15 CFR 904.108 - Factors considered in assessing civil penalties.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS CIVIL PROCEDURES Civil Penalties § 904.108 Factors considered in assessing civil penalties. (a) Factors to be taken into account in assessing a civil penalty, depending upon the statute in question, may... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Factors considered in assessing civil...

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors.

PubMed

Haines, Alina; Brown, Andrew; Javaid, Syed Fahad; Khan, Fayyaz; Noblett, Steve; Omodunbi, Oladipupo; Sadiq, Khurram; Zaman, Wahid; Whittington, Richard

2017-12-01

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management-20 (HCR-20) and the Psychopathy Checklist-Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

Longitudinal assessment of clinical risk factors for depression in schizophrenia spectrum disorders.

PubMed

Onwuameze, Obiora E; Uga, Aghaegbulam; Paradiso, Sergio

2016-08-01

During initial assessment of individuals with schizophrenia and related disorders (schizophrenia spectrum disorders [SSDs]), clinicians tend to pay greater attention to psychotic symptoms than mood symptoms, including depression. Depression is reported to influence the course of SSDs, but not much is known about the risk factors for depression in SSDs. In the present study, we examined clinical predictors of depression in SSDs. The sample included 71 patients with SSDs followed in a modified Assertive Community Treatment program, the Community Support Network of Springfield, Illinois. The study design was naturalistic, prospective, and longitudinal (mean follow-up = 8.3 years; SD = 7.3). The GENMOD procedure appropriate for repeated measures analysis with dichotomous outcome variables followed longitudinally was computed. Rates of depression ranged from 18% to 41% over the differing assessment periods. Schizophrenia and schizoaffective disorder did not vary by depression rate. Depression independent of SSD diagnosis was associated with greater hospitalization rates. Clinical variables predict- ing depression were auditory hallucinations, delusions, poor insight, and poor judgment. Psychotic symptoms in the course of SSDs are risk factors for depression. As a consequence, the mental status examination of patients with SSDs with active psychosis should include assessment of mood changes. Further research is warranted to determine if treatment of depression among patients with SSDs may reduce their rates of hospitalization.

Assessment of the five-factor model of personality.

PubMed

Widiger, T A; Trull, T J

1997-04-01

The five-factor model (FFM) of personality is obtaining construct validation, recognition, and practical consideration across a broad domain of fields, including clinical psychology, industrial-organizational psychology, and health psychology. As a result, an array of instruments have been developed and existing instruments are being modified to assess the FFM. In this article, we present an overview and critique of five such instruments (the Goldberg Big Five Markers, the revised NEO Personality Inventory, the Interpersonal Adjective Scales-Big Five, the Personality Psychopathology-Five, and the Hogan Personality Inventory), focusing in particular on their representation of the lexical FFM and their practical application.

The Swiss Transplant Cohort Study's framework for assessing lifelong psychosocial factors in solid-organ transplants.

PubMed

De Geest, Sabina; Burkhalter, Hanna; Berben, Lut; Bogert, Laura Jane; Denhaerynck, Kris; Glass, Tracy R; Goetzmann, Lutz; Kirsch, Monika; Kiss, Alexander; Koller, Michael T; Piot-Ziegler, Chantal; Schmidt-Trucksäss, Arno

2013-09-01

Understanding outcomes after transplant requires a biopsychosocial model that includes biomedical and psychosocial factors. The latter, to date, are assessed only in a limited way as part of transplant registries or cohort studies. The Swiss Transplant Cohort Study (STCS) is a nationwide open cohort study (starting May 2008) to systematically and prospectively assess psychosocial factors. This article describes the framework underpinning STCS's psychosocial assessment. The STCS framework was adapted from the multidimensional conceptual perspective of Dew et al to describe transplant psychosocial domains and specific outcomes by adding a time perspective, a system perspective, and interaction among domains. We propose a multidimensional, multilevel biopsychosocial framework representing mutually influencing domains from before to after transplant, and exemplify each domain by factors included in STCS and their measurement. The transplant patient, centrally positioned, is described by clinical and sociodemographic characteristics (eg, socioeconomic status, educational, professional, and relationship status). The following psychosocial domains further describe the patient: (1) physical/functional (eg, perceived health status, sleep quality, daytime sleepiness), (2) psychological (eg, depression, stress), (3) behavioral (eg, medication adherence, smoking, drug use, physical activity, sun protection), (4) social (eg, work capacity/return to work), and (5) global quality of life. Factors associated with health care system level (eg, trust in transplant team) are also included in the model. The STCS's psychosocial framework provides a basis for studying the interplay of biomedical, sociodemographic, psychosocial, behavioral, and health care system factors in view of transplant outcomes and therefore has the potential to guide biopsychosocial transplant research.

Including Students with Disabilities in Common Non-Summative Assessments. NCEO Brief. Number 6

ERIC Educational Resources Information Center

National Center on Educational Outcomes, 2012

2012-01-01

Inclusive large-scale assessments have become the norm in states across the U.S. Participation rates of students with disabilities in these assessments have increased dramatically since the mid-1990s. As consortia of states move toward the development and implementation of assessment systems that include both non-summative assessments and…

Including the introduction of exotic species in life cycle impact assessment: the case of inland shipping.

PubMed

Hanafiah, Marlia M; Leuven, Rob S E W; Sommerwerk, Nike; Tockner, Klement; Huijbregts, Mark A J

2013-12-17

While the ecological impact of anthropogenically introduced exotic species is considered a major threat for biodiversity and ecosystems functioning, it is generally not accounted for in the environmental life cycle assessment (LCA) of products. In this article, we propose a framework that includes exotic species introduction in an LCA context. We derived characterization factors for exotic fish species introduction related to the transport of goods across the Rhine-Main-Danube canal. These characterization factors are expressed as the potentially disappeared fraction (PDF) of native freshwater fish species in the rivers Rhine and Danube integrated over space and time per amount of goods transported (PDF·m(3)·yr·kg(-1)). Furthermore, we quantified the relative importance of exotic fish species introduction compared to other anthropogenic stressors in the freshwater environment (i.e., eutrophication, ecotoxicity, greenhouse gases, and water consumption) for transport of goods through the Rhine-Main-Danube waterway. We found that the introduction of exotic fish species contributed to 70-85% of the total freshwater ecosystem impact, depending on the distance that goods were transported. Our analysis showed that it is relevant and feasible to include the introduction of exotic species in an LCA framework. The proposed framework can be further extended by including the impacts of other exotic species groups, types of water bodies and pathways for introduction.

Risk Assessment: Factors Contributing to Discomfort for Menopausal Women in Workplace.

PubMed

Jafari, Mehdi; Seifi, Bahar; Heidari, Mohammad

2017-08-01

The purpose of this study was to review the Factors contributing to discomfort for menopausal women in workplace and the perceived effects of working conditions on menopausal symptoms, and to produce recommendations for managers and women. This study was a review article. We searched PubMed and Science Direct for articles related to menopause and workplace. Keywords included: menopause AND workplace OR occupational health or menopausal women AND managers. Because we aimed to update the literature following the 2011 review of menopause and workplace, only English-language articles published between 2011 and 2017 were included. This review showed that how managers could be help and awareness and what should be done for menopausal women in workplace by risk assessment. Many risk factors are contributing to discomfort for menopausal women in workplace and managers should be assessed them. Managers should be aware that menopausal transition causes difficulty for some women at work, then occupational health and safety and health promotion policies will be increasingly important. It may help inform the development of tailored occupational health policies and programs that cater for the needs of women as they transition through menopause in the workplace.

Qualitative models of seat discomfort including static and dynamic factors.

PubMed

Ebe, K; Griffin, M J

2000-06-01

Judgements of overall seating comfort in dynamic conditions sometimes correlate better with the static characteristics of a seat than with measures of the dynamic environment. This study developed qualitative models of overall seat discomfort to include both static and dynamic seat characteristics. A dynamic factor that reflected how vibration discomfort increased as vibration magnitude increased was combined with a static seat factor which reflected seating comfort without vibration. The ability of the model to predict the relative and overall importance of dynamic and static seat characteristics on comfort was tested in two experiments. A paired comparison experiment, using four polyurethane foam cushions (50, 70, 100, 120 mm thick), provided different static and dynamic comfort when 12 subjects were exposed to one-third octave band random vertical vibration with centre frequencies of 2.5 and 5.5 Hz, at magnitudes of 0.00, 0.25 and 0.50 m x s(-2) rms measured beneath the foam samples. Subject judgements of the relative discomfort of the different conditions depended on both static and dynamic characteristics in a manner consistent with the model. The effect of static and dynamic seat factors on overall seat discomfort was investigated by magnitude estimation using three foam cushions (of different hardness) and a rigid wooden seat at six vibration magnitudes with 20 subjects. Static seat factors (i.e. cushion stiffness) affected the manner in which vibration influenced the overall discomfort: cushions with lower stiffness were more comfortable and more sensitive to changes in vibration magnitude than those with higher stiffness. The experiments confirm that judgements of overall seat discomfort can be affected by both the static and dynamic characteristics of a seat, with the effect depending on vibration magnitude: when vibration magnitude was low, discomfort was dominated by static seat factors; as the vibration magnitude increased, discomfort became dominated

Factors confounding the assessment of reflection: a critical review

PubMed Central

2011-01-01

Background Reflection on experience is an increasingly critical part of professional development and lifelong learning. There is, however, continuing uncertainty about how best to put principle into practice, particularly as regards assessment. This article explores those uncertainties in order to find practical ways of assessing reflection. Discussion We critically review four problems: 1. Inconsistent definitions of reflection; 2. Lack of standards to determine (in)adequate reflection; 3. Factors that complicate assessment; 4. Internal and external contextual factors affecting the assessment of reflection. Summary To address the problem of inconsistency, we identified processes that were common to a number of widely quoted theories and synthesised a model, which yielded six indicators that could be used in assessment instruments. We arrived at the conclusion that, until further progress has been made in defining standards, assessment must depend on developing and communicating local consensus between stakeholders (students, practitioners, teachers, supervisors, curriculum developers) about what is expected in exercises and formal tests. Major factors that complicate assessment are the subjective nature of reflection's content and the dependency on descriptions by persons being assessed about their reflection process, without any objective means of verification. To counter these validity threats, we suggest that assessment should focus on generic process skills rather than the subjective content of reflection and where possible to consider objective information about the triggering situation to verify described reflections. Finally, internal and external contextual factors such as motivation, instruction, character of assessment (formative or summative) and the ability of individual learning environments to stimulate reflection should be considered. PMID:22204704

Robust Programming Problems Based on the Mean-Variance Model Including Uncertainty Factors

NASA Astrophysics Data System (ADS)

Hasuike, Takashi; Ishii, Hiroaki

2009-01-01

This paper considers robust programming problems based on the mean-variance model including uncertainty sets and fuzzy factors. Since these problems are not well-defined problems due to fuzzy factors, it is hard to solve them directly. Therefore, introducing chance constraints, fuzzy goals and possibility measures, the proposed models are transformed into the deterministic equivalent problems. Furthermore, in order to solve these equivalent problems efficiently, the solution method is constructed introducing the mean-absolute deviation and doing the equivalent transformations.

Literature Review and Assessment of Plant and Animal Transfer Factors Used in Performance Assessment Modeling

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

Robertson, David E.; Cataldo, Dominic A.; Napier, Bruce A.

2003-07-20

A literature review and assessment was conducted by Pacific Northwest National Laboratory (PNNL) to update information on plant and animal radionuclide transfer factors used in performance-assessment modeling. A group of 15 radionuclides was included in this review and assessment. The review is composed of four main sections, not including the Introduction. Section 2.0 provides a review of the critically important issue of physicochemical speciation and geochemistry of the radionuclides in natural soil-water systems as it relates to the bioavailability of the radionuclides. Section 3.0 provides an updated review of the parameters of importance in the uptake of radionuclides by plants,more » including root uptake via the soil-groundwater system and foliar uptake due to overhead irrigation. Section 3.0 also provides a compilation of concentration ratios (CRs) for soil-to-plant uptake for the 15 selected radionuclides. Section 4.0 provides an updated review on radionuclide uptake data for animal products related to absorption, homeostatic control, approach to equilibration, chemical and physical form, diet, and age. Compiled transfer coefficients are provided for cow’s milk, sheep’s milk, goat’s milk, beef, goat meat, pork, poultry, and eggs. Section 5.0 discusses the use of transfer coefficients in soil, plant, and animal modeling using regulatory models for evaluating radioactive waste disposal or decommissioned sites. Each section makes specific suggestions for future research in its area.« less

Review on pen-and-paper-based observational methods for assessing ergonomic risk factors of computer work.

PubMed

Rahman, Mohd Nasrull Abdol; Mohamad, Siti Shafika

2017-01-01

Computer works are associated with Musculoskeletal Disorders (MSDs). There are several methods have been developed to assess computer work risk factor related to MSDs. This review aims to give an overview of current techniques available for pen-and-paper-based observational methods in assessing ergonomic risk factors of computer work. We searched an electronic database for materials from 1992 until 2015. The selected methods were focused on computer work, pen-and-paper observational methods, office risk factors and musculoskeletal disorders. This review was developed to assess the risk factors, reliability and validity of pen-and-paper observational method associated with computer work. Two evaluators independently carried out this review. Seven observational methods used to assess exposure to office risk factor for work-related musculoskeletal disorders were identified. The risk factors involved in current techniques of pen and paper based observational tools were postures, office components, force and repetition. From the seven methods, only five methods had been tested for reliability. They were proven to be reliable and were rated as moderate to good. For the validity testing, from seven methods only four methods were tested and the results are moderate. Many observational tools already exist, but no single tool appears to cover all of the risk factors including working posture, office component, force, repetition and office environment at office workstations and computer work. Although the most important factor in developing tool is proper validation of exposure assessment techniques, the existing observational method did not test reliability and validity. Futhermore, this review could provide the researchers with ways on how to improve the pen-and-paper-based observational method for assessing ergonomic risk factors of computer work.

Factors underlying the psychological and behavioral characteristics of Office of Strategic Services candidates: the assessment of men data revisited.

PubMed

Lenzenweger, Mark F

2015-01-01

During World War II, the Office of Strategic Services (OSS), the forerunner of the Central Intelligence Agency, sought the assistance of clinical psychologists and psychiatrists to establish an assessment program for evaluating candidates for the OSS. The assessment team developed a novel and rigorous program to evaluate OSS candidates. It is described in Assessment of Men: Selection of Personnel for the Office of Strategic Services (OSS Assessment Staff, 1948). This study examines the sole remaining multivariate data matrix that includes all final ratings for a group of candidates (n = 133) assessed near the end of the assessment program. It applies the modern statistical methods of both exploratory and confirmatory factor analysis to this rich and highly unique data set. An exploratory factor analysis solution suggested 3 factors underlie the OSS assessment staff ratings. Confirmatory factor analysis results of multiple plausible substantive models reveal that a 3-factor model provides the best fit to these data. The 3 factors are emotional/interpersonal factors (social relations, emotional stability, security), intelligence processing (effective IQ, propaganda skills, observing and reporting), and agency/surgency (motivation, energy and initiative, leadership, physical ability). These factors are discussed in terms of their potential utility for personnel selection within the intelligence community.

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

PubMed

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

2018-06-01

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

Pesticide exposure as risk factor for non-Hodgkin lymphoma including histopathological subgroup analysis.

PubMed

Eriksson, Mikael; Hardell, Lennart; Carlberg, Michael; Akerman, Måns

2008-10-01

We report a population based case-control study of exposure to pesticides as risk factor for non-Hodgkin lymphoma (NHL). Male and female subjects aged 18-74 years living in Sweden were included during December 1, 1999, to April 30, 2002. Controls were selected from the national population registry. Exposure to different agents was assessed by questionnaire. In total 910 (91 %) cases and 1016 (92%) controls participated. Exposure to herbicides gave odds ratio (OR) 1.72, 95% confidence interval (CI) 1.18-2.51. Regarding phenoxyacetic acids highest risk was calculated for MCPA; OR 2.81, 95% CI 1.27-6.22, all these cases had a latency period >10 years. Exposure to glyphosate gave OR 2.02, 95% CI 1.10-3.71 and with >10 years latency period OR 2.26, 95% CI 1.16-4.40. Insecticides overall gave OR 1.28, 95% CI 0.96-1.72 and impregnating agents OR 1.57, 95% CI 1.07-2.30. Results are also presented for different entities of NHL. In conclusion our study confirmed an association between exposure to phenoxyacetic acids and NHL and the association with glyphosate was considerably strengthened.

The total assessment profile, volume 1. [including societal impact cost effectiveness, and economic analysis

NASA Technical Reports Server (NTRS)

Leininger, G.; Jutila, S.; King, J.; Muraco, W.; Hansell, J.; Lindeen, J.; Franckowiak, E.; Flaschner, A.

1975-01-01

A methodology is described for the evaluation of societal impacts associated with the implementation of a new technology. Theoretical foundations for the methodology, called the total assessment profile, are established from both the economic and social science perspectives. The procedure provides for accountability of nonquantifiable factors and measures through the use of a comparative value matrix by assessing the impacts of the technology on the value system of the society.

Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients.

PubMed

Nie, Sasa; Feng, Zhe; Tang, Li; Wang, Xiaolong; He, Yani; Fang, Jingai; Li, Suhua; Yang, Yibin; Mao, Huijuan; Jiao, Jundong; Liu, Wenhu; Cao, Ning; Wang, Wenge; Sun, Jifeng; Shao, Fengmin; Li, Wenge; He, Qiang; Jiang, Hongli; Lin, Hongli; Fu, Ping; Zhang, Xinzhou; Liu, Yinghong; Wu, Yonggui; Xi, ChunSheng; Liang, Meng; Qu, Zhijie; Zhu, Jun; Wu, Guangli; Zheng, Yali; Na, Yu; Li, Ying; Li, Wei; Cai, Guangyan; Chen, Xiangmei

2017-01-01

Risk factor studies for acute kidney injury (AKI) in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes' definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR) for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58) for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42) for a propensity score-matched set. In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI. © 2017 The Author(s). Published by S. Karger AG, Basel.

Environmental assessment of biofuel chains based on ecosystem modelling, including land-use change effects

NASA Astrophysics Data System (ADS)

Gabrielle, B.; Gagnaire, N.; Massad, R.; Prieur, V.; Python, Y.

2012-04-01

The potential greenhouse gas (GHG) savings resulting from the displacement of fossil energy sources by bioenergy mostly hinges on the uncertainty on the magnitude of nitrous oxide (N2O) emissions from arable soils occuring during feedstock production. These emissions are broadly related to fertilizer nitrogen input rates, but largely controlled by soil and climate factors which makes their estimation highly uncertain. Here, we set out to improve estimates of N2O emissions from bioenergy feedstocks by using ecosystem models and measurements and modeling of atmospheric N2O in the greater Paris (France) area. Ground fluxes were measured in two locations to assess the effect of soil type and management, crop type (including lignocellulosics such as triticale, switchgrass and miscanthus), and climate on N2O emission rates and dynamics. High-resolution maps of N2O emissions were generated over the Ile-de-France region (around Paris) with two ecosystem models using geographical databases on soils, weather data, land-use and crop management. The models were tested against ground flux measurements and the emission maps were fed into the atmospheric chemistry-transport model CHIMERE. The maps were tested by comparing the CHIMERE simulations with time series of N2O concentrations measured at various heights above the ground in two locations in 2007. The emissions of N2O, as integrated over the region, were used in a life-cycle assessment of representative biofuel pathways: bioethanol from wheat and sugar-beet (1st generation), and miscanthus (2nd generation chain); bio-diesel from oilseed rape. Effects related to direct and indirect land-use changes (in particular on soil carbon stocks) were also included in the assessment based on various land-use scenarios and literature references. The potential deployment of miscanthus was simulated by assuming it would be grown on the current sugar-beet growing area in Ile-de-France, or by converting land currently under permanent fallow

Impact factor: Universalism and reliability of assessment.

PubMed

Grzybowski, Andrzej; Patryn, Rafał

In 1955, Eugene Garfield (1925-1917) published a paper in Science where for the first time he advocated the necessity of introducing parameters to assess the quality of scientific journals. Underlying this necessity was an observation of a trend where the whole area of influence in academic publishing was dominated by a narrow group of large interdisciplinary research journals. For this reason, along with Irving H. Sher, they created the impact factor (IF), also called the Garfield impact factor, journal citation rate, journal influence, and journal impact factor. The concept of IF concerns a research discipline called bibliometrics, which uses mathematical and statistical methods to analyze scientific publications. Established by Garfield in 1963, the Science Citation Index, a record of scientific publications and citations therein, contributed directly to the increased importance of this method. Since the 1960s, the register of scientific publications has expanded and their evaluation by the IF has become a fundamental and universal measure of the journal's value. Contrary to the authors' intentions in the creation of the index (IF), it is often used to assess the quality of contributions, simultaneously assessing the authors' achievements or academic career and academic institutions' funding possibilities. Copyright © 2016 Elsevier Inc. All rights reserved.

Fix my child: The importance of including siblings in clinical assessments.

PubMed

Farnfield, Steve

2017-07-01

This study examined concordance in the attachment strategies of school-aged siblings with reference to environmental risk in terms of poverty and maltreatment. It also investigated the effect of child maltreatment and maternal mental illness on children's psychosocial functioning in terms of the Dynamic-Maturational Model of Attachment and Adaptation (DMM) including unresolved trauma and the DMM Depressed modifier. The attachment strategies of 30 sibling pairs, aged 5-14 years, were assessed using the School-age Assessment of Attachment (SAA). Unlike most previous studies, this study included siblings from large families of two to six children. The main finding was that as environmental risk increases, the diversity of sibling attachment strategies decreases with greater recourse to the DMM Type A3-6 and A/C strategies. Unlike previous studies, the highest level of concordance was found in sibling pairs with the opposite gender. Boys whose mothers had a history of mental illness were significantly more likely than girls to be assessed with the DMM-depression modifier. As danger increases, children in the same family experience more of the same childhood. Further research should focus on single case, intra-familial studies to build a systemic model of the shared environment. Research should also evaluate the effects of environmental risk compared with size of the sibling group on children's attachment strategies. The clinical implications point to the importance of assessing all children in the family using a model built around functional formulation rather than diagnosing the symptoms of a particular child.

Including Pupils with Special Educational Needs and Disability in National Assessment: Comparison of Three Country Case Studies through an Inclusive Assessment Framework

ERIC Educational Resources Information Center

Douglas, Graeme; McLinden, Mike; Robertson, Christopher; Travers, Joseph; Smith, Emma

2016-01-01

The assessment of educational progress and outcomes of pupils is important to all concerned with education. This includes testing which is undertaken for accountability and award bearing purposes. This article examines how students with special educational needs and disability (SEND) are included in assessment. An "inclusive assessment"…

Growth assessment and risk factors of malnutrition in children with cystic fibrosis

PubMed Central

Isa, Hasan M.; Al-Ali, Lina F.; Mohamed, Afaf M.

2016-01-01

Objectives: To evaluate the nutritional status, to screen for the presence of malnutrition, and to study the possible risk factors associated with malnutrition in patients with cystic fibrosis (CF). Methods: A retrospective cross-sectional review of medical records of all diagnosed CF patients in the Pediatric Department, Salmaniya Medical Complex, Manama, Kingdom of Bahrain, between January 1984 and May 2015 was conducted. Demographic and anthropometric data were collected from records of last visit to CF clinic. Nutritional status and risk factors of malnutrition were assessed. Results: All records of 109 CF patients were reviewed. Forty-seven pediatric patients were included in the study. All included patients were on pancreatic enzyme replacement and 42 (89%) received high-calorie supplementation. Growth failure was noted in 34 (72%) patients, 19 (56%) were wasted and stunted, 8 (23.5%) were wasted only, and 7 (20.5%) were stunted. Low birth weight (p=0.032), and the presence of gastroesophageal reflux disease (GERD) (p=0.039) were the significant risk factors for malnutrition. Conclusion: Most CF patients in Bahrain (72%) are malnourished. Low birth weight and the presence of GERD are risk factors. PMID:26905352

The Factor Structure of the English Language Development Assessment: A Confirmatory Factor Analysis

ERIC Educational Resources Information Center

Kuriakose, Anju

2011-01-01

This study investigated the internal factor structure of the English language development Assessment (ELDA) using confirmatory factor analysis. ELDA is an English language proficiency test developed by a consortium of multiple states and is used to identify and reclassify English language learners in kindergarten to grade 12. Scores on item…

An instrument for broadened risk assessment in antenatal health care including non-medical issues

PubMed Central

Vos, Amber A.; van Veen, Mieke J.; Birnie, Erwin; Denktaş, Semiha; Steegers, Eric A.P.; Bonsel, Gouke J.

2015-01-01

Introduction Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting. PMID:25780351

Pre-analytical Factors Influence Accuracy of Urine Spot Iodine Assessment in Epidemiological Surveys.

PubMed

Doggui, Radhouene; El Ati-Hellal, Myriam; Traissac, Pierre; El Ati, Jalila

2018-03-26

Urinary iodine concentration (UIC) is commonly used to assess iodine status of subjects in epidemiological surveys. As pre-analytical factors are an important source of measurement error and studies about this phase are scarce, our objective was to assess the influence of urine sampling conditions on UIC, i.e., whether the child ate breakfast or not, urine void rank of the day, and time span between last meal and urine collection. A nationwide, two-stage, stratified, cross-sectional study including 1560 children (6-12 years) was performed in 2012. UIC was determined by the Sandell-Kolthoff method. Pre-analytical factors were assessed from children's mothers by using a questionnaire. Association between iodine status and pre-analytical factors were adjusted for one another and socio-economic characteristics by multivariate linear and multinomial regression models (RPR: relative prevalence ratios). Skipping breakfast prior to morning urine sampling decreased UIC by 40 to 50 μg/L and the proportion of UIC < 100 μg/L was higher among children having those skipped breakfast (RPR = 3.2[1.0-10.4]). In unadjusted analyses, UIC was less among children sampled more than 5 h from their last meal. UIC decreased with rank of urine void (e.g., first vs. second, P < 0.001); also, the proportion of UIC < 100 μg/L was greater among 4th rank samples (vs. second RPR = 2.1[1.1-4.0]). Subjects' breakfast status and urine void rank should be accounted for when assessing iodine status. Providing recommendations to standardize pre-analytical factors is a key step toward improving accuracy and comparability of survey results for assessing iodine status from spot urine samples. These recommendations have to be evaluated by future research.

The relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus.

PubMed

Noh, Jin-Won; Jung, Jin Hee; Park, Jeong Eun; Lee, Jung Hwa; Sim, Kang Hee; Park, Jumin; Kim, Min Hee; Yoo, Ki-Bong

2018-02-01

[Purpose] The purpose of the present study was to assess the relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus (T2D). [Subjects and Methods] Subjects with T2D patients who received outpatient care for blood sugar control were randomly sampled at 13 general hospitals and 969 subjects were included. Cox proportional hazard models were used to confirm associations between age of onset and risk factors including family history and life style in Korean population with T2D. [Results] Parent history of T2D was significantly associated with age of onset. Compared to none of family members with T2D, those whose both father and mother had a history showed the highest the risk of early-onset (HR=2.36; 95% CI=1.45-3.85). Mother and father's history of T2D (HR=1.73; 95% CI=1.46-2.05; HR=1.83; 95% CI=1.40-2.37) were associated with the risk of early-onset. Moreover, exercise (HR=1.23, CI=1.08-1.40) smoking status (HR=1.62, CI=1.32-1.99), and drinking (HR=1.32, CI=1.13-1.54) were associated with a higher risk for the early-onset. [Conclusion] Family history as well as life style including exercise, smoking, and drinking are the risk factors for early-onset factor in Korean population with T2D.

What should be included in the assessment of laypersons' paediatric basic life support skills? Results from a Delphi consensus study.

PubMed

Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim; Bohnstedt, Cathrine; Sønderskov, Claus; Østergaard, Doris; Tolsgaard, Martin Grønnebæk

2018-01-18

Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts suggested items to assess laypersons' PBLS and FBAOM skills. In the second round, the suggested items received comments from and were rated by 26 experts (93%) on a 5-point scale (1 = not relevant to 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) experts completed a re-rating. Items with a score above 3 by more than 80% of the experts in the third round were included in an assessment instrument. In the first round, 19 and 15 items were identified to assess PBLS and FBAOM skills, respectively. The ratings and comments from the last two rounds resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. The PBLS items included: "Responsiveness"," Call for help", "Open airway"," Check breathing", "Rescue breaths", "Compressions", "Ventilations", "Time factor" and "Use of AED". The FBAOM items included: "Identify different stages of foreign body airway obstruction", "Identify consciousness", "Call for help", "Back blows", "Chest thrusts/abdominal thrusts according to age", "Identify loss of consciousness and change to CPR", "Assessment of breathing" and "Ventilation". For assessment of laypersons some PBLS and FBAOM skills described in guidelines are more important than others. Four out of nine of PBLS skills focus on airway and breathing skills, supporting the major importance of these skills for

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

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

ORAU's Oak Ridge Institute for Science Education

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do justmore » that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.« less

Assessing State Nuclear Weapons Proliferation: Using Bayesian Network Analysis of Social Factors

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

Coles, Garill A.; Brothers, Alan J.; Olson, Jarrod

A Bayesian network (BN) model of social factors can support proliferation assessments by estimating the likelihood that a state will pursue a nuclear weapon. Social factors including political, economic, nuclear capability, security, and national identity and psychology factors may play as important a role in whether a State pursues nuclear weapons as more physical factors. This paper will show how using Bayesian reasoning on a generic case of a would-be proliferator State can be used to combine evidence that supports proliferation assessment. Theories and analysis by political scientists can be leveraged in a quantitative and transparent way to indicate proliferationmore » risk. BN models facilitate diagnosis and inference in a probabilistic environment by using a network of nodes and acyclic directed arcs between the nodes whose connections, or absence of, indicate probabilistic relevance, or independence. We propose a BN model that would use information from both traditional safeguards and the strengthened safeguards associated with the Additional Protocol to indicate countries with a high risk of proliferating nuclear weapons. This model could be used in a variety of applications such a prioritization tool and as a component of state safeguards evaluations. This paper will discuss the benefits of BN reasoning, the development of Pacific Northwest National Laboratory’s (PNNL) BN state proliferation model and how it could be employed as an analytical tool.« less

Automated Neuropsychological Assessment Metrics (ANAM) Traumatic Brain Injury (TBI): Human Factors Assessment

DTIC Science & Technology

2011-07-01

Lindsay, Cory Overby, Angela Jeter, Petra E. Alfred, Gary L. Boykin, Carita DeVilbiss, and Raymond Bateman ARL-TN-0440 July 2011...Neuropsychological Assessment Metrics (ANAM) Traumatic Brain Injury (TBI): Human Factors Assessment Valerie J. Rice, Petra E. Alfred, Gary L. Boykin...Angela Jeter*, Petra E. Alfred, Gary L. Boykin, Carita DeVilbiss, and Raymond Bateman 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT

Risk factors for exposure to influenza a viruses, including subtype H5 viruses, in Thai free-grazing ducks.

