory.

Position paper on screening for breast cancer by the European Society of Breast Imaging (EUSOBI) and 30 national breast radiology bodies from Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Israel, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Sweden, Switzerland and Turkey.

PubMed

Sardanelli, Francesco; Aase, Hildegunn S; Álvarez, Marina; Azavedo, Edward; Baarslag, Henk J; Balleyguier, Corinne; Baltzer, Pascal A; Beslagic, Vanesa; Bick, Ulrich; Bogdanovic-Stojanovic, Dragana; Briediene, Ruta; Brkljacic, Boris; Camps Herrero, Julia; Colin, Catherine; Cornford, Eleanor; Danes, Jan; de Geer, Gérard; Esen, Gul; Evans, Andrew; Fuchsjaeger, Michael H; Gilbert, Fiona J; Graf, Oswald; Hargaden, Gormlaith; Helbich, Thomas H; Heywang-Köbrunner, Sylvia H; Ivanov, Valentin; Jónsson, Ásbjörn; Kuhl, Christiane K; Lisencu, Eugenia C; Luczynska, Elzbieta; Mann, Ritse M; Marques, Jose C; Martincich, Laura; Mortier, Margarete; Müller-Schimpfle, Markus; Ormandi, Katalin; Panizza, Pietro; Pediconi, Federica; Pijnappel, Ruud M; Pinker, Katja; Rissanen, Tarja; Rotaru, Natalia; Saguatti, Gianni; Sella, Tamar; Slobodníková, Jana; Talk, Maret; Taourel, Patrice; Trimboli, Rubina M; Vejborg, Ilse; Vourtsis, Athina; Forrai, Gabor

2017-07-01

EUSOBI and 30 national breast radiology bodies support mammography for population-based screening, demonstrated to reduce breast cancer (BC) mortality and treatment impact. According to the International Agency for Research on Cancer, the reduction in mortality is 40 % for women aged 50-69 years taking up the invitation while the probability of false-positive needle biopsy is <1 % per round and overdiagnosis is only 1-10 % for a 20-year screening. Mortality reduction was also observed for the age groups 40-49 years and 70-74 years, although with "limited evidence". Thus, we firstly recommend biennial screening mammography for average-risk women aged 50-69 years; extension up to 73 or 75 years, biennially, is a second priority, from 40-45 to 49 years, annually, a third priority. Screening with thermography or other optical tools as alternatives to mammography is discouraged. Preference should be given to population screening programmes on a territorial basis, with double reading. Adoption of digital mammography (not film-screen or phosphor-plate computer radiography) is a priority, which also improves sensitivity in dense breasts. Radiologists qualified as screening readers should be involved in programmes. Digital breast tomosynthesis is also set to become "routine mammography" in the screening setting in the next future. Dedicated pathways for high-risk women offering breast MRI according to national or international guidelines and recommendations are encouraged. • EUSOBI and 30 national breast radiology bodies support screening mammography. • A first priority is double-reading biennial mammography for women aged 50-69 years. • Extension to 73-75 and from 40-45 to 49 years is also encouraged. • Digital mammography (not film-screen or computer radiography) should be used. • DBT is set to become "routine mammography" in the screening setting in the next future.

Alcohol Use and Sexual Risk Behaviors in a Migrant Worker Community.

PubMed

McCoy, H Virginia; Shehadeh, Nancy; Rubens, Muni

2016-06-01

There are not many studies exploring the association between alcohol use and risky sexual behaviors among migrant workers. This study analyzed how changes in alcohol use was associated with changes in risky sexual behavior and psychosocial variables. Data for this study was drawn from an HIV risk reduction project. Repeated measures ANOVA and Linear mixed model statistical method was conducted to find changes and association between alcohol use, sexual risk and psychosocial variables over time. The sample (n = 203) was composed of African Americans (33.0 %) and Hispanics (77.0 %) men. Both groups, over time, showed reduction in sexual risk in accordance with reduction in alcohol use. Changes in alcohol use and psychosocial variables showed significant association with sexual risk changes over time. Psychological strategies like building social support should be considered for HIV risk reduction intervention directed towards high alcohol consuming migrant workers.

Parental Attitudes Regarding School-Based Sexuality Education in Utah

ERIC Educational Resources Information Center

Steadman, Mindy; Crookston, Benjamin; Page, Randy; Hall, Cougar

2014-01-01

Sexuality education programs can be broadly categorized as either risk-avoidance or risk-reduction approaches. Health educators in Utah public schools must teach a state mandated risk-avoidance curriculum which prohibits the advocacy or encouragement of contraception. Multiple national surveys indicate that parents prefer a risk-reduction approach…

Source reduction for prevention of methylene chloride hazards: cases from four industrial sectors.

PubMed

Roelofs, Cora R; Ellenbecker, Michael J

2003-07-21

Source reduction, defined as chemical, equipment and process changes that intervene in an industrial process to eliminate or reduce hazards, has not figured as a front-line strategy for the protection of workers' health. Such initiatives are popular for environmental protection, but their feasibility and effectiveness as an industrial hygiene approach have not been well described. We investigated four cases of source reduction as a hazard prevention strategy in Massachusetts companies that had used methylene chloride, an occupational carcinogen, for cleaning and adhesive thinning. Three cases were retrospective and one was prospective, where the researchers assisted with the source reduction process change. Data were collected using qualitative research methods, including in-depth interviews and site visits. Motivated by environmental restrictions, a new worker health standard, and opportunity for productivity improvements, three companies eliminated their use of methylene chloride by utilizing available technologies and drop-in substitutes. Aided by technical assistance from the investigators, a fourth case dramatically reduced its use of methylene chloride via process and chemistry changes. While the companies' evaluations of potential work environment impacts of substitutes were not extensive, and in two cases new potential hazards were introduced, the overall impact of the source reduction strategy was deemed beneficial, both from a worker health and a production standpoint. The findings from these four cases suggest that source reduction should be considered potentially feasible and effective for reducing or eliminating the potential hazards of methylene chloride exposure. Especially when faced with a hazard that is both an environmental and worker health concern, companies may chose to change their processes rather than rely on local exhaust ventilation equipment or personal protective equipment that might not be as effective, might transfer risk and/or not be integrated with financial goals. However, technical assistance sensitive to environmental and health and safety impacts as well as production issues should be provided to guide companies' source reduction efforts.

Source reduction for prevention of methylene chloride hazards: cases from four industrial sectors

PubMed Central

Roelofs, Cora R; Ellenbecker, Michael J

2003-01-01

Background Source reduction, defined as chemical, equipment and process changes that intervene in an industrial process to eliminate or reduce hazards, has not figured as a front-line strategy for the protection of workers' health. Such initiatives are popular for environmental protection, but their feasibility and effectiveness as an industrial hygiene approach have not been well described. Methods We investigated four cases of source reduction as a hazard prevention strategy in Massachusetts companies that had used methylene chloride, an occupational carcinogen, for cleaning and adhesive thinning. Three cases were retrospective and one was prospective, where the researchers assisted with the source reduction process change. Data were collected using qualitative research methods, including in-depth interviews and site visits. Results Motivated by environmental restrictions, a new worker health standard, and opportunity for productivity improvements, three companies eliminated their use of methylene chloride by utilizing available technologies and drop-in substitutes. Aided by technical assistance from the investigators, a fourth case dramatically reduced its use of methylene chloride via process and chemistry changes. While the companies' evaluations of potential work environment impacts of substitutes were not extensive, and in two cases new potential hazards were introduced, the overall impact of the source reduction strategy was deemed beneficial, both from a worker health and a production standpoint. Conclusion The findings from these four cases suggest that source reduction should be considered potentially feasible and effective for reducing or eliminating the potential hazards of methylene chloride exposure. Especially when faced with a hazard that is both an environmental and worker health concern, companies may chose to change their processes rather than rely on local exhaust ventilation equipment or personal protective equipment that might not be as effective, might transfer risk and/or not be integrated with financial goals. However, technical assistance sensitive to environmental and health and safety impacts as well as production issues should be provided to guide companies' source reduction efforts. PMID:12904266

Tumor Heterogeneity of FIGO Stage III Carcinoma of the Uterine Cervix

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

Kim, Yong Bae; Lee, Ik Jae; Kim, Song Yih

2009-12-01

Purpose: The purpose of this study was to analyze tumor heterogeneity based on tumor extent and suggest reappraisal of the system of the International Federation of Gynecology and Obstetrics (FIGO) for Stage III carcinoma of the uterine cervix from a radiotherapeutic viewpoint. Methods and Materials: Between 1986 and 2004, 407 patients with FIGO Stage III (FIGO Stage IIIa in 19 and IIIb in 388) were treated with external beam radiotherapy (RT) and high-dose rate brachytherapy. All patients were reviewed with respect to tumor extent. Patterns of failure and survival parameters were analyzed by use of the chi{sup 2} test andmore » Kaplan-Meier method. Results: The complete response rate was 79.6%, and the 5-year overall survival rates for Stage IIIa and Stage IIIb carcinoma of the cervix were 82.1% and 54.8%, respectively. To determine which parameters of tumor extent had an influence on prognosis for Stage IIIb patients, pelvic wall (PW) extension and hydronephrosis (HD) retained significance on multivariate analysis. Stage IIIb patients were divided into three subgroups according to PW extension and HD: low risk (unilateral PW extension without HD), intermediate risk (HD without PW extension or bilateral PW extension without HD), and high risk (unilateral or bilateral PW extension with HD). The high-risk group had a remarkably low complete response rate, high locoregional failure rate, and low 5-year survival rate compared with the intermediate- and low-risk groups. Conclusions: FIGO Stage III carcinoma of the cervix covers considerably heterogeneous subgroups according to tumor extent. Before initiation of treatment, we suggest that physicians determine a tailored treatment policy based on tumor heterogeneity for each Stage III patient.« less

A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission.

PubMed

Eaton, Lisa A; Kalichman, Seth C; O'Connell, Daniel A; Karchner, William D

2009-10-01

A common HIV/AIDS risk reduction strategy among men who have sex with men (MSM) is to limit their unprotected sex partners to those who are of the same HIV status, a practice referred to as serosorting. Decisions to serosort for HIV risk reduction are based on personal impressions and beliefs, and there is limited guidance offered on this community derived strategy from public health services. This paper reviews research on serosorting for HIV risk reduction and offers an evidence-based approach to serosorting guidance. Following a comprehensive electronic and manual literature search, we reviewed 51 studies relating to the implications of serosorting. Studies showed that HIV negative MSM who select partners based on HIV status are inadvertently placing themselves at risk for HIV. Infrequent HIV testing, lack of HIV status disclosure, co-occurring sexually transmitted infections, and acute HIV infection impede the potential protective benefits of serosorting. Public health messages should continue to encourage reductions in numbers of sexual partners and increases in condom use. Risk reduction messages should also highlight the limitations of relying on one's own and partner's HIV status in making sexual risk decisions.

[Effects of a lower body weight or waist circumference on cardiovascular risk].

PubMed

Labraña, Ana María; Durán, Eliana; Martínez, María Adela; Leiva, Ana María; Garrido-Méndez, Alex; Díaz, Ximena; Salas, Carlos; Celis-Morales, Carlos

2017-05-01

Overall and central obesity are important risk factors for cardiovascular disease. To investigate the association of body weight, body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors in Chile. We included 5,157 participants from the National Health Survey 2009-2010. Prevalence of type 2 diabetes, hypertension, metabolic syndrome and dyslipidemia (high total cholesterol and triglyceride levels and low HDL-cholesterol) were defined using international recommendations. BMI and WC were measured using standardized protocols. A five percent lower body weight, BMI and WC were associated with a significant reduction in cardiovascular risk factors. For each 5% reduction in body weight, the risk for hypertension decreased by 8 and 9% in women and men respectively. Similar risk reductions were observed for diabetes (9 and 11% respectively), metabolic syndrome (23 and 30% respectively), low HDL cholesterol (13 and 13% respectively), high triglyceride levels (16 and 18% respectively) and total cholesterol (8 and 10% respectively). Similar findings were observed for BMI and WC. Lower body weight, BMI or WC are associated with important reductions in cardiovascular risk factors. A 5% reduction in these adiposity markers could be a perfectly feasible goal for lifestyle interventions.

Competition-Induced Reductions in Soil Water Availability Reduced Pine Root Extension Rates

Treesearch

K.H. Ludovici; L.A. Morris

1997-01-01

The relationship between soil water availability, root extension, and shoot growth of loblolly pine seedlings (Pinus taeda L.) was evaluated in a rhizotron sand mixture in the absence and presence of crabgrass (Digitaria spp.) competition. Heights and diameters of seedlings grown with crabgrass were reduced 33 and SO%, respectively, compared with...

76 FR 69318 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... TRADE AND DEVELOPMENT AGENCY Notice of Request for Extension of a Currently Approved Information Collection AGENCY: United States Trade and Development. ACTION: Request for comments. SUMMARY: In accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35 et seq.), the U.S. Trade and Development...

78 FR 77660 - Proposed Extension of Approval of Information Collection; Comment Request-Safety Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

... CONSUMER PRODUCT SAFETY COMMISSION [Docket No. CPSC-2010-0075] Proposed Extension of Approval of... Cribs AGENCY: Consumer Product Safety Commission. ACTION: Notice. SUMMARY: As required by the Paperwork Reduction Act of 1995 (44 U.S.C. chapter 35), the Consumer Product Safety Commission (CPSC or Commission...

76 FR 78230 - Notice of Request for Extension of Approval of an Information Collection; Requirements for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request an extension of approval of an information collection associated with the requirements for requests to amend import regulations for plants, plant parts, and plant products.

75 FR 75169 - Notice of Request for Extension of Approval of an Information Collection; Update of Nursery Stock...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-02

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request extension of approval of an information collection associated with regulations for the importation of nursery stock into the United States.

75 FR 61694 - Notice of Request for Extension of the Organic Assessment Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-FV-10-0069; FV10-900-1NC] Notice of Request for Extension of the Organic Assessment Exemption AGENCY: Agricultural Marketing... Reduction Act of 1995 (44 U.S.C. 3501), this notice announces the Agricultural Marketing Service's (AMS...

76 FR 24060 - Proposed Extension of Existing Information Collection; Testing, Evaluation, and Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... Extension of Existing Information Collection; Testing, Evaluation, and Approval of Mining Products AGENCY... Reduction Act of 1995 [44 U.S.C. 3506(c)(2)(A)]. This program helps to ensure that requested data can be..., testing, approval and certification, and quality control of mining equipment and components, materials...

78 FR 64984 - Extension of the Approval of Information Collection Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... DEPARTMENT OF LABOR Wage and Hour Division RIN 1235-0018 Extension of the Approval of Information Collection Requirements AGENCY: Wage and Hour Division, Department of Labor. ACTION: Notice. SUMMARY: The Paperwork Reduction Act of 1995 (PRA), 44 U.S.C. 3501 et seq., and its attendant regulations, 5 CFR part...

The association between nitroglycerin use and adverse outcomes in women undergoing cesarean delivery in the second stage of labor.

PubMed

Isquick, Sarah; Henry, Dana; Nakagawa, Sanae; Moghadassi, Michelle; Thiet, Mari-Paule; Norton, Mary; Lucero, Jennifer

2017-06-01

To identify predictors of hysterotomy extension in women undergoing cesarean delivery (CD) in the second stage of labor, and whether use of nitroglycerin (NTG) during CD has a protective effect. We conducted a retrospective cohort study of women undergoing CD in the second stage of labor from 2012 to 2015. Some women received NTG at the obstetrician's request. Logistic regression was used to examine the relationship between second stage duration and NTG administration on maternal and neonatal outcomes. Of the 391 women in the sample, 27% had an extension and 12% received NTG. Second stage ≥4 h was associated with a 2.14-fold higher risk of extension (95% CI 1.22-3.75), a 2.00-fold higher risk of hemorrhage (95% CI: 1.20-3.33) and 2.42-fold higher risk of blood transfusion during delivery hospitalization (95% CI: 0.99-5.91). Intravenous (IV) and sublingual-spray (SL-spray) NTG administration were not associated with an increased risk of hemorrhage or extension. SL-NTG was associated with 4.68-fold increased odds of 5-min Apgar <7 (95% CI 1.42-15.41) and 3.36-fold greater odds of NICU admission (95% CI 1.20-9.41). We found no evidence that NTG protects against extension, and SL-NTG use was associated with adverse neonatal outcomes. Clinical trials should be conducted to evaluate risk and benefits of NTG use.

A greater reduction in high-frequency heart rate variability to a psychological stressor is associated with subclinical coronary and aortic calcification in postmenopausal women.

PubMed

Gianaros, Peter J; Salomon, Kristen; Zhou, Fan; Owens, Jane F; Edmundowicz, Daniel; Kuller, Lewis H; Matthews, Karen A

2005-01-01

Reduced cardiac parasympathetic activity, as indicated by a reduced level of clinic or ambulatory high-frequency heart rate variability (HF-HRV), is associated with an increased risk for atherosclerosis and coronary artery disease. We tested whether the reduction in HF-HRV to a psychological stressor relative to a baseline level is also associated with subclinical coronary or aortic atherosclerosis, as assessed by calcification in these vascular regions. Spectral estimates of 0.15 to 0.40 Hz HF-HRV were obtained from 94 postmenopausal women (61-69 years) who engaged in a 3-minute speech-preparation stressor after a 6-minute resting baseline. A median of 282 days later, electron beam tomography (EBT) was used to measure the extent of coronary and aortic calcification. In univariate analyses, a greater reduction in HF-HRV from baseline to speech preparation was associated with having more extensive calcification in the coronary arteries (rho = -0.29, p = .03) and in the aorta (rho = -0.22, p = .06). In multivariate analyses that controlled for age, education level, smoking status, hormone therapy use, fasting glucose, high-density lipoproteins, baseline HF-HRV, and the stressor-induced change in respiration rate, a greater stressor-induced reduction in HF-HRV was associated with more calcification in the coronary arteries (B = -1.21, p < .05), and it was marginally associated with more calcification in the aorta (B = -0.92, p = .09). In postmenopausal women, a greater reduction in cardiac parasympathetic activity to a psychological stressor from baseline may be an independent correlate of subclinical atherosclerosis, particularly in the coronary arteries.

[Smoking fewer cigarettes per day may determine a significant risk reduction in developing smoking attributable diseases? Is there a risk reduction for e-cigarette users?].

PubMed

Pieri, Luca; Chellini, Elisabetta; Gorini, Giuseppe

2014-01-01

Among Italian smokers--about 10 millions in 2013--about 600,000 began using electronic cigarettes (e-cigs) in last years. About 10% of e-cig users quitted smoking tobacco, whereas the 90% was dual users. Among them, about three out of four decreased the number of cigarettes smoked per day (cig/day), but did not quit. How many fewer cigarettes a smoker has to smoke to obtain significant health benefits? Is there a threshold? In order to observe a significant 27% reduction in the risk of developing lung cancer, a smoker must reduce the number of cig/day by at least 50%, while for the other smoking-related diseases (acute myocardial infarction - AMI, stroke, chronic obstructive pulmonary diseases), halving the number of cig/day did not drive to a significant risk reduction. Even smoking 5 cig/day increases the risk of AMI, whereas it significantly lowers the risk of lung cancer. Obviously, quitting smoking is the best choice to highly reduce risks for all smoking-related diseases. Therefore, in order to achieve significant risk reductions, e-cig users should quit smoking as first choice, or, if they feel it is impossible to them, reduce the consumption of traditional cigarettes to less than 5 cig/day.

Participatory action research methodology in disaster research: results from the World Trade Center evacuation study.

PubMed

Gershon, Robyn R M; Rubin, Marcie S; Qureshi, Kristine A; Canton, Allison N; Matzner, Frederick J

2008-10-01

Participatory action research (PAR) methodology is an effective tool in identifying and implementing risk-reduction interventions. It has been used extensively in occupational health research, but not, to our knowledge, in disaster research. A PAR framework was incorporated into the World Trade Center evacuation study, which was designed to identify the individual, organizational, and structural (environmental) factors that affected evacuation from the World Trade Center Towers 1 and 2 on September 11, 2001. PAR teams-comprising World Trade Center evacuees, study investigators, and expert consultants-worked collaboratively to develop a set of recommendations designed to facilitate evacuation from high-rise office buildings and reduce risk of injury among evacuees. Two PAR teams worked first separately and then collectively to identify data-driven strategies for improvement of high-rise building evacuation. The teams identified interventions targeting individual, organizational, and structural (environmental) barriers to safe and rapid evacuation. PAR teams were effective in identifying numerous feasible and cost-effective strategies for improvement of high-rise emergency preparedness and evacuation. This approach may have utility in other workplace disaster prevention planning and response programs.

37 CFR 1.704 - Reduction of period of adjustment of patent term.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Adjustment and Extension... patent office in a counterpart foreign or international application or from the Office, and this... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Reduction of period of...

78 FR 12755 - Federal Acquisition Regulation; Submission for OMB Review; Schedules for Construction Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... Paperwork Reduction Act, the Regulatory Secretariat will be submitting to the Office of Management and... contract when other management approaches for ensuring adequate progress are not used. If the Contractor... extension of the information collection would violate the fundamental purpose of the Paperwork Reduction Act...

Bosch CO2 Reduction System Development

NASA Technical Reports Server (NTRS)

Holmes, R. F.; King, C. D.; Keller, E. E.

1976-01-01

Development of a Bosch process CO2 reduction unit was continued, and, by means of hardware modifications, the performance was substantially improved. Benefits of the hardware upgrading were demonstrated by extensive unit operation and data acquisition in the laboratory. This work was accomplished on a cold seal configuration of the Bosch unit.

77 FR 16116 - Agency Information Collection; Activity Under OMB Review; Report of Extension of Credit to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-19

... Transportation Statistics [Docket: RITA 2008-0002 BTS Paperwork Reduction Notice] Agency Information Collection... of Transportation Statistics (BTS), DOT. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act of 1995, Public Law 104-13, the Bureau of Transportation Statistics invites the general public...

Reflections from the interface between seismological research and earthquake risk reduction

NASA Astrophysics Data System (ADS)

Sargeant, S.

2012-04-01

Scientific understanding of earthquakes and their attendant hazards is vital for the development of effective earthquake risk reduction strategies. Within the global disaster reduction policy framework (the Hyogo Framework for Action, overseen by the UN International Strategy for Disaster Reduction), the anticipated role of science and scientists is clear, with respect to risk assessment, loss estimation, space-based observation, early warning and forecasting. The importance of information sharing and cooperation, cross-disciplinary networks and developing technical and institutional capacity for effective disaster management is also highlighted. In practice, the degree to which seismological information is successfully delivered to and applied by individuals, groups or organisations working to manage or reduce the risk from earthquakes is variable. The challenge for scientists is to provide fit-for-purpose information that can be integrated simply into decision-making and risk reduction activities at all levels of governance and at different geographic scales, often by a non-technical audience (i.e. people without any seismological/earthquake engineering training). The interface between seismological research and earthquake risk reduction (defined here in terms of both the relationship between the science and its application, and the scientist and other risk stakeholders) is complex. This complexity is a function of a range issues that arise relating to communication, multidisciplinary working, politics, organisational practices, inter-organisational collaboration, working practices, sectoral cultures, individual and organisational values, worldviews and expectations. These factors can present significant obstacles to scientific information being incorporated into the decision-making process. The purpose of this paper is to present some personal reflections on the nature of the interface between the worlds of seismological research and risk reduction, and the implications for scientists and information delivery.

Epidural extension failure in obese women is comparable to that of non-obese women.

PubMed

Eley, V A; Chin, A; Tham, I; Poh, J; Aujla, P; Glasgow, E; Brown, H; Steele, K; Webb, L; van Zundert, A

2018-07-01

Management of labor epidurals in obese women is difficult and extension to surgical anesthesia is not always successful. Our previous retrospective pilot study found epidural extension was more likely to fail in obese women. This study used a prospective cohort to compare the failure rate of epidural extension in obese and non-obese women and to identify risk factors for extension failure. One hundred obese participants (Group O, body mass index ≥ 40 kg/m 2 ) were prospectively identified and allocated two sequential controls (Group C, body mass index ≤ 30 kg/m 2 ). All subjects utilized epidural labor analgesia and subsequently required anesthesia for cesarean section. The primary outcome measure was failure of the labor epidural to be used as the primary anesthetic technique. Risk factors for extension failure were identified using Chi-squared and logistic regression. The odds ratio (OR) of extension failure was 1.69 in Group O (20% vs. 13%; 95% CI: 0.88-3.21, P = 0.11). Risk factors for failure in obese women included ineffective labor analgesia requiring anesthesiologist intervention, (OR 3.94, 95% CI: 1.16-13.45, P = 0.028) and BMI > 50 kg/m 2 (OR 3.42, 95% CI: 1.07-10.96, P = 0.038). The failure rate of epidural extension did not differ significantly between the groups. Further research is needed to determine the influence of body mass index > 50 kg/m 2 on epidural extension for cesarean section. © 2018 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Disaster risk reduction capacity assessment for precarious settlements in Guatemala City.

PubMed

Miles, Scott B; Green, Rebekah A; Svekla, Walter

2012-07-01

This study presents findings of an institutional capacity analysis of urban disaster risk reduction for informal settlements in the Guatemala Metropolitan Region. It uses a resource access perspective of vulnerability, actor-network theory, and qualitative data collection. The analysis reveals that there is interest in disaster risk reduction for the informal settlements; however, there is little in the way of direct financial or oversight relationships between informal settlement residents and all other actors. Respondents observed that informal settlements would probably remain inhabited; thus, there is a need for disaster risk reduction within these settlements. Disaster risk reduction capacity for informal settlements exists and can be further leveraged, as long as steps are taken to ensure appropriate access to and control of resources and oversight. Further, the nascent institutional arrangements should be strengthened through increased communication and coordination between actors, a decentralization of oversight and financial relationships, and mediation of identified resource conflicts. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

Preferences for breast cancer risk reduction among BRCA1/BRCA2 mutation carriers: a discrete-choice experiment.

PubMed

Liede, Alexander; Mansfield, Carol A; Metcalfe, Kelly A; Price, Melanie A; Snyder, Carrie; Lynch, Henry T; Friedman, Sue; Amelio, Justyna; Posner, Joshua; Narod, Steven A; Lindeman, Geoffrey J; Evans, D Gareth

2017-09-01

Unaffected women who carry BRCA1 or BRCA2 mutations face difficult choices about reducing their breast cancer risk. Understanding their treatment preferences could help us improve patient counseling and inform drug trials. The objective was to explore preferences for various risk-reducing options among women with germline BRCA1/2 mutations using a discrete-choice experiment survey and to compare expressed preferences with actual behaviors. A discrete-choice experiment survey was designed wherein women choose between hypothetical treatments to reduce breast cancer risk. The hypothetical treatments were characterized by the extent of breast cancer risk reduction, treatment duration, impact on fertility, hormone levels, risk of uterine cancer, and ease and mode of administration. Data were analyzed using a random-parameters logit model. Women were also asked to express their preference between surgical and chemoprevention options and to report on their actual risk-reduction actions. Women aged 25-55 years with germline BRCA1/2 mutations who were unaffected with breast or ovarian cancer were recruited through research registries at five clinics and a patient advocacy group. Between January 2015 and March 2016, 622 women completed the survey. Breast cancer risk reduction was the most important consideration expressed, followed by maintaining fertility. Among the subset of women who wished to have children in future, the ability to maintain fertility was the most important factor, followed by the extent of risk reduction. Many more women said they would take a chemoprevention drug than had actually taken chemoprevention. Women with BRCA1/2 mutations indicated strong preferences for breast cancer risk reduction and maintaining fertility. The expressed desire to have a safe chemoprevention drug available to them was not met by current chemoprevention options.

Managing and eradicating wildlife tuberculosis in New Zealand

PubMed Central

Warburton, B; Livingstone, P

2015-01-01

Abstract Tuberculosis (TB) due to Mycobacterium bovis infection was first identified in brushtail possums (Trichosurus vulpecula) in New Zealand in the late 1960s. Since the early 1970s, possums in New Zealand have been controlled as part of an ongoing strategy to manage the disease in livestock. The TB management authority (TBfree New Zealand) currently implements three strategic choices for disease-related possum control: firstly TB eradication in areas selected for eradication of the disease from livestock and wildlife, secondly Free Area Protection in areas in which possums are maintained at low densities, normally along a Vector Risk Area (VRA) boundary, and thirdly Infected Herd Suppression, which includes the remaining parts of VRA where possums are targeted to minimise the infection risk to livestock. Management is primarily through a range of lethal control options. The frequency and intensity of control is driven by a requirement to reduce populations to very low levels (usually to a trap-catch index below 2%), then to hold them at or below this level for 5–10 years to ensure disease eradication.Lethal possum control is implemented using aerial- and ground-based applications, under various regulatory and operational constraints. Extensive research has been undertaken aimed at improving the efficacy and efficiency of control. Aerial applications use sodium fluoroacetate (1080) bait for controlling possums over extensive and rugged areas of forest that are difficult to access by foot. Ground-based control uses a range of toxins (primarily, a potassium cyanide-based product) and traps. In the last 5 years there has been a shift from simple possum population control to the collection of spatial data on possum presence/absence and relative density, using simple possum detection devices using global positioning system-supported data collection tools, with recovery of possum carcasses for diagnostic necropsy. Such data provide information subsequently used in predictive epidemiological models to generate a probability of TB freedom.The strategies for managing TB in New Zealand wildlife now operate on four major principles: firstly a target threshold for possum population reduction is defined and set, secondly an objective methodology is applied for assessing whether target reductions have been achieved, thirdly effective control tools for achieving possum population reductions are used, and fourthly the necessary legislative support is in place to ensure compliance. TBfree New Zealand's possum control programme meets these requirements, providing an excellent example of an effective pest and disease control programme. PMID:25582863

Trauma transitional care coordination: A mature system at work.

PubMed

Hall, Erin C; Tyrrell, Rebecca L; Doyle, Karen E; Scalea, Thomas M; Stein, Deborah M

2018-05-01

We have previously demonstrated effectiveness of a Trauma Transitional Care Coordination (TTCC) Program in reducing 30-day readmission rates for trauma patients most at risk. With program maturation, we achieved improved readmission rates for specific patient populations. TTCC is a nursing driven program that supports patients at high risk for 30-day readmission. The TTCC interventions include calls to patients within 72 hours of discharge, complete medication reconciliation, coordination of medical appointments, and individualized problem solving. Account IDs were used to link TTCC patients with the Health Services Cost Review Commission database to collect data on statewide unplanned 30-day readmissions. Four hundred seventy-five patients were enrolled in the TTCC program from January 2014 to September 2016. Only 10.5% (n = 50) of TTCC enrollees were privately insured, 54.5% had Medicaid (n = 259), and 13.5% had Medicare (n = 64). Seventy-three percent had Health Services Cost Review Commission severity of injury ratings of 3 or 4 (maximum severity of injury = 4). The most common All Patient Refined Diagnosis Related Groups for participants were: lower-extremity procedures (n = 67, 14%); extensive abdominal/thoracic procedures (n = 40, 8.4%); musculoskeletal procedures (n = 37, 7.8%); complicated tracheostomy and upper extremity procedures (n = 29 each, 6.1%); infectious disease complications (n = 14, 2.9%); major chest/respiratory trauma, major small and large bowel procedures and vascular procedures (n = 13 each, 2.7%). The TTCC participants with lower-extremity injury, complicated tracheostomy, and bowel procedures had 6-point reduction (10% vs. 16%, p = 0.05), 11-point reduction (13% vs. 24%, p = 0.05), and 16-point reduction (11% vs. 27%, p = 0.05) in 30-day readmission rates, respectively, compared to those without TTCC. Targeted outpatient support for high-risk patients can decrease 30-day readmission rates. As our TTCC program matured, we reduced 30-day readmission in patients with lower-extremity injury, complicated tracheostomy and bowel procedures. This represents over one million-dollar savings for the hospital per year through quality-based reimbursement. Therapeutic/care management, level III.

Case Study of Cardiovascular Risk Reduction in the Northwest Region and TRICARE Region 11

DTIC Science & Technology

2003-11-01

and TRICARE Region 11. The second employee is not directly hired for cardiovascular risk reduction , but for tobacco cessation classes and consultation...Canadians with diabetes mellitus . Advances in Cardiovascular Risk Reduction 67 Experimental Medicine and Biology, 373-380...does not display a currently valid OMB control number. 1. REPORT DATE JUN 2003 2 . REPORT TYPE Final 3. DATES COVERED Jul 2002 - Jul 2003 4

Colorectal Cancer Awareness for Women via Facebook: A Pilot Study.

PubMed

Brittain, Kelly; Pennings Kamp, Kendra J; Salaysay, Zachary

Colorectal cancer is the third leading cause of cancer death among U.S. women. Women report being screened for colorectal cancer less often than men, and if colorectal cancer screening guidelines were routinely followed, approximately 60% of colorectal cancer deaths could be prevented. Many colorectal cancer screening interventions have not used Facebook, which is the most popular social media site among women. Little is known about engaging women in colorectal cancer screening and risk reduction information using Facebook. The "Colorectal Cancer Screening Awareness for Women" Facebook page was created to promote colorectal cancer screening and risk reduction awareness among women. Facebook posts targeted women aged 45-64 years and highlighted colorectal cancer screening methods, guidelines, and colorectal cancer risk reduction strategies. Demographics and data about the women's interactions with the page were collected using Facebook analytics and analyzed. The majority of the 391 users of the Colorectal Cancer Screening Awareness for Women Facebook page were women aged 45-54 years (56.5%). The most "liked" posts were related to colorectal cancer risk reduction behaviors. In an effort to increase routine colorectal cancer screening and colorectal cancer risk reduction behaviors, gastroenterology nurses and practices should consider Facebook as a good method to regularly engage women in colorectal cancer screening and colorectal cancer risk reduction information.

Effect of Using Different Vehicle Weight Groups on the Estimated Relationship Between Mass Reduction and U.S. Societal Fatality Risk per Vehicle Miles of Travel

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

Wenzel, Tom P.

This report recalculates the estimated relationship between vehicle mass and societal fatality risk, using alternative groupings by vehicle weight, to test whether the trend of decreasing fatality risk from mass reduction as case vehicle mass increases, holds over smaller increments of the range in case vehicle masses. The NHTSA baseline regression model estimates the relationship using for two weight groups for cars and light trucks; we re-estimated the mass reduction coefficients using four, six, and eight bins of vehicle mass. The estimated effect of mass reduction on societal fatality risk was not consistent over the range in vehicle masses inmore » these weight bins. These results suggest that the relationship indicated by the NHTSA baseline model is a result of other, unmeasured attributes of the mix of vehicles in the lighter vs. heavier weight bins, and not necessarily the result of a correlation between mass reduction and societal fatality risk. An analysis of the average vehicle, driver, and crash characteristics across the various weight groupings did not reveal any strong trends that might explain the lack of a consistent trend of decreasing fatality risk from mass reduction in heavier vehicles.« less

Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention

PubMed Central

Mercer Kollar, Laura M.; Davis, Teaniese L.; Monahan, Jennifer L.; Samp, Jennifer A.; Coles, Valerie B.; Bradley, Erin L. P.; Sales, Jessica McDermott; Comer, Sarah K.; Worley, Timothy; Rose, Eve; DiClemente, Ralph J.

2016-01-01

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18–24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET’s efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one’s sexual partner as an assertive communication behavior within sexual health contexts. PMID:27164847

Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention.

PubMed

Mercer Kollar, Laura M; Davis, Teaniese L; Monahan, Jennifer L; Samp, Jennifer A; Coles, Valerie B; Bradley, Erin L P; Sales, Jessica McDermott; Comer, Sarah K; Worley, Timothy; Rose, Eve; DiClemente, Ralph J

2016-12-01

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18-24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET's efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one's sexual partner as an assertive communication behavior within sexual health contexts. © 2016 Society for Public Health Education.

Discount rates in risk versus money and money versus money tradeoffs.

PubMed

Alberini, Anna; Chiabai, Aline

2007-04-01

We use data from a survey of residents of five Italian cities conducted in late spring 2004 to estimate the discount rates implicit in (1) money versus future risk reductions and (2) money versus money tradeoffs. We find that the mean personal discount rate is 0.3-1.7% in (1) and 8.7% in (2). The latter is lower than the discount rates estimated in comparable situations in many recent studies, greater than market interest rates in Italy at the time, and exhibits modest variation with age and gender. The discount rate implicit in money versus risk tradeoffs is within the range of estimates from studies in the United States and Europe, and does not depend on observable individual characteristics. We use split samples to investigate whether a completely abstract risk reduction - one where the risk reduction delivery has been stripped of all specifics, so that respondents should focus on the risks without being distracted by details - results in WTP and discount figures comparable to those from an identified delivery mechanism (a medical test). We find that while WTP for an immediate risk reduction is 42-73% higher with the abstract risk reduction, the discount rate in the money versus risk tradeoffs and the variance of the error term in the WTP equation are the same across the two variants of the questionnaire.

An Analysis of the Relationship between Casualty Risk Per Crash and Vehicle Mass and Footprint for Model Year 2003-2010 Light-Duty Vehicles

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

Wenzel, Tom P.

The Department of Energy’s (DOE) Vehicle Technologies Office funds research on development of technologies to improve the fuel economy of both light- and heavy-duty vehicles, including advanced combustion systems, improved batteries and electric drive systems, and new lightweight materials. Of these approaches to increase fuel economy and reduce fuel consumption, reducing vehicle mass through more extensive use of strong lightweight materials is perhaps the easiest and least expensive method; however, there is a concern that reducing vehicle mass may lead to more fatalities. Lawrence Berkeley National Laboratory (LBNL) has conducted several analyses to better understand the relationship between vehicle mass,more » size and safety, in order to ameliorate concerns that down-weighting vehicles will inherently lead to more fatalities. These analyses include recreating the regression analyses conducted by the National Highway Traffic Safety Administration (NHTSA) that estimate the relationship between mass reduction and U.S. societal fatality risk per vehicle mile of travel (VMT), while holding vehicle size (i.e. footprint, wheelbase times track width) constant; these analyses are referred to as LBNL Phase 1 analysis. In addition, LBNL has conducted additional analysis of the relationship between mass and the two components of risk per VMT, crash frequency (crashes per VMT) and risk once a crash has occurred (risk per crash); these analyses are referred to as LBNL Phase 2 analysis.« less

Evaluating health risks from occupational exposure to pesticides and the regulatory response.

PubMed Central

Woodruff, T J; Kyle, A D; Bois, F Y

1994-01-01

In this study, we used measurements of occupational exposures to pesticides in agriculture to evaluate health risks and analyzed how the federal regulatory program is addressing these risks. Dose estimates developed by the State of California from measured occupational exposures to 41 pesticides were compared to standard indices of acute toxicity (LD50) and chronic effects (reference dose). Lifetime cancer risks were estimated using cancer potencies. Estimated absorbed daily doses for mixers, loaders, and applicators of pesticides ranged from less than 0.0001% to 48% of the estimated human LD50 values, and doses for 10 of 40 pesticides exceeded 1% of the estimated human LD50 values. Estimated lifetime absorbed daily doses ranged from 0.1% to 114,000% of the reference doses developed by the U.S. Environmental Protection Agency, and doses for 13 of 25 pesticides were above them. Lifetime cancer risks ranged from 1 per million to 1700 per million, and estimates for 12 of 13 pesticides were above 1 per million. Similar results were obtained for field workers and flaggers. For the pesticides examined, exposures pose greater risks of chronic effects than acute effects. Exposure reduction measures, including use of closed mixing systems and personal protective equipment, significantly reduced exposures. Proposed regulations rely primarily on requirements for personal protective equipment and use restrictions to protect workers. Chronic health risks are not considered in setting these requirements. Reviews of pesticides by the federal pesticide regulatory program have had little effect on occupational risks. Policy strategies that offer immediate protection for workers and that are not dependent on extensive review of individual pesticides should be pursued. Images Figure 1. PMID:7713022

Risk Reduction and Resource Pooling on a Cooperation Task

ERIC Educational Resources Information Center

Pietras, Cynthia J.; Cherek, Don R.; Lane, Scott D.; Tcheremissine, Oleg

2006-01-01

Two experiments investigated choice in adult humans on a simulated cooperation task to evaluate a risk-reduction account of sharing based on the energy-budget rule. The energy-budget rule is an optimal foraging model that predicts risk-averse choices when net energy gains exceed energy requirements (positive energy budget) and risk-prone choices…

Comparison of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection: results of a randomized controlled trial.

PubMed

Champion, Jane Dimmitt; Collins, Jennifer L

2012-02-01

Ethnic minority adolescent women with a history of sexual or physical abuse and sexually transmitted infections represent a vulnerable population at risk for HIV. Community-based interventions for behavior modification and subsequent risk reduction have not been effective among these women. To evaluate the effects of a theory-based (AIDS Risk Reduction Model) cognitive behavioral intervention model versus enhanced counseling for abused ethnic minority adolescent women on infection with sexually transmitted infection at 6 and 12 months follow-up. Controlled randomized trial with longitudinal follow-up. Southwestern United States, Metropolitan community-based clinic. Mexican-and-African American adolescent women aged 14-18 years with a history of abuse or sexually transmitted infection seeking sexual health care. Extensive preliminary study for intervention development was conducted including individual interviews, focus groups, secondary data analysis, pre-testing and feasibility testing for modification of an evidence-based intervention prior to testing in the randomized controlled trial. Following informed consents for participation in the trial, detailed interviews concerning demographics, abuse history, sexual risk behavior, sexual health and physical exams were obtained. Randomization into either control or intervention groups was conducted. Intervention participants received workshop, support group and individual counseling sessions. Control participants received abuse and enhanced clinical counseling. Follow-up including detailed interview and physical exam was conducted at 6 and 12 months following study entry to assess for infection. Intention to treat analysis was conducted to assess intervention effects using chi-square and multiple regression models. 409 Mexican-(n=342) and African-(n=67) American adolescent women with abuse and sexually transmitted infection histories were enrolled; 90% intervention group attendance; longitudinal follow-up at 6 (93%) and 12 (94%) months. Intervention (n=199) versus control (n=210) group participants experienced fewer infections at 0-6 (0% versus 6.6%, p=.001), 6-12 (3.6% versus 7.8%, p=.005, CI 95% lower-upper .001-.386) and 0-12 (4.8% versus 13.2%, p=.002, CI 95% lower-upper, .002-.531) month intervals. A cognitive behavioral intervention specifically designed for ethnic minority adolescent women with a history of abuse and sexually transmitted infection was effective for prevention of infection. These results provide evidence for development of evidence-based interventions for sexually transmitted infection/HIV. Implications include translation to community-clinic-based settings for prevention of adverse outcomes regarding sexual health of adolescent women. Copyright © 2011 Elsevier Ltd. All rights reserved.

Waiting for Disasters: A Risk Reduction Assessment of Technological Disasters

NASA Astrophysics Data System (ADS)

Rovins, Jane; Winningham, Sam

2010-05-01

This session provides a risk reduction/mitigation assessment of natural hazards causation of technological disasters and possible solution. People use technology in an attempt to not only control their environment but nature itself in order to make them feel safe and productive. Most strategies for managing hazards followed a traditional planning model i.e. study the problem, identify and implement a solution, and move on to the next problem. This approach is often viewed as static model and risk reduction is more of an upward, positive, linear trend. However, technological disasters do not allow risk reduction action to neatly fit this upward, positive, linear trend with actual or potential threats to the environment and society. There are different types of technological disasters, including industrial accidents; pipeline ruptures; accidents at power, water and heat supply systems and other lines of communication; sudden collapse of buildings and mines; air crashes; shipwrecks; automobile and railway accidents to name a few. Natural factors can play an essential role in triggering or magnifying technological disasters. They can result from the direct destruction of given technical objects by a hazardous natural process such as the destruction of an atomic power plant or chemical plant due to an earthquake. Other examples would include the destruction of communications or infrastructure systems by heavy snowfalls, strong winds, avalanches. Events in the past ten years clearly demonstrate that natural disasters and the technological disasters that accompany them are not problems that can be solved in isolation and risk reduction can play an important part. Risk reduction was designed to head off the continuing rising financial and structural tolls from disasters. All Hazard Risk Reduction planning was supposed to include not only natural, but technological, and human-made disasters as well. The subsequent disaster risk reduction (DRR) indicators were to provide the corner stone to sustained risk reduction. We are able to look at the ongoing work by UNISDR and other partners to develop DRR indicators to track progress toward the goals outlined in the Hyogo Framework for Action adopted by 168 countries in Kobe, Japan in January 2005. In addition, we can look at various global examples. Therefore the true question we shall address is whether or not the DRR indicators form a virtuous circle was created with risk reduction with a series of positive events triggering a self-perpetuating pattern of other positive occurrences or a vicious circle.

Taking Stock of Risk Factors for Child/Youth Externalizing Behavior Problems.

ERIC Educational Resources Information Center

Hann, Della M., Ed.

Research on child and adolescent conduct problems has proliferated over the past 15 years, resulting in an extensive array of risk factors, processes, and targets for intervention. To capitalize fully on this extensive research base and contribute effectively to public mental health, the field now needs to take stock of what is known about child…

TPSLVM: a dimensionality reduction algorithm based on thin plate splines.

PubMed

Jiang, Xinwei; Gao, Junbin; Wang, Tianjiang; Shi, Daming

2014-10-01

Dimensionality reduction (DR) has been considered as one of the most significant tools for data analysis. One type of DR algorithms is based on latent variable models (LVM). LVM-based models can handle the preimage problem easily. In this paper we propose a new LVM-based DR model, named thin plate spline latent variable model (TPSLVM). Compared to the well-known Gaussian process latent variable model (GPLVM), our proposed TPSLVM is more powerful especially when the dimensionality of the latent space is low. Also, TPSLVM is robust to shift and rotation. This paper investigates two extensions of TPSLVM, i.e., the back-constrained TPSLVM (BC-TPSLVM) and TPSLVM with dynamics (TPSLVM-DM) as well as their combination BC-TPSLVM-DM. Experimental results show that TPSLVM and its extensions provide better data visualization and more efficient dimensionality reduction compared to PCA, GPLVM, ISOMAP, etc.

NASA's J-2X Engine Builds on the Apollo Program for Lunar Return Missions

NASA Technical Reports Server (NTRS)

Snoddy, Jimmy R.

2006-01-01

In January 2006, NASA streamlined its U.S. Vision for Space Exploration hardware development approach for replacing the Space Shuttle after it is retired in 2010. The revised CLV upper stage will use the J-2X engine, a derivative of NASA s Apollo Program Saturn V s S-II and S-IVB main propulsion, which will also serve as the Earth Departure Stage (EDS) engine. This paper gives details of how the J- 2X engine effort mitigates risk by building on the Apollo Program and other lessons learned to deliver a human-rated engine that is on an aggressive development schedule, with first demonstration flight in 2010 and human test flights in 2012. It is well documented that propulsion is historically a high-risk area. NASA s risk reduction strategy for the J-2X engine design, development, test, and evaluation is to build upon heritage hardware and apply valuable experience gained from past development efforts. In addition, NASA and its industry partner, Rocketdyne, which originally built the J-2, have tapped into their extensive databases and are applying lessons conveyed firsthand by Apollo-era veterans of America s first round of Moon missions in the 1960s and 1970s. NASA s development approach for the J-2X engine includes early requirements definition and management; designing-in lessons learned from the 5-2 heritage programs; initiating long-lead procurement items before Preliminary Desi& Review; incorporating design features for anticipated EDS requirements; identifying facilities for sea-level and altitude testing; and starting ground support equipment and logistics planning at an early stage. Other risk reduction strategies include utilizing a proven gas generator cycle with recent development experience; utilizing existing turbomachinery ; applying current and recent main combustion chamber (Integrated Powerhead Demonstrator) and channel wall nozzle (COBRA) advances; and performing rigorous development, qualification, and certification testing of the engine system, with a philosophy of "test what you fly, and fly what you test". These and other active risk management strategies are in place to deliver the J-2X engine for LEO and lunar return missions as outlined in the U.S. Vision for Space Exploration.

Long-term effects of ovulation-stimulating drugs on cancer risk.

PubMed

Brinton, Louise

2007-07-01

Although nulliparity has been extensively related to the risk of ovarian, breast and endometrial cancers, with many studies showing the relationship largely attributable to infertility, treatment effects on cancer risk are poorly understood. Two early studies raised substantial concern when ovulation-stimulating drugs were linked with large increases in ovarian cancer, supporting the notion of an important aetiological role of incessant ovulation. Subsequent studies have been mainly reassuring, although some have suggested possible risk increases among nulligravid women, those with extensive follow-up, and those developing borderline tumours. Results regarding effects of fertility drugs on breast cancer risk are conflicting, with some showing no associations and others demonstrating possible risk increases, although for varying subgroups. In contrast, endometrial cancer results are more consistent, with two recent studies showing increased risks related to clomiphene usage. This is of interest given that clomiphene is structurally similar to tamoxifen, a drug extensively linked with this cancer. Given the recent marketing of fertility drugs and the fact that exposed women are only beginning to reach the cancer age range, further follow-up is necessary. This will also be important to fully resolve effects of exposures such as gonadotrophins, used more recently in conjunction with IVF.

The cardiovascular event reduction tool (CERT)--a simplified cardiac risk prediction model developed from the West of Scotland Coronary Prevention Study (WOSCOPS).

PubMed

L'Italien, G; Ford, I; Norrie, J; LaPuerta, P; Ehreth, J; Jackson, J; Shepherd, J

2000-03-15

The clinical decision to treat hypercholesterolemia is premised on an awareness of patient risk, and cardiac risk prediction models offer a practical means of determining such risk. However, these models are based on observational cohorts where estimates of the treatment benefit are largely inferred. The West of Scotland Coronary Prevention Study (WOSCOPS) provides an opportunity to develop a risk-benefit prediction model from the actual observed primary event reduction seen in the trial. Five-year Cox model risk estimates were derived from all WOSCOPS subjects (n = 6,595 men, aged 45 to 64 years old at baseline) using factors previously shown to be predictive of definite fatal coronary heart disease or nonfatal myocardial infarction. Model risk factors included age, diastolic blood pressure, total cholesterol/ high-density lipoprotein ratio (TC/HDL), current smoking, diabetes, family history of fatal coronary heart disease, nitrate use or angina, and treatment (placebo/ 40-mg pravastatin). All risk factors were expressed as categorical variables to facilitate risk assessment. Risk estimates were incorporated into a simple, hand-held slide rule or risk tool. Risk estimates were identified for 5-year age bands (45 to 65 years), 4 categories of TC/HDL ratio (<5.5, 5.5 to <6.5, 6.5 to <7.5, > or = 7.5), 2 levels of diastolic blood pressure (<90, > or = 90 mm Hg), from 0 to 3 additional risk factors (current smoking, diabetes, family history of premature fatal coronary heart disease, nitrate use or angina), and pravastatin treatment. Five-year risk estimates ranged from 2% in very low-risk subjects to 61% in the very high-risk subjects. Risk reduction due to pravastatin treatment averaged 31%. Thus, the Cardiovascular Event Reduction Tool (CERT) is a risk prediction model derived from the WOSCOPS trial. Its use will help physicians identify patients who will benefit from cholesterol reduction.

Impact of comprehensive cardiovascular risk reduction programme on risk factor clustering associated with elevated blood pressure in an Indian industrial population.

PubMed

Jeemon, Panniyammakal; Prabhakaran, Dorairaj; Goenka, Shifalika; Ramakrishnan, Lakshmy; Padmanabhan, Sandosh; Huffman, Mark; Joshi, Prashant; Sivasankaran, Sivasubramonian; Mohan, B V M; Ahmed, F; Ramanathan, Meera; Ahuja, R; Sinha, Nakul; Thankappan, K R; Reddy, K S

2012-04-01

Cardiovascular risk factors clustering associated with blood pressure (BP) has not been studied in the Indian population. This study was aimed at assessing the clustering effect of cardiovascular risk factors with suboptimal BP in Indian population as also the impact of risk reduction interventions. Data from 10543 individuals collected in a nation-wide surveillance programme in India were analysed. The burden of risk factors clustering with blood pressure and coronary heart disease (CHD) was assessed. The impact of a risk reduction programmme on risk factors clustering was prospectively studied in a sub-group. Mean age of participants was 40.9 ± 11.0 yr. A significant linear increase in number of risk factors with increasing blood pressure, irrespective of stratifying using different risk factor thresholds was observed. While hypertension occurred in isolation in 2.6 per cent of the total population, co-existence of hypertension and >3 risk factors was observed in 12.3 per cent population. A comprehensive risk reduction programme significantly reduced the mean number of additional risk factors in the intervention population across the blood pressure groups, while it continued to be high in the control arm without interventions (both within group and between group P<0.001). The proportion of 'low risk phenotype' increased from 13.4 to 19.9 per cent in the intervention population and it was decreased from 27.8 to 10.6 per cent in the control population (P<0.001). The proportion of individuals with hypertension and three more risk factors decreased from 10.6 to 4.7 per cent in the intervention arm while it was increased from 13.3 to 17.8 per cent in the control arm (P<0.001). Our findings showed that cardiovascular risk factors clustered together with elevated blood pressure and a risk reduction programme significantly reduced the risk factors burden.

Availability and assessment of fixing additives for the in situ remediation of heavy metal contaminated soils: a review.

PubMed

Guo, Guanlin; Zhou, Qixing; Ma, Lene Q

2006-05-01

The use of low-cost and environmental safety amendments for the in situ immobilization of heavy metals has been investigated as a promising method for contaminated soil remediation. Natural materials and waste products from certain industries with high captive capacity of heavy metals can be obtained and employed. Reduction of extractable metal concentration and phytotoxicity could be evaluated and demonstrated by the feasibility of various amendments in fixing remediation. In this review, an extensive list of references has been compiled to provide a summary of information on a wide range of potentially amendment resources, including organic, inorganic and combined organic-inorganic materials. The assessment based on the economic efficiency and environmental risks brought forth the potential application values and future development directions of this method on solving the soil contamination.

Pathophysiological Mechanisms of Chronic Venous Disease and Implications for Venoactive Drug Therapy.

PubMed

Mansilha, Armando; Sousa, Joel

2018-06-05

Chronic venous disease (CVD) is a common pathology, with significant physical and psychological impacts for patients and high economic costs for national healthcare systems. Throughout the last decades, several risk factors for this condition have been identified, but only recently, have the roles of inflammation and endothelial dysfunction been properly assessed. Although still incompletely understood, current knowledge of the pathophysiological mechanisms of CVD reveals several potential targets and strategies for therapeutic intervention, some of which are addressable by currently available venoactive drugs. The roles of these drugs in the clinical improvement of venous tone and contractility, reduction of edema and inflammation, as well as in improved microcirculation and venous ulcer healing have been studied extensively, with favorable results reported in the literature. Here, we aim to review these pathophysiological mechanisms and their implications regarding currently available venoactive drug therapies.

Assessing habitat risk from human activities to inform coastal and marine spatial planning: a demonstration in Belize

NASA Astrophysics Data System (ADS)

Arkema, Katie K.; Verutes, Gregory; Bernhardt, Joanna R.; Clarke, Chantalle; Rosado, Samir; Canto, Maritza; Wood, Spencer A.; Ruckelshaus, Mary; Rosenthal, Amy; McField, Melanie; de Zegher, Joann

2014-11-01

Integrated coastal and ocean management requires transparent and accessible approaches for understanding the influence of human activities on marine environments. Here we introduce a model for assessing the combined risk to habitats from multiple ocean uses. We apply the model to coral reefs, mangrove forests and seagrass beds in Belize to inform the design of the country’s first Integrated Coastal Zone Management (ICZM) Plan. Based on extensive stakeholder engagement, review of existing legislation and data collected from diverse sources, we map the current distribution of coastal and ocean activities and develop three scenarios for zoning these activities in the future. We then estimate ecosystem risk under the current and three future scenarios. Current levels of risk vary spatially among the nine coastal planning regions in Belize. Empirical tests of the model are strong—three-quarters of the measured data for coral reef health lie within the 95% confidence interval of interpolated model data and 79% of the predicted mangrove occurrences are associated with observed responses. The future scenario that harmonizes conservation and development goals results in a 20% reduction in the area of high-risk habitat compared to the current scenario, while increasing the extent of several ocean uses. Our results are a component of the ICZM Plan for Belize that will undergo review by the national legislature in 2015. This application of our model to marine spatial planning in Belize illustrates an approach that can be used broadly by coastal and ocean planners to assess risk to habitats under current and future management scenarios.

Adherence to Mediterranean Diet Offers an Additive Protection Over the Use of Statin Therapy: Results from the ATTICA Study (2002-2012).