PubMed

Beaudoin, A L; Kitikoon, P; Schreiner, P J; Singer, R S; Sasipreeyajan, J; Amonsin, A; Gramer, M R; Pakinsee, S; Bender, J B

2014-08-01

Free-grazing ducks (FGD) have been associated with highly pathogenic avian influenza (HPAI) H5N1 outbreaks and may be a viral reservoir. In July-August 2010, we assessed influenza exposure of Thai FGD and risk factors thereof. Serum from 6254 ducks was analysed with enzyme-linked immunosorbent assay (ELISA) to detect antibodies to influenza A nucleoprotein (NP), and haemagglutinin H5 protein. Eighty-five per cent (5305 ducks) were seropositive for influenza A. Of the NP-seropositive sera tested with H5 assays (n = 1423), 553 (39%) were H5 ELISA positive and 57 (4%) suspect. Twelve per cent (74 of 610) of H5 ELISA-positive/suspect ducks had H5 titres ≥ 1 : 20 by haemagglutination inhibition. Risk factors for influenza A seropositivity include older age, poultry contact, flock visitors and older purchase age. Study flocks had H5 virus exposure as recently as March 2010, but no HPAI H5N1 outbreaks have been identified in Thailand since 2008, highlighting a need for rigorous FGD surveillance. © 2012 Blackwell Verlag GmbH.

Coastal erosion risk assessment using natural and human factors in different scales.

NASA Astrophysics Data System (ADS)

Alexandrakis, George; Kampanis, Nikolaos

2015-04-01

Climate change, including sea-level rise and increasing storms, raise the threats of coastal erosion. Mitigating and adapting to coastal erosion risks in areas of human interest, like urban areas, culture heritage sites, and areas of economic interest, present a major challenge for society. In this context, decision making needs to be based in reliable risk assessment that includes environmental, social and economic factors. By integrating coastal hazard and risk assessments maps into coastal management plans, risks in areas of interest can be reduced. To address this, the vulnerability of the coast to sea level rise and associated erosion, in terms of expected land loss and socioeconomic importance need to be identified. A holistic risk assessment based in environmental, socioeconomic and economics approach can provide managers information how to mitigate the impact of coastal erosion and plan protection measures. Such an approach needs to consider social, economic and environmental factors, which interactions can be better assessed when distributed and analysed along the geographical space. In this work, estimations of climate change impact to coastline are based on a combination of environmental and economic data analysed in a GIS database. The risk assessment is implemented through the estimation of the vulnerability and exposure variables of the coast in two scales. The larger scale estimates the vulnerability in a regional level, with the use environmental factors with the use of CVI. The exposure variable is estimated by the use of socioeconomic factors. Subsequently, a smaller scale focuses on highly vulnerable beaches with high social and economic value. The vulnerability assessment of the natural processes to the environmental characteristics of the beach is estimated with the use of the Beach Vulnerability Index. As exposure variable, the value of beach width that is capitalized in revenues is implemented through a hedonic pricing model. In this

Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis

PubMed Central

Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

2018-01-01

Background: Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. Methods: We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. Results: We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Conclusion: Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at

Assessing peridomestic entomological factors as predictors for Lyme disease

USGS Publications Warehouse

Connally, N.P.; Ginsberg, H.S.; Mather, T.N.

2006-01-01

The roles of entomologic risk factors, including density of nymphal blacklegged ticks (Ixodes scapularis), prevalence of nymphal infection with the etiologic agent (Borrelia burgdorferi), and density of infected nymphs, in determining the risk of human Lyme disease were assessed at residences in the endemic community of South Kingstown, RI. Nymphs were sampled between May and July from the wooded edge around 51 and 47 residential properties in 2002 and 2003, respectively. Nymphs were collected from all residences sampled. Tick densities, infection rates, and densities of infected nymphs were all significantly higher around homes reporting Lyme disease histories in 2003, while only infection rates were significantly higher in 2002. However, densities of infected nymphs did not significantly predict the probability of Lyme disease at a residence (by logistic regression) in either year. There were no significant differences in entomologic risk factors between homes with state-confirmed Lyme disease histories and homes with self-reported cases (not reported to the state health department). Therefore, although entomologic risk factors tended to be higher at residences with cases of Lyme disease, entomological indices, in the absence of human behavior measures, were not useful predictors of Lyme disease at the scale of individual residences in a tick-endemic community.

The relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus

PubMed Central

Noh, Jin-Won; Jung, Jin Hee; Park, Jeong Eun; Lee, Jung Hwa; Sim, Kang Hee; Park, Jumin; Kim, Min Hee; Yoo, Ki-Bong

2018-01-01

[Purpose] The purpose of the present study was to assess the relationship between age of onset and risk factors including family history and life style in Korean population with type 2 diabetes mellitus (T2D). [Subjects and Methods] Subjects with T2D patients who received outpatient care for blood sugar control were randomly sampled at 13 general hospitals and 969 subjects were included. Cox proportional hazard models were used to confirm associations between age of onset and risk factors including family history and life style in Korean population with T2D. [Results] Parent history of T2D was significantly associated with age of onset. Compared to none of family members with T2D, those whose both father and mother had a history showed the highest the risk of early-onset (HR=2.36; 95% CI=1.45–3.85). Mother and father’s history of T2D (HR=1.73; 95% CI=1.46–2.05; HR=1.83; 95% CI=1.40–2.37) were associated with the risk of early-onset. Moreover, exercise (HR=1.23, CI=1.08–1.40) smoking status (HR=1.62, CI=1.32–1.99), and drinking (HR=1.32, CI=1.13–1.54) were associated with a higher risk for the early-onset. [Conclusion] Family history as well as life style including exercise, smoking, and drinking are the risk factors for early-onset factor in Korean population with T2D. PMID:29545678

Abuse liability assessment of tobacco products including potential reduced exposure products.

PubMed

Carter, Lawrence P; Stitzer, Maxine L; Henningfield, Jack E; O'Connor, Rich J; Cummings, K Michael; Hatsukami, Dorothy K

2009-12-01

The harm produced by tobacco products is a result of frequent use of a highly toxic product. Reducing the adverse public health impact of tobacco products might be most effectively achieved by reducing the likelihood of their use and the toxicity of the products. Products that retain some characteristics of cigarettes but have been altered with the intention of reducing toxicity have been referred to as modified risk tobacco products or potential reduced exposure products (MRTP/PREP). Evaluation of their content, emission, and toxicity is discussed in other articles in this special issue. Here, we discuss the methodology that has been used to examine the likelihood of abuse or addiction. Abuse liability assessment (ALA) methodology has been used by the Food and Drug Administration (FDA) and other drug regulatory agencies world-wide for decades to assess the risks posed by a wide variety of pharmacologically active substances. ALA is routinely required among other evaluations of safety during the pre-market assessment of new drugs, and is continually adapted to meet the challenges posed by new drug classes and drug formulations. In the 2009 law giving FDA regulation over tobacco products, FDA is now required to evaluate new tobacco products including MRTP/PREPs to determine their risk for abuse and toxicity at the population level. This article describes the traditional tools and methods of ALA that can be used to evaluate new tobacco and nicotine products including MRTP/PREPs. Such ALA data could contribute to the scientific foundation on which future public policy decisions are based.

77 FR 61012 - Expansion of Importer Self-Assessment Program To Include Qualified Importers of Focused...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

...-Assessment Program To Include Qualified Importers of Focused Assessment Audits AGENCY: U.S. Customs and... undergoing comprehensive CBP audits. This document announces that a company that has successfully undergone a CBP Focused Assessment (FA) audit may be eligible to transition into the ISA program without further...

Examining Factors in the Research Institute on Addictions Self-Inventory (RIASI): Associations with Alcohol Use and Problems at Assessment and Follow-Up

PubMed Central

Mann, Robert E.; Stoduto, Gina; Zalcman, Rosely Flam; Nochajski, Thomas H.; Hall, Louise; Dill, Patricia; Wells-Parker, Elisabeth

2009-01-01

Impaired driving is a leading cause of alcohol-related deaths and injuries. Rehabilitation or remedial programs, involving assessment and screening of convicted impaired drivers to determine problem severity and appropriate programs, are an important component of society’s response to this problem. Ontario’s remedial program, Back on Track (BOT), involves an assessment process that includes administration of the Research Institute on Addictions Self-Inventory (RIASI) to determine assignment to an education or treatment program. The purpose of this study is to identify factors within the RIASI and examine how factor scores are associated with alcohol use and problem indicators at assessment and six-month follow-up. The sample included 22,298 individuals who completed BOT from 2000 to 2005. Principal component factor analysis with varimax rotation was conducted on RIASI data and an eight factor solution was retained: (1) Negative Affect, (2) Sensation Seeking, (3) Alcohol-Quantity, (4) Social Conformity, (5) High Risk Lifestyle, (6) Alcohol Problems, (7) Interpersonal Competence, and (8) Family History. Regression analyses were conducted to examine associations between factors and alcohol and problem measures obtained at assessment and at follow-up. Most factors, except for Interpersonal Competence, were associated with more alcohol use and problems at assessment. A similar pattern was observed at 6-month follow-up, but interestingly some factors (Negative Affect, Sensation Seeking, Alcohol-Quantity and Family History) predicted fewer days of alcohol use. The Interpersonal Competence factor was associated with significantly lower levels of alcohol use and problems at both assessment and follow-up. This work suggests that the RIASI provides information on several domains that have important relationships with alcohol problem severity and outcomes. PMID:20049234

Personality Assessment Inventory scale characteristics and factor structure in the assessment of alcohol dependency.

PubMed

Schinka, J A

1995-02-01

Individual scale characteristics and the inventory structure of the Personality Assessment Inventory (PAI; Morey, 1991) were examined by conducting internal consistency and factor analyses of item and scale score data from a large group (N = 301) of alcohol-dependent patients. Alpha coefficients, mean inter-item correlations, and corrected item-total scale correlations for the sample paralleled values reported by Morey for a large clinical sample. Minor differences in the scale factor structure of the inventory from Morey's clinical sample were found. Overall, the findings support the use of the PAI in the assessment of personality and psychopathology of alcohol-dependent patients.

Assessing Young Adolescents' Personality with the Five-Factor Personality Inventory

ERIC Educational Resources Information Center

Hendriks, A. A. Jolijn; Kuyper, Hans; Offringa, G. Johan; Van der Werf, Margaretha P. C.

2008-01-01

The Five-Factor Personality Inventory (FFPI) assesses a person's position on the (Dutch) psycholexically based Big Five factors: Extraversion, Agreeableness, Conscientiousness, Emotional Stability, and Autonomy. FFPI factor scores are reliable and valid if ratings are made by adults. The present study yields preliminary evidence of whether young…

New strategies in the assessment of psychological factors affecting medical conditions.

PubMed

Sirri, Laura; Fabbri, Stefania; Fava, Giovanni A; Sonino, Nicoletta

2007-12-01

In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research. We assessed 8 areas concerned with the assessment of psychological factors in the setting of medical disease: hypochondriasis, disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, irritable mood, and Type A behavior. A new subclassification of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-V]; not yet published) category of psychological factors affecting physical conditions appears to be feasible and may provide the clinician with better tools for identifying psychological distress.

Allele frequency distribution of 1691G >A F5 (which confers Factor V Leiden) across Europe, including Slavic populations.

PubMed

Clark, Jeremy S C; Adler, Grażyna; Salkic, Nermin N; Ciechanowicz, Andrzej

2013-11-01

The allele 1691A F5, conferring Factor V Leiden, is a common risk factor in venous thromboembolism. The frequency distribution for this allele in Western Europe has been well documented; but here data from Central, Eastern and South-Eastern Europe has been included. In order to assess the significance of the collated data, a chi-squared test was applied, and Tukey tests and z-tests with Bonferroni correction were compared. A distribution with a North-Southeast band of high frequency of the 1691A F5 allele was discovered with a pocket including some Southern Slavic populations with low frequency. European countries/regions can be arbitrarily delimited into low (group 1, <2.8 %, mean 1.9 % 1691A F5 allele) or high (group 2, ≥2.8 %, mean 4.0 %) frequency groups, with many significant differences between groups, but only one intra-group difference (the Tukey test is suggested to be superior to the z-tests). In Europe a North-Southeast band of 1691A F5 high frequency has been found, clarified by inclusion of data from Central, Eastern and South-Eastern Europe, which surrounds a pocket of low frequency in the Balkans which could possibly be explained by Slavic migration. There seem to be no indications of variation in environmental selection due to geographical location.

Drought Risk Assessment based on Natural and Social Factors

NASA Astrophysics Data System (ADS)

Huang, Jing; Wang, Huimin; Han, Dawei

2015-04-01

In many parts of the world, drought hazard is becoming more frequent and severe due to climate change and human activities. It is crucial to monitor and assess drought conditions, especially for decision making support in agriculture sector. The vegetation index (VI) decreases, and the land surface temperature (LST) increases when the vegetation is under drought stress. Therefore both of these remotely sensed indices are widely used in drought monitoring and assessment. Temperature-Vegetation Dryness Index (TVDI) is obtained by establishing the feature space of the normalized difference vegetation index (NDVI) and LST, which reflects agriculture dry situation by inverting soil moisture. However, these indices only concern the natural hazard-causing factors. Our society is a complex large-scale system with various natural and social elements. The drought risk is the joint consequence of hazard-causing factors and hazard-affected bodies. For example, as the population increases, the exposure of the hazard-affected bodies also tends to increase. The high GDP enhances the response ability of government, and the irrigation and water conservancy reduces the vulnerability. Such characteristics of hazard-affected bodies should be coupled with natural factors. In this study, the 16-day moderate-resolution imaging spectroradiometer (MODIS) NDVI and LST data are combined to establish NDVI-Ts space according to different land use types in Yunnan Province, China. And then, TVDIs are calculated through dry and wet edges modeled as a linear fit to data for each land cover type. Next, the efforts are turned to establish an integrated drought assessment index of social factors and TVDI through ascertaining attribute weight based on rough sets theory. Thus, the new CDI (comprehensive drought index) recorded during spring of 2010 and the spatial variations in drought are analyzed and compared with TVDI dataset. Moreover, actual drought risk situation in the study area is given to

Develop a PWL System for Dense Graded Hot Mix Asphalt Construction, Including Pay Factors

DOT National Transportation Integrated Search

2015-01-01

This research project developed a PWL system that the Nevada DOT can effectively implement on the construction of dense graded HMA mixtures. The PWL system includes pay factors that are based on pavement performance indicators such as rutting and cra...

Development of new geomagnetic storm ground response scaling factors for utilization in hazard assessments

NASA Astrophysics Data System (ADS)

Pulkkinen, A. A.; Bernabeu, E.; Weigel, R. S.; Kelbert, A.; Rigler, E. J.; Bedrosian, P.; Love, J. J.

2017-12-01

Development of realistic storm scenarios that can be played through the exposed systems is one of the key requirements for carrying out quantitative space weather hazards assessments. In the geomagnetically induced currents (GIC) and power grids context, these scenarios have to quantify the spatiotemporal evolution of the geoelectric field that drives the potentially hazardous currents in the system. In response to the Federal Energy Regulatory Commission (FERC) order 779, a team of scientists and engineers that worked under the auspices of North American Electric Reliability Corporation (NERC), has developed extreme geomagnetic storm and geoelectric field benchmark(s) that use various scaling factors that account for geomagnetic latitude and ground structure of the locations of interest. These benchmarks, together with the information generated in the National Space Weather Action Plan, are the foundation for the hazards assessments that the industry will be carrying out in response to the FERC order and under the auspices of the National Science and Technology Council. While the scaling factors developed in the past work were based on the best available information, there is now significant new information available for parts of the U.S. pertaining to the ground response to external geomagnetic field excitation. The significant new information includes the results magnetotelluric surveys that have been conducted over the past few years across the contiguous US and results from previous surveys that have been made available in a combined online database. In this paper, we distill this new information in the framework of the NERC benchmark and in terms of updated ground response scaling factors thereby allowing straightforward utilization in the hazard assessments. We also outline the path forward for improving the overall extreme event benchmark scenario(s) including generalization of the storm waveforms and geoelectric field spatial patterns.

The total assessment profile, volume 2. [including societal impact, cost effectiveness, and economic analysis

NASA Technical Reports Server (NTRS)

Leininger, G.; Jutila, S.; King, J.; Muraco, W.; Hansell, J.; Lindeen, J.; Franckowiak, E.; Flaschner, A.

1975-01-01

Appendices are presented which include discussions of interest formulas, factors in regionalization, parametric modeling of discounted benefit-sacrifice streams, engineering economic calculations, and product innovation. For Volume 1, see .

Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

PubMed

Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

2018-05-10

Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

How to assess performance in cycling: the multivariate nature of influencing factors and related indicators

PubMed Central

Castronovo, A. Margherita; Conforto, Silvia; Schmid, Maurizio; Bibbo, Daniele; D'Alessio, Tommaso

2013-01-01

Finding an optimum for the cycling performance is not a trivial matter, since the literature shows the presence of many controversial aspects. In order to quantify different levels of performance, several indexes have been defined and used in many studies, reflecting variations in physiological and biomechanical factors. In particular, indexes such as Gross Efficiency (GE), Net Efficiency (NE) and Delta Efficiency (DE) have been referred to changes in metabolic efficiency (EffMet), while the Indexes of Effectiveness (IE), defined over the complete crank revolution or over part of it, have been referred to variations in mechanical effectiveness (EffMech). All these indicators quantify the variations of different factors [i.e., muscle fibers type distribution, pedaling cadence, setup of the bicycle frame, muscular fatigue (MFat), environmental variables, ergogenic aids, psychological traits (PsychTr)], which, moreover, show high mutual correlation. In the attempt of assessing cycling performance, most studies in the literature keep all these factors separated. This may bring to misleading results, leaving unanswered the question of how to improve cycling performance. This work provides an overview on the studies involving indexes and factors usually related to performance monitoring and assessment in cycling. In particular, in order to clarify all those aspects, the mutual interactions among these factors are highlighted, in view of a global performance assessment. Moreover, a proposal is presented advocating for a model-based approach that considers all factors mentioned in the survey, including the mutual interaction effects, for the definition of an objective function E representing the overall effectiveness of a training program in terms of both EffMet and EffMech. PMID:23734130

DNA Damage Response Factors from Diverse Pathways, Including DNA Crosslink Repair, Mediate Alternative End Joining

PubMed Central

Howard, Sean M.; Yanez, Diana A.; Stark, Jeremy M.

2015-01-01

Alternative end joining (Alt-EJ) chromosomal break repair involves bypassing classical non-homologous end joining (c-NHEJ), and such repair causes mutations often with microhomology at the repair junction. Since the mediators of Alt-EJ are not well understood, we have sought to identify DNA damage response (DDR) factors important for this repair event. Using chromosomal break reporter assays, we surveyed an RNAi library targeting known DDR factors for siRNAs that cause a specific decrease in Alt-EJ, relative to an EJ event that is a composite of Alt-EJ and c-NHEJ (Distal-EJ between two tandem breaks). From this analysis, we identified several DDR factors that are specifically important for Alt-EJ relative to Distal-EJ. While these factors are from diverse pathways, we also found that most of them also promote homologous recombination (HR), including factors important for DNA crosslink repair, such as the Fanconi Anemia factor, FANCA. Since bypass of c-NHEJ is likely important for both Alt-EJ and HR, we disrupted the c-NHEJ factor Ku70 in Fanca-deficient mouse cells and found that Ku70 loss significantly diminishes the influence of Fanca on Alt-EJ. In contrast, an inhibitor of poly ADP-ribose polymerase (PARP) causes a decrease in Alt-EJ that is enhanced by Ku70 loss. Additionally, the helicase/nuclease DNA2 appears to have distinct effects from FANCA and PARP on both Alt-EJ, as well as end resection. Finally, we found that the proteasome inhibitor Bortezomib, a cancer therapeutic that has been shown to disrupt FANC signaling, causes a significant reduction in both Alt-EJ and HR, relative to Distal-EJ, as well as a substantial loss of end resection. We suggest that several distinct DDR functions are important for Alt-EJ, which include promoting bypass of c-NHEJ and end resection. PMID:25629353

Hyponatremia and fractures: should hyponatremia be further studied as a potential biochemical risk factor to be included in FRAX algorithms?

PubMed

Ayus, J C; Bellido, T; Negri, A L

2017-05-01

The Fracture Risk Assessment Tool (FRAX®) was developed by the WHO Collaborating Centre for metabolic bone diseases to evaluate fracture risk of patients. It is based on patient models that integrate the risk associated with clinical variables and bone mineral density (BMD) at the femoral neck. The clinical risk factors included in FRAX were chosen to include only well-established and independent variables related to skeletal fracture risk. The FRAX tool has acquired worldwide acceptance despite having several limitations. FRAX models have not included biochemical derangements in estimation of fracture risk due to the lack of validation in large prospective studies. Recently, there has been an increasing number of studies showing a relationship between hyponatremia and the occurrence of fractures. Hyponatremia is the most frequent electrolyte abnormality measured in the clinic, and serum sodium concentration is a very reproducible, affordable, and readily obtainable measurement. Thus, we think that hyponatremia should be further studied as a biochemical risk factor for skeletal fractures prediction, particularly those at the hip which carries the greatest morbidity and mortality. To achieve this will require the collection of large patient cohorts from diverse geographical locations that include a measure of serum sodium in addition to the other FRAX variables in large numbers, in both sexes, over a wide age range and with wide geographical representation. It would also require the inclusion of data on duration and severity of hyponatremia. Information will be required both on the risk of fracture associated with the occurrence and length of exposure to hyponatremia and to the relationship with the other risk variables included in FRAX and also the independent effect on the occurrence of death which is increased by hyponatremia.

Aggregate Exposure and Cumulative Risk Assessment--Integrating Occupational and Non-occupational Risk Factors.

PubMed

Lentz, T J; Dotson, G S; Williams, P R D; Maier, A; Gadagbui, B; Pandalai, S P; Lamba, A; Hearl, F; Mumtaz, M

2015-01-01

Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational.

Integrated Assessment of Behavioral and Environmental Risk Factors for Lyme Disease Infection on Block Island, Rhode Island

PubMed Central

Krause, Peter J.; Niccolai, Linda; Steeves, Tanner; O’Keefe, Corrine Folsom; Diuk-Wasser, Maria A.

2014-01-01

Peridomestic exposure to Borrelia burgdorferi-infected Ixodes scapularis nymphs is considered the dominant means of infection with black-legged tick-borne pathogens in the eastern United States. Population level studies have detected a positive association between the density of infected nymphs and Lyme disease incidence. At a finer spatial scale within endemic communities, studies have focused on individual level risk behaviors, without accounting for differences in peridomestic nymphal density. This study simultaneously assessed the influence of peridomestic tick exposure risk and human behavior risk factors for Lyme disease infection on Block Island, Rhode Island. Tick exposure risk on Block Island properties was estimated using remotely sensed landscape metrics that strongly correlated with tick density at the individual property level. Behavioral risk factors and Lyme disease serology were assessed using a longitudinal serosurvey study. Significant factors associated with Lyme disease positive serology included one or more self-reported previous Lyme disease episodes, wearing protective clothing during outdoor activities, the average number of hours spent daily in tick habitat, the subject’s age and the density of shrub edges on the subject’s property. The best fit multivariate model included previous Lyme diagnoses and age. The strength of this association with previous Lyme disease suggests that the same sector of the population tends to be repeatedly infected. The second best multivariate model included a combination of environmental and behavioral factors, namely hours spent in vegetation, subject’s age, shrub edge density (increase risk) and wearing protective clothing (decrease risk). Our findings highlight the importance of concurrent evaluation of both environmental and behavioral factors to design interventions to reduce the risk of tick-borne infections. PMID:24416278

Integrated assessment of behavioral and environmental risk factors for Lyme disease infection on Block Island, Rhode Island.

PubMed

Finch, Casey; Al-Damluji, Mohammed Salim; Krause, Peter J; Niccolai, Linda; Steeves, Tanner; O'Keefe, Corrine Folsom; Diuk-Wasser, Maria A

2014-01-01

Peridomestic exposure to Borrelia burgdorferi-infected Ixodes scapularis nymphs is considered the dominant means of infection with black-legged tick-borne pathogens in the eastern United States. Population level studies have detected a positive association between the density of infected nymphs and Lyme disease incidence. At a finer spatial scale within endemic communities, studies have focused on individual level risk behaviors, without accounting for differences in peridomestic nymphal density. This study simultaneously assessed the influence of peridomestic tick exposure risk and human behavior risk factors for Lyme disease infection on Block Island, Rhode Island. Tick exposure risk on Block Island properties was estimated using remotely sensed landscape metrics that strongly correlated with tick density at the individual property level. Behavioral risk factors and Lyme disease serology were assessed using a longitudinal serosurvey study. Significant factors associated with Lyme disease positive serology included one or more self-reported previous Lyme disease episodes, wearing protective clothing during outdoor activities, the average number of hours spent daily in tick habitat, the subject's age and the density of shrub edges on the subject's property. The best fit multivariate model included previous Lyme diagnoses and age. The strength of this association with previous Lyme disease suggests that the same sector of the population tends to be repeatedly infected. The second best multivariate model included a combination of environmental and behavioral factors, namely hours spent in vegetation, subject's age, shrub edge density (increase risk) and wearing protective clothing (decrease risk). Our findings highlight the importance of concurrent evaluation of both environmental and behavioral factors to design interventions to reduce the risk of tick-borne infections.

Relationships of Functional Tests Following ACL Reconstruction: Exploratory Factor Analyses of the Lower Extremity Assessment Protocol.

PubMed

DiFabio, Melissa; Slater, Lindsay V; Norte, Grant; Goetschius, John; Hart, Joseph M; Hertel, Jay

2018-03-01

After ACL reconstruction (ACLR), deficits are often assessed using a variety of functional tests, which can be time consuming. It is unknown whether these tests provide redundant or unique information. To explore relationships between components of a battery of functional tests, the Lower Extremity Assessment Protocol (LEAP) was created to aid in developing the most informative, concise battery of tests for evaluating ACLR patients. Descriptive, cross-sectional. Laboratory. 76 ACLR patients (6.86±3.07 months postoperative) and 54 healthy participants. Isokinetic knee flexion and extension at 90 and 180 degrees/second, maximal voluntary isometric contraction for knee extension and flexion, single leg balance, 4 hopping tasks (single, triple, crossover, and 6-meter timed hop), and a bilateral drop vertical jump that was scored with the Landing Error Scoring System (LESS). Peak torque, average torque, average power, total work, fatigue indices, center of pressure area and velocity, hop distance and time, and LESS score. A series of factor analyses were conducted to assess grouping of functional tests on the LEAP for each limb in the ACLR and healthy groups and limb symmetry indices (LSI) for both groups. Correlations were run between measures that loaded on retained factors. Isokinetic and isometric strength tests for knee flexion and extension, hopping, balance, and fatigue index were identified as unique factors for all limbs. The LESS score loaded with various factors across the different limbs. The healthy group LSI analysis produced more factors than the ACLR LSI analysis. Individual measures within each factor had moderate to strong correlations. Isokinetic and isometric strength, hopping, balance, and fatigue index provided unique information. Within each category of measures, not all tests may need to be included for a comprehensive functional assessment of ACLR patients due to the high amount of shared variance between them.

Abuse Liability Assessment of Tobacco Products Including Potential Reduced Exposure Products (PREPs)

PubMed Central

Carter, Lawrence P.; Stitzer, Maxine L.; Henningfield, Jack E.; O'Connor, Rich J.; Cummings, K. Michael; Hatsukami, Dorothy K.

2009-01-01

The harm produced by tobacco products is a result of frequent use of a highly toxic product. Reducing the adverse public health impact of tobacco products might be most effectively achieved by reducing the likelihood of their use and the toxicity of the products. Products that retain some characteristics of cigarettes, but have been altered with the intention of reducing toxicity have been referred to as modified risk tobacco products or potential reduced exposure products (MRTP/PREPS). Evaluation of their content, emission, and toxicity is discussed in other articles in this special issue. Here, we discuss the methodology that has been used to examine the likelihood of abuse or addiction. Abuse liability assessment (ALA) methodology has been used by the Food and Drug Administration (FDA) and other drug regulatory agencies world-wide for decades to assess the risks posed by a wide variety of pharmacologically active substances. ALA is routinely required among other evaluations of safety during the premarket assessment of new drugs, and is continually adapted to meet the challenges posed by new drug classes and drug formulations. In the 2009 law giving FDA regulation over tobacco products, FDA is now required to evaluate new tobacco products including MRTP/PREPs to determine their risk for abuse and toxicity at the population level. This paper describes the traditional tools and methods of ALA that can be used to evaluate new tobacco and nicotine products including MRTP/PREPs. Such ALA data could contribute to the scientific foundation on which future public policy decisions are based. PMID:19959676

Meta-analyses including data from observational studies.

PubMed

O'Connor, Annette M; Sargeant, Jan M

2014-02-15

Observational studies represent a wide group of studies where the disease or condition of interest is naturally occurring and the investigator does not control allocation to interventions or exposures. Observational studies are used to test hypotheses about the efficacy of interventions or about exposure-disease relationships, to estimate incidence or prevalence of conditions, and to assess the sensitivity and specificity of diagnostic assays. Experimental-study designs and randomized controlled trials (RCTs) can also contribute to the body of evidence about such questions. Meta-analyses (either with or without systematic reviews) aim to combine information from primary research studies to better describe the entire body of work. The aim of meta-analyses may be to obtain a summary effect size, or to understand factors that affect effect sizes. In this paper, we discuss the role of observational studies in meta-analysis questions and some factors to consider when deciding whether a meta-analysis should include results from such studies. Our suggestion is that one should only include studies that are not at high risk of inherent bias when calculating a summary effect size. Study design however can be a meaningful variable in assessment of outcome heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

Calculating LOAEL/NOAEL uncertainty factors for wildlife species in ecological risk assessments

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

Suedel, B.C.; Clifford, P.A.; Ludwig, D.F.

1995-12-31

Terrestrial ecological risk assessments frequently require derivation of NOAELs or toxicity reference values (TRVS) against which to compare exposure estimates. However, much of the available information from the literature is LOAELS, not NOAELS. Lacking specific guidance, arbitrary factors of ten are sometimes employed for extrapolating NOAELs from LOAELs. In this study, the scientific literature was searched to obtain chronic and subchronic studies reporting NOAEL and LOAEL data for wildlife and laboratory species. Results to date indicate a mean conversion factor of 4.0 ({+-} 2.61 S.D.), with a minimum of 1. 6 and a maximum of 10 for 106 studies acrossmore » several classes of compounds (I.e., metals, pesticides, volatiles, etc.). These data suggest that an arbitrary factor of 10 conversion factor is unnecessarily restrictive for extrapolating NOAELs from LOAELs and that a factor of 4--5 would be more realistic for deriving toxicity reference values for wildlife species. Applying less arbitrary and more realistic conversion factors in ecological risk assessments will allow for a more accurate estimate of NOAEL values for assessing risk to wildlife populations.« less

Health assessment of French university students and risk factors associated with mental health disorders.

PubMed

Tran, Antoine; Tran, Laurie; Geghre, Nicolas; Darmon, David; Rampal, Marion; Brandone, Diane; Gozzo, Jean-Michel; Haas, Hervé; Rebouillat-Savy, Karine; Caci, Hervé; Avillach, Paul

2017-01-01

The first year of university is a particularly stressful period and can impact academic performance and students' health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms. Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students' lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression. A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly. The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms may improve students' health by implementing targeted

The challenges of including impacts on biodiversity in agricultural life cycle assessments.

PubMed

Gabel, Vanessa M; Meier, Matthias S; Köpke, Ulrich; Stolze, Matthias

2016-10-01

Agriculture is considered to be one of the main drivers for worldwide biodiversity loss but the impacts of agricultural production on biodiversity have not been extensively considered in Life Cycle Assessments (LCAs). Recent realisation that biodiversity impact should be included in comprehensive LCAs has led to attempts to develop and implement methods for biodiversity impact assessment. In this review, twenty-two different biodiversity impact assessment methods have been analysed to identify their strengths and weaknesses in terms of their comprehensiveness in the evaluation of agricultural products. Different criteria, which had to meet the specific requirements of biodiversity research, life cycle assessment methodology, and the evaluation of agricultural products, were selected to investigate the identified methods. Very few of the methods were developed with the specific intention of being used for agricultural LCAs. Furthermore, none of the methods can be applied globally while at the same time being able to differentiate between various agricultural intensities. Global value chains and the increasing awareness of different biodiversity impacts of agricultural production systems demand the development of evaluation methods that are able to overcome these shortcomings. Despite the progress that has already been achieved, there are still unresolved difficulties which need further research and improvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

Human factors and ergonomics assessment of food pantry work: A case study.

PubMed

Higgins, Nicholas A; Talone, Andrew B; Fraulini, Nicholas W; Smither, Janan A

2017-01-01

Research assessing work processes in food pantries has been limited to the client's experience and aspects of food donations [3-5]. Research on food pantries has yet to focus on understanding and evaluating worker-environment interaction. The present case study examined the interaction between workers and their work environment while performing common tasks in a food pantry. Data were collected through naturalistic observations and structured interviews. A task analysis was performed on the data. Several potential issues in the pantry were identified including with the workspace layout, environmental conditions, and signage. Human factors and ergonomics principles were then utilized to provide insights and recommendations (e.g., use of numbered rather than color-coded signage). Recommendations were provided to the case study food pantry for enhancing safety and productivity. Further research is needed to assess the generalizability of our findings to other food pantries.

Analysis of vehicle classification data, including monthly and seasonal ADT factors, hourly distribution factors, and lane distribution factors

DOT National Transportation Integrated Search

1998-11-01

This report documents the development of monthly and seasonal average daily traffic (ADT) factors for performing estimating AADTs. It appears that seasonal factors can estimate AADT as well as monthly factors, and it is recommended that seasonal fact...

Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia

PubMed Central

Gosadi, Ibrahim M.

2016-01-01

Metabolic syndrome (MS) is a combination of factors that increases the risk of cardiovascular atherosclerotic diseases including diabetes, obesity, dyslipidemia, and high blood pressure. Cardiovascular diseases are one of the leading causes of death in the adult Saudi population where the increase in cardiovascular-related mortality is augmented by the rise in the prevalence of MS. Metabolic syndrome is a multi-factorial disorder influenced by interactions between genetic and environmental components. This review aims to provide a comprehensive assessment of studied environmental and genetic factors explaining the prevalence of MS in the Kingdom of Saudi Arabia. Additionally, this review aims to illustrate factors related to the population genetics of Saudi Arabia, which might explain a proportion of the prevalence of MS. PMID:26739969

Evaluation of a short Food Frequency Questionnaire to assess cardiovascular disease-related diet and lifestyle factors

PubMed Central

Svendsen, Karianne; Henriksen, Hege Berg; Østengen, Beate; Jacobs, David R.; Telle-Hansen, Vibeke H.; Carlsen1, Monica H.; Retterstøl, Kjetil

2018-01-01

Background The Vascular lifestyle-Intervention and Screening in phArmacies (VISA) study investigates diet and lifestyle factors associated with risk of cardiovascular disease (CVD). As part of the study methodology, a short Food Frequency Questionnaire (FFQ), the VISA-FFQ, was adapted from the Norwegian NORDIET-FFQ. Objective The aim of this study was to evaluate the VISA-FFQ and its ability to estimate intakes of foods and lifestyle factors in screening for elevated risk of CVD. The evaluation included assessment of relative validity of intake of milk fat and assessment of reproducibility of several foods and lifestyle factors. Design Relative validity of milk fat estimated from the VISA-FFQ was assessed in 307 participants by comparing estimated dietary intake of the fatty acids pentadecanoic acid (15:0) and heptadecanoic acid (17:0), from milk fat with whole blood biomarkers 15:0 and 17:0. Reproducibility was evaluated in 122 participants by comparing consistency in intakes of different foods and lifestyle factors reported by the VISA-FFQ and administered twice with a 4-week interval. Results Dietary 15:0 milk fat estimated from the VISA-FFQ correlated positively with whole blood 15:0 (r = 0.32, P < 0.05). Men presented higher correlations than women did. Acceptable and consistent reproducibility (r = 0.44–0.94 and no large difference between test and retest) was observed for most beverages, milk products, spreads on bread and meat (all of which included food items categorised into at least two fat categories) and also for eggs, fruits and vegetables, nuts, pasta and rice, dessert/sweets, smoking and physical activity. Reproducibility did not consistently meet a satisfactory standard (r ≤ 0.41 or large difference between test and retest) for unsweetened cereals, fatty fish, cakes, oils, white-, bread, crispbread and rice. Conclusion The validity of the VISA-FFQ was acceptable for intake of milk fat, and there was an overall satisfactory, though variable

Development of a self-report physical function instrument for disability assessment: item pool construction and factor analysis.

PubMed

McDonough, Christine M; Jette, Alan M; Ni, Pengsheng; Bogusz, Kara; Marfeo, Elizabeth E; Brandt, Diane E; Chan, Leighton; Meterko, Mark; Haley, Stephen M; Rasch, Elizabeth K

2013-09-01

To build a comprehensive item pool representing work-relevant physical functioning and to test the factor structure of the item pool. These developmental steps represent initial outcomes of a broader project to develop instruments for the assessment of function within the context of Social Security Administration (SSA) disability programs. Comprehensive literature review; gap analysis; item generation with expert panel input; stakeholder interviews; cognitive interviews; cross-sectional survey administration; and exploratory and confirmatory factor analyses to assess item pool structure. In-person and semistructured interviews and Internet and telephone surveys. Sample of SSA claimants (n=1017) and a normative sample of adults from the U.S. general population (n=999). Not applicable. Model fit statistics. The final item pool consisted of 139 items. Within the claimant sample, 58.7% were white; 31.8% were black; 46.6% were women; and the mean age was 49.7 years. Initial factor analyses revealed a 4-factor solution, which included more items and allowed separate characterization of: (1) changing and maintaining body position, (2) whole body mobility, (3) upper body function, and (4) upper extremity fine motor. The final 4-factor model included 91 items. Confirmatory factor analyses for the 4-factor models for the claimant and the normative samples demonstrated very good fit. Fit statistics for claimant and normative samples, respectively, were: Comparative Fit Index=.93 and .98; Tucker-Lewis Index=.92 and .98; and root mean square error approximation=.05 and .04. The factor structure of the physical function item pool closely resembled the hypothesized content model. The 4 scales relevant to work activities offer promise for providing reliable information about claimant physical functioning relevant to work disability. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Development of a Self-Report Physical Function Instrument for Disability Assessment: Item Pool Construction and Factor Analysis

PubMed Central

McDonough, Christine M.; Jette, Alan M.; Ni, Pengsheng; Bogusz, Kara; Marfeo, Elizabeth E; Brandt, Diane E; Chan, Leighton; Meterko, Mark; Haley, Stephen M.; Rasch, Elizabeth K.

2014-01-01

Objectives To build a comprehensive item pool representing work-relevant physical functioning and to test the factor structure of the item pool. These developmental steps represent initial outcomes of a broader project to develop instruments for the assessment of function within the context of Social Security Administration (SSA) disability programs. Design Comprehensive literature review; gap analysis; item generation with expert panel input; stakeholder interviews; cognitive interviews; cross-sectional survey administration; and exploratory and confirmatory factor analyses to assess item pool structure. Setting In-person and semi-structured interviews; internet and telephone surveys. Participants A sample of 1,017 SSA claimants, and a normative sample of 999 adults from the US general population. Interventions Not Applicable. Main Outcome Measure Model fit statistics Results The final item pool consisted of 139 items. Within the claimant sample 58.7% were white; 31.8% were black; 46.6% were female; and the mean age was 49.7 years. Initial factor analyses revealed a 4-factor solution which included more items and allowed separate characterization of: 1) Changing and Maintaining Body Position, 2) Whole Body Mobility, 3) Upper Body Function and 4) Upper Extremity Fine Motor. The final 4-factor model included 91 items. Confirmatory factor analyses for the 4-factor models for the claimant and the normative samples demonstrated very good fit. Fit statistics for claimant and normative samples respectively were: Comparative Fit Index = 0.93 and 0.98; Tucker-Lewis Index = 0.92 and 0.98; Root Mean Square Error Approximation = 0.05 and 0.04. Conclusions The factor structure of the Physical Function item pool closely resembled the hypothesized content model. The four scales relevant to work activities offer promise for providing reliable information about claimant physical functioning relevant to work disability. PMID:23542402

Radium concentration factors and their use in health and environmental risk assessment

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

Meinhold, A.F.; Hamilton, L.D.

1991-12-31

Radium is known to be taken up by aquatic animals, and tends to accumulate in bone, shell and exoskeleton. The most common approach to estimating the uptake of a radionuclide by aquatic animals for use in health and environmental risk assessments is the concentration factor method. The concentration factor method relates the concentration of a contaminant in an organism to the concentration in the surrounding water. Site specific data are not usually available, and generic, default values are often used in risk assessment studies. This paper describes the concentration factor method, summarizes some of the variables which may influence themore » concentration factor for radium, reviews reported concentration factors measured in marine environments and presents concentration factors derived from data collected in a study in coastal Louisiana. The use of generic default values for the concentration factor is also discussed.« less

Radium concentration factors and their use in health and environmental risk assessment

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

Meinhold, A.F.; Hamilton, L.D.

1991-01-01

Radium is known to be taken up by aquatic animals, and tends to accumulate in bone, shell and exoskeleton. The most common approach to estimating the uptake of a radionuclide by aquatic animals for use in health and environmental risk assessments is the concentration factor method. The concentration factor method relates the concentration of a contaminant in an organism to the concentration in the surrounding water. Site specific data are not usually available, and generic, default values are often used in risk assessment studies. This paper describes the concentration factor method, summarizes some of the variables which may influence themore » concentration factor for radium, reviews reported concentration factors measured in marine environments and presents concentration factors derived from data collected in a study in coastal Louisiana. The use of generic default values for the concentration factor is also discussed.« less

Factor Structure and Basic Psychometric Properties of the "Transition Assessment and Goal Generator"

ERIC Educational Resources Information Center

Hennessey, Maeghan N.; Terry, Robert; Martin, James E.; McConnell, Amber E.; Willis, Donna M.

2018-01-01

We examined the theoretical factor structure fit and psychometric properties of the "Transition Assessment and Goal Generator" (TAGG). In the first study, 349 transition-aged students with disabilities, their special educators, and family members completed TAGG assessments, and using exploratory factor analysis (EFA)/confirmatory factor…

Factor Stability of the Organizational Assessment Package.

DTIC Science & Technology

1982-08-01

AD-AI7 122 LEADERSHIP AND MANAGEMENT DEVELOPMENT CENTER MAXWELL--ETC F/6ř/1 FACTOR STABILITY OF THE ORGANIZATIONAL ASSESSMENT PACKAGE.(U) UCAUG 82...the Leadership AM Manaemenat D Center (LIUC), NaxwllI Alir Force Base,, AlIbama, report a cinpltt project documented by literature review references... Leadership and Management Development Center (ATC) Maxwell Air Force Base, Alabama 36112 11. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE

Comparison of direct measures of adiposity with indirect measures for assessing cardiometabolic risk factors in preadolescent girls.

PubMed

Hetherington-Rauth, Megan; Bea, Jennifer W; Lee, Vinson R; Blew, Robert M; Funk, Janet; Lohman, Timothy G; Going, Scott B

2017-02-23

Childhood overweight and obesity remains high, contributing to cardiometabolic risk factors at younger ages. It is unclear which measures of adiposity serve as the best proxies for identifying children at metabolic risk. This study assessed whether DXA-derived direct measures of adiposity are more strongly related to cardiometabolic risk factors in children than indirect measures. Anthropometric and DXA measures of adiposity and a comprehensive assessment of cardiometabolic risk factors were obtained in 288, 9-12 year old girls, most being of Hispanic ethnicity. Multiple regression models for each metabolic parameter were run against each adiposity measure while controlling for maturation and ethnicity. In addition, regression models including both indirect and direct measures were developed to assess whether using direct measures of adiposity could provide a better prediction of the cardiometabolic risk factors beyond that of using indirect measures alone. Measures of adiposity were significantly correlated with cardiometabolic risk factors (p < 0.05) except fasting glucose. After adjusting for maturation and ethnicity, indirect measures of adiposity accounted for 29-34% in HOMA-IR, 10-13% in TG, 14-17% in HDL-C, and 5-8% in LDL-C while direct measures accounted for 29-34% in HOMA-IR, 10-12% in TG, 13-16% in HDL-C, and 5-6% in LDL-C. The addition of direct measures of adiposity to indirect measures added significantly to the variance explained for HOMA-IR (p = 0.04). Anthropometric measures may perform as well as the more precise direct DXA-derived measures of adiposity for assessing most CVD risk factors in preadolescent girls. The use of DXA-derived adiposity measures together with indirect measures may be advantageous for predicting insulin resistance risk. NCT02654262 . Retrospectively registered 11 January 2016.

Factor Structure and Basic Psychometric Properties of the "Transition Assessment" and "Goal Generator"

ERIC Educational Resources Information Center

Hennessey, Maeghan N.; Terry, Robert; Martin, James E.; McConnell, Amber E.; Willis, Donna M.

2017-01-01

The researchers examined the theoretical factor structure fit and psychometric properties of the Transition Assessment and Goal Generator (TAGG). In the first study, 349 transition-aged students with disabilities, their special educators, and family members completed TAGG assessments, and using exploratory factor analysis (EFA)/confirmatory factor…

Psychological assessment of factors affecting pain

PubMed Central

Pos, Robert

1974-01-01

Use of traditional stimulus-response models of pain leads to differentiation between organic and psychogenic pain, which is often not helpful, if not dangerous, in treating chronic pain. Pain does not simply reflect bodily damage but also complex psychological malfunctioning. Viewing chronic pain as an obsessional state may often help in treating the entire patient and prevent the physician from being obsessed with the patient's obsession. Psychological assessment of pain should focus on the role of psychological processes in the multifactorial causation of the illness causing the pain, notably their role in illness-proneness in general. Also, iatrogenic psychological distress, associatively precipitated psychological conflict and illness-perpetuating psychological processes should be looked for. A serious obstacle to progress with pain problems is not lack of hard data but conceptual confusion. Before medicine can meaningfully assess psychological factors in pain problems it must first learn to perceive psychological disturbances in medical and surgical patients. PMID:4434290

Analysis of psychological factors for quality assessment of interactive multimodal service

NASA Astrophysics Data System (ADS)

Yamagishi, Kazuhisa; Hayashi, Takanori

2005-03-01

We proposed a subjective quality assessment model for interactive multimodal services. First, psychological factors of an audiovisual communication service were extracted by using the semantic differential (SD) technique and factor analysis. Forty subjects participated in subjective tests and performed point-to-point conversational tasks on a PC-based TV phone that exhibits various network qualities. The subjects assessed those qualities on the basis of 25 pairs of adjectives. Two psychological factors, i.e., an aesthetic feeling and a feeling of activity, were extracted from the results. Then, quality impairment factors affecting these two psychological factors were analyzed. We found that the aesthetic feeling is mainly affected by IP packet loss and video coding bit rate, and the feeling of activity depends on delay time and video frame rate. We then proposed an opinion model derived from the relationships among quality impairment factors, psychological factors, and overall quality. The results indicated that the estimation error of the proposed model is almost equivalent to the statistical reliability of the subjective score. Finally, using the proposed model, we discuss guidelines for quality design of interactive audiovisual communication services.

Proposal for including what is valuable to ecosystems in environmental assessments.

PubMed

Campbell, D E

2001-07-15

Assessment scientists and managers depend on social values to identify the goals that will be used to guide environmental assessments. These goals are commonly identified by examining the vested interests of the various social groups that are stakeholders in a region. However, knowledge about what people value represents only part of the information needed to identify comprehensive assessment goals for environmental systems that include both economic and ecological components and processes. All parties also need to understand what is valuable to ecosystems because that determines the ecological patterns and processes that prevail in the long run. The competition among alternate system designs for available energy determines the viability of the choices that people make for their environment. Ecosystems that prevail in competition use the process of self-organization to create system designs that maximize the use of ever-changing sources of available energy. The efficacy of ecosystem designs can be evaluated using the maximum empower principle, which states that ecosystems evolve toward designs that maximize empower (energy use per unit time). Energy is an accounting quantity that normalizes the different kinds of energy developed in a system so that they may be compared. The counter-intuitive and sometimes controversial results that come from energy analyses are illustrated by examining three environmental problems on the interface between ecology and economics. A process for identifying and using social and ecosystem values to guide environmental assessments is proposed using a conceptual energy systems model that shows how these processes might interact within a region. The probability of realizing a given change in system empower production is suggested as a decision criterion that can be used by managers to evaluate the efficacy of alternatives.

Shifting attention from objective risk factors to patients' self-assessed health resources: a clinical model for general practice.

PubMed

Hollnagel, H; Malterud, K

1995-12-01

The study was designed to present and apply theoretical and empirical knowledge for the construction of a clinical model intended to shift the attention of the general practitioner from objective risk factors to self-assessed health resources in male and female patients. Review, discussion and analysis of selected theoretical models about personal health resources involving assessing existing theories according to their emphasis concerning self-assessed vs. doctor-assessed health resources, specific health resources vs. life and coping in general, abstract vs. clinically applicable theory, gender perspective explicitly included or not. Relevant theoretical models on health and coping (salutogenesis, coping and social support, control/demand, locus of control, health belief model, quality of life), and the perspective of the underprivileged Other (critical theory, feminist standpoint theory, the patient-centred clinical method) were presented and assessed. Components from Antonovsky's salutogenetic perspective and McWhinney's patient-centred clinical method, supported by gender perspectives, were integrated to a clinical model which is presented. General practitioners are recommended to shift their attention from objective risk factors to self-assessed health resources by means of the clinical model. The relevance and feasibility of the model should be explored in empirical research.

The Benefits of Including Clinical Factors in Rectal Normal Tissue Complication Probability Modeling After Radiotherapy for Prostate Cancer

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

Defraene, Gilles, E-mail: gilles.defraene@uzleuven.be; Van den Bergh, Laura; Al-Mamgani, Abrahim

2012-03-01

Purpose: To study the impact of clinical predisposing factors on rectal normal tissue complication probability modeling using the updated results of the Dutch prostate dose-escalation trial. Methods and Materials: Toxicity data of 512 patients (conformally treated to 68 Gy [n = 284] and 78 Gy [n = 228]) with complete follow-up at 3 years after radiotherapy were studied. Scored end points were rectal bleeding, high stool frequency, and fecal incontinence. Two traditional dose-based models (Lyman-Kutcher-Burman (LKB) and Relative Seriality (RS) and a logistic model were fitted using a maximum likelihood approach. Furthermore, these model fits were improved by including themore » most significant clinical factors. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminating ability of all fits. Results: Including clinical factors significantly increased the predictive power of the models for all end points. In the optimal LKB, RS, and logistic models for rectal bleeding and fecal incontinence, the first significant (p = 0.011-0.013) clinical factor was 'previous abdominal surgery.' As second significant (p = 0.012-0.016) factor, 'cardiac history' was included in all three rectal bleeding fits, whereas including 'diabetes' was significant (p = 0.039-0.048) in fecal incontinence modeling but only in the LKB and logistic models. High stool frequency fits only benefitted significantly (p = 0.003-0.006) from the inclusion of the baseline toxicity score. For all models rectal bleeding fits had the highest AUC (0.77) where it was 0.63 and 0.68 for high stool frequency and fecal incontinence, respectively. LKB and logistic model fits resulted in similar values for the volume parameter. The steepness parameter was somewhat higher in the logistic model, also resulting in a slightly lower D{sub 50}. Anal wall DVHs were used for fecal incontinence, whereas anorectal wall dose best described the other two endpoints. Conclusions

Assessment of Factors Influencing Communication in Clinical Pharmacy.

PubMed

Yao, Dongning; Jiang, Liang; Huang, Yuankai; Chen, Lei; Wang, Yitao; Xi, Xiaoyu

2018-01-01

This study aimed to identify and assess the factors that influence communication quality between clinical pharmacists and patients using a structural equation model based on the predisposing, reinforcing, and enabling constructs in educational/environmental diagnosis and evaluation-policy, regulatory, and organizational constructs in educational and ecological development model to identify the most effective path to increase their communication quality. A survey was conducted at 253 Class-A tertiary hospitals in China from March to December 2016. During on-site observations, verbal communications between clinical pharmacists ( n = 752) and patients were audio recorded, and communication quality was rated by an expert panel on an 8-item Quality of Communication Rating Scale. Clinical pharmacists completed questionnaires that examined the predisposing, enabling, and reinforcing factors that influenced communication quality. Finally, AMOS was employed to examine the relationships between the three factors and communication quality. The results indicated that all three factors positively affected communication quality, with correlation coefficients of .26, .13, and .17, respectively. The most influential predisposing factor was attitude (.77), the most influential enabling factors were self-efficacy (.71) and confidence (.72), and the most influential reinforcing factor was rewards (.74). The findings suggest that pharmacists' attitudes toward, perceived knowledge of, and skill and confidence in communication, and the rewards offered by pharmacy management are the most influential factors that influence communication quality.

Human Factors Engineering #2 Crewstation Assessment for the OH-58F Helicopter

DTIC Science & Technology

2013-03-01

1 ARMY RSCH LABORATORY – HRED (HC) HUMAN RSRCH AND ENGRNG DIRCTRT MCOE FIELD ELEMENT RDRL HRM DW C CARSTENS 6450 WAY ST BLDG 2839 RM... Human Factors Engineering #2 Crewstation Assessment for the OH-58F Helicopter by David B. Durbin, Jamison S. Hicks, Michael Sage Jessee...Research Laboratory Aberdeen Proving Ground, MD 21005 ARL-TR-6355 March 2013 Human Factors Engineering #2 Crewstation Assessment for the

Identifying social factors amongst older individuals in linked electronic health records: An assessment in a population based study

PubMed Central

van Hoek, Albert J.; Walker, Jemma L.; Mathur, Rohini; Smeeth, Liam; Thomas, Sara L.

2017-01-01

Identification and quantification of health inequities amongst specific social groups is a pre-requisite for designing targeted healthcare interventions. This study investigated the recording of social factors in linked electronic health records (EHR) of individuals aged ≥65 years, to assess the potential of these data to identify the social determinants of disease burden and uptake of healthcare interventions. Methodology was developed for ascertaining social factors recorded on or before a pre-specified index date (01/01/2013) using primary care data from Clinical Practice Research Datalink (CPRD) linked to hospitalisation and deprivation data in a cross-sectional study. Social factors included: religion, ethnicity, immigration status, small area-level deprivation, place of residence (including communal establishments such as care homes), marital status and living arrangements (e.g. living alone, cohabitation). Each social factor was examined for: completeness of recording including improvements in completeness by using other linked EHR, timeliness of recording for factors that might change over time and their representativeness (compared with English 2011 Census data when available). Data for 591,037 individuals from 389 practices from England were analysed. The completeness of recording varied from 1.6% for immigration status to ~80% for ethnicity. Linkages provided the deprivation data (available for 82% individuals) and improved completeness of ethnicity recording from 55% to 79% (when hospitalisation data were added). Data for ethnicity, deprivation, living arrangements and care home residence were comparable to the Census data. For time-varying variables such as residence and living alone, ~60% and ~35% respectively of those with available data, had this information recorded within the last 5 years of the index date. This work provides methods to identify social factors in EHR relevant to older individuals and shows that factors such as ethnicity

Health assessment of French university students and risk factors associated with mental health disorders

PubMed Central

Geghre, Nicolas; Darmon, David; Rampal, Marion; Brandone, Diane; Gozzo, Jean-Michel; Haas, Hervé; Rebouillat-Savy, Karine; Caci, Hervé; Avillach, Paul

2017-01-01

Objective The first year of university is a particularly stressful period and can impact academic performance and students’ health. The aim of this study was to evaluate the health and lifestyle of undergraduates and assess risk factors associated with psychiatric symptoms. Materials and methods Between September 2012 and June 2013, we included all undergraduate students who underwent compulsory a medical visit at the university medical service in Nice (France) during which they were screened for potential diseases during a diagnostic interview. Data were collected prospectively in the CALCIUM database (Consultations Assistés par Logiciel pour les Centres Inter-Universitaire de Médecine) and included information about the students’ lifestyle (living conditions, dietary behavior, physical activity, use of recreational drugs). The prevalence of psychiatric symptoms related to depression, anxiety and panic attacks was assessed and risk factors for these symptoms were analyzed using logistic regression. Results A total of 4,184 undergraduates were included. Prevalence for depression, anxiety and panic attacks were 12.6%, 7.6% and 1.0%, respectively. During the 30 days preceding the evaluation, 0.6% of the students regularly drank alcohol, 6.3% were frequent-to-heavy tobacco smokers, and 10.0% smoked marijuana. Dealing with financial difficulties and having learning disabilities were associated with psychiatric symptoms. Students who were dissatisfied with their living conditions and those with poor dietary behavior were at risk of depression. Being a woman and living alone were associated with anxiety. Students who screened positively for any psychiatric disorder assessed were at a higher risk of having another psychiatric disorder concomitantly. Conclusion The prevalence of psychiatric disorders in undergraduate students is low but the rate of students at risk of developing chronic disease is far from being negligible. Understanding predictors for these symptoms

Confirmatory Factor Analysis of the Kaufman Assessment Battery for Children: A Reevaluation.

ERIC Educational Resources Information Center

Strommen, Erik

1988-01-01

Performed confirmatory factor analyses of Kaufman Assessment Battery for Children (K-ABC) using subtest correlations for standardization samples provided in manuals to test hypothesis that factors underlying K-ABC are substantially intercorrelated at all age levels for two- and three-factor models. Findings suggest K-ABC cannot distinguish between…

Validating a measure to assess factors that affect assistive technology use by students with disabilities in elementary and secondary education.

PubMed

Zapf, Susan A; Scherer, Marcia J; Baxter, Mary F; H Rintala, Diana

2016-01-01

The purpose of this study was to measure the predictive validity, internal consistency and clinical utility of the Matching Assistive Technology to Child & Augmentative Communication Evaluation Simplified (MATCH-ACES) assessment. Twenty-three assistive technology team evaluators assessed 35 children using the MATCH-ACES assessment. This quasi-experimental study examined the internal consistency, predictive validity and clinical utility of the MATCH-ACES assessment. The MATCH-ACES assessment predisposition scales had good internal consistency across all three scales. A significant relationship was found between (a) high student perseverance and need for assistive technology and (b) high teacher comfort and interest in technology use (p = (0).002). Study results indicate that the MATCH-ACES assessment has good internal consistency and validity. Predisposition characteristics of student and teacher combined can influence the level of assistive technology use; therefore, assistive technology teams should assess predisposition factors of the user when recommending assistive technology. Implications for Rehabilitation Educational and medical professionals should be educated on evidence-based assistive technology assessments. Personal experience and psychosocial factors can influence the outcome use of assistive technology. Assistive technology assessments must include an intervention plan for assistive technology service delivery to measure effective outcome use.