PubMed

Panagiotakos, Demosthenes B; Georgousopoulou, Ekavi N; Georgiopoulos, Georgios A; Pitsavos, Christos; Chrysohoou, Christina; Skoumas, Ioannis; Ntertimani, Maria; Laskaris, Alexandros; Papadimitriou, Lampros; Tousoulis, Dimitrios; Stefanadis, Christodoulos

2015-01-01

The protective role of Mediterranean diet on cardiovascular disease (CVD) risk has been extensively discussed in the literature, but its incremental effect over the use of CVD risk reducing agents (such as hypolipidemic treatment) has rarely been evaluated. The ATTICA study was carried out in the Athens area during 2001-2002 and included 3042 participants free of CVD at baseline (49.8% men, aged 18-89 years). Adherence to Mediterranean diet was assessed using the MedDietScore (range 0-55) and statin use was recorded for all subjects. During 2011-2012, 2583 out of the 3042 baseline participants attended the 10-year follow-up of the ATTICA study (15% lost-to-follow-up) and CVD development was recorded. Adherence to Mediterranean diet (highest tertile) decreased CVD risk by 29.3% (Hazard Ratio (HR): 0.707, 95% Confidence Intervals (CI): 0.537-0.831) as compared with the lowest tertile, independently of statin use. Patients with hyperlipidemia on a statin that adopted unhealthy dietary habits (lowest tertile) had 75% increased CVD risk than normolipidemic subjects with healthy dietary habits (HR=1.75, 95%CI: 1.33-2.29). The addition of Mediterranean diet tertiles in the multivariable model reclassified 46.7% of the participants to CVD risk categories. Adherence to Mediterranean diet confers a considerable reduction in CVD risk, independently of gender, age, family history of CVD, diabetes mellitus, smoking status, hypertension and physical activity status. Therefore, CVD prevention strategies should involve the implementation of a Mediterranean diet in both the general population and patients on a statin.

Mothers' knowledge and attitudes to sudden infant death syndrome risk reduction messages: results from a UK survey.

PubMed

Pease, Anna S; Blair, Peter S; Ingram, Jenny; Fleming, Peter J

2018-01-01

To investigate mothers' knowledge of reducing the risks for sudden infant death syndrome (SIDS) and attitudes towards safer sleep practices. A cross-sectional survey was carried out in deprived areas of Bristol, UK. Recruitment took place in 2014 at local health visitor-led baby clinics. Of 432 mothers approached, 400 (93%) completed the face-to-face survey. Participants with infants at 'higher' risk of SIDS (using an algorithm based on a previous observational study) were compared with those at 'lower' risk. The survey asked participants to recall three SIDS risk reduction strategies (unprompted), and scored responses to 14 SIDS risk-related infant sleep scenarios (prompted). Overall, 48/400 (12%) mothers were classified as higher risk. Mothers in the higher risk group were less likely to breast feed (multivariate OR=3.59(95% CI 1.46 to 8.86)), less likely to be able to cite two or more unprompted correct SIDS risk reduction strategies (multivariate OR=2.05(95% CI 1.02 to 4.13)) and scored lower on prompted safer sleep scenarios overall.Notably, only 206/400 (52%) of all mothers surveyed (33% in the higher risk group) from these deprived areas in Bristol identified infant sleep position as a risk reduction strategy for SIDS, despite 25 years of campaigns. Mothers in the higher risk group were disadvantaged when it came to some aspects of knowledge of SIDS risk reduction and attitudes to safer sleep. The initial 'Back-to Sleep' message that dramatically reduced these deaths a generation ago needs more effective promotion for today's generation of mothers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Explosion Amplitude Reduction due to Fractures in Water-Saturated and Dry Granite

NASA Astrophysics Data System (ADS)

Stroujkova, A. F.; Leidig, M.; Bonner, J. L.

2013-12-01

Empirical observations made at the Semipalatinsk Test Site suggest that nuclear tests in the fracture zones left by previous explosions ('repeat shots') show reduced seismic amplitudes compared to the nuclear tests in virgin rocks. Likely mechanisms for the amplitude reduction in the repeat shots include increased porosity and reduced strength and elastic moduli, leading to pore closing and frictional sliding. Presence of pore water significantly decreases rock compressibility and strength, thus affecting seismic amplitudes. A series of explosion experiments were conducted in order to define the physical mechanism responsible for the amplitude reduction and to quantify the degree of the amplitude reduction in fracture zones of previously detonated explosions. Explosions in water-saturated granite were conducted in central New Hampshire in 2011 and 2012. Additional explosions in dry granite were detonated in Barre, VT in 2013. The amplitude reduction is different between dry and water-saturated crystalline rocks. Significant reduction in seismic amplitudes (by a factor of 2-3) in water-saturated rocks was achieved only when the repeat shot was detonated in the extensive damage zone created by a significantly larger (by a factor of 5) explosion. In case where the first and the second explosions were similar in yield, the amplitude reduction was relatively modest (5-20%). In dry rocks the amplitude reduction reached a factor of 2 even in less extensive damage zones. In addition there are differences in frequency dependence of the spectral amplitude ratios between explosions in dry and water-saturated rocks. Thus the amplitude reduction is sensitive to the extent of the damage zone as well as the pore water content.

Hydraulic "fracking": are surface water impacts an ecological concern?

PubMed

Burton, G Allen; Basu, Niladri; Ellis, Brian R; Kapo, Katherine E; Entrekin, Sally; Nadelhoffer, Knute

2014-08-01

Use of high-volume hydraulic fracturing (HVHF) in unconventional reservoirs to recover previously inaccessible oil and natural gas is rapidly expanding in North America and elsewhere. Although hydraulic fracturing has been practiced for decades, the advent of more technologically advanced horizontal drilling coupled with improved slickwater chemical formulations has allowed extensive natural gas and oil deposits to be recovered from shale formations. Millions of liters of local groundwaters are utilized to generate extensive fracture networks within these low-permeability reservoirs, allowing extraction of the trapped hydrocarbons. Although the technology is relatively standardized, the geographies and related policies and regulations guiding these operations vary markedly. Some ecosystems are more at risk from these operations than others because of either their sensitivities or the manner in which the HVHF operations are conducted. Generally, the closer geographical proximity of the susceptible ecosystem to a drilling site or a location of related industrial processes, the higher the risk of that ecosystem being impacted by the operation. The associated construction of roads, power grids, pipelines, well pads, and water-extraction systems along with increased truck traffic are common to virtually all HVHF operations. These operations may result in increased erosion and sedimentation, increased risk to aquatic ecosystems from chemical spills or runoff, habitat fragmentation, loss of stream riparian zones, altered biogeochemical cycling, and reduction of available surface and hyporheic water volumes because of withdrawal-induced lowering of local groundwater levels. The potential risks to surface waters from HVHF operations are similar in many ways to those resulting from agriculture, silviculture, mining, and urban development. Indeed, groundwater extraction associated with agriculture is perhaps a larger concern in the long term in some regions. Understanding the ecological impacts of these anthropogenic activities provides useful information for evaluations of potential HVHF hazards. Geographic information system-based modeling combined with strategic site monitoring has provided insights into the relative importance of these and other ecoregion and land-use factors in discerning potential HVHF impacts. Recent findings suggest that proper siting and operational controls along with strategic monitoring can reduce the potential for risks to aquatic ecosystems. Nevertheless, inadequate data exist to predict ecological risk at this time. The authors suggest considering the plausibility of surface water hazards associated with the various HVHF operations in terms of the ecological context and in the context of relevant anthropogenic activities. © 2014 SETAC.

Violence against female sex workers in Cameroon: accounts of violence, harm reduction, and potential solutions.

PubMed

Lim, Sahnah; Peitzmeier, Sarah; Cange, Charles; Papworth, Erin; LeBreton, Matthew; Tamoufe, Ubald; Kamla, Aristide; Billong, Serge; Fokam, Pamella; Njindam, Iliassou; Decker, Michele R; Sherman, Susan G; Baral, Stefan

2015-03-01

Female sex workers (FSWs) in Cameroon, and West Africa generally, suffer a disproportionate burden of HIV. Although violence against FSWs has been documented extensively in other parts of the world, data on violence from West African countries are lacking. The aim of this study was to qualitatively document violence and harm reduction strategies from the perspective of FSWs in Cameroon as well as to understand how experiences of violence may increase FSWs' HIV risk. FSWs from 7 major cities in Cameroon (Douala, Yaounde, Bamenda, Bertoua, Nagoundere, Kribi, and Bafoussam) were purposively recruited. Data from 31 in-depth interviews and 7 focus groups (n = 70; with some overlapping participants from in-depth interviews) conducted with these FSWs in 6 of these 7 cities (excluding Kribi) were analyzed using a grounded theory approach. Transcripts revealed 3 primary themes related to violence: (1) sources and types of violence, including sexual, physical, and financial violence perpetrated by clients and police, (2) harm reduction strategies, including screening clients and safe work locations, receipt of payment before sexual act, and formation of an informal security network, and (3) recommendations on structural changes to reduce violence that emphasized sex work decriminalization and increased police accountability. As in other parts of the world, violence against FSWs is pervasive in Cameroon. Interventions targeting violence and HIV must address the forms of violence cited locally by FSWs and can build on FSWs' existing strengths and harm reduction strategies. Structural changes are needed to ensure access to justice for this population.

Long-term efficacy and safety of mipomersen in patients with familial hypercholesterolaemia: 2-year interim results of an open-label extension.

PubMed

Santos, Raul D; Duell, P Barton; East, Cara; Guyton, John R; Moriarty, Patrick M; Chin, Wai; Mittleman, Robert S

2015-03-01

To evaluate the efficacy and safety of extended dosing with mipomersen in patients with familial hypercholesterolaemia (HC) taking maximally tolerated lipid-lowering therapy. A planned interim analysis of an ongoing, open-label extension trial in patients (n = 141) with familial HC receiving a subcutaneous injection of 200 mg mipomersen weekly plus maximally tolerated lipid-lowering therapy for up to 104 weeks. The mean changes in low-density lipoprotein cholesterol (LDL-C) from baseline to weeks 26 (n = 130), 52 (n = 111), 76 (n = 66), and 104 (n = 53) were -28, -27, -27, and -28%; and in apolipoprotein B -29, -28, -30, and -31%, respectively. Reductions in total cholesterol, non-high-density lipoprotein-cholesterol, and lipoprotein(a) were comparable with decreases in LDL-C and apolipoprotein B levels. Mean high-density lipoprotein cholesterol increased from baseline by 7 and 6% at weeks 26 and 52, respectively. The long-term safety profile of mipomersen was similar to that reported in the associated randomized placebo-controlled Phase 3 trials. Adverse events included injection site reactions and flu-like symptoms. There was an incremental increase in the median liver fat during the initial 6-12 months that appeared to diminish with continued mipomersen exposure beyond 1 year and returned towards baseline 24 weeks after last drug dose suggestive of adaptation. The median alanine aminotransferase level showed a similar trend over time. Long-term treatment with mipomersen for up to 104 weeks provided sustained reductions in all atherosclerotic lipoproteins measured and a safety profile consistent with prior controlled trials in these high-risk patient populations. CLINICALTRIALS.GOV: NCT00694109. © The Author 2013. Published by Oxford University Press on behalf of the European Society of Cardiology.

Long-term efficacy and safety of mipomersen in patients with familial hypercholesterolaemia: 2-year interim results of an open-label extension

PubMed Central

Santos, Raul D.; Duell, P. Barton; East, Cara; Guyton, John R.; Moriarty, Patrick M.; Chin, Wai; Mittleman, Robert S.

2015-01-01

Aims To evaluate the efficacy and safety of extended dosing with mipomersen in patients with familial hypercholesterolaemia (HC) taking maximally tolerated lipid-lowering therapy. Methods and results A planned interim analysis of an ongoing, open-label extension trial in patients (n = 141) with familial HC receiving a subcutaneous injection of 200 mg mipomersen weekly plus maximally tolerated lipid-lowering therapy for up to 104 weeks. The mean changes in low-density lipoprotein cholesterol (LDL-C) from baseline to weeks 26 (n = 130), 52 (n = 111), 76 (n = 66), and 104 (n = 53) were −28, −27, −27, and −28%; and in apolipoprotein B −29, −28, −30, and −31%, respectively. Reductions in total cholesterol, non-high-density lipoprotein-cholesterol, and lipoprotein(a) were comparable with decreases in LDL-C and apolipoprotein B levels. Mean high-density lipoprotein cholesterol increased from baseline by 7 and 6% at weeks 26 and 52, respectively. The long-term safety profile of mipomersen was similar to that reported in the associated randomized placebo-controlled Phase 3 trials. Adverse events included injection site reactions and flu-like symptoms. There was an incremental increase in the median liver fat during the initial 6–12 months that appeared to diminish with continued mipomersen exposure beyond 1 year and returned towards baseline 24 weeks after last drug dose suggestive of adaptation. The median alanine aminotransferase level showed a similar trend over time. Conclusion Long-term treatment with mipomersen for up to 104 weeks provided sustained reductions in all atherosclerotic lipoproteins measured and a safety profile consistent with prior controlled trials in these high-risk patient populations. Clinicaltrials.gov NCT00694109. PMID:24366918

Environmental and risk screening for prioritizing pollution prevention opportunities in the U.S. printed wiring board manufacturing industry.

PubMed

Lam, Carl W; Lim, Seong-Rin; Schoenung, Julie M

2011-05-15

Modern manufacturing of printed wiring boards (PWBs) involves extensive use of various hazardous chemicals in different manufacturing steps such as board preparation, circuit design transfer, etching and plating processes. Two complementary environmental screening methods developed by the U.S. EPA, namely: (i) the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) and (ii) Risk-Screening Environmental Indicators (RSEI), are used to quantify geographic and chemical environmental impacts in the U.S. PWB manufacturing industry based on Toxics Release Inventory (TRI) data. Although the release weight percentages of industrial chemicals such as methanol, glycol ethers and dimethylformamide comprise the larger fraction of reported air and water emissions, results indicate that lead, copper and their compounds' releases correspond to the highest environmental impact from toxicity potentials and risk-screening scores. Combining these results with further knowledge of PWB manufacturing, select alternative chemical processes and materials for pollution prevention are discussed. Examples of effective pollution prevention options in the PWB industry include spent etchant recovery technologies, and process and material substitutions. In addition, geographic assessment of environmental burden highlights states where promotion of pollution prevention strategies and emissions regulations can have the greatest effect to curb the PWB industry's toxic release impacts. Copyright © 2011 Elsevier B.V. All rights reserved.

Sexual health risk reduction interventions for people with severe mental illness: a systematic review.

PubMed

Pandor, Abdullah; Kaltenthaler, Eva; Higgins, Agnes; Lorimer, Karen; Smith, Shubulade; Wylie, Kevan; Wong, Ruth

2015-02-12

Despite variability in sexual activity among people with severe mental illness, high-risk sexual behavior (e.g. unprotected intercourse, multiple partners, sex trade and illicit drug use) is common. Sexual health risk reduction interventions (such as educational and behavioral interventions, motivational exercises, counselling and service delivery), developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. This systematic review evaluates the effectiveness of sexual health risk reduction interventions for people with severe mental illness. Thirteen electronic databases (including MEDLINE, EMBASE and PsycINFO) were searched to August 2014, and supplemented by hand-searching relevant articles and contacting experts. All controlled trials (randomized or non-randomized) comparing the effectiveness of sexual health risk reduction interventions with usual care for individuals living in the community with severe mental illness were included. Outcomes included a range of biological, behavioral and proxy endpoints. Narrative synthesis was used to combine the evidence. Thirteen controlled trials (all from the USA) were included. Although there was no clear and consistent evidence that interventions reduce the total number of sex partners or improved behavioral intentions in sexual risk behavior, positive effects were generally observed in condom use, condom protected intercourse and on measures of HIV knowledge, attitudes to condom use and sexual behaviors and practices. However, the robustness of these findings is low due to the large between study variability, small sample sizes and low-to-moderate quality of included studies. There is insufficient evidence at present to fully support or reject the identified sexual health risk reduction interventions for people with severe mental illness. Given the serious consequences of high-risk sexual behaviors, there is an urgent need for well-designed UK based trials, as well as training and support for staff implementing sexual health risk reduction interventions. PROSPERO CRD42013003674 .

Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials.

PubMed

Katsanos, Aristeidis H; Filippatou, Angeliki; Manios, Efstathios; Deftereos, Spyridon; Parissis, John; Frogoudaki, Alexandra; Vrettou, Agathi-Rosa; Ikonomidis, Ignatios; Pikilidou, Maria; Kargiotis, Odysseas; Voumvourakis, Konstantinos; Alexandrov, Anne W; Alexandrov, Andrei V; Tsivgoulis, Georgios

2017-01-01

Current recommendations do not specifically address the optimal blood pressure (BP) reduction for secondary stroke prevention in patients with previous cerebrovascular events. We conducted a systematic review and metaregression analysis on the association of BP reduction with recurrent stroke and cardiovascular events using data from randomized controlled clinical trials of secondary stroke prevention. For all reported events during each eligible study period, we calculated the corresponding risk ratios to express the comparison of event occurrence risk between patients randomized to antihypertensive treatment and those randomized to placebo. On the basis of the reported BP values, we performed univariate metaregression analyses according to the achieved BP values under the random-effects model (Method of Moments) for those adverse events reported in ≥10 total subgroups of included randomized controlled clinical trials. In pairwise meta-analyses, antihypertensive treatment lowered the risk for recurrent stroke (risk ratio, 0.73; 95% confidence interval, 0.62-0.87; P<0.001), disabling or fatal stroke (risk ratio, 0.71; 95% confidence interval, 0.59-0.85; P<0.001), and cardiovascular death (risk ratio, 0.85; 95% confidence interval, 0.75-0.96; P=0.01). In metaregression analyses, systolic BP reduction was linearly related to the lower risk of recurrent stroke (P=0.049), myocardial infarction (P=0.024), death from any cause (P=0.001), and cardiovascular death (P<0.001). Similarly, diastolic BP reduction was linearly related to a lower risk of recurrent stroke (P=0.026) and all-cause mortality (P=0.009). Funnel plot inspection and Egger statistical test revealed no evidence of publication bias. The extent of BP reduction is linearly associated with the magnitude of risk reduction in recurrent cerebrovascular and cardiovascular events. Strict and aggressive BP control seems to be essential for effective secondary stroke prevention. © 2016 American Heart Association, Inc.

78 FR 21338 - Notice of Request for Extension of a Currently Approved Information Collection (Registration...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

...In accordance with the Paperwork Reduction Act of 1995 and Office of Management and Budget (OMB) regulations, the Food Safety and Inspection Service (FSIS) is announcing its intention to request extension of an information collection for business registration requirements because the information collection approval is scheduled to expire on June 30, 2013.

77 FR 50982 - Notice of Request for Extension of Approval of an Information Collection; Foreign Quarantine Notices

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request an extension of approval of an information collection associated with regulations to prevent the introduction or spread of foreign plant pests into or within the United States.

Metachronous colorectal cancer following segmental or extended colectomy in Lynch syndrome: a systematic review and meta-analysis.

PubMed

Malik, Salim S; Lythgoe, Mark P; McPhail, Mark; Monahan, Kevin J

2017-11-30

Around 5% of colorectal cancers are due to mutations within DNA mismatch repair genes, resulting in Lynch syndrome (LS). These mutations have a high penetrance with early onset of colorectal cancer at a mean age of 45 years. The mainstay of surgical management is either a segmental or extensive colectomy. Currently there is no unified agreement as to which management strategy is superior due to limited conclusive empirical evidence available. A systematic review and meta- analysis to evaluate the risk of metachronous colorectal cancer (MCC) and mortality in LS following segmental and extensive colectomy. A systematic review of the PubMed database was conducted. Studies were included/ excluded based on pre-specified criteria. To assess the risk of MCC and mortality attributed to segmental or extensive colectomies, relative risks (RR) were calculated and corresponding 95% confidence intervals (CI). Publication bias was investigated using funnel plots. Data about mortality, as well as patient ascertainment [Amsterdam criteria (AC), germline mutation (GM)] were also extracted. Statistical analysis was conducted using the R program (version 3.2.3). The literature search identified 85 studies. After further analysis ten studies were eligible for inclusion in data synthesis. Pooled data identified 1389 patients followed up for a mean of 100.7 months with a mean age of onset of 45.5 years of age. A total 1119 patients underwent segmental colectomies with an absolute risk of MCC in this group of 22.4% at the end of follow-up. The 270 patients who had extensive colectomies had a MCC absolute risk of 4.7% (0% in those with a panproctocolecomy). Segmental colectomy was significantly associated with an increased relative risk of MCC (RR = 5.12; 95% CI 2.88-9.11; Fig. 1), although no significant association with mortality was identified (RR = 1.65; 95% CI 0.90-3.02). There was no statistically significant difference in the risk of MCC between AC and GM cohorts (p = 0.5, Chi-squared test). In LS, segmental colectomy results in a significant increased risk of developing MCC. Despite the choice of segmental or extensive colectomies having no statistically significant impact on mortality, the choice of initial surgical management can impact a patient's requirement for further surgery. An extensive colectomy can result in decreased need for further surgery; reduced hospital stays and associated costs. The significant difference in the risk of MCC, following segmental or extensive colectomies should be discussed with patients when deciding appropriate management. An individualised approach should be utilised, taking into account the patient's age, co-morbidities and genotype. In order to determine likely germline-specific effects, or a difference in survival, larger and more comprehensive studies are required.

Promoting the University Social Responsibility in the Capacity Development Program for Landslide Risk Reduction in Indonesia

NASA Astrophysics Data System (ADS)

Karnawati, D.; Wilopo, W.; Verrier, M.; Fathani, T. F.; Andayani, B.

2011-12-01

One of the most challenges efforts for landslides disaster risk reduction in Indonesia is to provide an effective program for capacity development of the community living in the vulnerable area. Limited access for appropriate information and knowledge about the geology and landslide phenomena as well as the social-security constrains are the major challenges in capacity development program in the landslide prone area. Accordingly, an action for conducting community-based research and education program with respect to landslide mitigation and disaster risk reduction at the village level was established by implementing the University Social Responsibility Program. Such program has been conducted regularly in every academic semester as a part of the formal academic program at Universitas Gadjah Mada , Indonesia. Twenty students with multi-discipline backgrounds and supported by their lectures/advisers have to be deployed at the village for two months to carry out such mission. This action is also conducted under the coordination with the local/ national Government together with the local community, and may also with the private sectors. A series of research actions such as landslide investigation and hazard-risk mapping, social mapping and development of landslide early warning system were carried out in parallel with public education and evacuation drill for community empowerment and landslide risk reduction. A Community Task Force for Disaster Risk Reduction was also established during the community empowerment program, in order to guarantee the affectivity and sustainability of the disaster risk reduction program at the village level. It is crucial that this program is not only beneficial for empowering the village community to tackle the landslide problems, but also important to support the education for sustainable development program at the disaster prone area. Indeed, this capacity development program may also be considered as one best practice for transforming the knowledge into action and the action into knowledge enhancement, with respect to landslide disaster risk reduction.
Scope of problems and the actions conducted by Universitas Gadjah Mada as The University Social Responsibility Program for Landslide Disaster Risk Reduction in Indonesia

Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma.

PubMed

Struewer, Johannes; Kiriazidis, Ilias; Figiel, Jens; Dukatz, Thomas; Frangen, Thomas; Ziring, Ewgeni

2012-07-01

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Owing to the proximity of the temporal glenoid fossa to the middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 36-year-old male patient, who was beaten up in a family dispute and presented with complex mandibular and maxillofacial fractures, including mandibular condyle intrusion into the middle cranial fossa causing extensive meningeal bleeding. The patient underwent immediate surgery, with evacuation of the epidural haematoma via a temporal approach. In addition open reduction and reconstruction of the temporal glenoid fossa via anatomic reduction of the fragments was performed. A functional occlusion was re-established via miniplate reconstruction of the complex mandibular body and ramus fractures. Prompt diagnosis and a multidisciplinary approach are essential to minimize the complications. Advanced imaging modalities of computed tomography are indicated. Treatment options should be individualized in particular in case of suspected neurological injury. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Efficacy of emamectin benzoate against sea lice infestations of Atlantic salmon, Salmo salar L.: evaluation in the absence of an untreated contemporary control.

PubMed

Gustafson, L; Ellis, S; Robinson, T; Marenghi, F; Endris, R

2006-10-01

The efficacy of emamectin benzoate (SLICE) against sea lice infestations of Atlantic salmon, Salmo salar L., is typically assessed using untreated fish, or fish treated with alternative therapeutants, as controls. The State of Maine, USA, is currently under active management for the OIE-notifiable pathogen, infectious salmon anaemia virus (ISAV); consequently, neither control group is feasible in this region. Untreated salmon risk extensive damage from the ectoparasites, and threaten to increase vector-borne exposure or susceptibility of farms to ISAV; and the only treatment presently available in Maine is SLICE. However, because sea lice infestations are unlikely to resolve spontaneously, and response to treatment occurs within weeks, use of a pretreatment baseline is a reasonable alternative for confirmatory studies. We evaluated SLICE efficacy on Atlantic salmon farms in Cobscook Bay 2002-2005, in the absence of untreated controls, using pretreatment lice loads as a reference for calculation. Maximum efficacy ranged from 68% to 100% reduction from initial levels. Time-to-maximum efficacy ranged from 1 to 8 weeks after treatment initiation. Efficacy duration, measured between first reduction and first progressive rise in counts, ranged from 4 to 16 weeks.

Screening of Potential Landing Gear Noise Control Devices at Virginia Tech For QTD II Flight Test

NASA Technical Reports Server (NTRS)

Ravetta, Patricio A.; Burdisso, Ricardo A.; Ng, Wing F.; Khorrami, Mehdi R.; Stoker, Robert W.

2007-01-01

In support of the QTD II (Quiet Technology Demonstrator) program, aeroacoustic measurements of a 26%-scale, Boeing 777 main landing gear model were conducted in the Virginia Tech Stability Tunnel. The objective of these measurements was to perform risk mitigation studies on noise control devices for a flight test performed at Glasgow, Montana in 2005. The noise control devices were designed to target the primary main gear noise sources as observed in several previous tests. To accomplish this task, devices to reduce noise were built using stereo lithography for landing gear components such as the brakes, the forward cable harness, the shock strut, the door/strut gap and the lower truck. The most promising device was down selected from test results. In subsequent stages, the initial design of the selected lower truck fairing was improved to account for all the implementation constraints encountered in the full-scale airplane. The redesigned truck fairing was then retested to assess the impact of the modifications on the noise reduction potential. From extensive acoustic measurements obtained using a 63-element microphone phased array, acoustic source maps and integrated spectra were generated in order to estimate the noise reduction achievable with each device.

Hydromorphic soil development in the coastal temperate rainforest of Alaska

Treesearch

David V. D' Amore; Chien-Lu Ping; Paul A. Herendeen

2015-01-01

Predictive relationships between soil drainage and soil morphological features are essential for understanding hydromorphic processes in soils. The linkage between patterns of soil saturation, reduction, and reductimorphic soil properties has not been extensively studied in mountainous forested terrain. We measured soil saturation and reduction during a 4-yr period in...

Optimum fiber distribution in singlewall corrugated fiberboard

Treesearch

Millard W. Johnson; Thomas J. Urbanik; William E. Denniston

1979-01-01

Determining optimum distribution of fiber through rational design of corrugated fiberboard could result in significant reductions in fiber required to meet end-use conditions, with subsequent reductions in price pressure and extension of the softwood timber supply. A theory of thin plates under large deformations is developed that is both kinematically and physically...

78 FR 16298 - Comment Request for Information Collection: Confidentiality and Disclosure of State Unemployment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

... State Income and Eligibility Verification Provisions of the Deficit Reduction Act of 1984, Extension... the Deficit Reduction Act of 1984, which expires September 30, 2013. A copy of the proposed..., Attention: Patricia Mertens. Telephone number: 202-693-3182 (this is not a toll-free number). Fax: 202-693...

37 CFR 1.704 - Reduction of period of adjustment of patent term.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Reduction of period of adjustment of patent term. 1.704 Section 1.704 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Adjustment and Extension...

37 CFR 1.704 - Reduction of period of adjustment of patent term.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Adjustment and Extension... first cited in any communication from a foreign patent office in a counterpart application and that this... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Reduction of period of...

75 FR 28777 - Information Collection; Pre-Decisional Objection Process for Hazardous Fuel Reduction Projects...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-24

... the Healthy Forests Restoration Act of 2003 is the minimum necessary for an individual or organization... for Hazardous Fuel Reduction Projects Authorized by the Healthy Forest Restoration Act of 2003 AGENCY... organizations on the extension, with no revision, of a currently approved information collection, OMB 0596-0172...

Nonvitamin-K-antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and previous stroke or transient ischemic attack: An updated systematic review and meta-analysis of randomized controlled trials.

PubMed

Ntaios, George; Papavasileiou, Vasileios; Diener, Hans-Chris; Makaritsis, Konstantinos; Michel, Patrik

2017-08-01

Background In a previous systematic review and meta-analysis, we assessed the efficacy and safety of nonvitamin-K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and stroke or transient ischemic attack. Since then, new information became available. Aim The aim of the present work was to update the results of the previous systematic review and meta-analysis. Methods We searched PubMed until 24 August 2016 for randomized controlled trials using the following search items: "atrial fibrillation" and "anticoagulation" and "warfarin" and "previous stroke or transient ischemic attack." Eligible studies had to be phase III trials in patients with atrial fibrillation comparing warfarin with nonvitamin-K antagonist oral anticoagulants currently on the market or with the intention to be brought to the market in North America or Europe. The outcomes assessed in the efficacy analysis included stroke or systemic embolism, stroke, ischemic or unknown stroke, disabling or fatal stroke, hemorrhagic stroke, cardiovascular death, death from any cause, and myocardial infarction. The outcomes assessed in the safety analysis included major bleeding, intracranial bleeding, and major gastrointestinal bleeding. We performed fixed effects analyses on intention-to-treat basis. Results Among 183 potentially eligible articles, four were included in the meta-analysis. In 20,500 patients, compared to warfarin, nonvitamin-K antagonist oral anticoagulants were associated with a significant reduction of stroke/systemic embolism (relative risk reduction: 13.7%, absolute risk reduction: 0.78%, number needed to treat to prevent one event: 127), hemorrhagic stroke (relative risk reduction: 50.0%, absolute risk reduction: 0.63%, number needed to treat: 157), any stroke (relative risk reduction: 13.1%, absolute risk reduction: 0.7%, number needed to treat: 142), and intracranial hemorrhage (relative risk reduction: 46.1%, absolute risk reduction: 0.88%, number needed to treat: 113) over 1.8-2.8 years. Conclusions This updated meta-analysis in 20,500 atrial fibrillation patients with previous stroke or transient ischemic attack shows that compared to warfarin non-vitamin-K antagonist oral anticoagulants are associated with a significant reduction of stroke, stroke or systemic embolism, hemorrhagic stroke, and intracranial bleeding.

An object-oriented data reduction system in Fortran

NASA Technical Reports Server (NTRS)

Bailey, J.

1992-01-01

A data reduction system for the AAO two-degree field project is being developed using an object-oriented approach. Rather than use an object-oriented language (such as C++) the system is written in Fortran and makes extensive use of existing subroutine libraries provided by the UK Starlink project. Objects are created using the extensible N-dimensional Data Format (NDF) which itself is based on the Hierarchical Data System (HDS). The software consists of a class library, with each class corresponding to a Fortran subroutine with a standard calling sequence. The methods of the classes provide operations on NDF objects at a similar level of functionality to the applications of conventional data reduction systems. However, because they are provided as callable subroutines, they can be used as building blocks for more specialist applications. The class library is not dependent on a particular software environment thought it can be used effectively in ADAM applications. It can also be used from standalone Fortran programs. It is intended to develop a graphical user interface for use with the class library to form the 2dF data reduction system.

HIV risk reduction intervention among traditionally circumcised young men in South Africa: a cluster randomized control trial.

PubMed

Peltzer, Karl; Simbayi, Leickness; Banyini, Mercy; Kekana, Queen

2011-01-01

The aim of this study was to test a 180-minute group HIV risk-reduction counseling intervention trial with men undergoing traditional circumcision in South Africa to reduce behavioral disinhibition (false security) as a result of the procedure. A cluster randomized controlled trial design was employed using a sample of 160 men, 80 in the experimental group and 80 in the control group. Comparisons between baseline and 3-month follow-up assessments on key behavioral outcomes were completed. We found that behavioral intentions, risk-reduction skills, and male role norms did not change in the experimental compared to the control condition. However, HIV-related stigma beliefs were significantly reduced in both conditions over time. These findings show that one small-group HIV risk-reduction intervention did not reduce sexual risk behaviors in recently traditionally circumcised men at high risk for behavioral disinhibition. Copyright © 2011 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Automated Reduction and Calibration of SCUBA Archive Data Using ORAC-DR

NASA Astrophysics Data System (ADS)

Jenness, T.; Stevens, J. A.; Archibald, E. N.; Economou, F.; Jessop, N.; Robson, E. I.; Tilanus, R. P. J.; Holland, W. S.

The Submillimetre Common User Bolometer Array (SCUBA) instrument has been operating on the James Clerk Maxwell Telescope (JCMT) since 1997. The data archive is now sufficiently large that it can be used for investigating instrumental properties and the variability of astronomical sources. This paper describes the automated calibration and reduction scheme used to process the archive data with particular emphasis on the pointing observations. This is made possible by using the ORAC-DR data reduction pipeline, a flexible and extensible data reduction pipeline that is used on UKIRT and the JCMT.

Disaster Risk Reduction in Myanmar: A Need for Focus on Community Preparedness and Improved Evaluation of Initiatives.

PubMed

Smith, Andrew D; Chan, Emily Y Y

2017-11-20

Myanmar is a country in political and economic transition. Facing a wide-variety of natural hazards and ongoing conflict, the country's under-developed infrastructure has resulted in high disaster risk. Following the devastation of Cyclone Nargis in 2008 and increased global focus on disaster management and risk reduction, Myanmar has begun development of national disaster policies. Myanmar's Action Plan for Disaster Risk Reduction addressed multiple stages of disaster development and has made progress towards national projects, however, has struggled to implement community-based preparedness and response initiatives. This article analyses Myanmar's disaster strategy, though the use of a disaster development framework and suggests areas for possible improvement. In particular, the article aims to generate discussion regarding methods of supporting objective evaluation of risk reduction initiatives in developing countries. (Disaster Med Public Health Preparedness. 2017;page 1 of 5).

A 12-week multidomain intervention versus active control to reduce risk of Alzheimer’s disease: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Disappointing results from clinical trials of disease-modifying interventions for Alzheimer’s dementia (AD), along with reliable identification of modifiable risk factors in mid life from epidemiological studies, have contributed to calls to invest in risk-reduction interventions. It is also well known that AD-related pathological processes begin more than a decade before the development of clinical signs. These observations suggest that lifestyle interventions might be most effective when targeting non-symptomatic adults at risk of AD. To date, however, the few dementia risk-reduction programs available have targeted individual risk factors and/or were restricted to clinical settings. The current study describes the development of an evidence-based, theoretically-driven multidomain intervention to reduce AD risk in adults at risk. Method The design of Body Brain Life (BBL) is a randomized controlled trial (RCT) to evaluate a 12-week online AD risk-reduction intervention. Eligible participants with several modifiable risk factors on the Australian National University (ANU) AD Risk Index (ANU-ADRI) are randomly allocated to an online only group, an online and face-to-face group, or an active control group. We aim to recruit 180 participants, to undergo a comprehensive cognitive and physical assessment at baseline, post-intervention, and 6-month follow-up assessment. The intervention comprises seven online modules (dementia literacy, risk factor education, engagement in physical, social, and cognitive lifestyles, nutrition, and health monitoring) designed using contemporary models of health behavior change. Discussion The BBL program is a novel online intervention to reduce the risk of AD in middle-aged adults at risk. The trial is currently under way. It is hypothesized that participants in the intervention arms will make lifestyle changes in several domains, and that this will lead to a reduction in their AD risk profile. We also expect to show that health behavior change is underpinned by changes in psychological determinants of behavior. If successful, the findings will contribute to the development of further dementia risk reduction interventions, and thus contribute to the urgent need to lower dementia risk factors in the population to alter future projections of disease prevalence. Longer follow-up of BBL participants and replications using large samples are required to examine whether reduction in AD risk factors will be associated with reduced prevalence. Trial registration Reg. no. ACTRN12612000147886 PMID:23442574

A randomized comparison of patients' understanding of number needed to treat and other common risk reduction formats.

PubMed

Sheridan, Stacey L; Pignone, Michael P; Lewis, Carmen L

2003-11-01

Commentators have suggested that patients may understand quantitative information about treatment benefits better when they are presented as numbers needed to treat (NNT) rather than as absolute or relative risk reductions. To determine whether NNT helps patients interpret treatment benefits better than absolute risk reduction (ARR), relative risk reduction (RRR), or a combination of all three of these risk reduction presentations (COMBO). Randomized cross-sectional survey. University internal medicine clinic. Three hundred fifty-seven men and women, ages 50 to 80, who presented for health care. Subjects were given written information about the baseline risk of a hypothetical "disease Y" and were asked (1) to compare the benefits of two drug treatments for disease Y, stating which provided more benefit; and (2) to calculate the effect of one of those drug treatments on a given baseline risk of disease. Risk information was presented to each subject in one of four randomly allocated risk formats: NNT, ARR, RRR, or COMBO. When asked to state which of two treatments provided more benefit, subjects who received the RRR format responded correctly most often (60% correct vs 43% for COMBO, 42% for ARR, and 30% for NNT, P =.001). Most subjects were unable to calculate the effect of drug treatment on the given baseline risk of disease, although subjects receiving the RRR and ARR formats responded correctly more often (21% and 17% compared to 7% for COMBO and 6% for NNT, P =.004). Patients are best able to interpret the benefits of treatment when they are presented in an RRR format with a given baseline risk of disease. ARR also is easily interpreted. NNT is often misinterpreted by patients and should not be used alone to communicate risk to patients.

Body contouring surgery following bariatric surgery and dietetically induced massive weight reduction: a risk analysis.

PubMed

de Kerviler, S; Hüsler, R; Banic, A; Constantinescu, M A

2009-05-01

This study analyzed the impact of weight reduction method, preoperative, and intraoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction. All patients presenting with a maximal BMI >/=35 kg/m(2) before weight reduction who underwent body contouring surgery of the trunk following massive weight loss (excess body mass index loss (EBMIL) >/= 30%) between January 2002 and June 2007 were retrospectively analyzed. Incomplete records or follow-up led to exclusion. Statistical analysis focused on weight reduction method and pre-, intra-, and postoperative risk factors. The outcome was compared to current literature results. A total of 104 patients were included (87 female and 17 male; mean age 47.9 years). Massive weight reduction was achieved through bariatric surgery in 62 patients (59.6%) and dietetically in 42 patients (40.4%). Dietetically achieved excess body mass index loss (EBMIL) was 94.20% and in this cohort higher than surgically induced reduction EBMIL 80.80% (p < 0.01). Bariatric surgery did not present increased risks for complications for the secondary body contouring procedures. The observed complications (26.9%) were analyzed for risk factors. Total tissue resection weight was a significant risk factor (p < 0.05). Preoperative BMI had an impact on infections (p < 0.05). No impact on the postoperative outcome was detected in EBMIL, maximal BMI, smoking, hemoglobin, blood loss, body contouring technique or operation time. Corrective procedures were performed in 11 patients (10.6%). The results were compared to recent data. Bariatric surgery does not increase risks for complications in subsequent body contouring procedures when compared to massive dietetic weight reduction.

Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

PubMed

El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Landis, J Richard; Remien, Robert H

2016-06-01

Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions.

Nation-building policies in Timor-Leste: disaster risk reduction, including climate change adaptation.

PubMed

Mercer, Jessica; Kelman, Ilan; do Rosario, Francisco; de Deus de Jesus Lima, Abilio; da Silva, Augusto; Beloff, Anna-Maija; McClean, Alex

2014-10-01

Few studies have explored the relationships between nation-building, disaster risk reduction and climate change adaptation. Focusing on small island developing states, this paper examines nation-building in Timor-Leste, a small island developing state that recently achieved independence. Nation-building in Timor-Leste is explored in the context of disaster risk reduction, which necessarily includes climate change adaptation. The study presents a synopsis of Timor-Leste's history and its nation-building efforts as well as an overview of the state of knowledge of disaster risk reduction including climate change adaptation. It also offers an analysis of significant gaps and challenges in terms of vertical and horizontal governance, large donor presence, data availability and the integration of disaster risk reduction and climate change adaptation for nation-building in Timor-Leste. Relevant and applicable lessons are provided from other small island developing states to assist Timor-Leste in identifying its own trajectory out of underdevelopment while it builds on existing strengths. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Exposure Perception as a Key Indicator of Risk Perception and Acceptance of Sources of Radio Frequency Electromagnetic Fields.

PubMed

Freudenstein, Frederik; Wiedemann, Peter M; Brown, Tim W C

2015-01-01

The presented survey was conducted in six European countries as an online study. A total of 2454 subjects participated. Two main research questions were investigated: firstly, how does the cognitive, moral, and affective framing of radio frequency electromagnetic field (RF EMF) exposure perception influence RF EMF risk perception? Secondly, can the deployment of mobile phone base stations have greater acceptance with RF EMF exposure reduction? The findings with respect to the first question clearly indicated that the cognitive framed exposure perception is the main determinant of RF EMF risk perception. The concomitant sensitivity to exposure strength offers an opportunity to improve the acceptance of base stations by exposure reduction. A linear regression analysis supported this assumption: in a fictional test situation, exposure reduction improved the acceptance of base stations, operationalized as the requested distance of the base station from one's own home. Furthermore, subjects with high RF EMF risk perception were most sensitive to exposure reduction. On average, a 70% exposure reduction reduced the requested distance from about 2000 meters to 1000 meters. The consequences for risk communication are discussed.

17 CFR 18.04 - Statement of reporting trader.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the reduction of risks in the conduct and management of a commercial enterprise: (i) Commercial... appropriate to the reduction of risks in the conduct and management of a commercial enterprise: (i) Commercial..., merchandising or processing of a cash commodity, asset or liability risk management by depository institutions...

78 FR 28892 - Hazardous Fire Risk Reduction, East Bay Hills, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA 2010-0037] Hazardous Fire Risk Reduction, East Bay Hills, CA AGENCY: Federal Emergency Management Agency, DHS. ACTION..., limbing and mowing, thinning, and grazing techniques as appropriate to reduce the risk of fire hazard...

Statistical correlations and risk analyses techniques for a diving dual phase bubble model and data bank using massively parallel supercomputers.

PubMed

Wienke, B R; O'Leary, T R

2008-05-01

Linking model and data, we detail the LANL diving reduced gradient bubble model (RGBM), dynamical principles, and correlation with data in the LANL Data Bank. Table, profile, and meter risks are obtained from likelihood analysis and quoted for air, nitrox, helitrox no-decompression time limits, repetitive dive tables, and selected mixed gas and repetitive profiles. Application analyses include the EXPLORER decompression meter algorithm, NAUI tables, University of Wisconsin Seafood Diver tables, comparative NAUI, PADI, Oceanic NDLs and repetitive dives, comparative nitrogen and helium mixed gas risks, USS Perry deep rebreather (RB) exploration dive,world record open circuit (OC) dive, and Woodville Karst Plain Project (WKPP) extreme cave exploration profiles. The algorithm has seen extensive and utilitarian application in mixed gas diving, both in recreational and technical sectors, and forms the bases forreleased tables and decompression meters used by scientific, commercial, and research divers. The LANL Data Bank is described, and the methods used to deduce risk are detailed. Risk functions for dissolved gas and bubbles are summarized. Parameters that can be used to estimate profile risk are tallied. To fit data, a modified Levenberg-Marquardt routine is employed with L2 error norm. Appendices sketch the numerical methods, and list reports from field testing for (real) mixed gas diving. A Monte Carlo-like sampling scheme for fast numerical analysis of the data is also detailed, as a coupled variance reduction technique and additional check on the canonical approach to estimating diving risk. The method suggests alternatives to the canonical approach. This work represents a first time correlation effort linking a dynamical bubble model with deep stop data. Supercomputing resources are requisite to connect model and data in application.

Personality Traits, Perceived Risk, and Risk-Reduction Behaviors: A Further Study of Smoking and Radon

PubMed Central

Hampson, Sarah E.; Andrews, Judy A.; Barckley, Maureen; Lichtenstein, Edward; Lee, Michael E.

2008-01-01

Personality traits and risk perceptions were examined as predictors of changes in smoking behavior. Participants (N = 697) were part of a randomized controlled trial of interventions to reduce exposure to the combined hazard of radon and cigarette smoke. Participants with higher perceived risk at baseline for the combination of smoking and radon were more likely to have a more restrictive household smoking ban in place at 12 months follow-up (p <. 05). Risk perceptions also predicted reductions in the total number of cigarettes smoked in the home for participants in the video intervention who had high or moderate levels of Extraversion (p <.001). Greater perceived risk predicted quitting for highly or moderately conscientious women (p <.05). The moderating effects of personality traits should be considered when evaluating risk-reduction interventions. PMID:16846328

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

PubMed

Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

2017-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents

PubMed Central

Letourneau, Elizabeth J.; McCart, Michael R.; Sheidow, Ashli J.; Mauro, Pia M.

2016-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N = 45) or usual services (US; N = 60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. PMID:27629581

Biomechanical comparison of a novel transoral atlantoaxial anchored cage with established fixation technique - a finite element analysis.

PubMed

Zhang, Bao-cheng; Liu, Hai-bo; Cai, Xian-hua; Wang, Zhi-hua; Xu, Feng; Kang, Hui; Ding, Ran; Luo, Xiao-qing

2015-09-22

The transoral atlantoaxial reduction plate (TARP) fixation has been introduced to achieve reduction, decompression, fixation and fusion of C1-C2 through a transoral-only approach. However, it may also be associated with potential disadvantages, including dysphagia and load shielding of the bone graft. To prevent potential disadvantages related to TARP fixation, a novel transoral atlantoaxial fusion cage with integrated plate (Cage + Plate) device for stabilization of the C1-C2 segment is designed. The aims of the present study were to compare the biomechanical differences between Cage + Plate device and Cage + TARP device for the treatment of basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD). A detailed, nonlinear finite element model (FEM) of the intact upper cervical spine had been developed and validated. Then a FEM of an unstable BI model treated with Cage + Plate fixation, was compared to that with Cage + TARP fixation. All models were subjected to vertical load with pure moments in flexion, extension, lateral bending and axial rotation. Range of motion (ROM) of C1-C2 segment and maximum von Mises Stress of the C2 endplate and bone graft were quantified for the two devices. Both devices significantly reduced ROM compared with the intact state. In comparison with the Cage + Plate model, the Cage + TARP model reduced the ROM by 82.5 %, 46.2 %, 10.0 % and 74.3 % in flexion, extension, lateral bending, and axial rotation. The Cage + Plate model showed a higher increase stresses on C2 endplate and bone graft than the Cage + TARP model in all motions. Our results indicate that the novel Cage + Plate device may provide lower biomechanical stability than the Cage + TARP device in flexion, extension, and axial rotation, however, it may reduce stress shielding of the bone graft for successful fusion and minimize the risk of postoperative dysphagia. Clinical trials are now required to validate the reproducibility and advantages of our findings using this anchored cage for the treatment of BI with IAAD.

Time to significant pain reduction following DETP application vs placebo for acute soft tissue injuries.

PubMed

Yanchick, J; Magelli, M; Bodie, J; Sjogren, J; Rovati, S

2010-08-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) provide fast and effective acute pain relief, but systemic administration has increased risk for some adverse reactions. The diclofenac epolamine 1.3% topical patch (DETP) is a topical NSAID with demonstrated safety and efficacy in treatment of acute pain from minor soft tissue injuries. Significant pain reduction has been observed in clinical trials within several hours following DETP application, suggesting rapid pain relief; however, this has not been extensively studied for topical NSAIDs in general. This retrospective post-hoc analysis examined time to onset of significant pain reduction after DETP application compared to a placebo patch for patients with mild-to-moderate acute ankle sprain, evaluating the primary efficacy endpoint from two nearly identical studies. Data from two double-blind, randomized, parallel-group, placebo-controlled studies (N = 274) of safety and efficacy of the DETP applied once daily for 7 days for acute ankle sprain were evaluated post-hoc using statistical modeling to estimate time to onset of significant pain reduction following DETP application. Pain on active movement on a 100 mm Visual Analog Scale (VAS) recorded in patient diaries; physician- and patient-assessed tolerability; and adverse events. DETP treatment resulted in significant pain reduction within approximately 3 hours compared to placebo. Within-treatment post-hoc analysis based on a statistical model suggested significant pain reduction occurred as early as 1.27 hours for the DETP group. The study may have been limited by the retrospective nature of the analyses. In both studies, the DETP was well tolerated with few adverse events, limited primarily to application site skin reactions. The DETP is an effective treatment for acute minor soft tissue injury, providing pain relief as rapidly as 1.27 hours post-treatment. Statistical modeling may be useful in estimating time to onset of pain relief for comparison of topical and oral NSAIDs.

Risk Reduction from Minimization of Persistent, Bioaccumulative, and Toxic Waste Materials Within the U.S. Industrial Solid Waste Management System

EPA Science Inventory

This study addressed three questions of interest in national-scale solid and hazardous waste management decision-making within the United States: 1) can we quantify the reduction in risk to human and ecological receptors resulting from the reduction of certain industrial waste s...

Surgical treatment of intra-articular calcaneal fractures.

PubMed

Stapleton, John J; Zgonis, Thomas

2014-10-01

Most intra-articular calcaneal fractures are a result of high-energy trauma. The operative management of calcaneal fractures has been based on achieving anatomic reduction and minimizing complications of the compromised soft tissue envelope. The traditional extensile lateral approach offers advantages of achieving adequate fracture reduction with the risk of wound-healing complications and infection. Limited open reduction and internal fixation techniques with or without using external fixation focuses on achieving fracture reduction with less risk of wound complications but higher risk of malunion. This article discusses key points of operative management for various intra-articular calcaneal fracture patterns and clinical presentations. Copyright © 2014 Elsevier Inc. All rights reserved.

Special Diabetes Program for Indians: Retention in Cardiovascular Risk Reduction

ERIC Educational Resources Information Center

Manson, Spero M.; Jiang, Luohua; Zhang, Lijing; Beals, Janette; Acton, Kelly J.; Roubideaux, Yvette

2011-01-01

Purpose: This study examined the associations between participant and site characteristics and retention in a multisite cardiovascular disease risk reduction project. Design and Methods: Data were derived from the Special Diabetes Program for Indians Healthy Heart Demonstration Project, an intervention to reduce cardiovascular risk among American…

Brief communication: Sendai framework for disaster risk reduction - success or warning sign for Paris?

NASA Astrophysics Data System (ADS)

Mysiak, Jaroslav; Surminski, Swenja; Thieken, Annegret; Mechler, Reinhard; Aerts, Jeroen

2016-09-01

In March 2015, a new international blueprint for disaster risk reduction (DRR) was adopted in Sendai, Japan, at the end of the Third UN World Conference on Disaster Risk Reduction (WCDRR, 14-18 March 2015). We review and discuss the agreed commitments and targets, as well as the negotiation leading the Sendai Framework for DRR (SFDRR) and discuss briefly its implication for the later UN-led negotiations on sustainable development goals and climate change.

Early Risk Reduction Phase 1 FLIR/Laser Designator Window. Revision

DTIC Science & Technology

1991-12-31

Sandwich-Type FLIR Windows," Air Force AFWAL-TR-83- 4122, Nov 1983. 4-1 Hughes Danbury Optical Systems Final Report, "ATA Window Technology Program," PRBll...Risk Reduction -- Phase I, Optical Properties Measurement Techniques of Three Wide Band Window Materials," 22 August 1991. xii I i 86PR0869 30... Optical Systems, Lexington, MA, 02173, 1 Feb 1991. 5-7 McDonnell Aircraft Company Technical Memorandum TM 256.91.0056.01, "Early Risk Reduction -- Phase

The Effect of a Coronary Artery Risk Evaluation Program on the Serum Lipid Values of a Selected Military Population

DTIC Science & Technology

1991-05-01

interventions reduced low density lipoproteins and serum cholesterol levels. The goals of risk factor reduction are disease prevention , delay of disease... preventing CAD (Lipid Research Clinics Program, 1984). A 1% reduction in cholesterol was associated with a 2 % reduction in risk (NIH, 1984). This includes...heart attack before age 65? Yes No 2 . Do you have Diabetes Mellitus ? Yes No 3. Do you have uncontrolled hypertension? (Blood Pressure consistently

The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

PubMed

Chin, Helen B; Sipe, Theresa Ann; Elder, Randy; Mercer, Shawna L; Chattopadhyay, Sajal K; Jacob, Verughese; Wethington, Holly R; Kirby, Doug; Elliston, Donna B; Griffith, Matt; Chuke, Stella O; Briss, Susan C; Ericksen, Irene; Galbraith, Jennifer S; Herbst, Jeffrey H; Johnson, Robert L; Kraft, Joan M; Noar, Seth M; Romero, Lisa M; Santelli, John

2012-03-01

Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education. Published by Elsevier Inc.

Suicide risk reduction in youths with attention-deficit/hyperactivity disorder prescribed methylphenidate: A Taiwan nationwide population-based cohort study.

PubMed

Liang, Sophie Hsin-Yi; Yang, Yao-Hsu; Kuo, Ting-Yu; Liao, Yin-To; Lin, Tzu-Chin; Lee, Yena; McIntyre, Roger S; Kelsen, Brent A; Wang, Tsu-Nai; Chen, Vincent Chin-Hung

2018-01-01

Attention-deficit/hyperactivity disorder (ADHD) youths have increased suicide risk. Nevertheless, the beneficial effects of methylphenidate (MPH) on suicide attempt have received relatively little attention. To investigate the MPH usage and the risk of suicide attempt among ADHD youths. We identified 84,898 youths less than 18 years old with ADHD diagnosis between 1997 and 2013 from National Health Insurance, and examined whether MPH use affected suicide attempt risk using Cox proportional-hazards models. Among ADHD youths, reduction of suicide risk was found in patients prescribed 90-180days of MPH after adjusting for confounding factors (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.19-0.90) and a greater reduction in those prescribed more than 180days of MPH (HR: 0.28, 95% CI: 0.17-0.48). We observed a 59% suicide attempt risk reduction among ADHD youths prescribed between 90 and 180days and a 72% risk reduction in those prescribed more than 180days of MPH. The protective benefit observed by the group prescribed MPH for longer duration underscores the importance of psychoeducation and compliance enhancement as part of ADHD management. Indication bias is identified as a limitation of this study, and future self-case control study to investigate the association between suicide attempt and ADHD medication is suggested. This nationwide population-based cohort study showed that among ADHD youths, reduction of suicide risk was observed in patients prescribed MPH for duration 90days and longer, underscoring the importance of appropriate ADHD pharmacotherapy and enhancing drug compliance. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Directional asymmetry of pelvic vestiges in threespine stickleback.

PubMed

Bell, Michael A; Khalef, Victoria; Travis, Matthew P

2007-03-15

Extensive reduction of the size and complexity of the pelvic skeleton (i.e., pelvic reduction) has evolved repeatedly in Gasterosteus aculeatus. Asymmetrical pelvic vestiges tend to be larger on the left side (i.e., left biased) in populations studied previously. Loss of Pitx1 expression is associated with pelvic reduction in G. aculeatus, and pelvic reduction maps to the Pitx1 locus. Pitx1 knockouts in mice have reduced hind limbs, but the left limb is larger. Thus left-biased directional asymmetry of stickleback pelvic vestiges may indicate the involvement of Pitx1 in pelvic reduction. We examined 6,356 specimens from 27 Cook Inlet populations of G. aculeatus with extensive pelvic reduction. Samples from 20 populations exhibit the left bias in asymmetrical pelvic vestiges expected if Pitx1 is involved, and three have a slight, non-significant left bias. However, samples from three populations have a significant right bias, and one large sample from another population has equal frequencies of specimens with larger vestiges on the left or right side. A sample of fossil threespine stickleback also has significantly left-biased pelvic vestiges. These results suggest that silencing of Pitx1 or the developmental pathway in which it functions in the pelvis is the usual cause of pelvic reduction in most Cook Inlet populations of G. aculeatu, and that it caused pelvic reduction at least 10 million years ago in a stickleback population. A different developmental genetic mechanism is implicated for three populations with right-biased pelvic vestiges and for the population without directional asymmetry. (c) 2006 Wiley-Liss, Inc.