Honorary authorship in radiologic research articles: assessment of frequency and associated factors.

PubMed

Eisenberg, Ronald L; Ngo, Long; Boiselle, Philip M; Bankier, Alexander A

2011-05-01

To quantify the frequency of perceived honorary authorship in radiologic journals and to identify specific factors that increase its prevalence. This study qualified for exempt status by the institutional review board. An electronic survey was sent to first authors of all original research articles published in Radiology and European Radiology over 3 years. Questions included guidelines used for determining authorship, contributions of coauthors, the perception of honorary authorship, and demographic information. Univariable analysis of sample proportions was performed by using χ(2) tests. Multivariable logistic regression models were used to assess the independent factors that were associated with the probability of perceiving honorary authorship. Of the 392 (29.3%) of 1338 first authors who responded to the survey, 102 (26.0%) perceived that one or more coauthors did not make sufficient contributions to merit being included as an author. Of the 392 respondents, 231 (58.9%) stated that one or more coauthors performed only "nonauthor" tasks according to International Committee of Medical Journal Editors criteria. Factors associated with an increased first-author perception of honorary authorship included lower academic rank (adjusted odds ratio [OR]: 2.89; 95% confidence interval [CI]: 1.66, 5.06), as well as working in an environment in which the section or department head was automatically listed as an author (adjusted OR: 3.80; 95% CI: 2.13, 6.79). The percentage of honorary authorship was significantly higher (P = .019) among respondents who did not follow journal requirements for authorship. The rate of perceived honorary authorship (overall, 26.0%) was substantially more frequent among respondents of lower academic rank and in those working in an environment in which their section or department head was automatically listed as an author. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101500/-/DC1. RSNA, 2011

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

PubMed

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-06-04

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

Higher-Order Exploratory Factor Analysis of the Reynolds Intellectual Assessment Scales with a Referred Sample

ERIC Educational Resources Information Center

Nelson, Jason M.; Canivez, Gary L.; Lindstrom, Will; Hatt, Clifford V.

2007-01-01

The factor structure of the Reynolds Intellectual Assessment Scales (RIAS; [Reynolds, C.R., & Kamphaus, R.W. (2003). "Reynolds Intellectual Assessment Scales". Lutz, FL: Psychological Assessment Resources, Inc.]) was investigated with a large (N=1163) independent sample of referred students (ages 6-18). More rigorous factor extraction criteria…

Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.

PubMed

Iizaka, Shinji; Tadaka, Etsuko; Sanada, Hiromi

2008-03-01

Malnutrition among the elderly has become a serious problem as their population increases in Japan. To approach the risk of malnutrition in the healthy, community-dwelling elderly is important for early prevention of malnutrition. The nutritional status and mutable associated factors with poor nutritional status specific to the healthy elderly were examined comprehensively. One hundred and thirty healthy elderly people from a senior college in Tokyo, Japan were eligible for this study. Nutritional status was evaluated by Mini-Nutritional Assessment (MNA). The demographic status and potential correlates with poor nutritional status, including the physical factors (mobility, cognitive impairment and oral status) and the psychosocial factors (depression, self-efficacy, attitudes toward health, instrumental activities of daily living, public health service knowledge, and difficulty and dissatisfaction with meal preparation) were investigated. The multiple linear regression analysis using a stepwise procedure adjusted for demographic status was performed to detect independent associated factors. There were 16 participants (12.6%) at risk of malnutrition. The independent associated factors with lower MNA scores were depression (beta = -0.27, P = 0.005), lower self-efficacy (beta = 0.25, P = 0.009), lower attitudes toward health scores (beta = 0.21, P = 0.02) and difficulty with meal preparation (beta = -0.18, P = 0.03). The prevalence of the healthy elderly at the initial risk of malnutrition was relatively high and should not be overlooked. The comprehensive geriatric screening and intervention including mental health, health management and life-situation will be important for the healthy, community-dwelling elderly.

Factor Structure Evaluation of the French Version of the Digital Natives Assessment Scale.

PubMed

Wagner, Vincent; Acier, Didier

2017-03-01

"Digital natives" concept defines young adults particularly familiar with emerging technologies such as computers, smartphones, or Internet. This notion is still controversial and so far, the primary identifying criterion was to consider their date of birth. However, literature highlighted the need to describe specific characteristics. The purpose of this research was to evaluate the factor structure of a French version of the Digital Natives Assessment Scale (DNAS). The sample of this study includes 590 participants from a 6-week massive open online course and from Web sites, electronic forums, and social networks. The DNAS was translated in French and then back-translated to English. A principal component analysis with orthogonal rotation followed by a confirmatory factorial analysis showed that a 15-item four-correlated component model provided the best fit for the data of our sample. Factor structure of this French-translated version of the DNAS was rather similar than those found in earlier studies. This study provides evidence of the DNAS robustness through cross-cultural and cross-generational validation. The French version of the DNAS appears to be appropriate as a quick and effective questionnaire to assess digital natives. More studies are needed to better define further features of this particular group.

Geriatric assessment factors are associated with mortality after hospitalization in older adults with cancer.

PubMed

Jonna, Sushma; Chiang, Leslie; Liu, Jingxia; Carroll, Maria B; Flood, Kellie; Wildes, Tanya M

2016-11-01

Survival in older adults with cancer varies given differences in functional status, comorbidities, and nutrition. Prediction of factors associated with mortality, especially in hospitalized patients, allows physicians to better inform their patients about prognosis during treatment decisions. Our objective was to analyze factors associated with survival in older adults with cancer following hospitalization. Through a retrospective cohort study, we reviewed 803 patients who were admitted to Barnes-Jewish Hospital's Oncology Acute Care of Elders (OACE) unit from 2000 to 2008. Data collected included geriatric assessments from OACE screening questionnaires as well as demographic and medical history data from chart review. The primary end point was time from index admission to death. The Cox proportional hazard modeling was performed. The median age was 72.5 years old. Geriatric syndromes and functional impairment were common. Half of the patients (50.4 %) were dependent in one or more activities of daily living (ADLs), and 74 % were dependent in at least one instrumental activity of daily living (IADLs). On multivariate analysis, the following factors were significantly associated with worse overall survival: male gender; a total score <20 on Lawton's IADL assessment; reason for admission being cardiac, pulmonary, neurologic, inadequate pain control, or failure to thrive; cancer type being thoracic, hepatobiliary, or genitourinary; readmission within 30 days; receiving cancer treatment with palliative rather than curative intent; cognitive impairment; and discharge with hospice services. In older adults with cancer, certain geriatric parameters are associated with shorter survival after hospitalization. Assessment of functional status, necessity for readmission, and cognitive impairment may provide prognostic information so that oncologists and their patients make more informed, individualized decisions.

Falls risk assessment outcomes and factors associated with falls for older Indigenous Australians.

PubMed

Hill, Keith D; Flicker, Leon; LoGiudice, Dina; Smith, Kate; Atkinson, David; Hyde, Zoë; Fenner, Stephen; Skeaf, Linda; Malay, Roslyn; Boyle, Eileen

2016-12-01

To describe the prevalence of falls and associated risk factors in older Indigenous Australians, and compare the accuracy of validated falls risk screening and assessment tools in this population in classifying fall status. Cross-sectional study of 289 Indigenous Australians aged ≥45 years from the Kimberley region of Western Australia who had a detailed assessment including self-reported falls in the past year (n=289), the adapted Elderly Falls Screening Tool (EFST; n=255), and the Falls Risk for Older People-Community (FROP-Com) screening tool (3 items, n=74) and FROP-Com falls assessment tool (n=74). 32% of participants had ≥1 fall in the preceding year, and 37.3% were classified high falls risk using the EFST (cut-off ≥2). In contrast, for the 74 participants assessed with the FROP-Com, only 14.9% were rated high risk, 35.8% moderate risk, and 49.3% low risk. The FROP-Com screen and assessment tools had the highest classification accuracy for identifying fallers in the preceding year (area under curve >0.85), with sensitivity/specificity highest for the FROP-Com assessment (cut-off ≥12), sensitivity=0.84 and specificity=0.73. Falls are common in older Indigenous Australians. The FROP-Com falls risk assessment tool appears useful in this population, and this research suggests changes that may improve its utility further. © 2016 Public Health Association of Australia.

Primary prophylaxis for children with severe congenital factor VII deficiency - Clinical and laboratory assessment.

PubMed

Kuperman, A A; Barg, A A; Fruchtman, Y; Shaoul, E; Rosenberg, N; Kenet, G; Livnat, T

2017-09-01

Severe congenital factor VII (FVII) deficiency is a rare bleeding disorder. Prophylaxis with replacement therapy has been suggested to patients, yet the most beneficial dosing regimens and therapy intervals are still to be defined. Due to the lack of evidence-based data, we hereby present our experience with long-term administration and monitoring primary prophylaxis in children with severe FVII deficiency and an extremely high bleeding risk. Four children with familial FVII deficiency, treated by prophylactic recombinant activated factor VII (rFVIIa), 15-30μg/kg/dose, given 2-3 times weekly since infancy, are discussed. Clinical follow up and monitoring laboratory assays, including thrombin generation, measured at various time points after prophylactic rFVIIa administration are presented. Among our treated patients neither FVII activity nor thrombin generation parameters (both already declined 24h post rFVIIa administration) were able to predict the impact of prophylaxis, and could not be used as surrogate markers in order to assess the most beneficial treatment frequency. However, the long clinical follow-up and comprehensive laboratory assessment performed, have shown that early primary prophylaxis as administered in our cohort was safe and effective. Copyright © 2016 Elsevier Inc. All rights reserved.

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I - Assessment and Management of Various Cardiovascular Risk Factors.

PubMed

Wang, Angela Yee Moon; Brimble, K Scott; Brunier, Gillian; Holt, Stephen G; Jha, Vivekanand; Johnson, David W; Kang, Shin-Wook; Kooman, Jeroen P; Lambie, Mark; McIntyre, Chris; Mehrotra, Rajnish; Pecoits-Filho, Roberto

2015-01-01

Cardiovascular disease contributes significantly to the adverse clinical outcomes of peritoneal dialysis (PD) patients. Numerous cardiovascular risk factors play important roles in the development of various cardiovascular complications. Of these, loss of residual renal function is regarded as one of the key cardiovascular risk factors and is associated with an increased mortality and cardiovascular death. It is also recognized that PD solutions may incur significant adverse metabolic effects in PD patients. The International Society for Peritoneal Dialysis (ISPD) commissioned a global workgroup in 2012 to formulate a series of recommendations regarding lifestyle modification, assessment and management of various cardiovascular risk factors, as well as management of the various cardiovascular complications including coronary artery disease, heart failure, arrhythmia (specifically atrial fibrillation), cerebrovascular disease, peripheral arterial disease and sudden cardiac death, to be published in 2 guideline documents. This publication forms the first part of the guideline documents and includes recommendations on assessment and management of various cardiovascular risk factors. The documents are intended to serve as a global clinical practice guideline for clinicians who look after PD patients. The ISPD workgroup also identifies areas where evidence is lacking and further research is needed. Copyright © 2015 International Society for Peritoneal Dialysis.

Zebrafish Caudal Fin Angiogenesis Assay—Advanced Quantitative Assessment Including 3-Way Correlative Microscopy

PubMed Central

Correa Shokiche, Carlos; Schaad, Laura; Triet, Ramona; Jazwinska, Anna; Tschanz, Stefan A.; Djonov, Valentin

2016-01-01

Background Researchers evaluating angiomodulating compounds as a part of scientific projects or pre-clinical studies are often confronted with limitations of applied animal models. The rough and insufficient early-stage compound assessment without reliable quantification of the vascular response counts, at least partially, to the low transition rate to clinics. Objective To establish an advanced, rapid and cost-effective angiogenesis assay for the precise and sensitive assessment of angiomodulating compounds using zebrafish caudal fin regeneration. It should provide information regarding the angiogenic mechanisms involved and should include qualitative and quantitative data of drug effects in a non-biased and time-efficient way. Approach & Results Basic vascular parameters (total regenerated area, vascular projection area, contour length, vessel area density) were extracted from in vivo fluorescence microscopy images using a stereological approach. Skeletonization of the vasculature by our custom-made software Skelios provided additional parameters including “graph energy” and “distance to farthest node”. The latter gave important insights into the complexity, connectivity and maturation status of the regenerating vascular network. The employment of a reference point (vascular parameters prior amputation) is unique for the model and crucial for a proper assessment. Additionally, the assay provides exceptional possibilities for correlative microscopy by combining in vivo-imaging and morphological investigation of the area of interest. The 3-way correlative microscopy links the dynamic changes in vivo with their structural substrate at the subcellular level. Conclusions The improved zebrafish fin regeneration model with advanced quantitative analysis and optional 3-way correlative morphology is a promising in vivo angiogenesis assay, well-suitable for basic research and preclinical investigations. PMID:26950851

Landslides geotechnical analysis. Qualitative assessment by valuation factors

NASA Astrophysics Data System (ADS)

Cuanalo Oscar, Sc D.; Oliva Aldo, Sc D.; Polanco Gabriel, M. E.

2012-04-01

In general, a landslide can cause a disaster when it is combined a number of factors such as an extreme event related to a geological phenomenon, vulnerable elements exposed in a specific geographic area, and the probability of loss and damage evaluated in terms of lives and economic assets, in a certain period of time. This paper presents the qualitative evaluation of slope stability through of Valuation Factors, obtained from the characterization of the determinants and triggers factors that influence the instability; for the first the morphology and topography, geology, soil mechanics, hydrogeology and vegetation to the second, the rain, earthquakes, erosion and scour, human activity, and ultimately dependent factors of the stability analysis, and its influence ranges which greatly facilitate the selection of construction processes best suited to improve the behavior of a slope or hillside. The Valuation Factors are a set of parameters for assessing the influence of conditioning and triggering factors that influence the stability of slopes and hillsides. The characteristics of each factor must be properly categorized to involve its effect on behavior; a way to do this is by assigning a weighted value range indicating its effect on the stability of a slope. It is proposed to use Valuation Factors with weighted values between 0 and 1 (arbitrarily selected but common sense and logic), the first corresponds to no or minimal effect on stability (no effect or very little influence) and the second, the greatest impact on it (has a significant influence). The meddle effects are evaluated with intermediate values.

Fuzzy comprehensive evaluation of multiple environmental factors for swine building assessment and control.

PubMed

Xie, Qiuju; Ni, Ji-Qin; Su, Zhongbin

2017-10-15

In confined swine buildings, temperature, humidity, and air quality are all important for animal health and productivity. However, the current swine building environmental control is only based on temperature; and evaluation and control methods based on multiple environmental factors are needed. In this paper, fuzzy comprehensive evaluation (FCE) theory was adopted for multi-factor assessment of environmental quality in two commercial swine buildings using real measurement data. An assessment index system and membership functions were established; and predetermined weights were given using analytic hierarchy process (AHP) combined with knowledge of experts. The results show that multi-factors such as temperature, humidity, and concentrations of ammonia (NH 3 ), carbon dioxide (CO 2 ), and hydrogen sulfide (H 2 S) can be successfully integrated in FCE for swine building environment assessment. The FCE method has a high correlation coefficient of 0.737 compared with the method of single-factor evaluation (SFE). The FCE method can significantly increase the sensitivity and perform an effective and integrative assessment. It can be used as part of environmental controlling and warning systems for swine building environment management to improve swine production and welfare. Copyright © 2017 Elsevier B.V. All rights reserved.

Internal and External Factors Affecting Teachers' Adoption of Formative Assessment to Support Learning

ERIC Educational Resources Information Center

Izci, Kemal

2016-01-01

Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student's learning gain and motivation. However, teachers rarely use assessment formatively to aid their students' learning. Thus reviewing the factors that limit or support teachers' practices of…

Internal and External Factors Affecting Teachers' Adoption of Formative Assessment to Support Learning

ERIC Educational Resources Information Center

Izci, Kemal

2016-01-01

Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student's learning gain and motivation. However, teachers rarely use assessment formatively to aid their students' learning. Thus, reviewing the factors that limit or support teachers' practices of…

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders

PubMed Central

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-01-01

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders. PMID:28587226

National Assessment of Data Quality and Associated Systems-Level Factors in Malawi

PubMed Central

O'Hagan, Richael; Marx, Melissa A; Finnegan, Karen E; Naphini, Patrick; Ng'ambi, Kumbukani; Laija, Kingsley; Wilson, Emily; Park, Lois; Wachepa, Sautso; Smith, Joseph; Gombwa, Lewis; Misomali, Amos; Mleme, Tiope; Yosefe, Simeon

2017-01-01

ABSTRACT Background: Routine health data can guide health systems improvements, but poor quality of these data hinders use. To address concerns about data quality in Malawi, the Ministry of Health and National Statistical Office conducted a data quality assessment (DQA) in July 2016 to identify systems-level factors that could be improved. Methods: We used 2-stage stratified random sampling methods to select health centers and hospitals under Ministry of Health auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police and military facilities, tertiary-level hospitals, and private facilities were excluded. We reviewed client registers and monthly reports to verify availability, completeness, and accuracy of data in 4 service areas: antenatal care (ANC), family planning, HIV testing and counseling, and acute respiratory infection (ARI). We also conducted interviews with facility and district personnel to assess health management information system (HMIS) functioning and systems-level factors that may be associated with data quality. We compared systems and quality factors by facility characteristics using 2-sample t tests with Welch's approximation, and calculated verification ratios comparing total entries in registers to totals from summarized reports. Results: We selected 16 hospitals (of 113 total in Malawi), 90 health centers (of 466), and 16 district health offices (of 28) in 16 of Malawi's 28 districts. Nearly all registers were available and complete in health centers and district hospitals, but data quality varied across service areas; median verification ratios comparing register and report totals at health centers ranged from 0.78 (interquartile range [IQR]: 0.25, 1.07) for ARI and 0.99 (IQR: 0.82, 1.36) for family planning to 1.00 (IQR: 0.96, 1.00) for HIV testing and counseling and 1.00 (IQR: 0.80, 1.23) for ANC. More than half (60%) of facilities reported receiving a documented supervisory visit for

A systematic way to assess compliance with human factors standards

DOT National Transportation Integrated Search

1996-01-01

Assessing the human factors : considerations associated : with the design or : evaluation of any major : new system can be a formidable challenge. : To make this more manageable, : the Federal Aviation Administrations : (FAA) Office of the Chief S...

Using clinical vignettes to assess doctors' and medical students' ability to identify sociocultural factors affecting health and health care.

PubMed

Hudelson, Patricia; Perron, N Junod; Perneger, Thomas

2011-01-01

Methods are needed for assessing clinicians' cultural knowledge frameworks. We used a mail survey containing four short clinical vignettes to explore respondents' ability to identify sociocultural factors affecting health and health care. Participants included 299 physicians working at the University Hospitals of Geneva, 156 private physicians, and all 134 local medical students in their clinical years. Twenty-one sociocultural "domains" were identified through inductive coding of responses. For each vignette, we obtained the sum of codes as a measure of the respondent's awareness of sociocultural factors that might affect care in this particular situation. As internal consistency was reasonably high (0.68), we computed a single total score as the sum of responses given to all four vignettes. Reponses correlated with factors that might be expected to impact clinicians' awareness of sociocultural factors affecting care. Medical students, females, respondents who had received cultural competence training, those with greater interest in caring for immigrant patients, and those with high self-assessed skills at exploring psychosocial and migration-related issues scored higher on the vignettes. Brief clinical vignettes appear to be a relevant and feasible method for exploring physicians' knowledge of social and cultural factors affecting health and health care.

A global call for action to include gender in research impact assessment.

PubMed

Ovseiko, Pavel V; Greenhalgh, Trisha; Adam, Paula; Grant, Jonathan; Hinrichs-Krapels, Saba; Graham, Kathryn E; Valentine, Pamela A; Sued, Omar; Boukhris, Omar F; Al Olaqi, Nada M; Al Rahbi, Idrees S; Dowd, Anne-Maree; Bice, Sara; Heiden, Tamika L; Fischer, Michael D; Dopson, Sue; Norton, Robyn; Pollitt, Alexandra; Wooding, Steven; Balling, Gert V; Jakobsen, Ulla; Kuhlmann, Ellen; Klinge, Ineke; Pololi, Linda H; Jagsi, Reshma; Smith, Helen Lawton; Etzkowitz, Henry; Nielsen, Mathias W; Carrion, Carme; Solans-Domènech, Maite; Vizcaino, Esther; Naing, Lin; Cheok, Quentin H N; Eckelmann, Baerbel; Simuyemba, Moses C; Msiska, Temwa; Declich, Giovanna; Edmunds, Laurel D; Kiparoglou, Vasiliki; Buchan, Alison M J; Williamson, Catherine; Lord, Graham M; Channon, Keith M; Surender, Rebecca; Buchan, Alastair M

2016-07-19

Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action.

Risky Business: Factor Analysis of Survey Data – Assessing the Probability of Incorrect Dimensionalisation

PubMed Central

van der Eijk, Cees; Rose, Jonathan

2015-01-01

This paper undertakes a systematic assessment of the extent to which factor analysis the correct number of latent dimensions (factors) when applied to ordered-categorical survey items (so-called Likert items). We simulate 2400 data sets of uni-dimensional Likert items that vary systematically over a range of conditions such as the underlying population distribution, the number of items, the level of random error, and characteristics of items and item-sets. Each of these datasets is factor analysed in a variety of ways that are frequently used in the extant literature, or that are recommended in current methodological texts. These include exploratory factor retention heuristics such as Kaiser’s criterion, Parallel Analysis and a non-graphical scree test, and (for exploratory and confirmatory analyses) evaluations of model fit. These analyses are conducted on the basis of Pearson and polychoric correlations. We find that, irrespective of the particular mode of analysis, factor analysis applied to ordered-categorical survey data very often leads to over-dimensionalisation. The magnitude of this risk depends on the specific way in which factor analysis is conducted, the number of items, the properties of the set of items, and the underlying population distribution. The paper concludes with a discussion of the consequences of over-dimensionalisation, and a brief mention of alternative modes of analysis that are much less prone to such problems. PMID:25789992

Reliability and maintainability assessment factors for reliable fault-tolerant systems

NASA Technical Reports Server (NTRS)

Bavuso, S. J.

1984-01-01

A long term goal of the NASA Langley Research Center is the development of a reliability assessment methodology of sufficient power to enable the credible comparison of the stochastic attributes of one ultrareliable system design against others. This methodology, developed over a 10 year period, is a combined analytic and simulative technique. An analytic component is the Computer Aided Reliability Estimation capability, third generation, or simply CARE III. A simulative component is the Gate Logic Software Simulator capability, or GLOSS. The numerous factors that potentially have a degrading effect on system reliability and the ways in which these factors that are peculiar to highly reliable fault tolerant systems are accounted for in credible reliability assessments. Also presented are the modeling difficulties that result from their inclusion and the ways in which CARE III and GLOSS mitigate the intractability of the heretofore unworkable mathematics.

An Exploratory Investigation of the Factor Structure of the Reynolds Intellectual Assessment Scales (RIAS)

ERIC Educational Resources Information Center

Dombrowski, Stefan C.; Watkins, Marley W.; Brogan, Michael J.

2009-01-01

This study investigated the factor structure of the Reynolds Intellectual Assessment Scales (RIAS) using rigorous exploratory factor analytic and factor extraction procedures. The results of this study indicate that the RIAS is a single factor test. Despite these results, higher order factor analysis using the Schmid-Leiman procedure indicates…

General Factors of the Korean Exposure Factors Handbook

PubMed Central

Kim, So-Yeon; Kim, Sun-Ja; Lee, Kyung-Eun; Cheong, Hae-Kwan; Kim, Eun-Hye; Choi, Kyung-Ho; Kim, Young-Hee

2014-01-01

Risk assessment considers the situations and characteristics of the exposure environment and host. Various physiological variables of the human body reflects the characteristics of the population that can directly influence risk exposure. Therefore, identification of exposure factors based on the Korean population is required for appropriate risk assessment. It is expected that a handbook about general exposure factors will be used by professionals in many fields as well as the risk assessors of the health department. The process of developing the exposure factors handbook for the Korean population will be introduced in this article, with a specific focus on the general exposure factors including life expectancy, body weight, surface area, inhalation rates, amount of water intake, and soil ingestion targeting the Korean population. The researchers used national databases including the Life Table and the 2005 Time Use Survey from the National Statistical Office. The anthropometric study of size in Korea used the resources provided by the Korean Agency for Technology and Standards. In addition, direct measurement and questionnaire surveys of representative samples were performed to calculate the inhalation rate, drinking water intake, and soil ingestion. PMID:24570802

Cultural factors affecting the differential performance of Israeli and Palestinian children on the Loewenstein Occupational Therapy Cognitive Assessment.

PubMed

Josman, Naomi; Abdallah, Taisir M; Engel-Yeger, Batya

2010-01-01

Cognitive performance is essential for children's functioning and may also predict school readiness. The suitability of Western standardized assessments for cognitive performance among children from different cultures needs to be elaborated. This study referred to the existence of differences in cognitive performance between and within children from the middle-east-Israeli and Palestinian on the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), by elucidating cultural effects on the construct validity of the LOTCA using factor analysis. Participants included 101 Israeli and 125 Palestinian children from kindergarten, first and second grade who underwent the LOTCA. Factor analysis revealed four factors underlying items on the LOTCA, explaining the differences found between Israeli and Palestinian children in most of LOTCA subtests. Culture may affect the construct validity of the LOTCA and may explain the difference in performance between both cultural groups. LOTCA's validity as well as the validity of other instruments on which norms and decisions regarding the child's development and performance are made should be further evaluated among children from different cultural backgrounds. 2010 Elsevier Ltd. All rights reserved.

The reasons for betel-quid chewing scale: assessment of factor structure, reliability, and validity.

PubMed

Little, Melissa A; Pokhrel, Pallav; Murphy, Kelle L; Kawamoto, Crissy T; Suguitan, Gil S; Herzog, Thaddeus A

2014-06-03

Despite the fact that betel-quid is one of the most commonly used psychoactive substances worldwide and a major risk-factor for head-and-neck cancer incidence and mortality globally, currently no standardized instrument is available to assess the reasons why individuals chew betel-quid. A measure to assess reasons for chewing betel-quid could help researchers and clinicians develop prevention and treatment strategies. In the current study, we sought to develop and evaluate a self-report instrument for assessing the reasons for chewing betel quid which contributes toward the goal of developing effective interventions to reduce betel quid chewing in vulnerable populations. The current study assessed the factor structure, reliability and convergent validity of the Reasons for Betel-quid Chewing Scale (RBCS), a newly developed 10 item measure adapted from several existing "reasons for smoking" scales. The measure was administered to 351 adult betel-quid chewers in Guam. Confirmatory factor analysis of this measure revealed a three factor structure: reinforcement, social/cultural, and stimulation. Further tests revealed strong support for the internal consistency and convergent validity of this three factor measure. The goal of designing an intervention to reduce betel-quid chewing necessitates an understanding of why chewers chew; the current study makes considerable contributions towards that objective.

Factors Considered by Vocational Rehabilitation Professionals in Employability and Earning Capacity Assessment

ERIC Educational Resources Information Center

Williams, John M.; Dunn, Patrick L.; Bast, Steve; Giesen, Judy

2006-01-01

The purpose of this study was to identify the factors that contributed to vocational rehabilitation assessment of earning capacity. Rehabilitation professionals who attended a national forensic rehabilitation conference were asked to rate the importance of 26 variables in development of opinions of earning capacity. Exploratory factor analysis…

An Assessment of Factors Relating to High School Students' Science Self-Efficacy

NASA Astrophysics Data System (ADS)

Gibson, Jakeisha Jamice

This mixed-methods case study examined two out-of-school (OST) Science, Technology, Engineering and Math (STEM) programs at a science-oriented high school on students' Self-Efficacy. Because STEM is a key for future innovation and economic growth, Americans have been developing a variety of approaches to increase student interest in science within the school curriculum and in OST programs. Nationwide, many OST programs are offered for students but few have engaged in an in-depth assessment. This study included an assessment of two different types of OST programs and direct observations by the researcher. This study involved two advisors (one male, one female), 111 students, and their parents during 2016. Student participants completed two standardized surveys, one to determine their Science Self-Efficacy and another to assess their engagement in science during their OST programs. Parents described their parental involvement and their child's interest in the OST program(s). The OST program advisors participated in lengthy interviews. Additionally, the advisors rated their perceived interest level of the enrolled students and recorded attendance data. Bandura's Social Cognitive Theory (1997a) provided the theoretical framework. This theory describes the multidirectional influence of behavioral factors, personal factors, and environmental factors have on a student's Self-Efficacy. Compiled data from the teachers, students, and parents were used to determine the relationship of selected variables on Science Self-Efficacy of students. A correlational analysis revealed that students who participated in these OST programs possessed a high Mindset for the Enjoyment of science and that teacher ratings were also positively correlated to Mindset and Enjoyment of Science. Descriptive analyses showed that (a) girls who chose to participate in these OST programs possessed higher school grades in their in-school coursework than boys, (b) that parents of girls participated in more

Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

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

HCTT-CHE

The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthenmore » existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.« less

Online assessment of risk factors for dementia and cognitive function in healthy adults.