Review of pathogen treatment reductions for onsite non ...

EPA Pesticide Factsheets

Communities face a challenge when implementing onsite reuse of collected waters for non-potable purposes given the lack of national microbial standards. Quantitative Microbial Risk Assessment (QMRA) can be used to predict the pathogen risks associated with the non-potable reuse of onsite-collected waters; the present work reviewed the relevant QMRA literature to prioritize knowledge gaps and identify health-protective pathogen treatment reduction targets. The review indicated that ingestion of untreated, onsite-collected graywater, rainwater, seepage water and stormwater from a variety of exposure routes resulted in gastrointestinal infection risks greater than the traditional acceptable level of risk. We found no QMRAs that estimated the pathogen risks associated with onsite, non-potable reuse of blackwater. Pathogen treatment reduction targets for non-potable, onsite reuse that included a suite of reference pathogens (i.e., including relevant bacterial, protozoan, and viral hazards) were limited to graywater (for a limited set of domestic uses) and stormwater (for domestic and municipal uses). These treatment reductions corresponded with the health benchmark of a probability of infection or illness of 10−3 per person per year or less. The pathogen treatment reduction targets varied depending on the target health benchmark, reference pathogen, source water, and water reuse application. Overall, there remains a need for pathogen reduction targets that are heal

Alcohol Consumption and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of More Than 1.9 Million Individuals From 38 Observational Studies.

PubMed

Knott, Craig; Bell, Steven; Britton, Annie

2015-09-01

Observational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. A systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. Thirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Effects of new urban motorway infrastructure on road traffic accidents in the local area: a retrospective longitudinal study in Scotland

PubMed Central

Olsen, Jonathan R; Mitchell, Richard; Mackay, Daniel F; Humphreys, David K; Ogilvie, David

2016-01-01

Background The M74 motorway extension, Glasgow, opened in June 2011. One justification for construction was an expectation that it would reduce road traffic accidents (RTAs) on local non-motorway roads. This study evaluated the impact of the extension on the number of RTAs, stratifying by accident severity. Methods Data for the period 1997–2014 were extracted from a UK database of reported RTAs involving a personal injury. RTA severity was defined by the level of injury: minor, severe or fatal. RTAs were assigned to (1) the local area surrounding the motorway extension, (2) a comparator area surrounding an existing motorway or (3) a control area elsewhere in the conurbation. Interrupted time-series regression with autoregressive integrated moving average (ARIMA) errors was used to determine longitudinal between-area differences in change in the number of RTAs, which might indicate an intervention effect. Results Glasgow and surrounding local authorities saw a 50.6% reduction in annual RTAs (n: 5901 to 2914) between 1997 and 2014. In the intervention area, the number of recorded RTAs decreased by 50.7% (n: 758 to 374), and that of fatal/severe RTAs by 57.4% (n: 129 to 55), with similar reductions in the comparator/control areas. The interrupted time-series analysis showed no significant between-area differences in temporal trends. The reduction of pedestrian casualties was attenuated in the intervention area relative to Glasgow and surrounding authorities. Conclusions Reduction in RTAs was not associated with the motorway extension. Our findings suggest that in planning future investment, it should not be taken for granted that new road infrastructure alone will reduce RTAs in local areas. Urbanisation is proceeding rapidly worldwide, and evidence of infrastructure changes is lacking; this novel study provides important findings for future developments. PMID:27279082

Effects of new urban motorway infrastructure on road traffic accidents in the local area: a retrospective longitudinal study in Scotland.

PubMed

Olsen, Jonathan R; Mitchell, Richard; Mackay, Daniel F; Humphreys, David K; Ogilvie, David

2016-11-01

The M74 motorway extension, Glasgow, opened in June 2011. One justification for construction was an expectation that it would reduce road traffic accidents (RTAs) on local non-motorway roads. This study evaluated the impact of the extension on the number of RTAs, stratifying by accident severity. Data for the period 1997-2014 were extracted from a UK database of reported RTAs involving a personal injury. RTA severity was defined by the level of injury: minor, severe or fatal. RTAs were assigned to (1) the local area surrounding the motorway extension, (2) a comparator area surrounding an existing motorway or (3) a control area elsewhere in the conurbation. Interrupted time-series regression with autoregressive integrated moving average (ARIMA) errors was used to determine longitudinal between-area differences in change in the number of RTAs, which might indicate an intervention effect. Glasgow and surrounding local authorities saw a 50.6% reduction in annual RTAs (n: 5901 to 2914) between 1997 and 2014. In the intervention area, the number of recorded RTAs decreased by 50.7% (n: 758 to 374), and that of fatal/severe RTAs by 57.4% (n: 129 to 55), with similar reductions in the comparator/control areas. The interrupted time-series analysis showed no significant between-area differences in temporal trends. The reduction of pedestrian casualties was attenuated in the intervention area relative to Glasgow and surrounding authorities. Reduction in RTAs was not associated with the motorway extension. Our findings suggest that in planning future investment, it should not be taken for granted that new road infrastructure alone will reduce RTAs in local areas. Urbanisation is proceeding rapidly worldwide, and evidence of infrastructure changes is lacking; this novel study provides important findings for future developments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Regional Screening Levels (RSLs) - User's Guide

EPA Pesticide Factsheets

Regional Screening Level RSL user guide provides extensive guidance for risk assessors doing Chemical Risk Assessment preliminary remediation goal PRG risk based concentration RBC and rick calculations for the assess

Receipt of HIV/STD prevention counseling by HIV-infected adults receiving medical care in the United States.

PubMed

Mizuno, Yuko; Zhu, Julia; Crepaz, Nicole; Beer, Linda; Purcell, David W; Johnson, Christopher H; Valverde, Eduardo E; Skarbinski, Jacek

2014-01-28

Guidelines recommend risk-reduction counseling by HIV providers to all HIV-infected persons. Among HIV-infected adults receiving medical care in the United States, we estimated prevalence of exposure to three types of HIV/sexually transmitted disease (STD) risk-reduction interventions and described the characteristics of persons who received these interventions. Data were from the Medical Monitoring Project (MMP), a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving medical care in the United States. Descriptive analyses were conducted to estimate the exposure to each type of HIV/STD risk-reduction intervention. Bivariate and multivariable analyses were conducted to assess associations between the selected correlates with each exposure variable. About 44% of participants reported a one-on-one conversation with a healthcare provider about HIV/STD prevention, 30% with a prevention program worker, 16% reported participation in a small group risk-reduction intervention, and 52% reported receiving at least one of the three interventions in the past 12 months. Minority race/ethnicity, low income, and risky sexual behavior consistently predicted greater intervention exposure. However, 39% of persons who reported risky sex did not receive any HIV/STD risk-reduction interventions. HIV-infected persons in care with fewer resources or those who engaged in risk behaviors were more likely to receive HIV/STD risk-reduction interventions. However, less than half of HIV-infected persons in care received HIV/STD prevention counseling from their provider, an intervention that has been shown to be effective and is supported by guidelines.

[Physical activity and blood pressure. An epidemiological brief review of primary preventive effects of physical exercise activities].

PubMed

Marti, B

1992-04-07

The relation between physical exercise and blood pressure as well as the risk of hypertension has been investigated extensively during recent years. Cross-sectional studies on exercising and physically fit subjects have shown that endurance capacity (i. e. maximum aerobic capacity) is inversely related to resting blood pressure. However, not all physical activities are associated with lower blood pressure levels; e.g. swimming, weight lifting and competitive cross-country skiing were found to be related to elevated blood pressure values in some studies. Population-based investigations reveal a trend towards lower blood pressure values in physically habitually active persons, with the difference between active and inactive subjects not exceeding 5 mmHg. Three epidemiological cohort studies have consistently demonstrated that sedentary, unfit persons have a 20 to 50% higher prospective risk of hypertension, as compared to exercising, physically fit persons. Some intervention studies with normotensive subjects show a reduction in resting blood pressure of 5 to 10 mmHg at best after several months of aerobic training, while other studies show no effect. At least two factors could be responsible for these somewhat inconsistent observations: 1. exercise intensity may act as an 'effect modifier', since vigorous to maximally hard exercise rather increases than lowers resting blood pressure, 2. in statistical analysis on the effect of physical training on blood pressure, it is crucial whether concomitant changes in body weight and body composition are taken into account: any adjustment for changes in body composition will substantially reduce the magnitude of 'exercise-induced' reductions in blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

[Estimates of Attributable Fraction of occupational cancers in the recent epidemiological literature].

PubMed

Merler, Enzo

2009-01-01

The article reviews the estimates of Attributable Fraction (AF) of occupational cancers. Because of their relevance, it starts with a synthesis and a comment on the estimates of avoidable cancers, and among these of cancers due to occupation, as expressed in 1981 by Doll and Peto. The main studies that have brought back into the epidemiological pathway the exercise of producing FA are quoted and the results of the new studies reviewed. The dimension of occupational cancers is of public health importance, because caused by exposures assumed to be avoidable. However, the estimates of AF are prone to uncertainties and limitations. Occupational cancers represent the major killer among deaths due to occupational diseases and injuries and a relevant fraction, especially among males, of total cancers. When related to developed countries, estimates may underestimate the risks, because of the insufficient data on exposures for workers in small firms, the lack of information on exposures in agriculture, the scanty availability of epidemiological studies on cancer risks among women. The trend towards a reduction of employees in industrial activities, the elimination or control of some exposures should suggest, instead, a reduction for occupational cancer. However, the more recent estimates of AF of occupational cancers are still in line with the estimates expressed more that 20 years ago. In developing countries, the estimates of AF are plenty of assumptions. In addition, some characteristics (i.e. the younger age of starting work, the extension of work at older age) suggest the need of better data, whereas information on exposures and events are dramatically lacking.

The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment

PubMed Central

Emiroğlu, Mustafa; Sert, İsmail; İnal, Abdullah

2015-01-01

The aim of this study is to discuss indications, advantages, disadvantages, oncologic and aesthetic results of Oncoplastic Surgery (OBS). Pubmed and Medline database were searched for articles published between 1998 and 2014 for keywords: oncoplastic breast surgery, therapeutic mammoplasty, oncoplastic breast reduction, synchrenous reconstructions. Role of OBS in breast cancer surgery, its aspects to be considered, its value and results have been interpreted. This technique has advantages by providing more extensive tumourectomy, yielding better aesthetic results compared with breast conserving surgery, allowing oncoplastic reduction in breast cancer patients with macromastia, with higher patient satisfaction and quality of life and by being inexpensive due to single session practice. As for its disadvantages are: re-excision is more difficult, risk for mastectomy is higher, it is depent on the Surgeron’s experience, it has a risk for delay in adjuvant therapies and its requirement for additional imaging studies during management. Main indications are patients with small tumour/breast volume, macromastia, multifocality, procedures which can disrupt breast cosmesis such as surgeries for upper inner breas tquadrient tumours. Contraindications are positive margin problems after wide excision, diffuse malign microcalsifications, inflammatory breast cancer, history of radiotherapy and patients’ preferences. Despite low evidence level, Oncoplastic Breast Surgery seems to be both reliable and acceptable in terms of oncologic and aesthetic aspects. Oncoplastic Breast Surgery increase the application rate of breast conserving surgery by obviating practical limitations and improve the results of breast conserving surgery. Correct patient and technique choice in OBS is vital for optimization of post surgical PMID:28331682

Metformin and the Risk of Cancer

PubMed Central

Suissa, Samy; Azoulay, Laurent

2012-01-01

OBJECTIVE Time-related biases in observational studies of drug effects have been described extensively in different therapeutic areas but less so in diabetes. Immortal time bias, time-window bias, and time-lag bias all tend to greatly exaggerate the benefits observed with a drug. RESEARCH DESIGN AND METHODS These time-related biases are described and shown to be prominent in observational studies that have associated metformin with impressive reductions in the incidence of and mortality from cancer. As a consequence, metformin received much attention as a potential anticancer agent; these observational studies sparked the conduction of randomized, controlled trials of metformin as cancer treatment. However, the spectacular effects reported in these studies are compatible with time-related biases. RESULTS We found that 13 observational studies suffered from immortal time bias; 9 studies had not considered time-window bias, whereas other studies did not consider inherent time-lagging issues when comparing the first-line treatment metformin with second- or third-line treatments. These studies, subject to time-related biases that are avoidable with proper study design and data analysis, led to illusory extraordinarily significant effects, with reductions in cancer risk with metformin ranging from 20 to 94%. Three studies that avoided these biases reported no effect of metformin use on cancer incidence. CONCLUSIONS Although observational studies are important to better understand the effects of drugs, their proper design and analysis is essential to avoid major time-related biases. With respect to metformin, the scientific evidence of its potential beneficial effects on cancer would need to be reassessed critically before embarking on further long and expensive trials. PMID:23173135

Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work.

PubMed

Shannon, Kate; Kerr, Thomas; Allinott, Shari; Chettiar, Jill; Shoveller, Jean; Tyndall, Mark W

2008-02-01

High rates of violence among street-level sex workers have been described across the globe, while in cities across Canada the disappearance and victimization of drug-using women in survival sex work is ongoing. Given the pervasive levels of violence faced by sex workers over the last decades, and extensive harm reduction and HIV prevention efforts operating in Vancouver, Canada, this research aimed to explore the role of social and structural violence and power relations in shaping the HIV risk environment and prevention practices of women in survival sex work. Through a participatory-action research project, a series of focus group discussions were conceptualized and co-facilitated by sex workers, community and research partners with a total of 46 women in early 2006. Based on thematic, content and theoretical analysis, the following key factors were seen to both directly and indirectly mediate women's agency and access to resources, and ability to practice HIV prevention and harm reduction: at the micro-level, boyfriends as pimps and the 'everyday violence' of bad dates; at the meso-level, a lack of safe places to take dates, and adverse impacts of local policing; and at the macro-level, dopesickness and the need to sell sex for drugs. Analysis of the narratives and daily lived experiences of women sex workers highlight the urgent need for a renewed HIV prevention strategy that moves beyond a solely individual-level focus to structural and environmental interventions, including legal reforms, that facilitate 'enabling environments' for HIV prevention.

Identification of appropriate patients for cardiometabolic risk management.

PubMed

Peters, Anne L

2007-01-01

Patients at increased risk for cardiovascular disease have a wide array of clinical features that should alert practitioners to the need for risk reduction. Some, but not all, of these features relate to insulin resistance. Multiple approaches exist for diagnosing and defining this risk, including the traditional Framingham risk assessment, various definitions of the metabolic syndrome, and assessment of risk factors not commonly included in the standard criteria. This article reviews the many clinical findings that should alert healthcare providers to the need for aggressive cardiovascular risk reduction.

The application of numerical debris flow modelling for the generation of physical vulnerability curves

NASA Astrophysics Data System (ADS)

Luna, B. Quan; Blahut, J.; van Westen, C. J.; Sterlacchini, S.; van Asch, T. W. J.; Akbas, S. O.

2011-07-01

For a quantitative assessment of debris flow risk, it is essential to consider not only the hazardous process itself but also to perform an analysis of its consequences. This should include the estimation of the expected monetary losses as the product of the hazard with a given magnitude and the vulnerability of the elements exposed. A quantifiable integrated approach of both hazard and vulnerability is becoming a required practice in risk reduction management. This study aims at developing physical vulnerability curves for debris flows through the use of a dynamic run-out model. Dynamic run-out models for debris flows are able to calculate physical outputs (extension, depths, velocities, impact pressures) and to determine the zones where the elements at risk could suffer an impact. These results can then be applied to consequence analyses and risk calculations. On 13 July 2008, after more than two days of intense rainfall, several debris and mud flows were released in the central part of the Valtellina Valley (Lombardy Region, Northern Italy). One of the largest debris flows events occurred in a village called Selvetta. The debris flow event was reconstructed after extensive field work and interviews with local inhabitants and civil protection teams. The Selvetta event was modelled with the FLO-2D program, an Eulerian formulation with a finite differences numerical scheme that requires the specification of an input hydrograph. The internal stresses are isotropic and the basal shear stresses are calculated using a quadratic model. The behaviour and run-out of the flow was reconstructed. The significance of calculated values of the flow depth, velocity, and pressure were investigated in terms of the resulting damage to the affected buildings. The physical damage was quantified for each affected structure within the context of physical vulnerability, which was calculated as the ratio between the monetary loss and the reconstruction value. Three different empirical vulnerability curves were obtained, which are functions of debris flow depth, impact pressure, and kinematic viscosity, respectively. A quantitative approach to estimate the vulnerability of an exposed element to a debris flow which can be independent of the temporal occurrence of the hazard event is presented.

Multi-Wave Prospective Examination of the Stress-Reactivity Extension of Response Styles Theory of Depression in High-Risk Children and Early Adolescents

ERIC Educational Resources Information Center

Abela, John R. Z.; Hankin, Benjamin L.; Sheshko, Dana M.; Fishman, Michael B.; Stolow, Darren

2012-01-01

The current study tested the stress-reactivity extension of response styles theory of depression (Nolen-Hoeksema "Journal of Abnormal Psychology" 100:569-582, 1991) in a sample of high-risk children and early adolescents from a vulnerability-stress perspective using a multi-wave longitudinal design. In addition, we examined whether obtained…

Constraints on mechanized treatment significantly limit mechanical fuels reduction extent in the Sierra Nevada

Treesearch

Malcolm P. North; April Brough; Jonathan W. Long; Brandon M. Collins; Phil Bowden; Don Yasuda; Jay Miller; Neil Suighara

2015-01-01

With air quality, liability, and safety concerns, prescribed burning and managed wildfire are often considered impractical treatments for extensive fuels reduction in western US forests. For California's Sierra Nevada forests, we evaluated the alternative and analyzed the amount and distribution of constraints on mechanical fuels treatments on USDA Forest Service...

Compressed Speech: Potential Application for Air Force Technical Training. Final Report, August 73-November 73.

ERIC Educational Resources Information Center

Dailey, K. Anne

Time-compressed speech (also called compressed speech, speeded speech, or accelerated speech) is an extension of the normal recording procedure for reproducing the spoken word. Compressed speech can be used to achieve dramatic reductions in listening time without significant loss in comprehension. The implications of such temporal reductions in…

75 FR 28070 - Comment Request for Information Collection: “Confidentiality & Disclosure of State Unemployment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... Provisions of the Deficit Reduction Act of 1984; OMB Control No. 1205-0238;'' Extension Without Change AGENCY...) provisions of the Deficit Reduction Act of 1984 (current expiration date is August 31, 2010). A copy of the... C4518, Washington, DC 20210, Attention: Patricia Mertens. Telephone number: 202-693-3182 (this is not a...

Multiple Alternatives Modeling in Determining Fiscal Roll-Backs during Educational Funding Crises. Interim Draft. Paper and Report Series No. 70.

ERIC Educational Resources Information Center

Wholeben, Brent E.; Sullivan, John M.

This report provides an extensive discussion of the use of criterion referenced, mathematical modeling procedures to determine which budget reductions minimize reduction in the quality of educational programs. Part I, "Evaluation of Potential Budgeting Roll-backs under Educational Fiscal Crisis," explains the basic design of multiple…

Classification of small lesions on dynamic breast MRI: Integrating dimension reduction and out-of-sample extension into CADx methodology

PubMed Central

Nagarajan, Mahesh B.; Huber, Markus B.; Schlossbauer, Thomas; Leinsinger, Gerda; Krol, Andrzej; Wismüller, Axel

2014-01-01

Objective While dimension reduction has been previously explored in computer aided diagnosis (CADx) as an alternative to feature selection, previous implementations of its integration into CADx do not ensure strict separation between training and test data required for the machine learning task. This compromises the integrity of the independent test set, which serves as the basis for evaluating classifier performance. Methods and Materials We propose, implement and evaluate an improved CADx methodology where strict separation is maintained. This is achieved by subjecting the training data alone to dimension reduction; the test data is subsequently processed with out-of-sample extension methods. Our approach is demonstrated in the research context of classifying small diagnostically challenging lesions annotated on dynamic breast magnetic resonance imaging (MRI) studies. The lesions were dynamically characterized through topological feature vectors derived from Minkowski functionals. These feature vectors were then subject to dimension reduction with different linear and non-linear algorithms applied in conjunction with out-of-sample extension techniques. This was followed by classification through supervised learning with support vector regression. Area under the receiver-operating characteristic curve (AUC) was evaluated as the metric of classifier performance. Results Of the feature vectors investigated, the best performance was observed with Minkowski functional ’perimeter’ while comparable performance was observed with ’area’. Of the dimension reduction algorithms tested with ’perimeter’, the best performance was observed with Sammon’s mapping (0.84 ± 0.10) while comparable performance was achieved with exploratory observation machine (0.82 ± 0.09) and principal component analysis (0.80 ± 0.10). Conclusions The results reported in this study with the proposed CADx methodology present a significant improvement over previous results reported with such small lesions on dynamic breast MRI. In particular, non-linear algorithms for dimension reduction exhibited better classification performance than linear approaches, when integrated into our CADx methodology. We also note that while dimension reduction techniques may not necessarily provide an improvement in classification performance over feature selection, they do allow for a higher degree of feature compaction. PMID:24355697

Flood risk change in some European, African and Asian catchments

NASA Astrophysics Data System (ADS)

Kreibich, Heidi

2017-04-01

In light of the expected increase of flood risk in large parts of the world due to climate change and globally increasing exposure, efficient integrated flood risk management needs to be implemented. Societies learn from floods, and consequently improve their risk management. Such learning can occur through 'focusing events', i.e. events that provide a sudden, strong push for action. For example, the 1953 North Sea flood triggered the Delta Works in The Netherlands and the construction of the Thames Barrier. We show how societies have learnt from focusing events in river systems, by a semi-quantitative assessment of eight paired flood events around the world, i.e. consecutive floods that occurred in the same catchments, with the second flood causing significantly lower damage. We unravel the main mechanisms underlying these eight success stories of risk reduction. Across all case studies, we find that lower damage caused by the second event was mainly due to significant reductions in vulnerability. The role of changes in exposure is less apparent; positive and negative changes are reported. In some cases, significant investments in flood protection between the floods have played a large role in exposure and damage reduction. Reduction of vulnerability seems to be a key for better risk reduction via integrated flood risk management. Thus, we need to redouble efforts to improve our understanding of vulnerability.

Farmers Prone to Drought Risk: Why Some Farmers Undertake Farm-Level Risk-Reduction Measures While Others Not?

NASA Astrophysics Data System (ADS)

Gebrehiwot, Tagel; van der Veen, Anne

2015-03-01

This research investigates farmers' cognitive perceptions of risk and the behavioral intentions to undertake farm-level risk-reduction measures. It has been observed that people who are susceptible to natural hazards often fail to act, or do very little, to protect their assets or lives. To answer the question of why some people show adaptive behavior while others do not, a socio-psychological model of precautionary adaptation based on protection motivation theory and trans-theoretical stage model has been applied for the first time to areas of drought risk in the developing countries cultural context. The applicability of the integrated model is explored by means of a representative sample survey of smallholder farmers in northern Ethiopia. The result of the study showed that there is a statistically significant association between farmer's behavioral intention to undertake farm-level risk-reduction measures and the main important protection motivation model variables. High perceived vulnerability, severity of consequences, self-efficacy, and response efficacy lead to higher levels of behavioral intentions to undertake farm-level risk-reduction measures. For farmers in the action stage, self-efficacy and response efficacy were the main motivators of behavioral intention. For farmers in the contemplative stage, self-efficacy and cost appear to be the main motivators for them to act upon risk reduction, while perceived severity of consequences and cost of response actions were found to be important for farmers in the pre-contemplative stage.

Tsunami Hazard, Vulnerability and Risk assessment for the coast of Oman

NASA Astrophysics Data System (ADS)

Gonzalez, Mauricio; Aniel-Quiroga, Íñigo; Aguirre-Ayerbe, Ignacio; Álvarez-Gómez, José Antonio; MArtínez, Jara; Gonzalez-Riancho, Pino; Fernandez, Felipe; Medina, Raúl; Al-Yahyai, Sultan

2016-04-01

Tsunamis are relatively infrequent phenomena representing a greater threat than earthquakes, hurricanes and tornadoes, and causing the loss of thousands of human lives and extensive damage to coastal infrastructures around the world. Advances in the understanding and prediction of tsunami impacts allow the development of new methodologies in this field. This work presents the methodology that has been followed for developing the tsunami hazard, vulnerability and risk assessment for the coast of Oman, including maps containing the results of the process. Oman is located in the south eastern corner of the Arabian Peninsula and of the Arabian plate, in front of the Makran Subduction Zone (MSZ), which is the major source of earthquakes in the eastern border of the Arabian plate and Oman (Al-Shaqsi, 2012). There are at least three historical tsunamis assigned to seismic origin in the MSZ (Heidarzadeh et al., 2008; Jordan, 2008). These events show the high potential for tsunami generation of the MSZ, being one of the most tsunamigenic zones in the Indian Ocean. For the tsunami hazard assessment, worst potential cases have been selected, as well as the historical case of 1945, when an 8.1 earthquake generated a tsunami affecting the coast of Oman, and prompting 4000 casualties in the countries of the area. These scenarios have been computationally simulated in order to get tsunami hazard maps, including flooding maps. These calculations have been carried out at national and local scale, in 9 municipalities all along the coast of Oman, including the cities of Sohar, Wudam, Sawadi, Muscat, Quriyat, Sur, Masirah, Al Duqm, and Salalah. Using the hazard assessment as input, this work presents as well an integrated framework for the tsunami vulnerability and risk assessment carried out in the Sultanate of Oman. This framework considers different dimensions (human, structural) and it is developed at two different spatial resolutions, national and local scale. The national vulnerability assessment is carried out for the entire Oman coastal area comprising 30 coastal wilayats, whereas the local sensitivity assessment is performed for the 9 coastal study areas. This work also connects vulnerability-risk assessment results to site-specific and target-oriented risk reduction measures. Results identify high risk areas along the coast of Oman in which measures for risk reduction are proposed. The identification and prioritization of mitigation measures were supported by a panel of local and international experts developed during a Risk Assessment Workshop held in Oman and a handbook containing the mitigation measures at national and local scales was developed and delivered to the stakeholders. We would like to thank the Ministry of Transport and Communications of the Government of the Sultanate of Oman (MOTC), Directorate General of Meteorology and Air Navigation (DGMAN), Public Authority for Civil Aviation (PACA), for supporting and funding this project and the collaboration of the IOC-UNESCO personnel. The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 603839 (Project ASTARTE - Assessment, Strategy and Risk Reduction for Tsunamis in Europe).

HYPERDIRE-HYPERgeometric functions DIfferential REduction: Mathematica-based packages for the differential reduction of generalized hypergeometric functions: Lauricella function FC of three variables

NASA Astrophysics Data System (ADS)

Bytev, Vladimir V.; Kniehl, Bernd A.

2016-09-01

We present a further extension of the HYPERDIRE project, which is devoted to the creation of a set of Mathematica-based program packages for manipulations with Horn-type hypergeometric functions on the basis of differential equations. Specifically, we present the implementation of the differential reduction for the Lauricella function FC of three variables. Catalogue identifier: AEPP_v4_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEPP_v4_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: GNU General Public License, version 3 No. of lines in distributed program, including test data, etc.: 243461 No. of bytes in distributed program, including test data, etc.: 61610782 Distribution format: tar.gz Programming language: Mathematica. Computer: All computers running Mathematica. Operating system: Operating systems running Mathematica. Classification: 4.4. Does the new version supersede the previous version?: No, it significantly extends the previous version. Nature of problem: Reduction of hypergeometric function FC of three variables to a set of basis functions. Solution method: Differential reduction. Reasons for new version: The extension package allows the user to handle the Lauricella function FC of three variables. Summary of revisions: The previous version goes unchanged. Running time: Depends on the complexity of the problem.

Reduction of Perceived Social Distance as an Explanation for Media's Influence on Personal Risk Perceptions: A Test of the Risk Convergence Model

ERIC Educational Resources Information Center

So, Jiyeon; Nabi, Robin

2013-01-01

The risk convergence model proposes reduction of perceived social distance to a mediated personality as a mechanism through which the mass media can influence audiences' personal risk perceptions. As an initial test of the model, this study examined whether 5 audience variables known to facilitate media effects on personal risk…

Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

PubMed Central

Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

2016-01-01

In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

The effect of risk perception on public preferences and willingness to pay for reductions in the health risks posed by toxic cyanobacterial blooms.