PubMed

Huntley, J; Corbett, A; Wesnes, K; Brooker, H; Stenton, R; Hampshire, A; Ballard, C

2018-02-01

Several potentially modifiable risk factors for cognitive decline and dementia have been identified, including low educational attainment, smoking, diabetes, physical inactivity, hypertension, midlife obesity, depression, and perceived social isolation. Managing these risk factors in late midlife and older age may help reduce the risk of dementia; however, it is unclear whether these factors also relate to cognitive performance in older individuals without dementia. Data from 14 201 non-demented individuals aged >50 years who enrolled in the online PROTECT study were used to examine the relationship between cognitive function and known modifiable risk factors for dementia. Multivariate regression analyses were conducted on 4 cognitive outcomes assessing verbal and spatial working memory, visual episodic memory, and verbal reasoning. Increasing age was associated with reduced performance across all tasks. Higher educational achievement, the presence of a close confiding relationship, and moderate alcohol intake were associated with benefits across all 4 cognitive tasks, and exercise was associated with better performance on verbal reasoning and verbal working memory tasks. A diagnosis of depression was negatively associated with performance on visual episodic memory and working memory tasks, whereas being underweight negatively affected performance on all tasks apart from verbal working memory. A history of stroke was negatively associated with verbal reasoning and working memory performance. Known modifiable risk factors for dementia are associated with cognitive performance in non-demented individuals in late midlife and older age. This provides further support for public health interventions that seek to manage these risk factors across the lifespan. Copyright © 2017 John Wiley & Sons, Ltd.

A new instrument to assess physician skill at thoracic ultrasound, including pleural effusion markup.

PubMed

Salamonsen, Matthew; McGrath, David; Steiler, Geoff; Ware, Robert; Colt, Henri; Fielding, David

2013-09-01

To reduce complications and increase success, thoracic ultrasound is recommended to guide all chest drainage procedures. Despite this, no tools currently exist to assess proceduralist training or competence. This study aims to validate an instrument to assess physician skill at performing thoracic ultrasound, including effusion markup, and examine its validity. We developed an 11-domain, 100-point assessment sheet in line with British Thoracic Society guidelines: the Ultrasound-Guided Thoracentesis Skills and Tasks Assessment Test (UGSTAT). The test was used to assess 22 participants (eight novices, seven intermediates, seven advanced) on two occasions while performing thoracic ultrasound on a pleural effusion phantom. Each test was scored by two blinded expert examiners. Validity was examined by assessing the ability of the test to stratify participants according to expected skill level (analysis of variance) and demonstrating test-retest and intertester reproducibility by comparison of repeated scores (mean difference [95% CI] and paired t test) and the intraclass correlation coefficient. Mean scores for the novice, intermediate, and advanced groups were 49.3, 73.0, and 91.5 respectively, which were all significantly different (P < .0001). There were no significant differences between repeated scores. Procedural training on mannequins prior to unsupervised performance on patients is rapidly becoming the standard in medical education. This study has validated the UGSTAT, which can now be used to determine the adequacy of thoracic ultrasound training prior to clinical practice. It is likely that its role could be extended to live patients, providing a way to document ongoing procedural competence.

Trends in burnout syndrome and emotional factors: an assessment of anesthesiologists in Southern Brazil, 2012.

PubMed

Freire, Patrícia Larrosa; Trentin, Jessica Puchalski; de Avila Quevedo, Luciana

2016-06-01

Burnout syndrome (BOS) is the result of chronic stress at work, and is characterized by emotional exhaustion (EE), depersonalization (DP), and low professional accomplishment. Anesthesiologyis a stressful profession. The aim of this study was to assess the prevalence of burnout as well as the sociodemographic and working characteristics associated with this syndrome's emotional factors, in anesthesiologists from Southern Brazil. We assessed burnout severity, depressive symptoms, and self-esteem using the Maslach burnout inventory, the Beck depression inventory, and the Rosenberg self-esteem scale, respectively. Of the 198 anesthesiologists included in this study, 48.7% were positive for burnout, 26.9% for EE, 41.3% for DP and 32.7% for low personal accomplishment. Trends in BOS was associated with a younger age, difficulty to conciliate family and work demands, low self-esteem, and depressive symptoms.

Standardized assessment of psychosocial factors and their influence on medically confirmed health outcomes in workers: a systematic review.

PubMed

Rosário, Susel; Fonseca, João A; Nienhaus, Albert; da Costa, José Torres

2016-01-01

Previous studies of psychosocial work factors have indicated their importance for workers' health. However, to what extent health problems can be attributed to the nature of the work environment or other psychosocial factors is not clear. No previous systematic review has used inclusion criteria based on specific medical evaluation of work-related health outcomes and the use of validated instruments for the assessment of the psychosocial (work) environment. The aim of this systematic review is to summarize the evidence assessing the relationship between the psychosocial work environment and workers' health based on studies that used standardized and validated instruments to assess the psychosocial work environment and that focused on medically confirmed health outcomes. A systematic review of the literature was carried out by searching the databases PubMed, B-ON, Science Direct, Psycarticles, Psychology and Behavioral Sciences Collection and the search engine (Google Scholar) using appropriate words for studies published from 2004 to 2014. This review follows the recommendations of the Statement for Reporting Systematic Reviews (PRISMA). Studies were included in the review if data on psychosocial validated assessment method(s) for the study population and specific medical evaluation of health-related work outcome(s) were presented. In total, the search strategy yielded 10,623 references, of which 10 studies (seven prospective cohort and three cross-sectional) met the inclusion criteria. Most studies (7/10) observed an adverse effect of poor psychosocial work factors on workers' health: 3 on sickness absence, 4 on cardiovascular diseases. The other 3 studies reported detrimental effects on sleep and on disease-associated biomarkers. A more consistent effect was observed in studies of higher methodological quality that used a prospective design jointly with the use of validated instruments for the assessment of the psychosocial (work) environment and clinical

Uncertainty factors in screening ecological risk assessments

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

Duke, L.D.; Taggart, M.

2000-06-01

The hazard quotient (HQ) method is commonly used in screening ecological risk assessments (ERAs) to estimate risk to wildlife at contaminated sites. Many ERAs use uncertainty factors (UFs) in the HQ calculation to incorporate uncertainty associated with predicting wildlife responses to contaminant exposure using laboratory toxicity data. The overall objective was to evaluate the current UF methodology as applied to screening ERAs in California, USA. Specific objectives included characterizing current UF methodology, evaluating the degree of conservatism in UFs as applied, and identifying limitations to the current approach. Twenty-four of 29 evaluated ERAs used the HQ approach: 23 of thesemore » used UFs in the HQ calculation. All 24 made interspecies extrapolations, and 21 compensated for its uncertainty, most using allometric adjustments and some using RFs. Most also incorporated uncertainty for same-species extrapolations. Twenty-one ERAs used UFs extrapolating from lowest observed adverse effect level (LOAEL) to no observed adverse effect level (NOAEL), and 18 used UFs extrapolating from subchronic to chronic exposure. Values and application of all UF types were inconsistent. Maximum cumulative UFs ranged from 10 to 3,000. Results suggest UF methodology is widely used but inconsistently applied and is not uniformly conservative relative to UFs recommended in regulatory guidelines and academic literature. The method is limited by lack of consensus among scientists, regulators, and practitioners about magnitudes, types, and conceptual underpinnings of the UF methodology.« less

Assessing an organizational culture instrument based on the Competing Values Framework: Exploratory and confirmatory factor analyses

PubMed Central

Helfrich, Christian D; Li, Yu-Fang; Mohr, David C; Meterko, Mark; Sales, Anne E

2007-01-01

Background The Competing Values Framework (CVF) has been widely used in health services research to assess organizational culture as a predictor of quality improvement implementation, employee and patient satisfaction, and team functioning, among other outcomes. CVF instruments generally are presented as well-validated with reliable aggregated subscales. However, only one study in the health sector has been conducted for the express purpose of validation, and that study population was limited to hospital managers from a single geographic locale. Methods We used exploratory and confirmatory factor analyses to examine the underlying structure of data from a CVF instrument. We analyzed cross-sectional data from a work environment survey conducted in the Veterans Health Administration (VHA). The study population comprised all staff in non-supervisory positions. The survey included 14 items adapted from a popular CVF instrument, which measures organizational culture according to four subscales: hierarchical, entrepreneurial, team, and rational. Results Data from 71,776 non-supervisory employees (approximate response rate 51%) from 168 VHA facilities were used in this analysis. Internal consistency of the subscales was moderate to strong (α = 0.68 to 0.85). However, the entrepreneurial, team, and rational subscales had higher correlations across subscales than within, indicating poor divergent properties. Exploratory factor analysis revealed two factors, comprising the ten items from the entrepreneurial, team, and rational subscales loading on the first factor, and two items from the hierarchical subscale loading on the second factor, along with one item from the rational subscale that cross-loaded on both factors. Results from confirmatory factor analysis suggested that the two-subscale solution provides a more parsimonious fit to the data as compared to the original four-subscale model. Conclusion This study suggests that there may be problems applying conventional

Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

NASA Astrophysics Data System (ADS)

Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

2017-08-01

This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

The factors related to self-other agreement/disagreement in nursing competence assessment: Comparative and correlational study.

PubMed

Takase, Miyuki; Yamamoto, Masako; Sato, Yoko

2018-04-01

While assessment made by nurses of themselves (self-assessment) and assessment made of them by others (other-assessment) provide unique and valuable information as to individual nurses' competence, the subjective nature of both assessments often causes a disagreement between them. This is problematic when educational interventions to foster nurses' competence are designed. However, the question of what factors contribute to the self-other disagreement in competence assessment has rarely been investigated in nursing. The aims of this study were to compare competence assessments made by nurses with that by others, and to investigate what types of demographic variables of nurses and others, and which personality traits of nurses were associated with the self-other agreement/disagreement in the competence assessment. A cross-sectional survey design. Three hospitals in Japan. A total of 1167 registered nurses, who were practising in these three hospitals, were invited to participate in the study. The inclusion criteria of the participants were as follows: 1) currently working in an inpatient department, and 2) directly involved in patient care. The survey package included two sets of questionnaires: one for self-assessment and the other for other-assessment, each of which was accompanied by an ID number for matching. Collected data were analysed using a Wilcoxon signed-rank test to compare the scores on competence assessed by nurses and others, and using multiple regression to examine the relationships between the demographics, personality traits, and the degree of self-other disagreement. A total of 207 matched questionnaires were obtained. The results showed that the scores on the assessment made by others were statistically significantly higher than those made by nurses of themselves. Moreover, regression analysis suggested that the age of nurses (i.e., younger nurses) and that of others (i.e., older evaluators), and nurses' personality traits of conscientiousness

The reasons for betel-quid chewing scale: assessment of factor structure, reliability, and validity

PubMed Central

2014-01-01

Background Despite the fact that betel-quid is one of the most commonly used psychoactive substances worldwide and a major risk-factor for head-and-neck cancer incidence and mortality globally, currently no standardized instrument is available to assess the reasons why individuals chew betel-quid. A measure to assess reasons for chewing betel-quid could help researchers and clinicians develop prevention and treatment strategies. In the current study, we sought to develop and evaluate a self-report instrument for assessing the reasons for chewing betel quid which contributes toward the goal of developing effective interventions to reduce betel quid chewing in vulnerable populations. Methods The current study assessed the factor structure, reliability and convergent validity of the Reasons for Betel-quid Chewing Scale (RBCS), a newly developed 10 item measure adapted from several existing “reasons for smoking” scales. The measure was administered to 351 adult betel-quid chewers in Guam. Results Confirmatory factor analysis of this measure revealed a three factor structure: reinforcement, social/cultural, and stimulation. Further tests revealed strong support for the internal consistency and convergent validity of this three factor measure. Conclusion The goal of designing an intervention to reduce betel-quid chewing necessitates an understanding of why chewers chew; the current study makes considerable contributions towards that objective. PMID:24889863

Assessing suicide risk among callers to crisis hotlines: a confirmatory factor analysis.

PubMed

Witte, Tracy K; Gould, Madelyn S; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie; Joiner, Thomas E; Kalafat, John

2010-09-01

Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. We conducted an Exploratory Factor Analysis (EFA), an EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and a CFA on independent subsamples derived from a total sample of 1,085. Similar to previous studies, we found consistent evidence for a two-factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations; RPP) and one factor representing milder suicidal ideation (i.e., Suicidal Desire and Ideation; SDI). The RPP factor trended toward being more predictive of suicidal ideation at follow-up than the SDI factor. (c) 2010 Wiley Periodicals, Inc.

Trait-based assessment of borderline personality disorder using the NEO Five-Factor Inventory: Phenotypic and genetic support

PubMed Central

Few, Lauren R.; Miller, Joshua D.; Grant, Julia D.; Maples, Jessica; Trull, Timothy J.; Nelson, Elliot C.; Oltmanns, Thomas F.; Martin, Nicholas G.; Lynskey, Michael T.; Agrawal, Arpana

2015-01-01

The aim of the current study was to examine the reliability and validity of a trait-based assessment of borderline personality disorder (BPD) using the NEO Five-Factor Inventory. Correlations between the Five-Factor Inventory-BPD composite (FFI-BPD) and explicit measures of BPD were examined across six samples, including undergraduate, community, and clinical samples. The median correlation was .60, which was nearly identical to the correlation between measures of BPD and a BPD composite generated from the full Revised NEO Personality Inventory (i.e., NEO-BPD; r =.61). Correlations between FFI-BPD and relevant measures of psychiatric symptomatology and etiology (e.g., childhood abuse, drug use, depression, and personality disorders) were also examined and compared to those generated using explicit measures of BPD and NEO-BPD. As expected, the FFI-BPD composite correlated most strongly with measures associated with high levels of Neuroticism, such as depression, anxiety, and emotion dysregulation, and the pattern of correlations generated using the FFI-BPD was highly similar to those generated using explicit measures of BPD and NEO-BPD. Finally, genetic analyses estimated that FFI-BPD is 44% heritable, which is comparable to meta-analytic research examining genetics associated with BPD, and revealed that 71% of the genetic influences are shared between FFI-BPD and a self-report measure assessing BPD (Personality Assessment Inventory – Borderline subscale; Morey, 1991). Generally, these results support the use of FFI-BPD as a reasonable proxy for BPD, which has considerable implications, particularly for potential gene-finding efforts in large, epidemiological datasets that include the NEO FFI. PMID:25984635

Trait-based assessment of borderline personality disorder using the NEO Five-Factor Inventory: Phenotypic and genetic support.

PubMed

Few, Lauren R; Miller, Joshua D; Grant, Julia D; Maples, Jessica; Trull, Timothy J; Nelson, Elliot C; Oltmanns, Thomas F; Martin, Nicholas G; Lynskey, Michael T; Agrawal, Arpana

2016-01-01

[Correction Notice: An Erratum for this article was reported in Vol 28(1) of Psychological Assessment (see record 2015-54029-001). The FFI-BPD values for Sample 3 in Table 2 should read 1.42 (0.44), 0.83.] The aim of the current study was to examine the reliability and validity of a trait-based assessment of borderline personality disorder (BPD) using the NEO Five-Factor Inventory. Correlations between the Five-Factor Inventory-BPD composite (FFI-BPD) and explicit measures of BPD were examined across 6 samples, including undergraduate, community, and clinical samples. The median correlation was .60, which was nearly identical to the correlation between measures of BPD and a BPD composite generated from the full Revised NEO Personality Inventory (i.e., NEO-BPD; r = .61). Correlations between FFI-BPD and relevant measures of psychiatric symptomatology and etiology (e.g., childhood abuse, drug use, depression, and personality disorders) were also examined and compared to those generated using explicit measures of BPD and NEO-BPD. As expected, the FFI-BPD composite correlated most strongly with measures associated with high levels of Neuroticism, such as depression, anxiety, and emotion dysregulation, and the pattern of correlations generated using the FFI-BPD was highly similar to those generated using explicit measures of BPD and NEO-BPD. Finally, genetic analyses estimated that FFI-BPD is 44% heritable, which is comparable to meta-analytic research examining genetics associated with BPD, and revealed that 71% of the genetic influences are shared between FFI-BPD and a self-report measure assessing BPD (Personality Assessment Inventory-Borderline subscale; Morey, 1991). Generally, these results support the use of FFI-BPD as a reasonable proxy for BPD, which has considerable implications, particularly for potential gene-finding efforts in large, epidemiological datasets that include the NEO FFI. (c) 2016 APA, all rights reserved).

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

PubMed

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

1997-01-01

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

Identification and assessment of potential water quality impact factors for drinking-water reservoirs.

PubMed

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-06-10

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources.

How do trained raters take context factors into account when assessing GP trainee communication performance? An exploratory, qualitative study.

PubMed

Essers, Geurt; Dielissen, Patrick; van Weel, Chris; van der Vleuten, Cees; van Dulmen, Sandra; Kramer, Anneke

2015-03-01

Communication assessment in real-life consultations is a complex task. Generic assessment instruments help but may also have disadvantages. The generic nature of the skills being assessed does not provide indications for context-specific behaviour required in practice situations; context influences are mostly taken into account implicitly. Our research questions are: 1. What factors do trained raters observe when rating workplace communication? 2. How do they take context factors into account when rating communication performance with a generic rating instrument? Nineteen general practitioners (GPs), trained in communication assessment with a generic rating instrument (the MAAS-Global), participated in a think-aloud protocol reflecting concurrent thought processes while assessing videotaped real-life consultations. They were subsequently interviewed to answer questions explicitly asking them to comment on the influence of predefined contextual factors on the assessment process. Results from both data sources were analysed. We used a grounded theory approach to untangle the influence of context factors on GP communication and on communication assessment. Both from the think-aloud procedure and from the interviews we identified various context factors influencing communication, which were categorised into doctor-related (17), patient-related (13), consultation-related (18), and education-related factors (18). Participants had different views and practices on how to incorporate context factors into the GP(-trainee) communication assessment. Raters acknowledge that context factors may affect communication in GP consultations, but struggle with how to take contextual influences into account when assessing communication performance in an educational context. To assess practice situations, raters need extra guidance on how to handle specific contextual factors.

Population pharmacokinetic characterization of BAY 81-8973, a full-length recombinant factor VIII: lessons learned - importance of including samples with factor VIII levels below the quantitation limit.

PubMed

Garmann, D; McLeay, S; Shah, A; Vis, P; Maas Enriquez, M; Ploeger, B A

2017-07-01

The pharmacokinetics (PK), safety and efficacy of BAY 81-8973, a full-length, unmodified, recombinant human factor VIII (FVIII), were evaluated in the LEOPOLD trials. The aim of this study was to develop a population PK model based on pooled data from the LEOPOLD trials and to investigate the importance of including samples with FVIII levels below the limit of quantitation (BLQ) to estimate half-life. The analysis included 1535 PK observations (measured by the chromogenic assay) from 183 male patients with haemophilia A aged 1-61 years from the 3 LEOPOLD trials. The limit of quantitation was 1.5 IU dL -1 for the majority of samples. Population PK models that included or excluded BLQ samples were used for FVIII half-life estimations, and simulations were performed using both estimates to explore the influence on the time below a determined FVIII threshold. In the data set used, approximately 16.5% of samples were BLQ, which is not uncommon for FVIII PK data sets. The structural model to describe the PK of BAY 81-8973 was a two-compartment model similar to that seen for other FVIII products. If BLQ samples were excluded from the model, FVIII half-life estimations were longer compared with a model that included BLQ samples. It is essential to assess the importance of BLQ samples when performing population PK estimates of half-life for any FVIII product. Exclusion of BLQ data from half-life estimations based on population PK models may result in an overestimation of half-life and underestimation of time under a predetermined FVIII threshold, resulting in potential underdosing of patients. © 2017 Bayer AG. Haemophilia Published by John Wiley & Sons Ltd.

Cardiovascular risk factors among college students: Knowledge, perception, and risk assessment.

PubMed

Tran, Dieu-My T; Zimmerman, Lani M; Kupzyk, Kevin A; Shurmur, Scott W; Pullen, Carol H; Yates, Bernice C

2017-04-01

To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. The final sample that responded to recruitment consisted of 158 college students from a midwestern university. A cross-sectional, descriptive study was performed using convenience sampling. College students were knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease (CVD). Knowledge of cardiovascular risk factors was correlated with the lifetime risk estimates (ρ = .17, p = .048), and perception of cardiovascular risk was positively associated with 30-year CVD risk estimates (ρ = .16, p = .048). More than 50% of the participants had 1 or more cardiovascular risk factors. High knowledge level of cardiovascular risk factors was not sufficient to lower cardiovascular risks within this study population, but changing perception of cardiovascular risk factors may play a bigger role in reducing long-term cardiovascular risks.

45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

Code of Federal Regulations, 2011 CFR

2011-10-01

... Program Design and Operations § 287.130 Can NEW Program activities include job market assessments, job...-sufficiency of program participants; (6) Surveys to collect information regarding client characteristics; and...

45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

Code of Federal Regulations, 2014 CFR

2014-10-01

... Program Design and Operations § 287.130 Can NEW Program activities include job market assessments, job...-sufficiency of program participants; (6) Surveys to collect information regarding client characteristics; and...

Children's exposure assessment: a review of factors influencing Children's exposure, and the data available to characterize and assess that exposure.

PubMed Central

Cohen Hubal, E A; Sheldon, L S; Burke, J M; McCurdy, T R; Berry, M R; Rigas, M L; Zartarian, V G; Freeman, N C

2000-01-01

We review the factors influencing children's exposure to environmental contaminants and the data available to characterize and assess that exposure. Children's activity pattern data requirements are demonstrated in the context of the algorithms used to estimate exposure by inhalation, dermal contact, and ingestion. Currently, data on children's exposures and activities are insufficient to adequately assess multimedia exposures to environmental contaminants. As a result, regulators use a series of default assumptions and exposure factors when conducting exposure assessments. Data to reduce uncertainty in the assumptions and exposure estimates are needed to ensure chemicals are regulated appropriately to protect children's health. To improve the database, advancement in the following general areas of research is required: identification of appropriate age/developmental benchmarks for categorizing children in exposure assessment; development and improvement of methods for monitoring children's exposures and activities; collection of activity pattern data for children (especially young children) required to assess exposure by all routes; collection of data on concentrations of environmental contaminants, biomarkers, and transfer coefficients that can be used as inputs to aggregate exposure models. PMID:10856019

Assessing the Structure of the Ways of Coping Questionnaire in Fibromyalgia Patients Using Common Factor Analytic Approaches.

PubMed

Van Liew, Charles; Santoro, Maya S; Edwards, Larissa; Kang, Jeremy; Cronan, Terry A

2016-01-01

The Ways of Coping Questionnaire (WCQ) is a widely used measure of coping processes. Despite its use in a variety of populations, there has been concern about the stability and structure of the WCQ across different populations. This study examines the factor structure of the WCQ in a large sample of individuals diagnosed with fibromyalgia. The participants were 501 adults (478 women) who were part of a larger intervention study. Participants completed the WCQ at their 6-month assessment. Foundational factoring approaches were performed on the data (i.e., maximum likelihood factoring [MLF], iterative principal factoring [IPF], principal axis factoring (PAF), and principal components factoring [PCF]) with oblique oblimin rotation. Various criteria were evaluated to determine the number of factors to be extracted, including Kaiser's rule, Scree plot visual analysis, 5 and 10% unique variance explained, 70 and 80% communal variance explained, and Horn's parallel analysis (PA). It was concluded that the 4-factor PAF solution was the preferable solution, based on PA extraction and the fact that this solution minimizes nonvocality and multivocality. The present study highlights the need for more research focused on defining the limits of the WCQ and the degree to which population-specific and context-specific subscale adjustments are needed.

Assessing the Structure of the Ways of Coping Questionnaire in Fibromyalgia Patients Using Common Factor Analytic Approaches

PubMed Central

Edwards, Larissa; Kang, Jeremy

2016-01-01

The Ways of Coping Questionnaire (WCQ) is a widely used measure of coping processes. Despite its use in a variety of populations, there has been concern about the stability and structure of the WCQ across different populations. This study examines the factor structure of the WCQ in a large sample of individuals diagnosed with fibromyalgia. The participants were 501 adults (478 women) who were part of a larger intervention study. Participants completed the WCQ at their 6-month assessment. Foundational factoring approaches were performed on the data (i.e., maximum likelihood factoring [MLF], iterative principal factoring [IPF], principal axis factoring (PAF), and principal components factoring [PCF]) with oblique oblimin rotation. Various criteria were evaluated to determine the number of factors to be extracted, including Kaiser's rule, Scree plot visual analysis, 5 and 10% unique variance explained, 70 and 80% communal variance explained, and Horn's parallel analysis (PA). It was concluded that the 4-factor PAF solution was the preferable solution, based on PA extraction and the fact that this solution minimizes nonvocality and multivocality. The present study highlights the need for more research focused on defining the limits of the WCQ and the degree to which population-specific and context-specific subscale adjustments are needed. PMID:28070160

Factors Affecting Student Learning Outcomes: A School-Level Analysis of the 1990 NAEP Mathematics Trial State Assessment.

ERIC Educational Resources Information Center

Kim, Lori Yoonkyung

Data from the 1990 National Assessment of Educational Progress (NAEP) Trial State Assessment (TSA) in mathematics were analyzed to determine what educational factors influence student learning, how these factors influence learning, and how important these factors are to student achievement. NAEP TSA data were collected from more than 100,000…

Children and adolescents' internal models of food-sharing behavior include complex evaluations of contextual factors.

PubMed

Markovits, Henry; Benenson, Joyce F; Kramer, Donald L

2003-01-01

This study examined internal representations of food sharing in 589 children and adolescents (8-19 years of age). Questionnaires, depicting a variety of contexts in which one person was asked to share a resource with another, were used to examine participants' expectations of food-sharing behavior. Factors that were varied included the value of the resource, the relation between the two depicted actors, the quality of this relation, and gender. Results indicate that internal models of food-sharing behavior showed systematic patterns of variation, demonstrating that individuals have complex contextually based internal models at all ages, including the youngest. Examination of developmental changes in use of individual patterns is consistent with the idea that internal models reflect age-specific patterns of interactions while undergoing a process of progressive consolidation.

First Spanish version of the Memorial Delirium Assessment Scale: psychometric properties, responsiveness, and factor loadings.

PubMed

Noguera, Antonio; Carvajal, Ana; Alonso-Babarro, Alberto; Chisholm, Gary; Bruera, Eduardo; Centeno, Carlos

2014-01-01

The Memorial Delirium Assessment Scale (MDAS) is a reliable and validated instrument with which to assess delirium. However, MDAS responsiveness has only been investigated in an indirect way. Also, neurobehavioral and global cognitive factors seem to be the MDAS main factor loads. The primary objective of this study was to evaluate MDAS responsiveness and analyze individual factors on this scale. The secondary objective was to confirm concurrent validity and reliability of the Spanish version of the MDAS. The translation-back translation method was used to obtain the Spanish version of the MDAS. Delirium diagnosis was determined by the clinical Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and with the Confusion Assessment Method. Responsiveness and factor loadings were determined with the Delirium Rating Scale-Revised-98, the Mini-Mental State Examination (MMSE), and the MDAS at baseline (0 hours) and at 72 hours. Variation in the scores of the Delirium Rating Scale-Revised-98 shows a correlation of r = 0.93, with variation in MDAS scores at P < 0.001. Variation in MMSE scores shows a correlation of r = -0.84, with variation in MDAS scores at P = 0.015. Factor I, neurobehavioral (reduced awareness, reduced attention, perceptual disturbance, delusions, altered psychomotor activity, and sleep-wake cycle disturbance), correlated moderately with the MMSE at -0.56. Factor II, global cognitive (disorientation, short-term memory impairment, impaired digit span, and disorganized thinking), correlated strongly with the MMSE at -0.81. Factor II was significantly more reliable than Factor I, rho = 0.7, P = 0.01. The high responsiveness confirms the value of the MDAS for ongoing delirium assessment. Two differentiated factor loadings point to a potential future need for MDAS subscales. Copyright © 2014 U.S. Cancer Pain Relief Committee. All rights reserved.

Including the effects of filamentous bulking sludge during the simulation of wastewater treatment plants using a risk assessment model.

PubMed

Flores-Alsina, Xavier; Comas, Joaquim; Rodriguez-Roda, Ignasi; Gernaey, Krist V; Rosen, Christian

2009-10-01

The main objective of this paper is to demonstrate how including the occurrence of filamentous bulking sludge in a secondary clarifier model will affect the predicted process performance during the simulation of WWTPs. The IWA Benchmark Simulation Model No. 2 (BSM2) is hereby used as a simulation case study. Practically, the proposed approach includes a risk assessment model based on a knowledge-based decision tree to detect favourable conditions for the development of filamentous bulking sludge. Once such conditions are detected, the settling characteristics of the secondary clarifier model are automatically changed during the simulation by modifying the settling model parameters to mimic the effect of growth of filamentous bacteria. The simulation results demonstrate that including effects of filamentous bulking in the secondary clarifier model results in a more realistic plant performance. Particularly, during the periods when the conditions for the development of filamentous bulking sludge are favourable--leading to poor activated sludge compaction, low return and waste TSS concentrations and difficulties in maintaining the biomass in the aeration basins--a subsequent reduction in overall pollution removal efficiency is observed. Also, a scenario analysis is conducted to examine i) the influence of sludge retention time (SRT), the external recirculation flow rate (Q(r)) and the air flow rate in the bioreactor (modelled as k(L)a) as factors promoting bulking sludge, and ii) the effect on the model predictions when the settling properties are changed due to a possible proliferation of filamentous microorganisms. Finally, the potentially adverse effects of certain operational procedures are highlighted, since such effects are normally not considered by state-of-the-art models that do not include microbiology-related solids separation problems.

Caseworker assessments of risk for recurrent maltreatment: association with case-specific risk factors and re-reports.

PubMed

Dorsey, Shannon; Mustillo, Sarah A; Farmer, Elizabeth M Z; Elbogen, Eric

2008-03-01

This article focuses on caseworkers' assessments of risk of maltreatment recurrence among families in contact with social services. Specifically, the article has two primary goals: (1) to examine the association between caseworkers' risk assessments and demographic, child, parent and family-level risk factors; and (2) to examine agreement between caseworkers' risk assessments and any subsequent report, or reports, of maltreatment. Data are from the baseline, 12-month, and 18-month assessments of the National Survey for Child and Adolescent Well-Being (NSCAW), a nationally representative sample of youth and families who were the subjects of allegations of maltreatment investigated by child welfare agencies. The sample consisted of a subset of NSCAW participants: cases with a report of child physical abuse or neglect who were not placed in out-of-home care (N=2,139). Analyses indicated that parent-level risk factors and a prior report of maltreatment were most strongly associated with caseworkers' assessments of risk for both physical abuse and neglect cases. A smaller set of factors, which varied by the type of maltreatment, were associated with a subsequent report of maltreatment. Despite some overlap in correlates of risk assessment and subsequent reports, analyses indicated that agreement between caseworkers' assessments of risk and re-reports was low. Findings suggest that although caseworkers' assessments were associated with a limited set of risk factors from the literature, few of these factors also were associated with a recurrent report of maltreatment. Correspondence between caseworkers' assessments of risk and a subsequent report of maltreatment was low, suggesting that considerable work may be needed to improve accuracy and identification of cases most at risk. This study provides information to assist caseworkers, administrators, and policymakers in thinking critically about risk assessment policies and procedures. Although caseworkers' assessments of

Assessment of seismic design response factors of concrete wall buildings

NASA Astrophysics Data System (ADS)

Mwafy, Aman

2011-03-01

To verify the seismic design response factors of high-rise buildings, five reference structures, varying in height from 20- to 60-stories, were selected and designed according to modern design codes to represent a wide range of concrete wall structures. Verified fiber-based analytical models for inelastic simulation were developed, considering the geometric nonlinearity and material inelasticity of the structural members. The ground motion uncertainty was accounted for by employing 20 earthquake records representing two seismic scenarios, consistent with the latest understanding of the tectonic setting and seismicity of the selected reference region (UAE). A large number of Inelastic Pushover Analyses (IPAs) and Incremental Dynamic Collapse Analyses (IDCAs) were deployed for the reference structures to estimate the seismic design response factors. It is concluded that the factors adopted by the design code are adequately conservative. The results of this systematic assessment of seismic design response factors apply to a wide variety of contemporary concrete wall buildings with various characteristics.

Best practice in wound assessment.

PubMed

Benbow, Maureen

2016-03-02

Accurate and considered wound assessment is essential to fulfil professional nursing requirements and ensure appropriate patient and wound management. This article describes the main aspects of holistic assessment of the patient and the wound, including identifying patient risk factors and comorbidities, and factors affecting wound healing to ensure optimal outcomes.

Exploring Global Exposure Factors Resources for Use in Consumer Exposure Assessments

EPA Science Inventory

This publication serves as a global comprehensive resource for readers seeking exposure factor data and information relevant to consumer exposure assessment. It describes the types of information that may be found in various official surveys and online and published resources. Th...

On the indiscriminate use of imported emission factors in environmental impact assessment: A case study in Chile

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

Bernal, María Fernanda; Oyarzún, Jorge; Oyarzún, Ricardo, E-mail: royarzun@userena.cl

Environmental Impact Assessment (EIA) aims to determine if the environmental effect of an activity or project complies with standards and regulations. A primary component of the environment to evaluate is air and the effect that various activities can have on its quality. To this end, emission factors (EFs), which are empirical coefficients or mathematical relationships, are normally used. The present research critically analyzes the implications and consequences of using imported EFs in environmental impact studies (EISs), taking as case of study the situation in Chile. Among the main results, the widespread use of EFs in EISs in the country andmore » the lack of assessments of their actual applicability stand out. In addition, the official guidelines related to emissions estimation that are used for EIA in the country mostly include EFs derived elsewhere, without considering the recommendations or restrictions that the original sources indicate for their use. Finally, the broad use of default values defined for the Metropolitan Region in Central Chile, is highly questionable for a country that extends north-south along more than 35° of latitude, with wide variability in climate, traffic conditions, population, soil types, etc. Finally, it is very likely that situations similar to those observed in the present work occurs in other countries with young environmental impact assessment systems, and therefore, that the results herein presented should be of general interest and relevance. - Highlights: • Emission factors are widely used in environmental impact assessment in Chile. • There is a lack of a proper understanding of the limitations of EFs for EIA. • Imported emission factors use requires caution and full understanding. • Misuse of foreign EFs may have serious environmental and economic consequences.« less

Development and Validation of a Questionnaire for the Assessment of Pelvic Floor Disorders and Their Risk Factors During Pregnancy and Post Partum.

PubMed

Metz, Melanie; Junginger, Bärbel; Henrich, Wolfgang; Baeßler, Kaven

2017-04-01

Introduction The aim of this study was to develop and validate a questionnaire for the assessment of pelvic floor disorders, their symptoms and risk factors in pregnancy and after birth including symptom course, severity and impact on quality of life. Methods The validated German pelvic floor questionnaire was modified and a new risk factor domain developed. The questionnaire was initially completed by 233 nulliparous women in the third trimester of pregnancy and at six weeks (n = 148) and one year (n = 120) post partum. Full pyschometric testing was performed. The clinical course of symptoms and the influence of risk factors were analysed. Results Study participants had a median age of 31 (19-46) years. 63 % had spontaneous vaginal deliveries, 15 % operative vaginal deliveries and 22 % were delivered by caesarean section. Content validity: Missing answers never exceeded 4 %. Construct validity: The questionnaire distinguished significantly between women who reported bothersome symptoms and those who did not. Reliability: Cronbach's alpha values exceeded 0.7 for bladder, bowel and support function, and 0.65 for sexual function. The test-retest analysis showed moderate to almost complete concordance. The intraclass coefficients for domain scores (between 0.732 and 0.818) were in acceptable to optimal range. Reactivity: The questionnaire was able to track changes significantly with good effect size for each domain. Risk factors for pelvic floor symptoms included familial predisposition, maternal age over 35 years, BMI above 25, nicotine abuse, subjective inability to voluntarily contract the pelvic floor musculature and postpartum wound pain. Conclusion This pelvic floor questionnaire proved to be valid, reliable and reactive for the assessment of pelvic floor disorders, their risk factors, incidence and impact on quality of life during pregnancy and post partum. The questionnaire can be utilised to assess the course of symptoms and treatment effects

Mesenchymal stem cell therapy ameliorates diabetic nephropathy via the paracrine effect of renal trophic factors including exosomes

PubMed Central

Nagaishi, Kanna; Mizue, Yuka; Chikenji, Takako; Otani, Miho; Nakano, Masako; Konari, Naoto; Fujimiya, Mineko

2016-01-01

Bone marrow-derived mesenchymal stem cells (MSCs) have contributed to the improvement of diabetic nephropathy (DN); however, the actual mediator of this effect and its role has not been characterized thoroughly. We investigated the effects of MSC therapy on DN, focusing on the paracrine effect of renal trophic factors, including exosomes secreted by MSCs. MSCs and MSC-conditioned medium (MSC-CM) as renal trophic factors were administered in parallel to high-fat diet (HFD)-induced type 2 diabetic mice and streptozotocin (STZ)-induced insulin-deficient diabetic mice. Both therapies showed approximately equivalent curative effects, as each inhibited the exacerbation of albuminuria. They also suppressed the excessive infiltration of BMDCs into the kidney by regulating the expression of the adhesion molecule ICAM-1. Proinflammatory cytokine expression (e.g., TNF-α) and fibrosis in tubular interstitium were inhibited. TGF-β1 expression was down-regulated and tight junction protein expression (e.g., ZO-1) was maintained, which sequentially suppressed the epithelial-to-mesenchymal transition of tubular epithelial cells (TECs). Exosomes purified from MSC-CM exerted an anti-apoptotic effect and protected tight junction structure in TECs. The increase of glomerular mesangium substrate was inhibited in HFD-diabetic mice. MSC therapy is a promising tool to prevent DN via the paracrine effect of renal trophic factors including exosomes due to its multifactorial action. PMID:27721418

Assessing vulnerability to drought: identifying underlying factors across Europe

NASA Astrophysics Data System (ADS)

Urquijo, Julia; Gonzalez Tánago, Itziar; Ballesteros, Mario; De Stefano, Lucia

2015-04-01

Drought is considered one of the most severe and damaging natural hazards in terms of people and sectors affected and associated losses. Drought is a normal and recurrent climatic phenomenon that occurs worldwide, although its spatial and temporal characteristics vary significantly among climates. In the case of Europe, in the last thirty years, the region has suffered several drought events that have caused estimated economic damages over a €100 billion and have affected almost 20% of its territory and population. In recent years, there has been a growing awareness among experts and authorities of the need to shift from a reactive crisis approach to a drought risk management approach, as well as of the importance of designing and implementing policies, strategies and plans at country and river basin levels to deal with drought. The identification of whom and what is vulnerable to drought is a central aspect of drought risk mitigation and planning and several authors agree that societal vulnerability often determines drought risk more than the actual precipitation shortfalls. The final aim of a drought vulnerability assessment is to identify the underlying sources of drought impact, in order to develop policy options that help to enhance coping capacity and therefore to prevent drought impact. This study identifies and maps factors underlying vulnerability to drought across Europe. The identification of factors influencing vulnerability starts from the analysis of past drought impacts in four European socioeconomic sectors. This analysis, along with an extensive literature review, led to the selection of vulnerability factors that are both relevant and adequate for the European context. Adopting the IPCC model, vulnerability factors were grouped to describe exposure, sensitivity and adaptive capacity. The aggregation of these components has resulted in the mapping of vulnerability to drought across Europe at NUTS02 level. Final results have been compared with

Parental concern about vaccine safety in Canadian children partially immunized at age 2: a multivariable model including system level factors.

PubMed

MacDonald, Shannon E; Schopflocher, Donald P; Vaudry, Wendy

2014-01-01

Children who begin but do not fully complete the recommended series of childhood vaccines by 2 y of age are a much larger group than those who receive no vaccines. While parents who refuse all vaccines typically express concern about vaccine safety, it is critical to determine what influences parents of 'partially' immunized children. This case-control study examined whether parental concern about vaccine safety was responsible for partial immunization, and whether other personal or system-level factors played an important role. A random sample of parents of partially and completely immunized 2 y old children were selected from a Canadian regional immunization registry and completed a postal survey assessing various personal and system-level factors. Unadjusted odds ratios (OR) and adjusted ORs (aOR) were calculated with logistic regression. While vaccine safety concern was associated with partial immunization (OR 7.338, 95% CI 4.138-13.012), other variables were more strongly associated and reduced the strength of the relationship between concern and partial immunization in multivariable analysis (aOR 2.829, 95% CI 1.151-6.957). Other important factors included perceived disease susceptibility and severity (aOR 4.629, 95% CI 2.017-10.625), residential mobility (aOR 3.908, 95% CI 2.075-7.358), daycare use (aOR 0.310, 95% CI 0.144-0.671), number of needles administered at each visit (aOR 7.734, 95% CI 2.598-23.025) and access to a regular physician (aOR 0.219, 95% CI 0.057-0.846). While concern about vaccine safety may be addressed through educational strategies, this study suggests that additional program and policy-level strategies may positively impact immunization uptake.

Assessing Suicide Risk Among Callers to Crisis Hotlines: A Confirmatory Factor Analysis

PubMed Central

Witte, Tracy K.; Gould, Madelyn S.; Munfakh, Jimmie Lou Harris; Kleinman, Marjorie; Joiner, Thomas E.; Kalafat, John

2012-01-01

Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. 1,085 suicidal callers to crisis hotlines were divided into three sub-samples, which allowed us to conduct an independent Exploratory Factor Analysis (EFA), EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and CFA. Similar to previous factor analytic studies (Beck et al., 1997; Holden & DeLisle, 2005; Joiner, Rudd, & Rajab, 1997; Witte et al., 2006), we found consistent evidence for a two-factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations) and one factor representing more mild suicidal ideation (i.e., Suicidal Desire and Ideation). Using structural equation modeling techniques, we found preliminary evidence that the Resolved Plans and Preparations factor trended toward being more predictive of suicidal ideation than the Suicidal Desire and Ideation factor. This factor analytic study is the first longitudinal study of the obtained factors. PMID:20578186

Risk Factors for Pressure Ulcers Including Suspected Deep Tissue Injury in Nursing Home Facility Residents: Analysis of National Minimum Data Set 3.0.

PubMed

Ahn, Hyochol; Cowan, Linda; Garvan, Cynthia; Lyon, Debra; Stechmiller, Joyce

2016-04-01

To provide information on risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home residents in the United States. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Examine the literature related to risk factors for the development of PrUs.2. Compare risk factors associated with the prevalence of PrUs and sDTI from the revised Minimum Data Set 3.0 2012 using a modified Defloor's conceptual model of PrUs as a theoretical framework. This study aims to characterize and compare risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home (NH) residents in the United States. Secondary analysis of the 2012 Minimum Data Set (MDS 3.0). Medicare- or Medicaid-certified NHs in the United States. Nursing home residents (n = 2,936,146) 18 years or older with complete PrU data, who received comprehensive assessments from January to December 2012. Pressure ulcer by stage was the outcome variable. Explanatory variables (age, gender, race and ethnicity, body mass index, skin integrity, system failure, disease, infection, mobility, and cognition) from the MDS 3.0 were aligned with the 4 elements of Defloor's conceptual model: compressive forces, shearing forces, tissue tolerance for pressure, and tissue tolerance for oxygen. Of 2,936,146 NH residents who had complete data for PrU, 89.9% had no PrU; 8.4% had a Stage 2, 3, or 4 or unstagable PrU; and 1.7% had an sDTI. The MDS variables corresponding to the 4 elements of Defloor's model were significantly predictive of both PrU and sDTI. Black residents had the highest risk of any-stage PrU, and Hispanic residents had the highest risk of sDTI. Skin integrity, system failure, infection, and disease risk factors had larger effect sizes for sDTI than for other PrU stages

Risk factor assessment and prognosis of eye involvement in Behcet's disease in Turkey.

PubMed

Demiroğlu, H; Barişta, I; Dündar, S

1997-04-01

Behcet's disease (BD) shows great regional differences in clinical manifestations and prognosis, including eye involvement. Thus, it is hard to predict in which patient the eyes will be involved and what the outcome will be. In this study we assessed various risk factors for eye involvement and attempted to predict the visual outcome in our patient population in Turkey. Data from a total of 224 patients with BD, diagnosed between 1982 and 1996, were analyzed retrospectively. A detailed physical examination and ophthalmologic work up were performed on each patient. Factors that might contribute to eye involvement were investigated, after which prognostic factors for vision were evaluated. Eighty-eight patients had eye involvement during a median follow-up of 32 months. The risk of involvement was highest within the first year of diagnosis. Young age was the most significant factor for eye involvement (P < 0.0001), but vascular thrombosis, central nervous system (CNS) involvement, and male gender were other risk factors (P < 0.001; P < 0.01; and P < 0.05, respectively). The most important determinant for the prognosis of vision was CNS involvement (P < 0.0001). Vascular thrombosis and an age of < or = 32 were other risk factors for visual impairment (P < 0.001 and P < 0.05, respectively). The risk of eye involvement and prognosis for vision were similar with different treatment regimens (P > 0.05). It is suggested that the first 2 years after diagnosis is the most critical period for eye involvement, and conventional forms of therapy generally are unsuccessful in preventing such involvement. It seems reasonable to treat patients who are at increased risk for eye involvement more aggressively, especially within the first 2 years of disease onset.

Problems with Single Interest Scales: Implications of the General Factor

ERIC Educational Resources Information Center

Tracey, Terence J. G.

2012-01-01

The presence of the general factor in interest and self-efficacy assessment and its meaning are reviewed. The general factor is found in all interest and self-efficacy assessment and has been viewed as (a) a nuisance factor with little effect on assessment, (b) a variable having substantive meaning and thus worthy of including in interpretation,…

43 CFR 3835.32 - What should I include when I submit an affidavit of assessment work?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) WAIVERS FROM ANNUAL MAINTENANCE FEES Annual FLPMA Documents § 3835.32 What should I include when I submit... microfilm or other electronic media, of either: (1) The affidavit of assessment work that you filed or will...

43 CFR 3835.32 - What should I include when I submit an affidavit of assessment work?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) WAIVERS FROM ANNUAL MAINTENANCE FEES Annual FLPMA Documents § 3835.32 What should I include when I submit... microfilm or other electronic media, of either: (1) The affidavit of assessment work that you filed or will...

43 CFR 3835.32 - What should I include when I submit an affidavit of assessment work?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) WAIVERS FROM ANNUAL MAINTENANCE FEES Annual FLPMA Documents § 3835.32 What should I include when I submit... microfilm or other electronic media, of either: (1) The affidavit of assessment work that you filed or will...

43 CFR 3835.32 - What should I include when I submit an affidavit of assessment work?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) WAIVERS FROM ANNUAL MAINTENANCE FEES Annual FLPMA Documents § 3835.32 What should I include when I submit... microfilm or other electronic media, of either: (1) The affidavit of assessment work that you filed or will...

Child-Specific Exposure Factors Handbook (Final Report) ...

EPA Pesticide Factsheets

The National Center for Environmental Assessment Staff (NCEA) have prepared this handbook to provide information on various physiological and behavioral factors commonly used in assessing children’s exposure to environmental chemicals. Children have different exposure circumstances than do adults. Understanding these differences is key for evaluating potential for environmental hazards from pollutants. They consume more of certain foods and water and have higher inhalation rates per unit of body weight than adults. Young children play close to the ground and come into contact with contaminated soil outdoors and with contaminated dust on surfaces and carpets indoors. Ingestion of human milk may be another potential pathway of exposure for infants and young children. The Child-Specific Exposure Factors Handbook provides a summary of statistical data on various exposure factors used in assessing children exposures. These factors include: drinking water consumption; soil ingestion and mouthing behavior; inhalation rates; dermal factors including skin surface area and soil adherence factors; consumption of retail and home-grown foods; breast milk intake; body weight; and activity pattern data.

The bias of experimental design, including strain background, in the determination of critical Streptococcus suis serotype 2 virulence factors

PubMed Central

Auger, Jean-Philippe; Chuzeville, Sarah; Roy, David; Mathieu-Denoncourt, Annabelle; Xu, Jianguo; Grenier, Daniel

2017-01-01

Streptococcus suis serotype 2 is an important porcine bacterial pathogen and emerging zoonotic agent mainly responsible for sudden death, septic shock, and meningitis. However, serotype 2 strains are genotypically and phenotypically heterogeneous. Though a multitude of virulence factors have been described for S. suis serotype 2, the lack of a clear definition regarding which ones are truly “critical” has created inconsistencies that have only recently been highlighted. Herein, the involvement of two factors previously described as being critical for S. suis serotype 2 virulence, whether the dipeptidyl peptidase IV and autolysin, were evaluated with regards to different ascribed functions using prototype strains belonging to important sequence types. Results demonstrate a lack of reproducibility with previously published data. In fact, the role of the dipeptidyl peptidase IV and autolysin as critical virulence factors could not be confirmed. Though certain in vitro functions may be ascribed to these factors, their roles are not unique for S. suis, probably due to compensation by other factors. As such, variations and discrepancies in experimental design, including in vitro assays, cell lines, and animal models, are an important source of differences between results. Moreover, the use of different sequence types in this study demonstrates that the role attributed to a virulence factor may vary according to the S. suis serotype 2 strain background. Consequently, it is necessary to establish standard experimental designs according to the experiment and purpose in order to facilitate comparison between laboratories. Alongside, studies should include strains of diverse origins in order to prevent erroneous and biased conclusions that could affect future studies. PMID:28753679

Identification and Assessment of Potential Water Quality Impact Factors for Drinking-Water Reservoirs

PubMed Central

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-01-01

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources. PMID:24919129

Assessing the Ability of a VR-Based Assembly Task Simulation to Evaluate Physical Risk Factors.

PubMed

Pontonnier, Charles; Samani, Afshin; Badawi, Marwan; Madeleine, Pascal; Dumont, Georges

2014-05-01

Nowadays the process of workstation design tends to include assessment steps in a virtual environment (VE) to evaluate the ergonomic features. These approaches are cost-effective and convenient since working directly on the digital mock-up in a VE is preferable to constructing a real physical mock-up in a real environment (RE). This study aimed at understanding the ability of a VR-based assembly tasks simulator to evaluate physical risk factors in ergonomics. Sixteen subjects performed simplified assembly tasks in RE and VE. Motion of the upper body and five muscle electromyographic activities were recorded to compute normalized and averaged objective indicators of discomfort, that is, rapid upper limb assessment score, averaged muscle activations, and total task time. Rated perceived exertion (RPE) and a questionnaire were used as subjective indicators of discomfort. The timing regime and complexity of the assembly tasks were investigated as within-subject factors. The results revealed significant differences between measured indicators in RE and VE. While objective measures indicated lower activity and exposure in VE, the subjects experienced more discomfort than in RE. Fairly good correlation levels were found between RE and VE for six of the objective indicators. This study clearly demonstrates that ergonomic studies of assembly tasks using VR are still challenging. Indeed, objective and subjective measurements of discomfort that are usually used in ergonomics to minimize the risks of work-related musculoskeletal disorders development exhibit opposite trends in RE and VE. Nevertheless, the high level of correlation found during this study indicates that the VR-based simulator can be used for such assessments.

Fever in trauma patients: evaluation of risk factors, including traumatic brain injury.

PubMed

Bengualid, Victoria; Talari, Goutham; Rubin, David; Albaeni, Aiham; Ciubotaru, Ronald L; Berger, Judith

2015-03-01

The role of fever in trauma patients remains unclear. Fever occurs as a response to release of cytokines and prostaglandins by white blood cells. Many factors, including trauma, can trigger release of these factors. To determine whether (1) fever in the first 48 hours is related to a favorable outcome in trauma patients and (2) fever is more common in patients with head trauma. Retrospective study of trauma patients admitted to the intensive care unit for at least 2 days. Data were analyzed by using multivariate analysis. Of 162 patients studied, 40% had fever during the first 48 hours. Febrile patients had higher mortality rates than did afebrile patients. When adjusted for severity of injuries, fever did not correlate with mortality. Neither the incidence of fever in the first 48 hours after admission to the intensive care unit nor the number of days febrile in the unit differed between patients with and patients without head trauma (traumatic brain injury). About 70% of febrile patients did not have a source found for their fever. Febrile patients without an identified source of infection had lower peak white blood cell counts, lower maximum body temperature, and higher minimum platelet counts than did febrile patients who had an infectious source identified. The most common infection was pneumonia. No relationship was found between the presence of fever during the first 48 hours and mortality. Patients with traumatic brain injury did not have a higher incidence of fever than did patients without traumatic brain injury. About 30% of febrile patients had an identifiable source of infection. Further studies are needed to understand the origin and role of fever in trauma patients. ©2015 American Association of Critical-Care Nurses.

What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand.

PubMed

Haigh, Fiona; Harris, Elizabeth; Harris-Roxas, Ben; Baum, Fran; Dannenberg, Andrew L; Harris, Mark F; Keleher, Helen; Kemp, Lynn; Morgan, Richard; Ng Chok, Harrison; Spickett, Jeff

2015-10-03

While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas' conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the conceptual framework. A stakeholder forum was utilised to test face validity and practical adequacy of the findings. We found that some features of HIA are essential, such as the stepwise but flexible process, and evidence based approach. Non-essential features that can enhance the impact of HIAs include capacity and experience; 'right person right level'; involvement of decision-makers and communities; and relationships and partnerships. There are contextual factors outside of HIA such as fit with planning and decision making context, broader global context and unanticipated events, and shared values and goals that may influence a HIA. Crosscutting factors include proactive positioning, and time and timeliness. These all operate within complex open systems, involving multiple decision-makers, levels of decision-making, and points of influence. The Harris and Harris-Roxas framework was generally supported. We have confirmed previously identified factors influencing effectiveness of HIA and identified new

Characterization factors for global warming in life cycle assessment based on damages to humans and ecosystems.

PubMed

De Schryver, An M; Brakkee, Karin W; Goedkoop, Mark J; Huijbregts, Mark A J

2009-03-15

Human and ecosystem health damage due to greenhouse gas (GHG) emissions is generally poorly quantified in the life cycle assessment of products, preventing an integrated comparison of the importance of GHGs with other stressor types, such as ozone depletion and acidifying emissions. In this study, we derived new characterization factors for 63 GHGs that quantify the impact of an emission change on human and ecosystem health damage. For human health damage, the Disability Adjusted Life Years (DALYs) per unit emission related to malaria, diarrhea, malnutrition, drowning, and cardiovascular diseases were quantified. For ecosystem health damage, the Potentially Disappeared Fraction (PDF) over space and time of various species groups, including plants, butterflies, birds, and mammals, per unit emission was calculated. The influence of value choices in the modeling procedure was analyzed by defining three coherent scenarios, based on Cultural theory perspectives. It was found that the characterization factor for human health damage by carbon dioxide (CO2) ranges from 1.1 x 10(-2) to 1.8 x 10(+1) DALY per kton of emission, while the characterization factor for ecosystem damage by CO2 ranges from 5.4 x 10(-2) to 1.2 x 10(+1) disappeared fraction of species over space and time ((km2 x year)/kton), depending on the scenario chosen. The characterization factor of a GHG can change up to 4 orders of magnitude, depending on the scenario. The scenario-specific differences are mainly explained by the choice for a specific time horizon and stresses the importance of dealing with value choices in the life cycle impact assessment of GHG emissions.

Cardiovascular Risk Factors among College Students: Knowledge, Perception, and Risk Assessment

ERIC Educational Resources Information Center

Tran, Dieu-My T.; Zimmerman, Lani M.; Kupzyk, Kevin A.; Shurmur, Scott W.; Pullen, Carol H.; Yates, Bernice C.

2017-01-01

Objective: To assess college students' knowledge and perception of cardiovascular risk factors and to screen for their cardiovascular risks. Participants: The final sample that responded to recruitment consisted of 158 college students from a midwestern university. Methods: A cross-sectional, descriptive study was performed using convenience…

Discourse and Assessment.

ERIC Educational Resources Information Center

McNamara, Tim; Hill, Kathryn; May, Lynette

2002-01-01

Focuses on the increase in discourse-based studies of oral proficiency assessment techniques. Discusses research carried out on a number of factors in the assessment setting, including the role of interlocutor, candidate, and rater, and the impact of tasks, task performance conditions, and rating criteria. (Author/VWL)

Assessing the influence of risk factors on rates and dynamics of peripheral vein phlebitis: an observational cohort study.

PubMed

Mestre Roca, Gabriel; Berbel Bertolo, Cristina; Tortajada Lopez, Purificación; Gallemi Samaranch, Gema; Aguilar Ramirez, Mari Carmen; Caylà Buqueras, Joan; Rodríguez-Baño, Jesús; Martinez, José Antonio

2012-07-21

To assess the influence of risk factors on the rates and kinetics of peripheral vein phlebitis (PVP) development and its theoretical influence in absolute PVP reduction after catheter replacement. All peripheral short intravenous catheters inserted during one month were included (1201 catheters and 967 patients). PVP risk factors were assessed by a Cox proportional hazard model. Cumulative probability, conditional failure of PVP and theoretical estimation of the benefit from replacement at different intervals were performed. Female gender, catheter insertion at the emergency or medical-surgical wards, forearm site, amoxicillin-clavulamate or aminoglycosides were independent predictors of PVP with hazard ratios (95 confidence interval) of 1.46 (1.09-2.15), 1.94 (1.01-3.73), 2.51 (1.29-4.88), 1.93 (1.20-3.01), 2.15 (1.45-3.20) and 2.10 (1.01-4.63), respectively. Maximum phlebitis incidence was reached sooner in patients with ≥2 risk factors (days 3-4) than in those with <2 (days 4-5). Conditional failure increased from 0.08 phlebitis/one catheter-day for devices with ≤1 risk factors to 0.26 for those with ≥3. The greatest benefit of routine catheter exchange was obtained by replacement every 60h. However, this benefit differed according to the number of risk factors: 24.8% reduction with ≥3, 13.1% with 2, and 9.2% with ≤1. PVP dynamics is highly influenced by identifiable risk factors which may be used to refine the strategy of catheter management. Routine replacement every 72h seems to be strictly necessary only in high-risk catheters. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Exploring Global Exposure Factors Resources for Use in ...

EPA Pesticide Factsheets

This publication serves as a global comprehensive resource for readers seeking exposure factor data and information relevant to consumer exposure assessment. It describes the types of information that may be found in various official surveys and online and published resources. The relevant exposure factors cover a broad range, including general exposure factor data found in published compendia and databases and resources about specific exposure factors, such as human activity patterns and housing information. Also included are resources on exposure factors related to specific types of consumer products and the associated patterns of use, such as for a type of personal care product or a type of children’s toy. Further, a section on using exposure factors for designing representative exposure scenarios is included, along with a look into the future for databases and other exposure science developments relevant for consumer exposure assessment. Review article in the International Journal of Environmental Research and Public Health

The Transition Readiness Assessment Questionnaire (TRAQ): its factor structure, reliability, and validity.

PubMed

Wood, David L; Sawicki, Gregory S; Miller, M David; Smotherman, Carmen; Lukens-Bull, Katryne; Livingood, William C; Ferris, Maria; Kraemer, Dale F

2014-01-01

National consensus statements recommend that providers regularly assess the transition readiness skills of adolescent and young adults (AYA). In 2010 we developed a 29-item version of Transition Readiness Assessment Questionnaire (TRAQ). We reevaluated item performance and factor structure, and reassessed the TRAQ's reliability and validity. We surveyed youth from 3 academic clinics in Jacksonville, Florida; Chapel Hill, North Carolina; and Boston, Massachusetts. Participants were AYA with special health care needs aged 14 to 21 years. From a convenience sample of 306 patients, we conducted item reduction strategies and exploratory factor analysis (EFA). On a second convenience sample of 221 patients, we conducted confirmatory factor analysis (CFA). Internal reliability was assessed by Cronbach's alpha and criterion validity. Analyses were conducted by the Wilcoxon rank sum test and mixed linear models. The item reduction and EFA resulted in a 20-item scale with 5 identified subscales. The CFA conducted on a second sample provided a good fit to the data. The overall scale has high reliability overall (Cronbach's alpha = .94) and good reliability for 4 of the 5 subscales (Cronbach's alpha ranging from .90 to .77 in the pooled sample). Each of the 5 subscale scores were significantly higher for adolescents aged 18 years and older versus those younger than 18 (P < .0001) in both univariate and multivariate analyses. The 20-item, 5-factor structure for the TRAQ is supported by EFA and CFA on independent samples and has good internal reliability and criterion validity. Additional work is needed to expand or revise the TRAQ subscales and test their predictive validity. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Context factors in general practitioner-patient encounters and their impact on assessing communication skills--an exploratory study.