PubMed

Hunter, Peter D; Hanley, Nick; Czajkowski, Mikołaj; Mearns, Kathryn; Tyler, Andrew N; Carvalho, Laurence; Codd, Geoffrey A

2012-06-01

Mass populations of toxin-producing cyanobacteria are an increasingly common occurrence in inland and coastal waters used for recreational purposes. These mass populations pose serious risks to human and animal health and impose potentially significant economic costs on society. In this study, we used contingent valuation (CV) methods to elicit public willingness to pay (WTP) for reductions in the morbidity risks posed by blooms of toxin-producing cyanobacteria in Loch Leven, Scotland. We found that 55% of respondents (68% excluding protest voters) were willing to pay for a reduction in the number of days per year (from 90, to either 45 or 0 days) that cyanobacteria pose a risk to human health at Loch Leven. The mean WTP for a risk reduction was UK£9.99-12.23/household/year estimated using a logistic spike model. In addition, using the spike model and a simultaneous equations model to control for endogeneity bias, we found the respondents' WTP was strongly dependent on socio-demographic characteristics, economic status and usage of the waterbody, but also individual-specific attitudes and perceptions towards health risks. This study demonstrates that anticipated health risk reductions are an important nonmarket benefit of improving water quality in recreational waters and should be accounted for in future cost-benefit analyses such as those being undertaken under the auspices of the European Union's Water Framework Directive, but also that such values depend on subjective perceptions of water-related health risks and general attitudes towards the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

A two-dimensional lattice equation as an extension of the Heideman-Hogan recurrence

NASA Astrophysics Data System (ADS)

Kamiya, Ryo; Kanki, Masataka; Mase, Takafumi; Tokihiro, Tetsuji

2018-03-01

We consider a two dimensional extension of the so-called linearizable mappings. In particular, we start from the Heideman-Hogan recurrence, which is known as one of the linearizable Somos-like recurrences, and introduce one of its two dimensional extensions. The two dimensional lattice equation we present is linearizable in both directions, and has the Laurent and the coprimeness properties. Moreover, its reduction produces a generalized family of the Heideman-Hogan recurrence. Higher order examples of two dimensional linearizable lattice equations related to the Dana Scott recurrence are also discussed.

Effect of electronic stability control on automobile crash risk.

PubMed

Farmer, Charles

2004-12-01

Per vehicle crash involvement rates were compared for otherwise identical vehicle models with and without electronic stability control (ESC) systems. ESC was found to affect single-vehicle crashes to a greater extent than multiple-vehicle crashes, and crashes with fatal injuries to a greater extent than less severe crashes. Based on all police-reported crashes in 7 states over 2 years, ESC reduced single-vehicle crash involvement risk by approximately 41 percent (95 percent confidence limits 3348) and single-vehicle injury crash involvement risk by 41 percent (2752). This translates to an estimated 7 percent reduction in overall crash involvement risk (310) and a 9 percent reduction in overall injury crash involvement risk (314). Based on all fatal crashes in the United States over 3 years, ESC was found to have reduced single-vehicle fatal crash involvement risk by 56 percent (3968). This translates to an estimated 34 percent reduction in overall fatal crash involvement risk (2145).

New algorithms for optimal reduction of technical risks

NASA Astrophysics Data System (ADS)

Todinov, M. T.

2013-06-01

The article features exact algorithms for reduction of technical risk by (1) optimal allocation of resources in the case where the total potential loss from several sources of risk is a sum of the potential losses from the individual sources; (2) optimal allocation of resources to achieve a maximum reduction of system failure; and (3) making an optimal choice among competing risky prospects. The article demonstrates that the number of activities in a risky prospect is a key consideration in selecting the risky prospect. As a result, the maximum expected profit criterion, widely used for making risk decisions, is fundamentally flawed, because it does not consider the impact of the number of risk-reward activities in the risky prospects. A popular view, that if a single risk-reward bet with positive expected profit is unacceptable then a sequence of such identical risk-reward bets is also unacceptable, has been analysed and proved incorrect.

Longitudinal patterns of gambling activities and associated risk factors in college students

PubMed Central

Goudriaan, Anna E.; Slutske, Wendy S.; Krull, Jennifer L.; Sher, Kenneth J.

2009-01-01

Aims To investigate which clusters of gambling activities exist within a longitudinal study of college health, how membership in gambling clusters change over time and whether particular clusters of gambling are associated with unhealthy risk behaviour. Design Four-year longitudinal study (2002–2006). Setting Large, public university. Participants Undergraduate college students. Measurements Ten common gambling activities were measured during 4 consecutive college years (years 1–4). Clusters of gambling activities were examined using latent class analyses. Relations between gambling clusters and gender, Greek membership, alcohol use, drug use, personality indicators of behavioural undercontrol and psychological distress were examined. Findings Four latent gambling classes were identified: (1) a low-gambling class, (2) a card gambling class, (3) a casino/slots gambling class and (4) an extensive gambling class. Over the first college years a high probability of transitioning from the low-gambling class and the card gambling class into the casino/slots gambling class was present. Membership in the card, casino/slots and extensive gambling classes were associated with higher scores on alcohol/drug use, novelty seeking and self-identified gambling problems compared to the low-gambling class. The extensive gambling class scored higher than the other gambling classes on risk factors. Conclusions Extensive gamblers and card gamblers are at higher risk for problem gambling and other risky health behaviours. Prospective examinations of class membership suggested that being in the extensive and the low gambling classes was highly stable across the 4 years of college. PMID:19438422

Regional Screening Levels (RSLs) - User's Guide (November 2017)

EPA Pesticide Factsheets

Regional Screening Level RSL user guide provides extensive guidance for risk assessors doing Chemical Risk Assessment preliminary remediation goal PRG risk based concentration RBC and rick calculations for the assess

Risk-based enteric pathogen reduction targets for non-potable and direct potable use of roof runoff, stormwater, and greywater

EPA Science Inventory

This paper presents risk-based enteric pathogen log reduction targets for non-potable and potable uses of a variety of alternative source waters (i.e., locally-collected greywater, roof runoff, and stormwater). A probabilistic Quantitative Microbial Risk Assessment (QMRA) was use...

Impacts of extension access and cooperative membership on technology adoption and household welfare.

PubMed

Wossen, Tesfamicheal; Abdoulaye, Tahirou; Alene, Arega; Haile, Mekbib G; Feleke, Shiferaw; Olanrewaju, Adetunji; Manyong, Victor

2017-08-01

This paper examines the impacts of access to extension services and cooperative membership on technology adoption, asset ownership and poverty using household-level data from rural Nigeria. Using different matching techniques and endogenous switching regression approach, we find that both extension access and cooperative membership have a positive and statistically significant effect on technology adoption and household welfare. Moreover, we find that both extension access and cooperative membership have heterogeneous impacts. In particular, we find evidence of a positive selection as the average treatment effects of extension access and cooperative membership are higher for farmers with the highest propensity to access extension and cooperative services. The impact of extension services on poverty reduction and of cooperatives on technology adoption is significantly stronger for smallholders with access to formal credit than for those without access. This implies that expanding rural financial markets can maximize the potential positive impacts of extension and cooperative services on farmers' productivity and welfare.

The societal benefits of reducing six behavioural risk factors: an economic modelling study from Australia

PubMed Central

2011-01-01

Background A large proportion of disease burden is attributed to behavioural risk factors. However, funding for public health programs in Australia remains limited. Government and non-government organisations are interested in the productivity effects on society from reducing chronic diseases. We aimed to estimate the potential health status and economic benefits to society following a feasible reduction in the prevalence of six behavioural risk factors: tobacco smoking; inadequate fruit and vegetable consumption; high risk alcohol consumption; high body mass index; physical inactivity; and intimate partner violence. Methods Simulation models were developed for the 2008 Australian population. A realistic reduction in current risk factor prevalence using best available evidence with expert consensus was determined. Avoidable disease, deaths, Disability Adjusted Life Years (DALYs) and health sector costs were estimated. Productivity gains included workforce (friction cost method), household production and leisure time. Multivariable uncertainty analyses and correction for the joint effects of risk factors on health status were undertaken. Consistent methods and data sources were used. Results Over the lifetime of the 2008 Australian adult population, total opportunity cost savings of AUD2,334 million (95% Uncertainty Interval AUD1,395 to AUD3,347; 64% in the health sector) were found if feasible reductions in the risk factors were achieved. There would be 95,000 fewer DALYs (a reduction of about 3.6% in total DALYs for Australia); 161,000 less new cases of disease; 6,000 fewer deaths; a reduction of 5 million days in workforce absenteeism; and 529,000 increased days of leisure time. Conclusions Reductions in common behavioural risk factors may provide substantial benefits to society. For example, the total potential annual cost savings in the health sector represent approximately 2% of total annual health expenditure in Australia. Our findings contribute important new knowledge about productivity effects, including the potential for increased household and leisure activities, associated with chronic disease prevention. The selection of targets for risk factor prevalence reduction is an important policy decision and a useful approach for future analyses. Similar approaches could be applied in other countries if the data are available. PMID:21689461

The role of service learning in teaching and research for disaster-risk reduction

NASA Astrophysics Data System (ADS)

Suckale, J.; Saiyed, Z.; Alvisyahrin, T.; Hilley, G. E.; Muhari, A.; Zoback, M. L. C.; Truebe, S.

2016-12-01

An important motivation for natural-hazards research is to reduce threats posed by natural disasters to at-risk communities. Yet, we rarely teach students how research may be used to construct implementable solutions that reduce disaster risk. The goal of this contribution is to evaluate the potential of service learning to impart students with both the scientific background and the skills necessary to navigate real-world constraints of disaster risk reduction. We present results from a service-learning class taught at Stanford in the Winter quarter of 2016 in collaboration with the Indonesian Ministry of Marine Affairs and Fisheries and Syiah Kuala University, Banda Aceh. The main deliverable of the class was a final project in which students developed a specific idea of how to contribute to tsunami-risk reduction in Indonesia. A common critique of the service-learning approach posits that it may implicitly embed social and political perspectives within risk-reduction strategies that may be inappropriate within a particular culture. We attempted to avoid this problem using three strategies: First, we paired students from Stanford with students at Syiah Kuala University, Banda Aceh, to facilitate a close dialogue. Second, the Ministry of Marine Affairs and Fisheries provided a list of current risk-reduction strategies without requiring students to contribute to one specific project to minimally precondition project suggestions. Third, our community partners provided ongoing feedback on the scope and feasibility of the proposed projects and students were assessed based on their ability to integrate the feedback. Preliminary results from our class suggest significant promise for a service-learning approach to teaching disaster-risk reduction. There was substantial student interest in service learning, particularly among undergraduates. Pre-and post-assessment surveys showed that over 75% of students adjusted previous notions about disaster-risk reduction during the class. The course evaluations also provided several suggestions for improvement such as enabling more dialogue with community partners and better preparation prior to the class for our partner students at Syiah Kuala University that we will adopt in future iterations of the class.

Strengthening insurance partnerships in the face of climate change - Insights from an agent-based model of flood insurance in the UK.

PubMed

Crick, Florence; Jenkins, Katie; Surminski, Swenja

2018-04-25

Multisectoral partnerships are increasingly cited as a mechanism to deliver and improve disaster risk management. Yet, partnerships are not a panacea and more research is required to understand the role that they can play in disaster risk management and particularly disaster risk reduction. This paper investigates how partnerships can incentivise flood risk reduction by focusing on the UK public-private partnership on flood insurance. Developing the right flood insurance arrangements to incentivise flood risk reduction and adaptation to climate change is a key challenge. In the face of rising flood risks due to climate change and socio-economic development insurance partnerships can no longer afford to focus only on the risk transfer function. However, while expectations of the insurance industry have traditionally been high when it comes to flood risk management, the insurance industry alone will not provide the solution to the challenge of rising risks. The case of flood insurance in the UK illustrates this: even national government and industry together cannot fully address these risks and other actors need to be involved to create strong incentives for risk reduction. Using an agent-based model focused on surface water flood risk in London we analyse how other partners could strengthen the insurance partnership by reducing flood risk and thus helping to maintain affordable insurance premiums. Our findings are relevant for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and also internationally. Copyright © 2018. Published by Elsevier B.V.

Pilot Test of an Integrated Sexual Risk Reduction Intervention for Women with a History of Childhood Sexual Abuse.

PubMed

Senn, Theresa E; Braksmajer, Amy; Urban, Marguerite A; Coury-Doniger, Patricia; Carey, Michael P

2017-11-01

HIV and childhood sexual abuse (CSA) are intersecting public health problems for women. We pilot tested an integrated sexual risk reduction intervention for women with a history of CSA that addressed both the consequences of CSA [based on the Traumagenic Dynamics (TD) framework] and the antecedents of sexual risk behavior (based on the Information-Motivation-Behavioral Skills [IMB] model). Women with a history of CSA who were attending a public STI clinic (n = 84) were randomly assigned to a five-session integrated TD/IMB (experimental) group intervention or to a time-matched IMB-guided sexual risk reduction (control) group intervention. Preliminary findings indicated that women in the integrated TD/IMB intervention reduced their average number of episodes of unprotected sex with a primary partner, their alcohol use, and their likelihood of being in a violent relationship, relative to women in the IMB-only group. Our findings suggest that sexual risk reduction interventions that address both the consequences of CSA and the antecedents of sexual risk behavior may be efficacious in reducing sexual risk behavior among women who were sexually abused.

Are Cultural Values and Beliefs Included in U.S. Based HIV Interventions?

PubMed Central

Wyatt, Gail E.; Williams, John K.; Gupta, Arpana; Malebranche, Dominique

2013-01-01

Objective To determine the extent to which current U.S. based HIV/AIDS prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method A comprehensive literature review was conducted to determine which published HIV/AIDS prevention and risk reduction interventions incorporated aspects of cultural beliefs. Results This review of 166 HIV prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. Conclusion HIV interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual’s risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. PMID:21884721

Dynapenia and Aging: An Update

PubMed Central

Clark, Brian C.

2012-01-01

In 2008, we published an article arguing that the age-related loss of muscle strength is only partially explained by the reduction in muscle mass and that other physiologic factors explain muscle weakness in older adults (Clark BC, Manini TM. Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci. 2008;63:829–834). Accordingly, we proposed that these events (strength and mass loss) be defined independently, leaving the term “sarcopenia” to be used in its original context to describe the age-related loss of muscle mass. We subsequently coined the term “dynapenia” to describe the age-related loss of muscle strength and power. This article will give an update on both the biological and clinical literature on dynapenia—serving to best synthesize this translational topic. Additionally, we propose a working decision algorithm for defining dynapenia. This algorithm is specific to screening for and defining dynapenia using age, presence or absence of risk factors, a grip strength screening, and if warranted a test for knee extension strength. A definition for a single risk factor such as dynapenia will provide information in building a risk profile for the complex etiology of physical disability. As such, this approach mimics the development of risk profiles for cardiovascular disease that include such factors as hypercholesterolemia, hypertension, hyperglycemia, etc. Because of a lack of data, the working decision algorithm remains to be fully developed and evaluated. However, these efforts are expected to provide a specific understanding of the role that dynapenia plays in the loss of physical function and increased risk for disability among older adults. PMID:21444359

The impact of lean production on musculoskeletal and psychosocial risks: an examination of sociotechnical trends over 20 years.

PubMed

Koukoulaki, Theoni

2014-03-01

This paper provides an extensive review of studies carried out in lean production environments in the last 20 years. It aims to identify the effects of lean production (negative or positive) on occupational health and related risk factors. Thirty-six studies of lean effects were accepted from the literature search and sorted by sector and type of outcome. Lean production was found to have a negative effect on health and risk factors; the most negative outcomes being found in the earliest studies in the automotive industry. However, examples of mixed and positive effects were also found in the literature. The strongest correlations of lean production with stress were found for characteristics found in Just-In-Time production that related to reduced cycle time and reduction of resources. Increased musculoskeletal risk symptoms were related to increases of work pace and lack of recovery time also found in Just-In-Time systems. An interaction model is developed to propose a pathway from lean production characteristics to musculoskeletal and psychosocial risk factors and also positive outcomes. An examination is also made of the changing focus of studies investigating the consequences of lean production over a 20-year period. Theories about the effects of lean production have evolved from a conceptualization that it is an inherently harmful management system, to a view that it can have mixed effects depending on the management style of the organization and the specific way it is implemented. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Dynapenia and aging: an update.

PubMed

Manini, Todd M; Clark, Brian C

2012-01-01

In 2008, we published an article arguing that the age-related loss of muscle strength is only partially explained by the reduction in muscle mass and that other physiologic factors explain muscle weakness in older adults (Clark BC, Manini TM. Sarcopenia =/= dynapenia. J Gerontol A Biol Sci Med Sci. 2008;63:829-834). Accordingly, we proposed that these events (strength and mass loss) be defined independently, leaving the term "sarcopenia" to be used in its original context to describe the age-related loss of muscle mass. We subsequently coined the term "dynapenia" to describe the age-related loss of muscle strength and power. This article will give an update on both the biological and clinical literature on dynapenia-serving to best synthesize this translational topic. Additionally, we propose a working decision algorithm for defining dynapenia. This algorithm is specific to screening for and defining dynapenia using age, presence or absence of risk factors, a grip strength screening, and if warranted a test for knee extension strength. A definition for a single risk factor such as dynapenia will provide information in building a risk profile for the complex etiology of physical disability. As such, this approach mimics the development of risk profiles for cardiovascular disease that include such factors as hypercholesterolemia, hypertension, hyperglycemia, etc. Because of a lack of data, the working decision algorithm remains to be fully developed and evaluated. However, these efforts are expected to provide a specific understanding of the role that dynapenia plays in the loss of physical function and increased risk for disability among older adults.

Motivational interviewing for HIV risk reduction among gay men in commercial and public sex settings.

PubMed

Harding, R; Dockrell, M J; Dockrell, J; Corrigan, N

2001-08-01

The present paper addresses the feasibility of combining motivational interviewing and cognitive interventions to HIV risk reduction in commercial venues and public sex environments (PSEs). The logic for these two approaches is considered and an intervention combining key elements of the two is presented. The intervention uses a questionnaire format to encourage individuals to compare their desired versus actual behaviour (i.e. chosen personal risk reduction strategy versus 'slip-ups'/unwanted risk taking), and to recognize their risk-related cognitions. High-risk individuals are identified, and health-focused conversations developed from the brief schedule. The structure and key design issues in the development of a feasible, acceptable and evidence-based tool are reviewed. The limitations of more complex, focused interventions in the context of commercial and PSE settings are discussed.

Evaluating a Brief, Video-Based Sexual Risk Reduction Intervention and Assessment Reactivity with STI Clinic Patients: Results from a Randomized Controlled Trial

PubMed Central

Carey, Michael P.; Senn, Theresa E.; Walsh, Jennifer L.; Coury-Doniger, Patricia; Urban, Marguerite A.; Fortune, Thierry; Vanable, Peter A.; Carey, Kate B.

2014-01-01

We report results from a randomized controlled trial designed to evaluate the efficacy of a video-based sexual risk reduction intervention and to measure assessment reactivity. Patients (N = 1010; 56 % male; 69 % African American) receiving care at a sexually transmitted infection (STI) clinic were assigned to one of four conditions formed by crossing assessment condition (i.e., sexual health vs. general health) with intervention condition (i.e., sexual risk reduction intervention vs. general health promotion). After completing their assigned baseline assessment, participants received their assigned intervention, and subsequently returned for follow-up assessments at 3, 6, 9, and 12 months. Participants in all conditions reduced their self-reported sexual risk behavior, and the incidence of new STIs declined from baseline through the follow-ups; however, there was no effect of intervention or assessment condition. We conclude that further risk reduction will require more intensive interventions, especially in STI clinics that already provide excellent clinical care. PMID:25433653

HIV RISK REDUCTION INTERVENTIONS AMONG SUBSTANCE-ABUSING REPRODUCTIVE-AGE WOMEN: A SYSTEMATIC REVIEW

PubMed Central

Weissman, Jessica; Kanamori, Mariano; Dévieux, Jessy G.; Trepka, Mary Jo; De La Rosa, Mario

2017-01-01

HIV/AIDS is one of the leading causes of death among reproductive-age women throughout the world, and substance abuse plays a major role in HIV infection. We conducted a systematic review, in accordance with the 2015 Preferred Items for Reporting Systematic Reviews and Meta-analysis tool, to assess HIV risk-reduction intervention studies among reproductive-age women who abuse substances. We initially identified 6,506 articles during our search and, after screening titles and abstracts, examining articles in greater detail, and finally excluding those rated methodologically weak, a total of 10 studies were included in this review. Studies that incorporated behavioral skills training into the intervention and were based on theoretical model(s) were the most effective in general at decreasing sex and drug risk behaviors. Additional HIV risk-reduction intervention research with improved methodological designs is warranted to determine the most efficacious HIV risk-reduction intervention for reproductive-age women who abuse substances. PMID:28467160

Evaluation of the stepwise collimation method for the reduction of the patient dose in full spine radiography

NASA Astrophysics Data System (ADS)

Lee, Boram; Lee, Sunyoung; Yang, Injeong; Yoon, Myeonggeun

2014-05-01

The purpose of this study is to evaluate the dose reduction when using the stepwise collimation method for scoliosis patients undergoing full spine radiography. A Monte Carlo simulation was carried out to acquire dose vs. volume data for organs at risk (OAR) in the human body. While the effective doses in full spine radiography were reduced by 8, 15, 27 and 44% by using four different sizes of the collimation, the doses to the skin were reduced by 31, 44, 55 and 66%, indicating that the reduction of the dose to the skin is higher than that to organs inside the body. Although the reduction rates were low for the gonad, being 9, 14, 18 and 23%, there was more than a 30% reduction in the dose to the heart, suggesting that the dose reduction depends significantly on the location of the OARs in the human body. The reduction rate of the secondary cancer risk based on the excess absolute risk (EAR) varied from 0.6 to 3.4 per 10,000 persons, depending on the size of the collimation. Our results suggest that the stepwise collimation method in full spine radiography can effectively reduce the patient dose and the radiation-induced secondary cancer risk.

A new DPYD genotyping assay for improving the safety of 5-fluorouracil therapy.

PubMed

Sistonen, Johanna; Smith, Chingying; Fu, Yung-Kang; Largiadèr, Carlo R

2012-12-24

Chemotherapeutic use of 5-fluorouracil (5FU) is compromised by 10-20% of patients developing severe toxicity. Recently described genetic variation in dihydropyrimidine dehydrogenase (DPYD) has been shown to be a major predictor of 5FU toxicity. Here, we describe a new genotyping assay for routine clinical use that covers all the major DPYD risk variants. Genomic regions targeting DPYD risk variants (c.1129-5923C>G, c.1679T>G/A, c.1905+1G>A, c.2846A>T) and additional markers (c.234-123G>C, c.496A>G, c.775A>G) were amplified in a multiplex PCR reaction. The subsequent steps including allele-specific primer extension, hybridization of the primers to a microarray, scanning of the array, and data analysis were automated within the INFINITI® Analyzer (AutoGenomics). The assay was validated by analyzing 107 blood samples obtained from patients previously re-sequenced for the DPYD. The genotypes obtained with the developed assay were 100% concordant with the re-sequencing. The procedure is suitable for routine clinical use since the results are obtained within one day. For heterozygous risk variant carriers (~7% of Europeans), the treatment can be adjusted by 5FU dose reduction, whereas carriers of two risk alleles should be treated with an alternative therapy. The developed assay provides a novel tool to improve the safety of commonly used 5FU-based chemotherapies. Copyright © 2012 Elsevier B.V. All rights reserved.

Effects of a Community-Based HIV Risk Reduction Intervention Among HIV-Positive Individuals: Results of a Quasi-Experimental Study in Nepal.

PubMed

Poudel, Krishna C; Buchanan, David R; Poudel-Tandukar, Kalpana

2015-06-01

We evaluated the efficacy of a sexual risk reduction intervention utilizing protection motivation and social cognitive theories to address knowledge, threat and coping appraisals, and condom use intentions among HIV-positive individuals in Nepal. Using a quasi-experimental research design, we assigned 277 participants to intervention (n=146) and control (n=131) groups. The intervention group received six sessions on sexual risk reduction strategies and the control group six sessions on medication adherence, smoking, and mental health. Data were collected at baseline and immediately after the intervention. Results indicate that the sexual risk reduction intervention produced a significant increase in HIV transmission knowledge, perceived threat and coping appraisals, and intentions to use condoms with regular, HIV-positive, and HIV-negative partners. The positive effects of the intervention remained significant after adjusting for baseline scores and other potential confounders. In conclusion, our theory-based sexual risk reduction intervention was effective in improving HIV transmission knowledge, perceived threat and coping appraisals, and condom use intentions. Further studies are needed to evaluate the long-term efficacy of the intervention in increasing protection motivation and maintaining preventive behaviors.

Exposure Perception as a Key Indicator of Risk Perception and Acceptance of Sources of Radio Frequency Electromagnetic Fields

PubMed Central

Wiedemann, Peter M.; Brown, Tim W. C.

2015-01-01

The presented survey was conducted in six European countries as an online study. A total of 2454 subjects participated. Two main research questions were investigated: firstly, how does the cognitive, moral, and affective framing of radio frequency electromagnetic field (RF EMF) exposure perception influence RF EMF risk perception? Secondly, can the deployment of mobile phone base stations have greater acceptance with RF EMF exposure reduction? The findings with respect to the first question clearly indicated that the cognitive framed exposure perception is the main determinant of RF EMF risk perception. The concomitant sensitivity to exposure strength offers an opportunity to improve the acceptance of base stations by exposure reduction. A linear regression analysis supported this assumption: in a fictional test situation, exposure reduction improved the acceptance of base stations, operationalized as the requested distance of the base station from one's own home. Furthermore, subjects with high RF EMF risk perception were most sensitive to exposure reduction. On average, a 70% exposure reduction reduced the requested distance from about 2000 meters to 1000 meters. The consequences for risk communication are discussed. PMID:26229540

Blood Glucose Reduction by Diabetic Drugs with Minimal Hypoglycemia Risk for Cardiovascular Outcomes: Evidence from Meta-regression Analysis of Randomized Controlled Trials.

PubMed

Huang, Chi-Jung; Wang, Wei-Ting; Sung, Shih-Hsien; Chen, Chen-Huan; Lip, Gregory Yh; Cheng, Hao-Min; Chiang, Chern-En

2018-05-02

To investigate the effects of blood glucose control with antihyperglycemic agents with minimal hypoglycemia risk on cardiovascular outcomes in patients with type 2 diabetes (T2D). Randomized controlled trials (RCTs) comparing the relative efficacy and safety of antidiabetic drugs with less hypoglycemia risk were comprehensively searched in MEDLINE, Embase, and the Cochrane Library up to January 27, 2018. Mixed-effects meta-regression analysis was conducted to explore the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse cardiovascular events (MACE), myocardial infarction, stroke, cardiovascular death, all-cause death, and hospitalization for heart failure. Ten RCTs comprising 92400 participants with T2D were included and provided information on 9773 MACE during a median follow-up of 2.6 years. The mean HbA1c concentration was 0.42% lower (median, 0.27-0.86%) for participants given antihyperglycemic agents than those given placebo. The meta-regression analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of MACE (β value, -0.39 to -0.55; P<0.02) even after adjusting for each of the following possible confounding factors including age, sex, baseline HbA1c, duration of follow-up, difference in achieved systolic blood pressure, difference in achieved body weight, or risk difference in hypoglycemia. Lowering HbA1c by 1% conferred a significant risk reduction of 30% (95% CI, 17-40%) for MACE. By contrast, the meta-regression analysis for trials using conventional agents failed to demonstrate a significant relationship between achieved HbA1c difference and MACE risk (P>0.74). Compared with placebo, newer T2D agents with less hypoglycemic hazard significantly reduced the risk of MACE. The MACE reduction seems to be associated with HbA1c reduction in a linear relationship. This article is protected by copyright. All rights reserved.

Development and Verification of the Soil-Pile Interaction Extension for SubDyn

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

Damiani, Rick R; Wendt, Fabian F

SubDyn is the substructure structural-dynamics module for the aero-hydro-servo-elastic tool FAST v8. SubDyn uses a finite-element model (FEM) to simulate complex multimember lattice structures connected to conventional turbines and towers, and it can make use of the Craig-Bampton model reduction. Here we describe the newly added capability to handle soil-pile stiffness and compare results for monopile and jacket-based offshore wind turbines as obtained with FAST v8, SACS, and EDP (the latter two are modeling software packages commonly used in the offshore oil and gas industry). The level of agreement in terms of modal properties and loads for the entire offshoremore » wind turbine components is excellent, thus allowing SubDyn and FAST v8 to accurately simulate offshore wind turbines on fixed-bottom structures and accounting for the effect of soil dynamics, thus reducing risk to the project.« less

Evaluation of Ceftolozane-Tazobactam in Combination with Meropenem against Pseudomonas aeruginosa Sequence Type 175 in a Hollow-Fiber Infection Model.