PubMed

Essers, Geurt; Kramer, Anneke; Andriesse, Boukje; van Weel, Chris; van der Vleuten, Cees; van Dulmen, Sandra

2013-05-22

Assessment of medical communication performance usually focuses on rating generically applicable, well-defined communication skills. However, in daily practice, communication is determined by (specific) context factors, such as acquaintance with the patient, or the presented problem. Merely valuing the presence of generic skills may not do justice to the doctor's proficiency.Our aim was to perform an exploratory study on how assessment of general practitioner (GP) communication performance changes if context factors are explicitly taken into account. We used a mixed method design to explore how ratings would change. A random sample of 40 everyday GP consultations was used to see if previously identified context factors could be observed again. The sample was rated twice using a widely used assessment instrument (the MAAS-Global), first in the standard way and secondly after context factors were explicitly taken into account, by using a context-specific rating protocol to assess communication performance in the workplace. In between first and second rating, the presence of context factors was established. Item score differences were calculated using paired sample t-tests. In 38 out of 40 consultations, context factors prompted application of the context-specific rating protocol. Mean overall score on the 7-point MAAS-Global scale increased from 2.98 in standard to 3.66 in the context-specific rating (p<0.00); the effect size for the total mean score was 0.84. In earlier research the minimum standard score for adequate communication was set at 3.17. Applying the protocol, the mean overall score rose above the level set in an earlier study for the MAAS-Global scores to represent 'adequate GP communication behaviour'. Our findings indicate that incorporating context factors in communication assessment thus makes a meaningful difference and shows that context factors should be considered as 'signal' instead of 'noise' in GP communication assessment. Explicating context

Assessments of fluid friction factors for use in leak rate calculations

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

Chivers, T.C.

1997-04-01

Leak before Break procedures require estimates of leakage, and these in turn need fluid friction to be assessed. In this paper available data on flow rates through idealized and real crack geometries are reviewed in terms of a single friction factor k It is shown that for {lambda} < 1 flow rates can be bounded using correlations in terms of surface R{sub a} values. For {lambda} > 1 the database is less precise, but {lambda} {approx} 4 is an upper bound, hence in this region flow calculations can be assessed using 1 < {lambda} < 4.

Factors impacting the assessment of maternal culpability in cases of alleged fetal abuse.

PubMed

McCoy, Monica L

2003-01-01

These studies explored attitudes toward maternal culpability in cases of alleged fetal abuse. In experiment one, general culpability for the use of various substances during pregnancy was assessed as well as the impact of other potentially relevant factors. One hundred and twenty students completed the survey. Participants overwhelmingly supported treating drug use by pregnant women as a criminal offense. With regard to the assessment of more specific questions, the lack of consensus regarding what factors effect culpability is striking. Experiment two examined the possible impact of the mothers' race (White or Black) and social class (Poor or Middle class) on the assessment of culpability. One hundred and sixty-four community members responded to a survey sent to randomly selected persons in upstate South Carolina. The results indicate that at least in response to a brief, written, case scenario, neither race nor social class make a large impact on participants' sanction recommendations.

Prognostic factors for head and neck cancer of unknown primary including the impact of human papilloma virus infection.

PubMed

Axelsson, Lars; Nyman, Jan; Haugen-Cange, Hedda; Bove, Mogens; Johansson, Leif; De Lara, Shahin; Kovács, Anikó; Hammerlid, Eva

2017-06-10

Head and neck cancer of unknown primary (HNCUP) is rare and prospective studies are lacking. The impact of different prognostic factors such as age and N stage is not completely known, the optimal treatment is not yet established, and the reported survival rates vary. In the last decade, human papilloma virus (HPV) has been identified as a common cause of and important prognostic factor in oropharyngeal cancer, and there is now growing interest in the importance of HPV for HNCUP. The aim of the present study on curatively treated HNCUP was to investigate the prognostic importance of different factors, including HPV status, treatment, and overall survival. A search for HNCUP was performed in the Swedish Cancer Registry, Western health district, between the years 1992-2009. The medical records were reviewed, and only patients with squamous cell carcinoma or undifferentiated carcinoma treated with curative intent were included. The tumor specimens were retrospectively analyzed for HPV with p16 immunostaining. Sixty-eight patients were included. The mean age was 59 years. The majority were males, and had N2 tumors. Sixty-nine percent of the tumors were HPV positive using p16 staining. Patients who were older than 70 years, patients with N3-stage tumors, and patients with tumors that were p16 negative had a significantly worse prognosis. The overall 5-year survival rate for patients with p16-positive tumors was 88% vs 61% for p16-negative tumors. Treatment with neck dissection and postoperative radiation or (chemo) radiation had 81 and 88% 5-year survival rates, respectively. The overall and disease-free 5-year survival rates for all patients in the study were 82 and 74%. Curatively treated HNCUP had good survival. HPV infection was common. Independent prognostic factors for survival were age over 70 years, HPV status and N3 stage. We recommend that HPV analysis should be performed routinely for HNCUP. Treatment with neck dissection and postoperative radiation or

Assessment of psychosocial factors and predictors of psychopathology in a sample of heart transplantation recipients: a prospective 12-month follow-up.

PubMed

Sánchez, Roberto; Baillès, Eva; Peri, Josep Maria; Bastidas, Anna; Pérez-Villa, Félix; Bulbena, Antonio; Pintor, Luis

2016-01-01

In the last decades, researchers of heart transplantation (HT) programs have attempted to identify the existence of psychosocial factors that might influence the clinical outcome before and after the transplantation. The first objective of this study is the prospective description of changes in psychiatric and psychosocial factors in a sample of HT recipients through a 12-month follow-up. The second goal is to identify predictors of psychopathology 1 year after HT. Pretransplant baseline assessment consisted of clinical form; Hospital Anxiety and Depression Scale (HADS); Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Structured Clinical Interview; Coping questionnaire (COPE); Five Factors Inventory Revised; Apgar-Family questionnaire and Multidimensional Health Locus of Control (MHLC). The assessment 1 year after HT consisted of HADS, COPE, Apgar-Family and MHLC. The sample included 78 recipients. During the waiting list period, 32.1% of them had a psychiatric disorder; personality factors profile was similar to the general population, and they showed adaptive coping strategies. Some changes in psychosocial factors were observed at 12 months after the surgery: lower scores of anxiety and depression, less necessity of publicly venting of feelings and a trend to an internal locus of control. Neuroticism and Disengagement pre-HT were predictors of psychopathology in the follow-up assessment. Pretransplant psychosocial screening is important and enables to find out markers of emotional distress like Neuroticism or Disengagement coping styles to identify patients who might benefit from psychiatric and psychological interventions. Successful HT involved some positive changes in psychosocial factors 12 months after the surgery beyond physical recovery. Copyright © 2016 Elsevier Inc. All rights reserved.

Arctic National Wildlife Refuge, 1002 area, petroleum assessment, 1998, including economic analysis

USGS Publications Warehouse

Bird, K.J.; Houseknecht, D.W.

2001-01-01

The Alaska National Interest Lands Conservation Act (1980) established the Arctic National Wildlife Refuge (ANWR). In section 1002 of that act, Congress deferred a decision regarding future management of the 1.5-million-acre coastal plain ("1002 area") in recognition of the area’s potentially enormous oil and gas resources and its importance as wildlife habitat. A report on the resources (including petroleum) of the 1002 area was submitted in 1987 to Congress by the Department of the Interior (DOI). Since completion of that report, numerous wells have been drilled and oil fields discovered near ANWR, new geologic and geophysical data have become available, seismic processing and interpretation capabilities have improved, and the economics of North Slope oil development have changed significantly.The U.S. Geological Survey (USGS) commonly is asked to provide the Federal Government with timely scientific information in support of decisions regarding land management, environmental quality, and economic and strategic policy. To do so, the USGS must anticipate issues most likely to be the focus of policymakers in the future. Anticipating the need for scientific information and considering the decade-old perspective of the petroleum resource estimates included in the 1987 Report to Congress, the USGS has reexamined the geology of the ANWR 1002 area and has prepared a new petroleum resource assessment.

45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

Code of Federal Regulations, 2012 CFR

2012-10-01

... Program Design and Operations § 287.130 Can NEW Program activities include job market assessments, job...) Communication with any training, research, or educational agencies that have produced economic development plans...-sufficiency of program participants; (6) Surveys to collect information regarding client characteristics; and...

45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

Code of Federal Regulations, 2013 CFR

2013-10-01

... Program Design and Operations § 287.130 Can NEW Program activities include job market assessments, job...) Communication with any training, research, or educational agencies that have produced economic development plans...-sufficiency of program participants; (6) Surveys to collect information regarding client characteristics; and...

45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Program Design and Operations § 287.130 Can NEW Program activities include job market assessments, job...) Communication with any training, research, or educational agencies that have produced economic development plans...-sufficiency of program participants; (6) Surveys to collect information regarding client characteristics; and...

Environmental Sustainability - Including Land and Water Use

EPA Science Inventory

Assessments of environmental sustainability can be conducted in many ways with one of the most quantitative methods including Life Cycle Impact Assessment (LCIA). While historically LCIA has included a comprehensive list of impact categories including: ozone depletion, global c...

A structured interview for the assessment of the Five-Factor Model of personality: facet-level relations to the axis II personality disorders.

PubMed

Trull, T J; Widiger, T A; Burr, R

2001-04-01

The Structured Interview for the Five-Factor Model (SIFFM; Trull & Widiger, 1997) is an 120-item semistructured interview that assesses both adaptive and maladaptive features of the personality traits included in the five-factor model of personality, or "Big Five." In this article, we evaluate the ability of SIFFM scores to predict personality disorder symptomatology in a sample of 232 adults (46 outpatients and 186 nonclinical college students). Personality disorder symptoms were assessed using the Personality Diagnostic Questionnaire-Revised (PDQ-R; Hyler & Rider, 1987). Results indicated that many of the predicted associations between lower-order personality traits and personality disorders were supported. Further, many of these associations held even after controlling for comorbid personality disorder symptoms. These findings may help inform conceptualizations of the personality disorders, as well as etiological theories and treatment.

Assessment of Human Factors

NASA Technical Reports Server (NTRS)

Mount, Frances; Foley, Tico

1999-01-01

Human Factors Engineering, often referred to as Ergonomics, is a science that applies a detailed understanding of human characteristics, capabilities, and limitations to the design, evaluation, and operation of environments, tools, and systems for work and daily living. Human Factors is the investigation, design, and evaluation of equipment, techniques, procedures, facilities, and human interfaces, and encompasses all aspects of human activity from manual labor to mental processing and leisure time enjoyments. In spaceflight applications, human factors engineering seeks to: (1) ensure that a task can be accomplished, (2) maintain productivity during spaceflight, and (3) ensure the habitability of the pressurized living areas. DSO 904 served as a vehicle for the verification and elucidation of human factors principles and tools in the microgravity environment. Over six flights, twelve topics were investigated. This study documented the strengths and limitations of human operators in a complex, multifaceted, and unique environment. By focusing on the man-machine interface in space flight activities, it was determined which designs allow astronauts to be optimally productive during valuable and costly space flights. Among the most promising areas of inquiry were procedures, tools, habitat, environmental conditions, tasking, work load, flexibility, and individual control over work.

PROPOSAL FOR INCLUDING WHAT IS VALUABLE TO ECOSYSTEMS IN ENVIRONMENTAL ASSESSMENTS

EPA Science Inventory

Assessment scientists and managers depend on social values to identify the goals that will be used to guide environmental assessments. These goals are commonly identified by examining the vested interests of the various social groups that are stakeholders in a region. However, kn...

Sexual harassment: identifying risk factors.

PubMed

O'Hare, E A; O'Donohue, W

1998-12-01

A new model of the etiology of sexual harassment, the four-factor model, is presented and compared with several models of sexual harassment including the biological model, the organizational model, the sociocultural model, and the sex role spillover model. A number of risk factors associated with sexually harassing behavior are examined within the framework of the four-factor model of sexual harassment. These include characteristics of the work environment (e.g., sexist attitudes among co-workers, unprofessional work environment, skewed sex ratios in the workplace, knowledge of grievance procedures for sexual harassment incidents) as well as personal characteristics of the subject (e.g., physical attractiveness, job status, sex-role). Subjects were 266 university female faculty, staff, and students who completed the Sexual Experience Questionnaire to assess the experience of sexual harassment and a questionnaire designed to assess the risk factors stated above. Results indicated that the four-factor model is a better predictor of sexual harassment than the alternative models. The risk factors most strongly associated with sexual harassment were an unprofessional environment in the workplace, sexist atmosphere, and lack of knowledge about the organization's formal grievance procedures.

Assessment of Ecological Factors as an Integral Part of Academic and Mental Health Consultation

ERIC Educational Resources Information Center

Ysseldyke, Jim; Lekwa, Adam J.; Klingbeil, David A.; Cormier, Damien C.

2012-01-01

The assessment of ecological factors that affect individual mental health or academic functioning is an important component of educational and psychological consultation. Researchers and practitioners have conceptualized such ecological or environmental factors in a variety of ways and from a broad range of perspectives. In this article we…

Risk factor assessment of endoscopically removed malignant colorectal polyps.

PubMed

Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schönegg, R; Maurer, C; Hüsler, J; Halter, F; Schmassmann, A

1998-11-01

Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. To determine the significance of histological findings of patients with malignant polyps. Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67 months). Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16 (42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk.

An Examination of the Factors Affecting Stakeholder's Assessment of School Decentralization.

ERIC Educational Resources Information Center

Jenni, Roger W.; Mauriel, John J.

Factors that influence the perceptions held by school site council members and others about the quality of site-based management (SBM) are examined in this study. Specifically, the relationships among a group's assessment of SBM, perceived level of influence on council decision making, perceived level of support from other groups, and perceived…

Endometrial cancer risk prediction including serum-based biomarkers: results from the EPIC cohort.

PubMed

Fortner, Renée T; Hüsing, Anika; Kühn, Tilman; Konar, Meric; Overvad, Kim; Tjønneland, Anne; Hansen, Louise; Boutron-Ruault, Marie-Christine; Severi, Gianluca; Fournier, Agnès; Boeing, Heiner; Trichopoulou, Antonia; Benetou, Vasiliki; Orfanos, Philippos; Masala, Giovanna; Agnoli, Claudia; Mattiello, Amalia; Tumino, Rosario; Sacerdote, Carlotta; Bueno-de-Mesquita, H B As; Peeters, Petra H M; Weiderpass, Elisabete; Gram, Inger T; Gavrilyuk, Oxana; Quirós, J Ramón; Maria Huerta, José; Ardanaz, Eva; Larrañaga, Nerea; Lujan-Barroso, Leila; Sánchez-Cantalejo, Emilio; Butt, Salma Tunå; Borgquist, Signe; Idahl, Annika; Lundin, Eva; Khaw, Kay-Tee; Allen, Naomi E; Rinaldi, Sabina; Dossus, Laure; Gunter, Marc; Merritt, Melissa A; Tzoulaki, Ioanna; Riboli, Elio; Kaaks, Rudolf

2017-03-15

Endometrial cancer risk prediction models including lifestyle, anthropometric and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at p < 0.157 indicating improvement in the Akaike information criterion (AIC). Improvement in discrimination was assessed using the C-statistic for all biomarkers alone, and change in C-statistic from addition of biomarkers to preexisting absolute risk estimates. We used internal validation with bootstrapping (1000-fold) to adjust for over-fitting. Adiponectin, estrone, interleukin-1 receptor antagonist, tumor necrosis factor-alpha and triglycerides were selected into the model. After accounting for over-fitting, discrimination was improved by 2.0 percentage points when all evaluated biomarkers were included and 1.7 percentage points in the model including the selected biomarkers. Models including etiologic markers on independent pathways and genetic markers may further improve discrimination. © 2016 UICC.

Health-related quality of life and hand eczema--a comparison of two instruments, including factor analysis.

PubMed

Wallenhammar, Lena-Marie; Nyfjäll, Mats; Lindberg, Magnus; Meding, Birgitta

2004-06-01

Hand eczema is a disease of long duration, affecting the individual and society. The purpose of this study of 100 patients (51 females and 49 males) at an occupational dermatology clinic was to investigate whether the generic questionnaire Short Form-36 (SF-36), and the dermatology-specific Dermatology Life Quality Index (DLQI) are appropriate for assessing health-related quality of life (HRQL) in patients with hand eczema, and whether gender differences in HRQL could be detected. HRQL was affected by hand eczema, measured with both SF-36 and DLQI. The SF-36 showed more impaired HRQL for females than for males, in the mental health dimension, whereas no gender-related differences were detected with the DLQI. To compare the instruments we used factor analysis, with a polychoric correlation matrix as input, thus taking the ordinal aspect of the data into account. There was a high correlation between the instruments for physical health, but lower for mental health. In this context our interpretation of the factor analysis is that the SF-36 measures mental health better than the DLQI. The SF-36 therefore appears suitable for use in future studies for measuring HRQL, and gender differences in HRQL, in persons with reported hand eczema.

Assessing Saudi medical students learning approach using the revised two-factor study process questionnaire.

PubMed

Shaik, Shaffi Ahamed; Almarzuqi, Ahmed; Almogheer, Rakan; Alharbi, Omar; Jalal, Abdulaziz; Alorainy, Majed

2017-08-17

To assess learning approaches of 1st, 2nd, and 3rd-year medical students by using revised two-factor study process questionnaire, and to assess reliability and validity of the questionnaire. This cross-sectional study was conducted at the College of Medicine, Riyadh, Saudi Arabia in 2014. The revised two-factor study process questionnaire (R-SPQ-2F) was completed by 610 medical students of both genders, from foundation (first year), central nervous system (second year), medicine and surgery (third year) courses. The study process was evaluated by computing mean scores of two research study approaches (deep & surface) using student's t-test and one-way analysis of variance. The internal consistency and construct validity of the questionnaire were assessed using Cronbach's α and factor analysis. The mean score of deep approach was significantly higher than the surface approach among participants(t (770) =7.83, p= 0.000) for the four courses. The mean scores of deep approach were significantly higher among participants with higher grade point average (F (2,768) =13.31, p=0.001) along with more number of study hours by participants (F (2,768) =20.08, p=0.001). The Cronbach's α-values of items at 0.70 indicate the good internal consistency of questionnaire used. Factor analysis confirms two factors (deep and surface approaches) of R-SPQ-2F. The deep approach to learning was the primary approach among 1st, 2nd and 3rd-year King Saud University medical students. This study confirms reliability and validity of the revised two-factor study process questionnaire. Medical educators could use the results of such studies to make required changes in the curriculum.

Dispelling urban myths about default uncertainty factors in chemical risk assessment--sufficient protection against mixture effects?

PubMed

Martin, Olwenn V; Martin, Scholze; Kortenkamp, Andreas

2013-07-01

Assessing the detrimental health effects of chemicals requires the extrapolation of experimental data in animals to human populations. This is achieved by applying a default uncertainty factor of 100 to doses not found to be associated with observable effects in laboratory animals. It is commonly assumed that the toxicokinetic and toxicodynamic sub-components of this default uncertainty factor represent worst-case scenarios and that the multiplication of those components yields conservative estimates of safe levels for humans. It is sometimes claimed that this conservatism also offers adequate protection from mixture effects. By analysing the evolution of uncertainty factors from a historical perspective, we expose that the default factor and its sub-components are intended to represent adequate rather than worst-case scenarios. The intention of using assessment factors for mixture effects was abandoned thirty years ago. It is also often ignored that the conservatism (or otherwise) of uncertainty factors can only be considered in relation to a defined level of protection. A protection equivalent to an effect magnitude of 0.001-0.0001% over background incidence is generally considered acceptable. However, it is impossible to say whether this level of protection is in fact realised with the tolerable doses that are derived by employing uncertainty factors. Accordingly, it is difficult to assess whether uncertainty factors overestimate or underestimate the sensitivity differences in human populations. It is also often not appreciated that the outcome of probabilistic approaches to the multiplication of sub-factors is dependent on the choice of probability distributions. Therefore, the idea that default uncertainty factors are overly conservative worst-case scenarios which can account both for the lack of statistical power in animal experiments and protect against potential mixture effects is ill-founded. We contend that precautionary regulation should provide an

Combined assessment of clinical and patient factors on doctors' decisions to prescribe antibiotics.

PubMed

Strumiło, Julia; Chlabicz, Sławomir; Pytel-Krolczuk, Barbara; Marcinowicz, Ludmiła; Rogowska-Szadkowska, Dorota; Milewska, Anna Justyna

2016-06-03

Antibiotic overprescription is a worldwide problem. Decisions regarding antibiotic prescription for respiratory tract infections (RTIs) are influenced by medical and non-medical factors. In family medicine practices in Białystok, Poland, family medicine residents directly observed consultations with patients with RTI symptoms. The observing residents completed a questionnaire including patient data, clinical symptoms, diagnosis, any prescribed antibiotic, and assessment of ten patient pressure factors. Of 1546 consultations of patients with RTIs, 54.26 % resulted in antibiotic prescription. Antibiotic prescription was strongly associated with rales (OR 26.90, 95 % CI 9.00-80.40), tonsillar exudates (OR 13.03, 95 % CI 7.10-23.80), and wheezing (OR 14.72, 95 % CI 7.70-28.10). The likelihood of antibiotic prescription was increased by a >7-day disease duration (OR 3.94, 95 % CI 2.80-5.50), purulent nasal discharge (OR 3.87, 95 % CI 2.40-6.10), starting self-medication with antibiotics (OR 4.11, 95 % CI 2.30-7.30), and direct request for antibiotics (OR 1.87, 95 % CI 1.30-2.80). Direct request not to prescribe antibiotics decreased the likelihood of receiving antibiotics (OR 0.34, 95 % CI 0.27-0.55). While clinical signs and symptoms principally impact prescribing decisions, patient factors also contribute. The most influential patient pressure factors were starting self-medication with antibiotics, and directly requesting antibiotic prescription or no antibiotic prescription. Interventions aiming to improve clinical sign and symptom interpretation and to help doctors resist direct patient pressure could be beneficial for reducing unnecessary antibiotic prescribing.

Double burden: a cross-sectional survey assessing factors associated with underweight and overweight status in Danang, Vietnam

PubMed Central

2013-01-01

Background Many low- to middle-income countries are faced with an increasing prevalence of overweight/obesity while that for underweight remains high, a duality termed “double burden”; both are key risk factors for chronic diseases. This cross-sectional study assesses the prevalence and factors for underweight and overweight/obesity among adults in Danang, Vietnam, using WHO standard and suggested Asian-specific BMI cut-offs. Methods In 2010, 1713 residents age ≥35 years from 900 households in 6 of 56 urban, rural and mixed urban–rural communes in Danang were selected using multistage-cluster sampling methodology to participate; 1621 qualified adults enrolled. Participants completed a health survey based on WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance and additional questions on chest pain and stroke symptoms. Anthropometric and other measurements were conducted. Relative risk regression was used to identify independent risk factors for underweight or overweight/obesity according to WHO standard cut-offs and suggested Asian-specific cut-offs (<18.5 kg/m2 or 23–27.49 kg/m2; and ≥27.5 kg/m2). Results We observed 12.4% prevalence of underweight and 16.0% for overweight/obesity using WHO standard. The prevalence of overweight/obesity doubled (33.7%) when Asian-specific cut-offs were applied. For both definitions, rural communes had the highest prevalence of underweight while urban communes had the highest prevalence of overweight/obesity. Being underweight was associated with less urbanization. Factors independently associated with being underweight included older age, rural living, current smoking, and lower systolic pressure. Factors independently associated with Asian-specific BMI definition for being overweight/obese included older age, urbanization, higher systolic pressure, and diabetes. Age was not an independent factor with WHO standard cut-offs; however, myocarial infarction and diabetes showed strong associations. Conclusions

Accurate expressions for solar cell fill factors including series and shunt resistances

NASA Astrophysics Data System (ADS)

Green, Martin A.

2016-02-01

Together with open-circuit voltage and short-circuit current, fill factor is a key solar cell parameter. In their classic paper on limiting efficiency, Shockley and Queisser first investigated this factor's analytical properties showing, for ideal cells, it could be expressed implicitly in terms of the maximum power point voltage. Subsequently, fill factors usually have been calculated iteratively from such implicit expressions or from analytical approximations. In the absence of detrimental series and shunt resistances, analytical fill factor expressions have recently been published in terms of the Lambert W function available in most mathematical computing software. Using a recently identified perturbative relationship, exact expressions in terms of this function are derived in technically interesting cases when both series and shunt resistances are present but have limited impact, allowing a better understanding of their effect individually and in combination. Approximate expressions for arbitrary shunt and series resistances are then deduced, which are significantly more accurate than any previously published. A method based on the insights developed is also reported for deducing one-diode fits to experimental data.

Users' manual for the Hydroecological Integrity Assessment Process software (including the New Jersey Assessment Tools)

USGS Publications Warehouse

Henriksen, James A.; Heasley, John; Kennen, Jonathan G.; Nieswand, Steven

2006-01-01

Applying the Hydroecological Integrity Assessment Process involves four steps: (1) a hydrologic classification of relatively unmodified streams in a geographic area using long-term gage records and 171 ecologically relevant indices; (2) the identification of statistically significant, nonredundant, hydroecologically relevant indices associated with the five major flow components for each stream class; and (3) the development of a stream-classification tool and a hydrologic assessment tool. Four computer software tools have been developed.

An Empirical Comparison of Competing Factor Structures for the Repeatable Battery for the Assessment of Neuropsychological Status: A Project FRONTIER Study†

PubMed Central

Torrence, Nicole D.; John, Samantha E.; Gavett, Brandon E.; O'Bryant, Sid E.

2016-01-01

The original factor structure of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has received little empirical support, but at least eight alternative factor structures have been identified in the literature. The current study used confirmatory factor analysis to compare the original RBANS model with eight alternatives, which were adjusted to include a general factor. Participant data were obtained from Project FRONTIER, an epidemiological study of rural health, and comprised 341 adults (229 women, 112 men) with mean age of 61.2 years (SD = 12.1) and mean education of 12.4 years (SD = 3.3). A bifactor version of the model proposed by Duff and colleagues provided the best fit to the data (CFI = 0.98; root-mean-squared error of approximation = 0.07), but required further modification to produce appropriate factor loadings. The results support the inclusion of a general factor and provide partial replication of the Duff and colleagues RBANS model. PMID:26429558

Identifying items to assess methodological quality in physical therapy trials: a factor analysis.

PubMed

Armijo-Olivo, Susan; Cummings, Greta G; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd

2014-09-01

Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). A methodological research design was used, and an EFA was performed. Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor analysis of these results are needed to validate these items. �

The hidden risk of deep vein thrombosis--the need for risk factor assessment: case reviews.

PubMed

Race, Tara Kay; Collier, Paul E

2007-01-01

Deep vein thrombosis (DVT) is a very serious, potentially fatal, and very preventable medical condition. It is important for all patients admitted to the hospital to be screened for the risk of developing a DVT. This could be easily accomplished by performing a risk factor assessment-screening tool on all patients. It is also important to educate the medical and nursing staff on the fact that all patients are at risk for developing DVT, not just surgical patients who are often believed to be at the highest risk of DVT. The implementation of the risk factor assessment could potentially save lives and reduce the hospital costs of treating and managing the complications of DVT and venous thromboembolic disease. The cases chosen for review in this article will demonstrate many risk factors that often go overlooked in nonsurgical patients. The implementation of a risk factor assessment tool could potentially aid in the recognition and appropriate prophylaxis of those patients who are at extremely high risk for DVT. Without appropriate recognition of the risk for DVT, patients may be placed at risk for DVT and the potentially fatal and/or debilitating complications associated with the development of DVT.

Assessment of Attention to Clothing and Impact of Its Restrictive Factors in Iranian Patients with Traumatic Spinal Cord Injury (ACIRF-SCI): Introduction of a New Questionnaire.

PubMed

Laleh, Leila; Latifi, Sahar; Koushki, Davood; Matin, Marzieh; Javidan, Abbas Norouzi; Yekaninejad, Mir Saeed

2015-01-01

Patients with spinal cord injury (SCI) deal with various restrictive factors regarding their clothing, such as disability and difficulty with access to shopping centers. We designed a questionnaire to assess attention to clothing and impact of its restrictive factors among Iranian patients with SCI (ACIRF-SCI). The ACIRF-SCI has 5 domains: functional, medical, attitude, aesthetic, and emotional. The first 3 domains reflect the impact of restrictive factors (factors that restrict attention to clothing), and the last 2 domains reflect attention to clothing and fashion. Functional restrictive factors include disability and dependence. Medical restrictive factors include existence of specific medical conditions that interfere with clothing choice. Construct validity was assessed by factorial analysis, and reliability was expressed by Cronbach's alpha. A total of 100 patients (75 men and 25 women) entered this study. Patients with a lower injury level had a higher total score (P < .0001), and similarly, patients with paraplegia had higher scores than those with tetraplegia (P < .0001), which illustrates an admissible discriminant validity. Postinjury duration was positively associated with total scores (r = 0.21, P = .04). Construct validity was 0.97, and Cronbach's alpha was 0.61. Iranian patients with SCI who have greater ability and independence experience a lower impact of restrictive factors related to clothing. The ACIRF-SCI reveals that this assumption is statistically significant, which shows its admissible discriminant validity. The measured construct validity (0.97) and reliability (internal consistency expressed by alpha = 0.61) are acceptable.

Factors influencing wound dehiscence.