PubMed

Montero, M; VanScoy, Brian D; López-Causapé, Carla; Conde, Haley; Adams, Jonathan; Segura, Concepción; Zamorano, Laura; Oliver, Antonio; Horcajada, Juan P; Ambrose, Paul G

2018-05-01

The aim of this study was to investigate the efficacy of ceftolozane-tazobactam in combination with meropenem against an extensively drug-resistant (XDR) Pseudomonas aeruginosa high-risk clone, sequence type 175, isolated in a Spanish university hospital. A 14-day hollow-fiber infection model was used to simulate clinical exposure of the two drug regimens alone and in combination, and serial samples were collected to determine drug concentrations and CFU counts. The untreated control failed, as did each study regimen when administered alone. However, when ceftolozane-tazobactam was administered in combination with meropenem, there was a >4-log 10 CFU/ml bacterial density reduction and suppression of resistance for the duration of the study. These data suggest that ceftolozane-tazobactam plus meropenem may be a useful combination for treating XDR P. aeruginosa . Copyright © 2018 American Society for Microbiology.

[Security specifications for electronic medical records on the Internet].

PubMed

Mocanu, Mihai; Mocanu, Carmen

2007-01-01

The extension for the Web applications of the Electronic Medical Record seems both interesting and promising. Correlated with the expansion of Internet in our country, it allows the interconnection of physicians of different specialties and their collaboration for better treatment of patients. In this respect, the ophthalmologic medical applications consider the increased possibilities for monitoring chronic ocular diseases and for the identification of some elements for early diagnosis and risk factors supervision. We emphasize in this survey some possible solutions to the problems of interconnecting medical information systems to the Internet: the achievement of interoperability within medical organizations through the use of open standards, the automated input and processing for ocular imaging, the use of data reduction techniques in order to increase the speed of image retrieval in large databases, and, last but not least, the resolution of security and confidentiality problems in medical databases.

Trial of a psychoeducational eating disturbance intervention for college women: a replication and extension.

PubMed

Stice, Eric; Orjada, Kendra; Tristan, Jennifer

2006-04-01

We conducted a controlled trial of a psychoeducational eating disturbance intervention to replicate the positive findings observed in the preliminary evaluation of this intervention and to determine whether the effects persist for a longer follow-up period. College women who took the psychoeducational class and a matched control sample of students (N = 95) completed pretest, posttest, and 6-month follow-up surveys. Intervention participants showed significantly greater reductions in thin-ideal internalization, body dissatisfaction, dieting, and eating disorder symptoms, as well as significantly less weight gain, relative to matched controls over the study period. Intervention effects tended to be larger at 6-month follow-up than at posttest. These findings suggest that the intervention effects for eating disorder risk factors and eating disorder symptoms, as well as the weight gain prevention effects, are reproducible and persist over time. This intervention has both mental health and public health significance. 2006 by Wiley Periodicals, Inc.

Drink, drugs and disruption: memory manipulation for the treatment of addiction.

PubMed

Milton, A L

2013-08-01

Addiction is a complex disorder, and one characterised by the acquisition of maladaptive instrumental (drug-seeking and drug-taking) and pavlovian (cue-drug associations) memories. These memories markedly contribute to the long-term risk of relapse, so reduction of the impact of these memories on behaviour could potentially be an important addition to current therapies for addiction. Memory reconsolidation may provide such a target for disrupting well-consolidated pavlovian cue-drug memories following an extensive drug history. Reconsolidation can be disrupted either by administering amnestic drugs in conjunction with a memory reactivation session, or by updating the memory adaptively through the induction of 'superextinction'. More work is needed before these therapies are ready for translation to the clinic, but if found clinically effective memory manipulation promises a radical new way of treating addiction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of an expert data reduction assistant

NASA Technical Reports Server (NTRS)

Miller, Glenn E.; Johnston, Mark D.; Hanisch, Robert J.

1992-01-01

We propose the development of an expert system tool for the management and reduction of complex data sets. The proposed work is an extension of a successful prototype system for the calibration of CCD images developed by Dr. Johnston in 1987. The reduction of complex multi-parameter data sets presents severe challenges to a scientist. Not only must a particular data analysis system be mastered, (e.g. IRAF/SDAS/MIDAS), large amounts of data can require many days of tedious work and supervision by the scientist for even the most straightforward reductions. The proposed Expert Data Reduction Assistant will help the scientist overcome these obstacles by developing a reduction plan based on the data at hand and producing a script for the reduction of the data in a target common language.

Sound transit climate risk reduction project.

DOT National Transportation Integrated Search

2013-09-01

The Climate Risk Reduction Project assessed how climate change may affect Sound Transit commuter rail, light rail, and express bus : services. The project identified potential climate change impacts on agency operations, assets, and long-term plannin...

Differential effects of PPAR-{gamma} activation versus chemical or genetic reduction of DPP-4 activity on bone quality in mice.

PubMed

Kyle, Kimberly A; Willett, Thomas L; Baggio, Laurie L; Drucker, Daniel J; Grynpas, Marc D

2011-02-01

Patients with type 2 diabetes mellitus have an increased risk of fracture that can be further exacerbated by thiazolidinediones. A new class of antidiabetic agents control glucose through reduction of dipeptidyl peptidase-4 (DPP-4) activity; however the importance of DPP-4 for the control of bone quality has not been extensively characterized. We compared the effects of the thiazolidinedione pioglitazone and the DPP-4 inhibitor sitagliptin on bone quality in high-fat diet (HFD)-fed wild-type mice. In complementary studies, we examined bone quality in Dpp4(+/+) vs. Dpp4(-/-) mice. Pioglitazone produced yellow bones with greater bone marrow adiposity and significantly reduced vertebral bone mechanics in male, female, and ovariectomized (OVX) HFD fed female mice. Pioglitazone negatively affected vertebral volumetric bone mineral density, trabecular architecture, and mineral apposition rate in male mice. Sitagliptin treatment of HFD-fed wild-type mice significantly improved vertebral volumetric bone mineral density and trabecular architecture in female mice, but these improvements were lost in females after OVX. Genetic inactivation of Dpp4 did not produce a major bone phenotype in male and female Dpp4(-/-) mice; however, OVX Dpp4(-/-) mice exhibited significantly reduced femoral size and mechanics. These findings delineate the skeletal consequences of pharmacological and genetic reduction of DPP-4 activity and reveal significant differences in the effects of pioglitazone vs. sitagliptin vs. genetic Dpp4 inactivation on bone mechanics in mice.

The effect of lung volume reduction surgery on chronic obstructive pulmonary disease exacerbations.

PubMed

Washko, George R; Fan, Vincent S; Ramsey, Scott D; Mohsenifar, Zab; Martinez, Fernando; Make, Barry J; Sciurba, Frank C; Criner, Gerald J; Minai, Omar; Decamp, Malcolm M; Reilly, John J

2008-01-15

Lung volume reduction surgery (LVRS) has been demonstrated to provide a functional and mortality benefit to a select group of subjects with chronic obstructive pulmonary disease (COPD). The effect of LVRS on COPD exacerbations has not been as extensively studied, and whether improvement in postoperative lung function alters the risk of disease exacerbations is not known. To examine the effect, and mechanism of potential benefit, of LVRS on COPD exacerbations by comparing the medical and surgical cohorts of the National Emphysema Treatment Trial (NETT). A COPD exacerbation was defined using Centers for Medicare and Medicaid Services data and International Classification of Diseases, Ninth Revision, discharge diagnosis. There was no difference in exacerbation rate or time to first exacerbation between the medical and surgical cohorts during the year before study randomization (P = 0.58 and 0.85, respectively). Postrandomization, the surgical cohort experienced an approximate 30% reduction in exacerbation frequency (P = 0.0005). This effect was greatest in those subjects with the largest postoperative improvement in FEV(1) (P = 0.04) when controlling for changes in other spirometric measures of lung function, lung capacities, and room air arterial blood gas tensions. Finally, LVRS increased the time to first exacerbation in both those subjects with and those without a prior history of exacerbations (P = 0.0002 and P < 0.0001, respectively). LVRS reduces the frequency of COPD exacerbations and increases the time to first exacerbation. One explanation for this benefit may be the postoperative improvement in lung function.

Quantifying the effects of promoting smokeless tobacco as a harm reduction strategy in the USA.

PubMed

Mejia, Adrienne B; Ling, Pamela M; Glantz, Stanton A

2010-08-01

Snus (a form of smokeless tobacco) is less dangerous than cigarettes. Some health professionals argue that snus should be promoted as a component of a harm reduction strategy, while others oppose this approach. Major US tobacco companies (RJ Reynolds and Philip Morris) are marketing snus products as cigarette brand line extensions. The population effects of smokeless tobacco promotion will depend on the combined effects of changes in individual risk with population changes in tobacco use patterns. To quantitatively evaluate the health impact of smokeless tobacco promotion as part of a harm reduction strategy in the US. A Monte Carlo simulation of a decision tree model of tobacco initiation and use was used to estimate the health effects associated with five different patterns of increased smokeless tobacco use. With cigarette smoking having a health effect of 100, the base case scenario (based on current US prevalence rates) yields a total health effect of 24.2 (5% to 95% interval 21.7 to 26.5) and the aggressive smokeless promotion (less cigarette use and increased smokeless, health-concerned smokers switching to snus, smokers in smokefree environments switching to snus) was associated with a health effect of 30.4 (5% to 95% interval 25.9 to 35.2). The anticipated health effects for additional scenarios with lower rates of smokeless uptake also overlapped with the base case. Promoting smokeless tobacco as a safer alternative to cigarettes is unlikely to result in substantial health benefits at a population level.

Thermal remediation alters soil properties - a review.

PubMed

O'Brien, Peter L; DeSutter, Thomas M; Casey, Francis X M; Khan, Eakalak; Wick, Abbey F

2018-01-15

Contaminated soils pose a risk to human and ecological health, and thermal remediation is an efficient and reliable way to reduce soil contaminant concentration in a range of situations. A primary benefit of thermal treatment is the speed at which remediation can occur, allowing the return of treated soils to a desired land use as quickly as possible. However, this treatment also alters many soil properties that affect the capacity of the soil to function. While extensive research addresses contaminant reduction, the range and magnitude of effects to soil properties have not been explored. Understanding the effects of thermal remediation on soil properties is vital to successful reclamation, as drastic effects may preclude certain post-treatment land uses. This review highlights thermal remediation studies that have quantified alterations to soil properties, and it supplements that information with laboratory heating studies to further elucidate the effects of thermal treatment of soil. Notably, both heating temperature and heating time affect i) soil organic matter; ii) soil texture and mineralogy; iii) soil pH; iv) plant available nutrients and heavy metals; v) soil biological communities; and iv) the ability of the soil to sustain vegetation. Broadly, increasing either temperature or time results in greater contaminant reduction efficiency, but it also causes more severe impacts to soil characteristics. Thus, project managers must balance the need for contaminant reduction with the deterioration of soil function for each specific remediation project. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials.

PubMed

Darby, S; McGale, P; Correa, C; Taylor, C; Arriagada, R; Clarke, M; Cutter, D; Davies, C; Ewertz, M; Godwin, J; Gray, R; Pierce, L; Whelan, T; Wang, Y; Peto, R

2011-11-12

After breast-conserving surgery, radiotherapy reduces recurrence and breast cancer death, but it may do so more for some groups of women than for others. We describe the absolute magnitude of these reductions according to various prognostic and other patient characteristics, and relate the absolute reduction in 15-year risk of breast cancer death to the absolute reduction in 10-year recurrence risk. We undertook a meta-analysis of individual patient data for 10,801 women in 17 randomised trials of radiotherapy versus no radiotherapy after breast-conserving surgery, 8337 of whom had pathologically confirmed node-negative (pN0) or node-positive (pN+) disease. Overall, radiotherapy reduced the 10-year risk of any (ie, locoregional or distant) first recurrence from 35·0% to 19·3% (absolute reduction 15·7%, 95% CI 13·7-17·7, 2p<0·00001) and reduced the 15-year risk of breast cancer death from 25·2% to 21·4% (absolute reduction 3·8%, 1·6-6·0, 2p=0·00005). In women with pN0 disease (n=7287), radiotherapy reduced these risks from 31·0% to 15·6% (absolute recurrence reduction 15·4%, 13·2-17·6, 2p<0·00001) and from 20·5% to 17·2% (absolute mortality reduction 3·3%, 0·8-5·8, 2p=0·005), respectively. In these women with pN0 disease, the absolute recurrence reduction varied according to age, grade, oestrogen-receptor status, tamoxifen use, and extent of surgery, and these characteristics were used to predict large (≥20%), intermediate (10-19%), or lower (<10%) absolute reductions in the 10-year recurrence risk. Absolute reductions in 15-year risk of breast cancer death in these three prediction categories were 7·8% (95% CI 3·1-12·5), 1·1% (-2·0 to 4·2), and 0·1% (-7·5 to 7·7) respectively (trend in absolute mortality reduction 2p=0·03). In the few women with pN+ disease (n=1050), radiotherapy reduced the 10-year recurrence risk from 63·7% to 42·5% (absolute reduction 21·2%, 95% CI 14·5-27·9, 2p<0·00001) and the 15-year risk of breast cancer death from 51·3% to 42·8% (absolute reduction 8·5%, 1·8-15·2, 2p=0·01). Overall, about one breast cancer death was avoided by year 15 for every four recurrences avoided by year 10, and the mortality reduction did not differ significantly from this overall relationship in any of the three prediction categories for pN0 disease or for pN+ disease. After breast-conserving surgery, radiotherapy to the conserved breast halves the rate at which the disease recurs and reduces the breast cancer death rate by about a sixth. These proportional benefits vary little between different groups of women. By contrast, the absolute benefits from radiotherapy vary substantially according to the characteristics of the patient and they can be predicted at the time when treatment decisions need to be made. Cancer Research UK, British Heart Foundation, and UK Medical Research Council. Copyright © 2011 Elsevier Ltd. All rights reserved.

Breast Cancer Risk Reduction, Version 2.2015.

PubMed

Bevers, Therese B; Ward, John H; Arun, Banu K; Colditz, Graham A; Cowan, Kenneth H; Daly, Mary B; Garber, Judy E; Gemignani, Mary L; Gradishar, William J; Jordan, Judith A; Korde, Larissa A; Kounalakis, Nicole; Krontiras, Helen; Kumar, Shicha; Kurian, Allison; Laronga, Christine; Layman, Rachel M; Loftus, Loretta S; Mahoney, Martin C; Merajver, Sofia D; Meszoely, Ingrid M; Mortimer, Joanne; Newman, Lisa; Pritchard, Elizabeth; Pruthi, Sandhya; Seewaldt, Victoria; Specht, Michelle C; Visvanathan, Kala; Wallace, Anne; Bergman, Mary Ann; Kumar, Rashmi

2015-07-01

Breast cancer is the most frequently diagnosed malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. To assist women who are at increased risk of developing breast cancer and their physicians in the application of individualized strategies to reduce breast cancer risk, NCCN has developed these guidelines for breast cancer risk reduction. Copyright © 2015 by the National Comprehensive Cancer Network.

Risk-Based Prioritization of Research for Aviation Security Using Logic-Evolved Decision Analysis

NASA Technical Reports Server (NTRS)

Eisenhawer, S. W.; Bott, T. F.; Sorokach, M. R.; Jones, F. P.; Foggia, J. R.

2004-01-01

The National Aeronautics and Space Administration is developing advanced technologies to reduce terrorist risk for the air transportation system. Decision support tools are needed to help allocate assets to the most promising research. An approach to rank ordering technologies (using logic-evolved decision analysis), with risk reduction as the metric, is presented. The development of a spanning set of scenarios using a logic-gate tree is described. Baseline risk for these scenarios is evaluated with an approximate reasoning model. Illustrative risk and risk reduction results are presented.

Characterizing the Benefits of Seismic Isolation for Nuclear Structures: A Framework for Risk-Based Decision Making

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

Bolisetti, Chandrakanth; Yu, Chingching; Coleman, Justin

This report provides a framework for assessing the benefits of seismic isolation and exercises the framework on a Generic Department of Energy Nuclear Facility (GDNF). These benefits are (1) reduction in the risk of unacceptable seismic performance and a dramatic reduction in the probability of unacceptable performance at beyond-design basis shaking, and (2) a reduction in capital cost at sites with moderate to high seismic hazard. The framework includes probabilistic risk assessment and estimates of overnight capital cost for the GDNF.

Dementia Medications and Risk of Falls, Syncope, and Related Adverse Events Meta-Analysis of Randomized Controlled Trials

PubMed Central

Kim, Dae Hyun; Brown, Rebecca T.; Ding, Eric L.; Kiel, Douglas P.; Berry, Sarah D.

2012-01-01

Background Conflicting evidence exists on whether cholinesterase inhibitors and memantine increase the risk of falls, syncope, and related events, defined as fracture and accidental injury. Objectives To evaluate the effect of cholinesterase inhibitors and memantine on the risk of falls, syncope, and related events Design, Setting, Participants, and Intervention Meta-analysis of 54 placebo-controlled randomized trials and extension studies of cholinesterase inhibitors and memantine that reported falls, syncope, and related events in cognitively impaired older adults. Trials were identified from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (no language restriction, through July 2009), and manual search. Measurements Falls, syncope, fracture, and accidental injury Results Compared to placebo, cholinesterase inhibitor use was associated with an increased risk of syncope (odds ratio [95% confidence interval]: 1.53 [1.02-2.30]), but not with other events (falls: 0.88 [0.74-1.04]; fracture: 1.39 [0.75-2.56]; accidental injury: 1.13 [0.87-1.45]). Memantine use was associated with fewer fractures (0.21 [0.05-0.85]), but not with other events (fall: 0.92 [0.72-1.18]; syncope: 1.04 [0.35-3.04]; accidental injury: 0.80 [0.56-1.12]). There was no differential effect by type and severity of cognitive impairment, residential status, nor length of follow-up. However, due to underreporting and small number of events, a potential benefit or risk cannot be excluded. Conclusion Cholinesterase inhibitors may increase the risk of syncope, with no effects on falls, fracture, and accidental injury in cognitively impaired older adults. Memantine may have a favorable effect on fracture, with no effects on other events. More research is needed to confirm the reduction in fractures observed for memantine. PMID:21649634

Mammographic density and breast cancer risk: current understanding and future prospects

PubMed Central

2011-01-01

Variations in percent mammographic density (PMD) reflect variations in the amounts of collagen and number of epithelial and non-epithelial cells in the breast. Extensive PMD is associated with a markedly increased risk of invasive breast cancer. The PMD phenotype is important in the context of breast cancer prevention because extensive PMD is common in the population, is strongly associated with risk of the disease, and, unlike most breast cancer risk factors, can be changed. Work now in progress makes it likely that measurement of PMD will be improved in the near future and that understanding of the genetics and biological basis of the association of PMD with breast cancer risk will also improve. Future prospects for the application of PMD include mammographic screening, risk prediction in individuals, breast cancer prevention research, and clinical decision making. PMID:22114898

Susceptibility of Murine Norovirus and Hepatitis A Virus to Electron Beam Irradiation in Oysters and Quantifying the Reduction in Potential Infection Risks

PubMed Central

Praveen, Chandni; Dancho, Brooke A.; Kingsley, David H.; Calci, Kevin R.; Meade, Gloria K.; Mena, Kristina D.

2013-01-01

Consumption of raw oysters is an exposure route for human norovirus (NoV) and hepatitis A virus (HAV). Therefore, efficient postharvest oyster treatment technology is needed to reduce public health risks. This study evaluated the inactivation of HAV and the NoV research surrogate, murine norovirus-1 (MNV-1), in oysters (Crassostrea virginica) by electron beam (E-beam) irradiation. The reduction of potential infection risks was quantified for E-beam irradiation technology employed on raw oysters at various virus contamination levels. The E-beam dose required to reduce the MNV and HAV titer by 90% (D10 value) in whole oysters was 4.05 (standard deviations [SD], ±0.63) and 4.83 (SD, ±0.08) kGy, respectively. Microbial risk assessment suggests that if a typical serving of 12 raw oysters was contaminated with 105 PFU, a 5-kGy treatment would achieve a 12% reduction (from 4.49 out of 10 persons to 3.95 out of 10 persons) in NoV infection and a 16% reduction (from 9.21 out of 10 persons to 7.76 out of 10 persons) in HAV infections. If the serving size contained only 102 PFU of viruses, a 5-kGy treatment would achieve a 26% reduction (2.74 out of 10 persons to 2.03 out of 10 persons) of NoV and 91% reduction (2.1 out of 10 persons to 1.93 out of 100 persons) of HAV infection risks. This study shows that although E-beam processing cannot completely eliminate the risk of viral illness, infection risks can be reduced. PMID:23584781

Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

PubMed

Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

2017-05-01

This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p < 0.05): open fracture (OR 3.78; 95% CI 2.71-5.27), compartment syndrome (OR 3.53; 95% CI 2.13-5.86), operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

Susceptibility of murine norovirus and hepatitis A virus to electron beam irradiation in oysters and quantifying the reduction in potential infection risks.

PubMed

Praveen, Chandni; Dancho, Brooke A; Kingsley, David H; Calci, Kevin R; Meade, Gloria K; Mena, Kristina D; Pillai, Suresh D

2013-06-01

Consumption of raw oysters is an exposure route for human norovirus (NoV) and hepatitis A virus (HAV). Therefore, efficient postharvest oyster treatment technology is needed to reduce public health risks. This study evaluated the inactivation of HAV and the NoV research surrogate, murine norovirus-1 (MNV-1), in oysters (Crassostrea virginica) by electron beam (E-beam) irradiation. The reduction of potential infection risks was quantified for E-beam irradiation technology employed on raw oysters at various virus contamination levels. The E-beam dose required to reduce the MNV and HAV titer by 90% (D(10) value) in whole oysters was 4.05 (standard deviations [SD], ±0.63) and 4.83 (SD, ±0.08) kGy, respectively. Microbial risk assessment suggests that if a typical serving of 12 raw oysters was contaminated with 10(5) PFU, a 5-kGy treatment would achieve a 12% reduction (from 4.49 out of 10 persons to 3.95 out of 10 persons) in NoV infection and a 16% reduction (from 9.21 out of 10 persons to 7.76 out of 10 persons) in HAV infections. If the serving size contained only 10(2) PFU of viruses, a 5-kGy treatment would achieve a 26% reduction (2.74 out of 10 persons to 2.03 out of 10 persons) of NoV and 91% reduction (2.1 out of 10 persons to 1.93 out of 100 persons) of HAV infection risks. This study shows that although E-beam processing cannot completely eliminate the risk of viral illness, infection risks can be reduced.

Targeting the impact of agri-environmental policy - Future scenarios in two less favoured areas in Portugal.

PubMed

Jones, Nadia; Fleskens, Luuk; Stroosnijder, Leo

2016-10-01

Targeting agri-environmental measures (AEM) improves their effectiveness in the delivery of public goods, provided the necessary coordination with other incentives. In less favoured areas (LFA) measures focusing on the conservation of extensive farming contribute to sustainable land management in these areas. In this paper we investigate the implementation of a possible AEM supporting the improvement of permanent pastures coordinated with the extensive livestock and single farm payments actually in place. Through applying a spatially-explicit mixed integer optimisation model we simulate future land use scenarios for two less favoured areas in Portugal (Centro and Alentejo) considering two policy scenarios: a 'targeted AEM', and a 'non-targeted AEM'. We then compare the results with a 'basic policy' option (reflecting a situation without AEM). This is done with regard to landscape-scale effects on the reduction of fire hazard and erosion risk, as well as effects on farm income. The results show that an AEM for permanent pastures would be more cost-effective for erosion and fire hazard mitigation if implemented within a spatially targeted framework. However when cost-effectiveness is assessed with other indicators (e.g. net farm income and share of grazing livestock) 'non-targeted AEM' implementation delivers the best outcome in Alentejo. In Centro the implementation of an AEM involves important losses of income compared to the 'basic policy'. 'Targeted AEM' tends to favour farms in very marginal conditions, i.e. targeting is demonstrated to perform best in landscapes where spatial heterogeneity is higher. The results also show the risk of farm abandonment in the two studied less favoured areas: in all three scenarios more than 30% of arable land is deemed to be abandoned. Copyright © 2016 Elsevier Ltd. All rights reserved.

Risk Evaluation of Bogie System Based on Extension Theory and Entropy Weight Method

PubMed Central

Du, Yanping; Zhang, Yuan; Zhao, Xiaogang; Wang, Xiaohui

2014-01-01

A bogie system is the key equipment of railway vehicles. Rigorous practical evaluation of bogies is still a challenge. Presently, there is overreliance on part-specific experiments in practice. In the present work, a risk evaluation index system of a bogie system has been established based on the inspection data and experts' evaluation. Then, considering quantitative and qualitative aspects, the risk state of a bogie system has been evaluated using an extension theory and an entropy weight method. Finally, the method has been used to assess the bogie system of four different samples. Results show that this method can assess the risk state of a bogie system exactly. PMID:25574159

Risk evaluation of bogie system based on extension theory and entropy weight method.

PubMed

Du, Yanping; Zhang, Yuan; Zhao, Xiaogang; Wang, Xiaohui

2014-01-01

A bogie system is the key equipment of railway vehicles. Rigorous practical evaluation of bogies is still a challenge. Presently, there is overreliance on part-specific experiments in practice. In the present work, a risk evaluation index system of a bogie system has been established based on the inspection data and experts' evaluation. Then, considering quantitative and qualitative aspects, the risk state of a bogie system has been evaluated using an extension theory and an entropy weight method. Finally, the method has been used to assess the bogie system of four different samples. Results show that this method can assess the risk state of a bogie system exactly.

Consequent use of IT tools as a driver for cost reduction and quality improvements

NASA Astrophysics Data System (ADS)

Hein, Stefan; Rapp, Roberto; Feustel, Andreas

2013-10-01

The semiconductor industry drives a lot of efforts in the field of cost reductions and quality improvements. The consequent use of IT tools is one possibility to support these goals. With the extensions of its 150mm Fab to 200mm Robert Bosch increased the systematic use of data analysis and Advanced Process Control (APC).

Effects of adjunctive treatment with aripiprazole on body weight and clinical efficacy in schizophrenia patients treated with clozapine: a randomized, double-blind, placebo-controlled trial.

PubMed

Fleischhacker, W Wolfgang; Heikkinen, Martti E; Olié, Jean-Pierre; Landsberg, Wally; Dewaele, Patricia; McQuade, Robert D; Loze, Jean-Yves; Hennicken, Delphine; Kerselaers, Wendy

2010-09-01

Clozapine is associated with significant weight gain and metabolic disturbances. This multicentre, randomized study comprised a double-blind, placebo-controlled treatment phase of 16 wk, and an open-label extension phase of 12 wk. Outpatients who met DSM-IV-TR criteria for schizophrenia, who were not optimally controlled while on stable dosage of clozapine for > or =3 months and had experienced weight gain of > or =2.5 kg while taking clozapine, were randomized (n=207) to aripiprazole at 5-15 mg/d or placebo, in addition to a stable dose of clozapine. The primary endpoint was mean change from baseline in body weight at week 16 (last observation carried forward). Secondary endpoints included clinical efficacy, body mass index (BMI) and waist circumference. A statistically significant difference in weight loss was reported for aripiprazole vs. placebo (-2.53 kg vs. -0.38 kg, respectively, difference=-2.15 kg, p<0.001). Aripiprazole-treated patients also showed BMI (median reduction 0.8 kg/m(2)) and waist circumference reduction (median reduction 2.0 cm) vs. placebo (no change in either parameter, p<0.001 and p=0.001, respectively). Aripiprazole-treated patients had significantly greater reductions in total and low-density lipoprotein (LDL) cholesterol. There were no significant differences in Positive and Negative Syndrome Scale total score changes between groups but Clinical Global Impression Improvement and Investigator's Assessment Questionnaire scores favoured aripiprazole over placebo. Safety and tolerability were generally comparable between groups. Combining aripiprazole and clozapine resulted in significant weight, BMI and fasting cholesterol benefits to patients suboptimally treated with clozapine. Improvements may reduce metabolic risk factors associated with clozapine treatment.

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication.

PubMed

Keyworth, C; Nelson, P A; Bundy, C; Pye, S R; Griffiths, C E M; Cordingley, L

2018-08-01

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor  of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = -.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.

Diffusion of Social Media among County 4-H Programs in Tennessee

ERIC Educational Resources Information Center

Bowen, Rebekah D.; Stephens, Carrie A.; Childers, Courtney C.; Avery, Elizabeth J.; Stripling, Christopher T.

2013-01-01

Over the past decade, Cooperative Extension and 4-H professionals have been faced with the decision of whether to adopt new communication technologies such as social media. Research on social media and Cooperative Extension has identified risks and barriers to adoption; however, many Cooperative Extension professionals believe that social media…

Reducing the risks of diabetes complications through diabetes self-management education and support.

PubMed

Kent, Dan; D'Eramo Melkus, Gail; Stuart, Patricia Mickey W; McKoy, June M; Urbanski, Patti; Boren, Suzanne Austin; Coke, Lola; Winters, Janis E; Horsley, Neil L; Sherr, Dawn; Lipman, Ruth

2013-04-01

People with diabetes are at risk of developing complications that contribute to substantial morbidity and mortality. In 2011, the American Association of Diabetes Educators convened an invitational Reducing Risks Symposium, during which an interdisciplinary panel of 11 thought leaders examined current knowledge about the reduction and prevention of diabetes-related risks and translated evidence into diabetes care and self-management education. Symposium participants reviewed findings from the literature and engaged in a moderated roundtable discussion. This report summarizes the discussion and presents recommendations to incorporate into practice to improve outcomes. The objective of the symposium was to develop practical advice for diabetes educators and other members of the diabetes care team regarding the reduction of diabetes-related risks. Optimal diabetes management requires patients to actively participate in their care, which occurs most effectively with a multidisciplinary team. Diabetes education is an integral part of this team approach because it not only helps the patient understand diabetes, its progression, and possible complications, but also provides guidance and encouragement to the patient to engage in proactive risk-reduction decisions for optimal health. A variety of tools are available to help the diabetes educator develop an individualized, patient-centered plan for risk reduction. More research is needed regarding intervention efficacy, best practices to improve adherence, and quantification of benefits from ongoing diabetes support in risk reduction. Diabetes educators are urged to stay abreast of evolving models of care and to build relationships with health care providers both within and beyond the diabetes care team.

Economic Valuation of Mortality Risk Reduction - Volumes 1 and 2 (2004)

EPA Pesticide Factsheets

Reports prepared on economic valuation of mortality risk reduction using information collected from sstated preference surveys of individuals, as well as using information on revealed behavior from safety expenditures in context of automobile purchases.

Adoption and implementation of a computer-delivered HIV/STD risk-reduction intervention for African American adolescent females seeking services at county health departments: implementation optimization is urgently needed.

PubMed

DiClemente, Ralph J; Bradley, Erin; Davis, Teaniese L; Brown, Jennifer L; Ukuku, Mary; Sales, Jessica M; Rose, Eve S; Wingood, Gina M

2013-06-01

Although group-delivered HIV/sexually transmitted disease (STD) risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across 8 participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding, and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics.

Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model

PubMed Central

Bandali, Sarah

2014-01-01

The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA) continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR) model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs. PMID:25089093

Adoption and Implementation of a Computer-delivered HIV/STD Risk-Reduction Intervention for African American Adolescent Females Seeking Services at County Health Departments: Implementation Optimization is Urgently Needed

PubMed Central

DiClemente, Ralph J.; Bradley, Erin; Davis, Teaniese L.; Brown, Jennifer L.; Ukuku, Mary; Sales, Jessica M.; Rose, Eve S.; Wingood, Gina M.

2013-01-01

Although group-delivered HIV/STD risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across eight participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics. PMID:23673891

Media use and school achievement--boys at risk?

PubMed

Mössle, Thomas; Kleimann, Matthias; Rehbein, Florian; Pfeiffer, Christian

2010-09-01

In work done at the German Criminological Research Institute of Lower Saxony (KFN) various methods have been used to investigate how specific inappropriate media usage patterns affect academic performance in children and adolescents. The findings are paralleled by current international research indicating a negative relationship between these two variables. Based on a cross-sectional survey of 5,529 fourth grade students and a longitudinal panel study with 1,157 primary schoolchildren, a key finding can be demonstrated: the more time students spend on consuming media and the more violent its contents are, the worse are their marks at school, even when controlling for vital factors such as family, educational, or immigrant background. In particular, boys who gender-specifically are better equipped with electronic media devices, who partially have extensive media usage times and who strongly prefer violent media content, are at the risk of showing poor school performance. In fact, a decrease in academic performance of boys can be observed in German school statistics. By presenting first results of a school-based intervention programme, a promising approach to the reduction of detrimental effects of electronic media use on school performance is introduced.

Natural Atmospheric Environment Model Development for the National Aeronautics and Space Administration's Second Generation Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

Roberts, Barry C.; Leahy, Frank; Overbey, Glenn; Batts, Glen W.; Parker, Nelson (Technical Monitor)

2002-01-01

The National Aeronautics and Space Administration (NASA) recently began development of a new reusable launch vehicle. The program office is located at Marshall Space Flight Center (MSFC) and is called the Second Generation Reusable Launch Vehicle (2GRLV). The purpose of the program is to improve upon the safety and reliability of the first generation reusable launch vehicle, the Space Shuttle. Specifically, the goals are to reduce the risk of crew loss to less than 1-in-10,000 missions and decreased costs by a factor of 10 to approximately $1,000 per pound of payload launched to low Earth orbit. The program is currently in the very early stages of development and many two-stage vehicle concepts will be evaluated. Risk reduction activities are also taking place. These activities include developing new technologies and advancing current technologies to be used by the vehicle. The Environments Group at MSFC is tasked by the 2GRLV Program to develop and maintain an extensive series of analytical tools and environmental databases which enable it to provide detailed atmospheric studies in support of structural, guidance, navigation and control, and operation of the 2GRLV.

A global probabilistic tsunami hazard assessment from earthquake sources

USGS Publications Warehouse

Davies, Gareth; Griffin, Jonathan; Lovholt, Finn; Glimsdal, Sylfest; Harbitz, Carl; Thio, Hong Kie; Lorito, Stefano; Basili, Roberto; Selva, Jacopo; Geist, Eric L.; Baptista, Maria Ana

2017-01-01

Large tsunamis occur infrequently but have the capacity to cause enormous numbers of casualties, damage to the built environment and critical infrastructure, and economic losses. A sound understanding of tsunami hazard is required to underpin management of these risks, and while tsunami hazard assessments are typically conducted at regional or local scales, globally consistent assessments are required to support international disaster risk reduction efforts, and can serve as a reference for local and regional studies. This study presents a global-scale probabilistic tsunami hazard assessment (PTHA), extending previous global-scale assessments based largely on scenario analysis. Only earthquake sources are considered, as they represent about 80% of the recorded damaging tsunami events. Globally extensive estimates of tsunami run-up height are derived at various exceedance rates, and the associated uncertainties are quantified. Epistemic uncertainties in the exceedance rates of large earthquakes often lead to large uncertainties in tsunami run-up. Deviations between modelled tsunami run-up and event observations are quantified, and found to be larger than suggested in previous studies. Accounting for these deviations in PTHA is important, as it leads to a pronounced increase in predicted tsunami run-up for a given exceedance rate.

Prevalence of prescription opioid use disorder among chronic opioid therapy patients after health plan opioid dose and risk reduction initiatives.

PubMed

Von Korff, Michael; Walker, Rod L; Saunders, Kathleen; Shortreed, Susan M; Thakral, Manu; Parchman, Michael; Hansen, Ryan N; Ludman, Evette; Sherman, Karen J; Dublin, Sascha

2017-08-01

No studies have assessed the comparative effectiveness of guideline-recommended interventions to reduce risk of prescription opioid use disorder among chronic opioid therapy (COT) patients. We compared the prevalence of prescription opioid use disorder among COT patients from intervention clinics that had implemented opioid dose and risk reduction initiatives for more than 4 years relative to control clinics that had not. After a healthcare system in Washington State implemented interventions to reduce opioid dose and risks, we surveyed 1588 adult primary care COT patients to compare the prevalence of prescription opioid use disorder among COT patients from the intervention and control clinics. Intervention clinics managed COT patients at lower COT doses and with more consistent use of risk reduction practices. Control clinics cared for similar COT patients but prescribed higher opioid doses and used COT risk reduction practices inconsistently. Prescription opioid use disorder was assessed with the Psychiatric Research Interview for Substance and Mental Disorders. The prevalence of prescription opioid use disorder was 21.5% (95% CI=18.9% to 24.4%) among COT patients in the intervention clinics and 23.9% (95% CI=20.5% to 27.6%) among COT patients in the control clinics. The adjusted relative risk of prescription opioid use disorder was 1.08 (95% CI=0.89, 1.32) among the control clinic patients relative to the intervention clinic patients. Long-term implementation of opioid dose and risk reduction initiatives was not associated with lower rates of prescription opioid use disorder among prevalent COT patients. Extreme caution should be exercised by clinicians considering COT for patients with chronic non-cancer pain until benefits of this treatment and attendant risks are clarified. Copyright © 2017 Elsevier B.V. All rights reserved.

Poor balance and lower gray matter volume predict falls in older adults with mild cognitive impairment

PubMed Central

2013-01-01

Background The risk of falling is associated with cognitive dysfunction. Older adults with mild cognitive impairment (MCI) exhibit an accelerated reduction of brain volume, and face an increased risk of falling. The current study examined the relationship between baseline physical performance, baseline gray matter volume and falls during a 12-month follow-up period among community-dwelling older adults with MCI. Methods Forty-two older adults with MCI (75.6 years, 43% women) underwent structural magnetic resonance imaging and baseline physical performance assessment, including knee-extension strength, one-legged standing time, and walking speed with normal pace. ‘Fallers’ were defined as people who had one or more falls during the 12-month follow-up period. Results Of the 42 participants, 26.2% (n = 11) experienced at least one fall during the 12-month follow-up period. Fallers exhibited slower walking speed and shorter one-legged standing time compared with non-fallers (both p < .01). One-legged standing time (sec) (standardized odds ratio [95% confidence interval]: 0.89 [0.81, 0.98], p = .02) was associated with a significantly lower rate of falls during the 12-month follow-up after adjusting for age, sex, body mass index, and history of falling in the past year at baseline. Voxel-based morphometry was used to examine differences in baseline gray matter volume between fallers and non-fallers, revealing that fallers exhibited a significantly greater reduction in the bilateral middle frontal gyrus and superior frontal gyrus. Conclusions Poor balance predicts falls over 12 months, and baseline lower gray matter densities in the middle frontal gyrus and superior frontal gyrus were associated with falls in older adults with MCI. Maintaining physical function, especially balance, and brain structural changes through many sorts of prevention strategies in the early stage of cognitive decline may contribute to decreasing the risk of falls in older adults with MCI. PMID:23915144

Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part II—Law and Ethics

PubMed Central

Rothstein, Mark A.; Harrell, Heather L.

2011-01-01

Objective We sought to examine the legal and ethical implications of workplace health risk reduction programs (HRRPs) using health risk assessments, individually focused risk reduction, and financial incentives to promote compliance. Methods We conducted a literature review, analyzed relevant statutes and regulations, and considered the effects of these programs on employee health privacy. Results A variety of laws regulate HRRPs, and there is little evidence that employer-sponsored HRRPs violate these provisions; infringement on individual health privacy is more difficult to assess. Conclusion Although current laws permit a wide range of employer health promotion activities, HRRPs also may entail largely unquantifiable costs to employee privacy and related interests. PMID:19625971

Combining Primary Prevention and Risk Reduction Approaches in Sexual Assault Protection Programming.

PubMed

Menning, Chadwick; Holtzman, Mellisa

2015-01-01

The object of this study is to extend prior evaluations of Elemental, a sexual assault protection program that combines primary prevention and risk reduction strategies within a single program. During 2012 and 2013, program group and control group students completed pretest, posttest, and 6-week and 6-month follow-up surveys assessing sexual attitudes and knowledge as well as experiences with assault. The results reinforce previous findings that Elemental is effective in reducing sexual assault risk. Program effects were both direct, in that participation was associated with lower risk of assault, and mediated, in that participation impacted attitudes and beliefs that are empirically linked to risk of later assault. By combining both primary prevention and risk reduction approaches, Elemental is not only effective at reducing incidences of assault, it is also consistent with a number of recent recommendations for directions in sexual assault prevention programming.

Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact of community-level risk-reduction interventions.

PubMed

Parry, C D H; Carney, T; Petersen Williams, P

2017-12-01

Alcohol and other drug (AOD) use is increasingly recognised as having a direct and indirect effect on the transmission of human immunodeficiency virus (HIV). However, there is evidence to suggest that drug- and sex-related HIV risk-reduction interventions targeted at drug users within drug treatment centres or via community outreach efforts can lead to positive health outcomes. This study aimed to test whether a community-level intervention aimed at AOD users has an impact on risky AOD use and sexual risk behaviour. In 2007, in collaboration with a local non-governmental organisation (NGO) in Durban, an initiative was begun to implement a number of harm reduction strategies for injection and non-injection drug users. The NGO recruited peer outreach workers who received intensive initial training, which was followed by six-monthly monitoring and evaluation of their performance. Participants had to be 16 years of age or older, and self-reported alcohol and/or drug users. Peer outreach workers completed a face-to-face baseline questionnaire with participants which recorded risk behaviours and a risk-reduction plan was developed with participants which consisted of reducing injection (if applicable) and non-injection drug use and sex-related risks. Other components of the intervention included distribution of condoms, risk-reduction counselling, expanded access to HIV Testing Services, HIV/sexually transmitted infection care and treatment, and referrals to substance abuse treatment and social services. At follow-up, the baseline questionnaire was completed again and participants were also asked the frequency of reducing identified risk behaviours. Baseline information was collected from 138 drug users recruited into the study through community-based outreach, and who were subsequently followed up between 2010 and 2012. No injection drug users were reached. The data presented here are for first contact (baseline) and the final follow-up contact with the participants. There were no decreases in drug use practices such as use of cannabis, heroin, cocaine and Ecstasy after the intervention with drug users; however, there was a significant reduction in alcohol use following the intervention. While there was a substantial increase in the proportion of participants using drugs daily as opposed to more often, the reduction in the frequency of drug use was not statistically significant. Following the intervention, drug users had significantly fewer sexual partners, but there were no significant differences following the intervention with regard to frequency of sex or use of condoms. Substance use in general and during sex was, however, decreased. While the findings were mixed, the study shows that it is possible to provide HIV risk-reduction services to a population of substance users who are less likely to receive services through community outreach, and provide risk-reduction information, condoms and condom demonstration and other services. More intensive interventions might be needed to have a substantial impact on substance use and substance use-related HIV risk behaviours.

Risk reduction in road and rail LPG transportation by passive fire protection.

PubMed

Paltrinieri, Nicola; Landucci, Gabriele; Molag, Menso; Bonvicini, Sarah; Spadoni, Gigliola; Cozzani, Valerio

2009-08-15

The potential reduction of risk in LPG (Liquefied Petroleum Gas) road transport due to the adoption of passive fire protections was investigated. Experimental data available for small scale vessels fully engulfed by a fire were extended to real scale road and rail tankers through a finite elements model. The results of mathematical simulations of real scale fire engulfment scenarios that may follow accidents involving LPG tankers proved the effectiveness of the thermal protections in preventing the "fired" BLEVE (Boiling Liquid Expanding Vapour Explosion) scenario. The presence of a thermal coating greatly increases the "time to failure", providing a time lapse that in the European experience may be considered sufficient to allow the start of effective mitigation actions by fire brigades. The results obtained were used to calculate the expected reduction of individual and societal risk due to LPG transportation in real case scenarios. The analysis confirmed that the introduction of passive fire protections turns out in a significant reduction of risk, up to an order of magnitude in the case of individual risk and of about 50% if the expectation value is considered. Thus, the adoption of passive fire protections, not compulsory in European regulations, may be an effective technical measure for risk reduction, and may contribute to achieve the control of "major accidents hazards" cited by the European legislation.

[ACE inhibitors and the kidney].

PubMed

Hörl, W H

1996-01-01

Treatment with ACE inhibitors results in kidney protection due to reduction of systemic blood pressure, intraglomerular pressure, an antiproliferative effect, reduction of proteinuria and a lipid-lowering effect in proteinuric patients (secondary due to reduction of protein excretion). Elderly patients with diabetes melitus, coronary heart disease or peripheral vascular occlusion are at risk for deterioration of kidney function due to a high frequency of renal artery stenosis in these patients. In patients with renal insufficiency dose reduction of ACE inhibitors is necessary (exception: fosinopril) but more important is the risk for development of hyperkalemia. Patients at risk for renal artery stenosis and patients pretreated with diuretics should receive a low ACE inhibitor dosage initially ("start low - go slow"). For compliance reasons once daily ACE inhibitor dosage is recommended.

Grand Challenges for Disaster Reduction

DTIC Science & Technology

2005-06-01

6—Promote risk-wise behavior. Develop and apply principles of economics and human behavior to enhance communications, trust, and understand- ing...Challenges for Disaster Reduction Promote Risk-Wise Behavior. Develop and apply principles of economics and human behavior to enhance communications

Estimation of norovirus infection risks to consumers of wastewater-irrigated food crops eaten raw.

PubMed

Mara, Duncan; Sleigh, Andrew

2010-03-01

A quantitative microbial risk analysis-Monte Carlo method was used to estimate norovirus infection risks to consumers of wastewater-irrigated lettuce. Using the same assumptions as used in the 2006 WHO guidelines for the safe use of wastewater in agriculture, a norovirus reduction of 6 log units was required to achieve a norovirus infection risk of approximately 10(-3) per person per year (pppy), but for a lower consumption of lettuce (40-48 g per week vs. 350 g per week) the required reduction was 5 log units. If the tolerable additional disease burden is increased from a DALY (disability-adjusted life year) loss of 10(-6) pppy (the value used in the WHO guidelines) to 10(-5) pppy, the required pathogen reduction is one order of magnitude lower. Reductions of 4-6 log units can be achieved by very simple partial treatment (principally settling to achieve a 1-log unit reduction) supplemented by very reliable post-treatment health-protection control measures such as pathogen die-off (1-2 log units), produce washing in cold water (1 log unit) and produce disinfection (3 log units).

Relative costs of transporting low-level waste according to four postulated regional-management cases

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

Wilmot, E.L.; Shirley, C.G.

1982-01-01

Results presented in this paper show that almost any compact binding states into cooperating regions for disposal of LLW will reduce nationwide transportation costs markedly. As a corollary, the reduction of costs may reflect a two- to four-fold reduction of transportation distances with consequent reduction of risk to the public since risk generally decreases directly as transport distances decrease.

Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting.

PubMed

Natarajan, Pradeep; Young, Robin; Stitziel, Nathan O; Padmanabhan, Sandosh; Baber, Usman; Mehran, Roxana; Sartori, Samantha; Fuster, Valentin; Reilly, Dermot F; Butterworth, Adam; Rader, Daniel J; Ford, Ian; Sattar, Naveed; Kathiresan, Sekar

2017-05-30

Relative risk reduction with statin therapy has been consistent across nearly all subgroups studied to date. However, in analyses of 2 randomized controlled primary prevention trials (ASCOT [Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm] and JUPITER [Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin]), statin therapy led to a greater relative risk reduction among a subgroup at high genetic risk. Here, we aimed to confirm this observation in a third primary prevention randomized controlled trial. In addition, we assessed whether those at high genetic risk had a greater burden of subclinical coronary atherosclerosis. We studied participants from a randomized controlled trial of primary prevention with statin therapy (WOSCOPS [West of Scotland Coronary Prevention Study]; n=4910) and 2 observational cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults] and BioImage; n=1154 and 4392, respectively). For each participant, we calculated a polygenic risk score derived from up to 57 common DNA sequence variants previously associated with coronary heart disease. We compared the relative efficacy of statin therapy in those at high genetic risk (top quintile of polygenic risk score) versus all others (WOSCOPS), as well as the association between the polygenic risk score and coronary artery calcification (CARDIA) and carotid artery plaque burden (BioImage). Among WOSCOPS trial participants at high genetic risk, statin therapy was associated with a relative risk reduction of 44% (95% confidence interval [CI], 22-60; P <0.001), whereas in all others, the relative risk reduction was 24% (95% CI, 8-37; P =0.004) despite similar low-density lipoprotein cholesterol lowering. In a study-level meta-analysis across the WOSCOPS, ASCOT, and JUPITER primary prevention, relative risk reduction in those at high genetic risk was 46% versus 26% in all others ( P for heterogeneity=0.05). Across all 3 studies, the absolute risk reduction with statin therapy was 3.6% (95% CI, 2.0-5.1) among those in the high genetic risk group and 1.3% (95% CI, 0.6-1.9) in all others. Each 1-SD increase in the polygenic risk score was associated with 1.32-fold (95% CI, 1.04-1.68) greater likelihood of having coronary artery calcification and 9.7% higher (95% CI, 2.2-17.8) burden of carotid plaque. Those at high genetic risk have a greater burden of subclinical atherosclerosis and derive greater relative and absolute benefit from statin therapy to prevent a first coronary heart disease event. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00738725 (BioImage) and NCT00005130 (CARDIA). WOSCOPS was carried out and completed before the requirement for clinical trial registration. © 2017 American Heart Association, Inc.

Systematic review with meta-analysis: proximal disease extension in limited ulcerative colitis.

PubMed

Roda, G; Narula, N; Pinotti, R; Skamnelos, A; Katsanos, K H; Ungaro, R; Burisch, J; Torres, J; Colombel, J-F

2017-06-01

Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. To perform a systematic review and meta-analysis of epidemiological studies reporting on extension of ulcerative colitis to determine frequency of disease extension in patients with limited ulcerative colitis at diagnosis. We performed a systematic literature search to identify studies on disease extension of ulcerative colitis (UC) and predictors of disease progression. Overall, 41 studies were eligible for systematic review but only 30 for meta-analysis. The overall pooled frequency of UC extension was 22.8% with colonic extension being 17.8% at 5 years and 31% at 10 years. Extension was 17.8% (95% CI 11.2-27.3) from E1 to E3, 27.5% (95% CI 7.6-45.6) from E2 to E3 and 20.8% (95% CI 11.4-26.8) from E1 to E2. Rate of extension was significantly higher in patients younger than 18 years (29.2% (CI 6.4-71.3) compared to older patients (20.2% (CI 13.0-30.1) (P<.0001). Risk of extension was significantly higher in patients from North America (37.8%) than from Europe (19.6%) (P<.0001). In this meta-analysis, approximately one quarter of patients with limited UC extend over time with most extension occurring during the first 10 years. Rate of extension depends on age at diagnosis and geographic origin. Predicting those at high risk of disease extension from diagnosis could lead to personalised therapeutic strategies. © 2017 John Wiley & Sons Ltd.

CHANGES SDSS: the development of a Spatial Decision Support System for analysing changing hydro-meteorological risk

NASA Astrophysics Data System (ADS)

van Westen, Cees; Bakker, Wim; Zhang, Kaixi; Jäger, Stefan; Assmann, Andre; Kass, Steve; Andrejchenko, Vera; Olyazadeh, Roya; Berlin, Julian; Cristal, Irina

2014-05-01

Within the framework of the EU FP7 Marie Curie Project CHANGES (www.changes-itn.eu) and the EU FP7 Copernicus project INCREO (http://www.increo-fp7.eu) a spatial decision support system is under development with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. The Spatial Decision Support System will be composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to quantitative analysis (using different hazard types, temporal scenarios and vulnerability curves) resulting into risk curves. The platform does not include a component to calculate hazard maps, and existing hazard maps are used as input data for the risk component. The second component of the SDSS is a risk reduction planning component, which forms the core of the platform. This component includes the definition of risk reduction alternatives (related to disaster response planning, risk reduction measures and spatial planning) and links back to the risk assessment module to calculate the new level of risk if the measure is implemented, and a cost-benefit (or cost-effectiveness/ Spatial Multi Criteria Evaluation) component to compare the alternatives and make decision on the optimal one. The third component of the SDSS is a temporal scenario component, which allows to define future scenarios in terms of climate change, land use change and population change, and the time periods for which these scenarios will be made. The component doesn't generate these scenarios but uses input maps for the effect of the scenarios on the hazard and assets maps. The last component is a communication and visualization component, which can compare scenarios and alternatives, not only in the form of maps, but also in other forms (risk curves, tables, graphs). The envisaged users of the platform are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analysing spatial data at a municipal scale.

Survey of adaptive control using Liapunov design

NASA Technical Reports Server (NTRS)

Lindorff, D. P.; Carroll, R. L.

1972-01-01

A survey was made of the literature devoted to the synthesis of model-tracking adaptive systems based on application of Liapunov's second method. The basic synthesis procedure is introduced and a critical review of extensions made to the theory since 1966 is made. The extensions relate to design for relative stability, reduction of order techniques, design with disturbance, design with time variable parameters, multivariable systems, identification, and an adaptive observer.

78 FR 7738 - Notice of Request for Revision to and Extension of Approval of an Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request a revision to and extension of approval of an information collection associated with the regulations for a certification program for imported articles of Pelargonium spp. and Solanum spp. to prevent the introduction of potato brown rot into the United States.

78 FR 54619 - Notice of Request for Extension of Approval of an Information Collection; Importation of Emerald...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

...In accordance with the Paperwork Reduction Act of 1995, this notice announces the Animal and Plant Health Inspection Service's intention to request an extension of approval of an information collection associated with the regulations for the importation of emerald ash borer host material from Canada to prevent the introduction and spread of emerald ash borer in the United States.

Mathematical modeling of a nickel-cadmium battery

NASA Technical Reports Server (NTRS)

Fan, Deyuan; White, Ralph E.

1991-01-01

Extensions are presented for a mathematical model of an Ni-CD cell (Fan and White, 1991). These extensions consist of intercalation thermodynamics for the nickel electrode and oxygen generation and reduction reactions during charge and overcharge. The simulated results indicate that intercalation may be important in the nickel electrode and that including the oxygen reactions provides a means of predicting the efficiency of the cell on charge and discharge.

A Contextualized Approach to Faith-Based HIV Risk Reduction for African American Women.

PubMed

Stewart, Jennifer M; Rogers, Christopher K; Bellinger, Dawn; Thompson, Keitra

2016-07-01

HIV/AIDS has a devastating impact on African Americans, particularly women and young adults. We sought to characterize risks, barriers, and content and delivery needs for a faith-based intervention to reduce HIV risk among African American women ages 18 to 25. In a convergent parallel mixed methods study, we conducted four focus groups (n = 38) and surveyed 71 young adult women. Data were collected across four African American churches for a total of 109 participants. We found the majority of women in this sample were engaged in behaviors that put them at risk for contracting HIV, struggled with religiously based barriers and matters of sexuality, and had a desire to incorporate their intimate relationships, parenting, and financial burdens into faith-based HIV risk-reduction interventions. Incorporating additional social context-related factors into HIV risk-reduction interventions for young African American women is critical to adapting and developing HIV interventions to reduce risk among young adult women in faith settings. © The Author(s) 2016.

Army Communicator. Volume 37, Number 1, Spring 2012

DTIC Science & Technology

2012-01-01

consortium conducts a risk reduction experiment and lab-based assessment on each of them. A successful example of this risk reduction process was the...include pre-experimental assessments , risk mitigation experiments, and configuration testing. The Network Battle Lab is proud to serve as a...experimentation, assessment , rehearsals, SATCOM/network services and vendor mentorship support to the NIE team. COL Michael Brownfield

Efficacy of the Young Women's CoOp: An HIV Risk-Reduction Intervention for Substance-Using African-American Female Adolescents in the South

ERIC Educational Resources Information Center

Wechsberg, Wendee M.; Browne, Felicia A.; Zule, William A.; Novak, Scott P.; Doherty, Irene A.; Kline, Tracy L.; Carry, Monique G.; Raiford, Jerris L.; Herbst, Jeffrey H.

2017-01-01

HIV/sexually transmitted infection (STI) risk-reduction interventions are needed to address the complex risk behaviors among African-American female adolescents in disadvantaged communities in North Carolina. In a two-group randomized trial, we reached 237 sexually active, substance-using African-American female adolescents, to test a…