PubMed

Riou, J P; Cohen, J R; Johnson, H

1992-03-01

Thirty-one abdominal fascial wound dehiscences occurred in 2,761 patients undergoing major abdominal surgery during a 5-year period (1%). Twenty-two specific local and systemic risk factors were analyzed and compared with the risk factors of a control group of 38 patients undergoing similar procedures without dehiscence. Through multivariate analysis, each factor was assessed as an independent statistical variable. Significant factors (p less than 0.05) were found to include age over 65, wound infection, pulmonary disease, hemodynamic instability, and ostomies in the incision. Additional systemic risk factors that were found to be significant included hypoproteinemia, systemic infection, obesity, uremia, hyperalimentation, malignancy, ascites, steroid use, and hypertension. Risk factors not found to be important independent variables included sex, type of incision, type of closure, foreign body in the wound, anemia, jaundice, and diabetes. When dehiscence and control groups were combined, 30% of patients with at least five significant risk factors developed dehiscence, and all the patients with more than eight risk factors developed a wound dehiscence. There was an overall mortality of 29%, which was directly related to the number of significant risk factors. The co-existence of 9 risk factors portended death in one third of the patients, and all the patients with more than 10 risk factors died.

Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: the impact of method variance and suppressor effects.

PubMed

Blonigen, Daniel M; Patrick, Christopher J; Douglas, Kevin S; Poythress, Norman G; Skeem, Jennifer L; Lilienfeld, Scott O; Edens, John F; Krueger, Robert F

2010-03-01

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective-interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. PsycINFO Database Record (c) 2010 APA, all rights reserved.

An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods.

PubMed

Alizai, Hamza; Roemer, Frank W; Hayashi, Daichi; Crema, Michel D; Felson, David T; Guermazi, Ali

2015-03-01

Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available for evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems.

Assessment of economic factors affecting the satellite power system. Volume 1: System cost factors

NASA Technical Reports Server (NTRS)

Hazelrigg, G. A., Jr.

1978-01-01

The factors relevant to SPS costing and selection of preferred SPS satellite configurations were studied. The issues discussed are: (1) consideration of economic factors in the SPS system that relate to selection of SPS satellite configuration; (2) analysis of the proper rate of interest for use in SPS system definition studies; and (3) the impacts of differential inflation on SPS system definition costing procedures. A cost-risk comparison of the SPS satellite configurations showed a significant difference in the levelized cost of power from them. It is concluded, that this difference is the result more of differences in the procedures for assessing costs rather than in the satellite technologies required or of any advantages of one satellite configuration over the other. Analysis of the proper rate of interest for use in SPS system is 4 percent. The major item of differential inflation to be expected over this period of time is the real cost of labor. This cost is likely to double between today and the period of SPS construction.

Level Descriptions and Teacher Assessment in England: Towards a Community of Assessment Practice.

ERIC Educational Resources Information Center

Hall, Kathy; Harding, Austin

2002-01-01

Interviews with 48 British elementary teachers and assessment coordinators about level descriptions to evaluate students (summary statements of performance on the National Curriculum) found that communities of assessment practice have developed within schools but not more widely. Factors inhibiting growth include lesser status of teacher…

Risk factor assessment to anticipate performance in the National Developmental Screening Test in children from a disadvantaged area.

PubMed

Montes, Alejandro; Pazos, Gustavo

2016-02-01

Identifying children at risk of failing the National Developmental Screening Test by combining prevalences of children suspected of having inapparent developmental disorders (IDDs) and associated risk factors (RFs) would allow to save resources. 1. To estimate the prevalence of children suspected of having IDDs. 2. To identify associated RFs. 3. To assess three methods developed based on observed RFs and propose a pre-screening procedure. The National Developmental Screening Test was administered to 60 randomly selected children aged between 2 and 4 years old from a socioeconomically disadvantaged area from Puerto Madryn. Twenty-four biological and socioenvironmental outcome measures were assessed in order to identify potential RFs using bivariate and multivariate analyses. The likelihood of failing the screening test was estimated as follows: 1. a multivariate logistic regression model was developed; 2. a relationship was established between the number of RFs present in each child and the percentage of children who failed the test; 3. these two methods were combined. The prevalence of children suspected of having IDDs was 55.0% (95% confidence interval: 42.4%-67.6%). Six RFs were initially identified using the bivariate approach. Three of them (maternal education, number of health checkups and Z scores for height-for-age, and maternal age) were included in the logistic regression model, which has a greater explanatory power. The third method included in the assessment showed greater sensitivity and specificity (85% and 79%, respectively). The estimated prevalence of children suspected of having IDDs was four times higher than the national standards. Seven RFs were identified. Combining the analysis of risk factor accumulation and a multivariate model provides a firm basis for developing a sensitive, specific and practical pre-screening procedure for socioeconomically disadvantaged areas. Sociedad Argentina de Pediatría.

Risk factor assessment of endoscopically removed malignant colorectal polyps

PubMed Central

Netzer, P; Forster, C; Biral, R; Ruchti, C; Neuweiler, J; Stauffer, E; Schonegg, R; Maurer, C; Husler, J; Halter, F; Schmassmann, A

1998-01-01

Background—Malignant colorectal polyps are defined as endoscopically removed polyps with cancerous tissue which has invaded the submucosa. Various histological criteria exist for managing these patients. 
Aims—To determine the significance of histological findings of patients with malignant polyps. 
Methods—Five pathologists reviewed the specimens of 85 patients initially diagnosed with malignant polyps. High risk malignant polyps were defined as having one of the following: incomplete polypectomy, a margin not clearly cancer-free, lymphatic or venous invasion, or grade III carcinoma. Adverse outcome was defined as residual cancer in a resection specimen and local or metastatic recurrence in the follow up period (mean 67months). 
Results—Malignant polyps were confirmed in 70 cases. In the 32 low risk malignant polyps, no adverse outcomes occurred; 16(42%) of the 38 patients with high risk polyps had adverse outcomes (p<0.001). Independent adverse risk factors were incomplete polypectomy and a resected margin not clearly cancer-free; all other risk factors were only associated with adverse outcome when in combination. 
Conclusion—As no patients with low risk malignant polyps had adverse outcomes, polypectomy alone seems sufficient for these cases. In the high risk group, surgery is recommended when either of the two independent risk factors, incomplete polypectomy or a resection margin not clearly cancer-free, is present or if there is a combination of other risk factors. As lymphatic or venous invasion or grade III cancer did not have an adverse outcome when the sole risk factor, operations in such cases should be individually assessed on the basis of surgical risk. 

 Keywords: malignant polyps; colon cancer; colonoscopy; polypectomy; histology PMID:9824349

Factor Structure and Reliability of Test Items for Saudi Teacher Licence Assessment

ERIC Educational Resources Information Center

Alsadaawi, Abdullah Saleh

2017-01-01

The Saudi National Assessment Centre administers the Computer Science Teacher Test for teacher certification. The aim of this study is to explore gender differences in candidates' scores, and investigate dimensionality, reliability, and differential item functioning using confirmatory factor analysis and item response theory. The confirmatory…

Assessing and Promoting Spiritual Wellness as a Protective Factor in Secondary Schools

ERIC Educational Resources Information Center

Briggs, Michele Kielty; Akos, Patrick; Czyszczon, Greg; Eldridge, Ashley

2011-01-01

Spiritual wellness, much like resilience, is a multidimensional protective factor for students. This article reviews the relevant literature linking spiritual wellness and thriving in the adolescent population. Assessment and intervention methods that can be used in secondary school settings to promote spiritual wellness are provided.

Assessing culturally sensitive factors in the learning environment of science classrooms

NASA Astrophysics Data System (ADS)

Fisher, Darrell L.; Waldrip, Bruce G.

1997-03-01

As schools are becoming increasingly diverse in their scope and clientele, any examination of the interaction of culturally sensitive factors of students' learning environments with learning science assumes critical importance. The purpose of this exploratory study was to develop an instrument to assess learning environment factors that are culturally sensitive, to provide initial validation information on the instrument and to examine associations between students' perceptions of their learning environments and their attitudes towards science and achievement of enquiry skills. A measure of these factors of science student's learning environment, namely the Cultural Learning Environment Questionnaire (CLEQ), was developed from past learning environment instruments and influenced by Hofstede's four dimensions of culture (Power Distance, Uncertainty Avoidance, Individualism, and Masculinity/Femininity). The reliability and discriminant validity for each scale were obtained and associations between learning environment, attitude to science and enquiry skills achievement were found.

Assessment of relevant factors and relationships concerning human dermal exposure to pesticides in greenhouse applications.

PubMed

Martínez Vidal, Jose L; Egea González, Francisco J; Garrido Frenich, Antonia; Martínez Galera, María; Aguilera, Pedro A; López Carrique, Enrique

2002-08-01

Principal component analysis (PCA) was applied to the gas chromatographic data obtained from 23 different greenhouse trials. This was used to establish which factors, including application technique (very small, small, medium and large drop-size), crop characteristics (short/tall, thin/dense) and pattern application of the operator (walking towards or away from the treated area) are relevant to the dermal exposure levels of greenhouse applicators. The results showed that the highest exposure by pesticides during field applications in greenhouses, in the climatic conditions and in the crop conditions typical of a southern European country, occurs on the lower legs and front thighs of the applicators. Similar results were obtained by hierarchical cluster analysis (HCA). Drop-size seems to be very important in determining total exposure, while height and density of crops have little influence on total exposure under the conditions of the present study. No pesticide type is a major factor in total exposure. The application of multiple regression analysis (MRA) allowed assessment of the relationships between the pesticide exposure of the less affected parts of the body with the most affected parts.

Latent Factor Structure of the Das-Naglieri Cognitive Assessment System: A Confirmatory Factor Analysis in a Chinese Setting

ERIC Educational Resources Information Center

Deng, Ci-ping; Liu, Ming; Wei, Wei; Chan, Raymond C. K.; Das, J. P.

2011-01-01

This study aims to measure the psychometric properties of the Das-Naglieri Cognitive Assessment System (D-N CAS) and to determine its clinical utility in a Chinese context. Confirmatory factor analysis (CFA) was conducted to examine the construct validity of the Chinese version of the D-N CAS among a group of 567, normally developed children.…

[Study on the relationship between childhood obesity and various determinants, including socioeconomic factors, in an urban area].

PubMed

Kang, Hee-Tae; Ju, Young-Su; Park, Kyung-Hee; Kwon, Young-Jun; Im, Hyoung-June; Paek, Do-Myung; Lee, Hyun-Joo

2006-09-01

This study was conducted to investigate the prevalence of childhood obesity, the association between the undesirable lifestyles and socioeconomic factors, the association between childhood obesity and various risk factors, including socioeconomic factors, and the agreement between the body mass index (BMI) classification and the body fat percentage. The study subjects were all the 5th grade students from all the elementary schools in Gunpo City, Kyunggi Province, South Korea (4043 children at 22 schools). The subjects were measured for their height, weight and percent body fat etc. and they were also surveyed by questionnaire from March 18th to April 25th, 2005. To determine whether the children were within normal limits or not, standardized BMIs for each age group were used. The data was analyzed by logistic regression analysis using SAS 9.0 version. The prevalence of childhood obesity prevalence was 25.1%. Boys had a higher prevalence of obesity (27.5%) than did the girls (22.5%). Children had tendencies of having undesirable lifestyles and getting obese if they had a lower socioeconomic status. The risk factors for childhood obesity were low paternal education (OR: 1.17, 95% CI: 0.97-1.42) and non-parental caregivers (OR: 1.34, 95% CI: 0.98-1.82). Other risk factors for childhood obesity were a high birth-weight, longer TV/computer-using time, a lower fruit-eating frequency, short sleeping hours and parental obesity. The agreement rate between the BMI classification and the body fat percentage was 93.1%. This study showed the children had a higher prevalence of obesity: further, not only individual lifestyles, but also socioeconomic factors could influence childhood obesity. Childhood obesity was especially more problematic for children with a low socioeconomic status.

Modelling the pre-assessment learning effects of assessment: evidence in the validity chain.

PubMed

Cilliers, Francois J; Schuwirth, Lambert W T; van der Vleuten, Cees P M

2012-11-01

We previously developed a model of the pre-assessment learning effects of consequential assessment and started to validate it. The model comprises assessment factors, mechanism factors and learning effects. The purpose of this study was to continue the validation process. For stringency, we focused on a subset of assessment factor-learning effect associations that featured least commonly in a baseline qualitative study. Our aims were to determine whether these uncommon associations were operational in a broader but similar population to that in which the model was initially derived. A cross-sectional survey of 361 senior medical students at one medical school was undertaken using a purpose-made questionnaire based on a grounded theory and comprising pairs of written situational tests. In each pair, the manifestation of an assessment factor was varied. The frequencies at which learning effects were selected were compared for each item pair, using an adjusted alpha to assign significance. The frequencies at which mechanism factors were selected were calculated. There were significant differences in the learning effect selected between the two scenarios of an item pair for 13 of this subset of 21 uncommon associations, even when a p-value of < 0.00625 was considered to indicate significance. Three mechanism factors were operational in most scenarios: agency; response efficacy, and response value. For a subset of uncommon associations in the model, the role of most assessment factor-learning effect associations and the mechanism factors involved were supported in a broader but similar population to that in which the model was derived. Although model validation is an ongoing process, these results move the model one step closer to the stage of usefully informing interventions. Results illustrate how factors not typically included in studies of the learning effects of assessment could confound the results of interventions aimed at using assessment to influence learning

Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury

PubMed Central

Dobscha, Steven K.; Clark, Michael E.; Morasco, Benjamin J.; Freeman, Michele; Campbell, Rose; Helfand, Mark

2010-01-01

Objective To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design Systematic review. Methods We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated. PMID:19818031

Assessment of Risk Factors of Helicobacter Pylori Infection and Peptic Ulcer Disease

PubMed Central

Mhaskar, Rahul S; Ricardo, Izurieta; Azliyati, Azizan; Laxminarayan, Rajaram; Amol, Bapaye; Santosh, Walujkar; Boo, Kwa

2013-01-01

Background: Helicobacter pylori (H. pylori) infection is a risk factor for peptic ulcer. There have been no studies addressing environmental and dietary risk factors in western India. We conducted a case control study enrolling peptic ulcer patients in Pune, India. Materials and Methods: Risk factors for peptic ulcer and H. pylori infection were assessed in a participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. Results: We enrolled 190 peptic ulcer, 35 stomach cancer patients, and 125 controls. Fifty-one percent (180/350) of the participants were infected with H. pylori. Lower socioeconomic status (SES) [odds ratio (OR): 1.10, 95% confidence interval (CI): 1.02–1.39], meat consumption (OR: 2.35, 95% CI: 1.30–4.23), smoking (OR: 2.23, 95% CI: 1.24–4.02), eating restaurant food (OR: 3.77, 95% CI: 1.39–10.23), and drinking nonfiltered or nonboiled water (OR: 1.05, 95% CI: 1.01–1.23) were risk factors for H. pylori infection. H. pylori infection (OR: 1.70, 95% CI: 1.03–2.89), meat (OR: 1.10, 95% CI: 1.02-1.75), fish (OR: 1.05, 95% CI: 1.02–1.89) consumption, and a family history of ulcer (OR: 1.20, 95% CI: 1.08–1.60) were risk factors for peptic ulcer. Consumption of chili peppers (OR: 0.20, 95% CI: 0.10–0.37) and parasite infestation (OR: 0.44, 95% CI: 0.24–0.80) were protective against H. pylori infection. Conclusion: H. pylori infection is associated with peptic ulcer. Lower SES, consumption of restaurant food, meat, nonfiltered water, and smoking are risk factors for H. pylori. Consumption of meat, fish, and a family history of peptic ulcer are risk factors for peptic ulcer. Consumption of chili peppers and concurrent parasite infestation appear to be protective against H. pylori. PMID:23853433

Exposure Factors Handbook (1996, External Review Draft)

EPA Science Inventory

This handbook provided a summary of the available statistical data on various factors used in assessing human exposure.

Volume I, General Factors, includes an introduction and discussion of uncertainty and provides data for drinking water consumption, soil ingestion, inha...

Assessing risk factors for early hip osteoarthritis in activity-related hip pain: a Delphi study

PubMed Central

Jackson, K A; Glyn-Jones, S; Batt, M E; Arden, N K; Newton, J L

2015-01-01

Objective Hip pain and injury as a result of activity can lead to the development of early hip osteoarthritis (OA) in susceptible individuals. Our understanding of the factors that increase susceptibility continues to evolve. The ability to clearly identify individuals (and cohorts) with activity-related hip pain who are at risk of early hip OA is currently lacking. The purpose of this study was to gain expert consensus on which key clinical measures might help predict the risk of early hip OA in individuals presenting with activity-related hip pain. The agreed measures would constitute a standardised approach to initial clinical assessment to help identify these individuals. Methods This Dephi study used online surveys to gain concordance of expert opinion in a structured process of ‘rounds’. In this study, we asked ‘What outcome measures are useful in predicting hip OA in activity-related hip pain?’ The Delphi panel consisted of experts from sport and exercise medicine, orthopaedics, rheumatology, physiotherapy and OA research. Results The study identified key clinical measures in the history, examination and investigations (plain anteroposterior radiograph and femoroacetabular impingement views) that the panel agreed would be useful in predicting future risk of hip OA when assessing activity-related hip pain. The panel also agreed that certain investigations and tests (eg, MR angiography) did not currently have a role in routine assessment. There was a lack of consensus regarding the role of MRI, patient-reported outcome measures (PROMs) and certain biomechanical and functional assessments. Conclusions We provide a standardised approach to the clinical assessment of patients with activity-related hip pain. Assessment measures rejected by the Delphi panel were newer, more expensive investigations that currently lack evidence. Assessment measures that did not reach consensus include MRI and PROMs. Their role remains ambiguous and would benefit from further

Identification and Quantification of Cumulative Factors that ...

EPA Pesticide Factsheets

Evaluating the combined adverse effects of multiple stressors upon human health is an imperative component of cumulative risk assessment (CRA)1. In addition to chemical stressors, other non-chemical factors are also considered. For examples, smoking will elevate the risks of having lung cancer associated with radon exposure2; toluene and noise together will induce higher levels of hearing loss3; children exposed to violence will have higher risks of developing asthma in the presence of air pollution4. Environmental Justice (EJ) indicators, used as a tool to assess and quantify some of these non-chemical factors, include health, economic, and social indicators such as vulnerability and susceptibility5. Vulnerability factors encompass race, ethnicity, behavior, geographic location, etc., while susceptibility factors include life stage, genetic predisposition, pre-existing health condition and others6, although these two categories are not always mutually exclusive. Numerous findings regarding combined effects of EJ indicators and chemical stressors have been identified7-11. However, fewer studies have analyzed the interrelation between multiple stressors that exert combined harmful effects upon individual or population health in the context of exposure assessment within the risk assessment framework12. In this study, we connected EJ indicators to variables in the exposure assessment model, especially the Average Daily Dose (ADD) model13, in order to better underst

Defining Community Disaster Preparedness as a Resilience Factor for Earthquake Risk Assessment in Istanbul

NASA Astrophysics Data System (ADS)

Sungay, B.; Durukal, E.; Kilic, O.; Konukcu, B.; Basmaci, A. E.; Khazai, B.; Erdik, M.

2009-04-01

The natural events such as earthquakes turn out to be disasters as a result of not only the poor conditions of the built area and infrastructure, but also affected by the socioeconomic fragility and lack of resilience of the community exposed. Likewise, resilience factors play role in increasing the ability of people to cope with hazards. Social resilience is the capacity of social groups and communities to recover from, or respond positively to, crises. Emergency management plans must recognize and build on this capacity, and that improved indicators of social resilience should receive priority consideration in the application of these plans. The physical risk factors and their damage assessment have been pointed out in previous earthquake risk assessment and scenario studies conducted by Bogazici University and OYO International. A rational assessment of the risk aggravating factors is essential in order to reach to a more complete coverage of the overall risk. It would also introduce the social factors that need to be reduced or strengthened through public policies and actions in order to increase the resilience of the community. With experience from several social studies conducted under CENDIM, Kandilli Observatory & Earthquake Research Institute's Disaster Preparedness Education Unit, and research of the studies conducted by several other national and international institutions, we are defining the community disaster preparedness as an indicator for resilience. Social resilience is understood to have two important properties: resistance, recovery. Resistance relates to a community's efforts to withstand a disaster and its consequences whereas recovery relates to a community's ability to coming back to its pre-disaster level of "normalcy". Researches also indicate that the need for local-level and community-based approaches is recognized in achieving sustainable hazard risk reduction. We will conceptually discuss the description and assessment of the community

Assessing efficacy and therapeutic claims in emerging indications for recombinant factor VIIa: regulatory perspectives.

PubMed

Farrugia, Albert

2006-01-01

When compared with the evidence-based, cost-effectiveness criteria underpinning most government reimbursement schemes in the social market economies, the three regulatory hurdles of safety, quality and efficacy are probably of modest impact in influencing increased usage of recombinant activated factor VII (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark). Nevertheless, efficacy claims must be supported if regulatory approval is to be granted for the wider range of indications that have been proposed for rFVIIa. With the refinement of clinical trial designs over the past 40 years, the randomized controlled trial (RCT) has assumed the role of gold standard, providing the highest level of evidence for therapeutic efficacy. However, it is incorrect to assume that regulatory authorities give sole credence to RCTs in assessing claims. It is noteworthy that the indications already accepted for rFVIIa by international regulatory authorities--including the treatment of inhibitors to factor VIII and factor IX, substitution for FVII deficiency, and treatment of Glanzmann's thrombasthenia--were supported not by RCTs but by studies conventionally considered to provide modest evidence levels. Therefore, the use of studies other than RCTs for the more recently proposed indications for rFVIIa in a range of conditions requiring hemostatic correction is perfectly feasible. What regulators expect are well-conducted and well-described studies adhering to principles of good clinical practice, which can be scrutinized for evidence of clinical efficacy and which are based on the initially proven principle for the drug. This paper discusses the regulatory history of rFVIIa in the major regulatory authorities and assesses the route needed to support claims being made in the mainstream literature. Recent episodes where post-market events have forced regulators to be more than usually cautious will be used as examples to suggest possible pitfalls to the extension of approved claims for

Identifying Items to Assess Methodological Quality in Physical Therapy Trials: A Factor Analysis

PubMed Central

Cummings, Greta G.; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd

2014-01-01

Background Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. Objective The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). Design A methodological research design was used, and an EFA was performed. Methods Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Results Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Limitation Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. Conclusions To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor

Multi-method Assessment of Psychopathy in Relation to Factors of Internalizing and Externalizing from the Personality Assessment Inventory: The Impact of Method Variance and Suppressor Effects

PubMed Central

Blonigen, Daniel M.; Patrick, Christopher J.; Douglas, Kevin S.; Poythress, Norman G.; Skeem, Jennifer L.; Lilienfeld, Scott O.; Edens, John F.; Krueger, Robert F.

2010-01-01

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multi-method approach to psychopathy assessment (self-report, interview/file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (PAI; L. Morey, 2007). Consistent with prediction, scores on the affective-interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. PMID:20230156

What factors are most relevant to the assessment of work ability of employees on long-term sick leave? The physicians' perspective.

PubMed

Dekkers-Sánchez, Patricia M; Wind, Haije; Sluiter, Judith K; Frings-Dresen, Monique H W

2013-07-01

To reach insurance physician (IPs) consensus on factors that must be taken into account in the assessment of the work ability of employees who are sick-listed for 2 years. A Delphi study using online questionnaires was conducted from October 2010 to March 2011. One hundred and two insurance physicians reached a consensus on important factors for return to work (RTW) of employees on long-term sick leave; from those factors, the most relevant for the assessment of work ability was determined. From a total of 22 relevant factors considered for the return to work of long-term sick-listed employees, consensus was reached on nine relevant factors that need to be taken into account in the assessment of the work ability of employees on long-term sick leave. Relevant factors that support return to work are motivation, attitude towards RTW, assessment of cognitions and behaviour, vocational rehabilitation in an early stage and instruction for the sick-listed employee to cope with his disabilities. Relevant factors that hinder RTW are secondary gain from illness, negative perceptions of illness, inefficient coping style and incorrect advice of treating physicians regarding RTW. Non-medical personal and environmental factors may either hinder or promote RTW and must be considered in the assessment of the work ability of long-term sick-listed employees. Assessment of work ability should start early during the sick leave period. These factors may be used by IPs to improve the quality of the assessment of the work ability of employees on long-term sick leave.

Using Dynamic Risk and Protective Factors to Predict Inpatient Aggression: Reliability and Validity of START Assessments

PubMed Central

Desmarais, Sarah L.; Nicholls, Tonia L.; Wilson, Catherine M.; Brink, Johann

2012-01-01

The Short-Term Assessment of Risk and Treatability (START) is a relatively new structured professional judgment guide for the assessment and management of short-term risks associated with mental, substance use, and personality disorders. The scheme may be distinguished from other violence risk instruments because of its inclusion of 20 dynamic factors that are rated in terms of both vulnerability and strength. This study examined the reliability and validity of START assessments in predicting inpatient aggression. Research assistants completed START assessments for 120 male forensic psychiatric patients through review of hospital files. They additionally completed Historical-Clinical-Risk Management – 20 (HCR-20) and the Hare Psychopathy Checklist: Screening Version (PCL:SV) assessments. Outcome data was coded from hospital files for a 12-month follow-up period using the Overt Aggression Scale (OAS). START assessments evidenced excellent interrater reliability and demonstrated both predictive and incremental validity over the HCR-20 Historical subscale scores and PCL:SV total scores. Overall, results support the reliability and validity of START assessments, and use of the structured professional judgment approach more broadly, as well as the value of using dynamic risk and protective factors to assess violence risk. PMID:22250595

Assessment of Attention to Clothing and Impact of Its Restrictive Factors in Iranian Patients with Traumatic Spinal Cord Injury (ACIRF-SCI): Introduction of a New Questionnaire

PubMed Central

Laleh, Leila; Koushki, Davood; Matin, Marzieh; Javidan, Abbas Norouzi; Yekaninejad, Mir Saeed

2015-01-01

Background: Patients with spinal cord injury (SCI) deal with various restrictive factors regarding their clothing, such as disability and difficulty with access to shopping centers. Objectives: We designed a questionnaire to assess attention to clothing and impact of its restrictive factors among Iranian patients with SCI (ACIRF-SCI). Methods: The ACIRF-SCI has 5 domains: functional, medical, attitude, aesthetic, and emotional. The first 3 domains reflect the impact of restrictive factors (factors that restrict attention to clothing), and the last 2 domains reflect attention to clothing and fashion. Functional restrictive factors include disability and dependence. Medical restrictive factors include existence of specific medical conditions that interfere with clothing choice. Construct validity was assessed by factorial analysis, and reliability was expressed by Cronbach’s alpha. Results: A total of 100 patients (75 men and 25 women) entered this study. Patients with a lower injury level had a higher total score (P < .0001), and similarly, patients with paraplegia had higher scores than those with tetraplegia (P < .0001), which illustrates an admissible discriminant validity. Postinjury duration was positively associated with total scores (r = 0.21, P = .04). Construct validity was 0.97, and Cronbach’s alpha was 0.61. Conclusion: Iranian patients with SCI who have greater ability and independence experience a lower impact of restrictive factors related to clothing. The ACIRF-SCI reveals that this assumption is statistically significant, which shows its admissible discriminant validity. The measured construct validity (0.97) and reliability (internal consistency expressed by alpha = 0.61) are acceptable. PMID:26363593

Dispelling urban myths about default uncertainty factors in chemical risk assessment – sufficient protection against mixture effects?

PubMed Central

2013-01-01

Assessing the detrimental health effects of chemicals requires the extrapolation of experimental data in animals to human populations. This is achieved by applying a default uncertainty factor of 100 to doses not found to be associated with observable effects in laboratory animals. It is commonly assumed that the toxicokinetic and toxicodynamic sub-components of this default uncertainty factor represent worst-case scenarios and that the multiplication of those components yields conservative estimates of safe levels for humans. It is sometimes claimed that this conservatism also offers adequate protection from mixture effects. By analysing the evolution of uncertainty factors from a historical perspective, we expose that the default factor and its sub-components are intended to represent adequate rather than worst-case scenarios. The intention of using assessment factors for mixture effects was abandoned thirty years ago. It is also often ignored that the conservatism (or otherwise) of uncertainty factors can only be considered in relation to a defined level of protection. A protection equivalent to an effect magnitude of 0.001-0.0001% over background incidence is generally considered acceptable. However, it is impossible to say whether this level of protection is in fact realised with the tolerable doses that are derived by employing uncertainty factors. Accordingly, it is difficult to assess whether uncertainty factors overestimate or underestimate the sensitivity differences in human populations. It is also often not appreciated that the outcome of probabilistic approaches to the multiplication of sub-factors is dependent on the choice of probability distributions. Therefore, the idea that default uncertainty factors are overly conservative worst-case scenarios which can account both for the lack of statistical power in animal experiments and protect against potential mixture effects is ill-founded. We contend that precautionary regulation should provide an

Implementing groundwater extraction in life cycle impact assessment: characterization factors based on plant species richness for The Netherlands.

PubMed

van Zelm, Rosalie; Schipper, Aafke M; Rombouts, Michiel; Snepvangers, Judith; Huijbregts, Mark A J

2011-01-15

An operational method to evaluate the environmental impacts associated with groundwater use is currently lacking in life cycle assessment (LCA). This paper outlines a method to calculate characterization factors that address the effects of groundwater extraction on the species richness of terrestrial vegetation. Characterization factors (CF) were derived for The Netherlands and consist of a fate and an effect part. The fate factor equals the change in drawdown due to a change in groundwater extraction and expresses the amount of time required for groundwater replenishment. It was obtained with a grid-specific steady-state groundwater flow model. Effect factors were obtained from groundwater level response curves of potential plant species richness, which was constructed based on the soil moisture requirements of 625 plant species. Depending on the initial groundwater level, effect factors range up to 9.2% loss of species per 10 cm of groundwater level decrease. The total Dutch CF for groundwater extraction depended on the value choices taken and ranged from 0.09 to 0.61 m(2)·yr/m(3). For tap water production, we showed that groundwater extraction can be responsible for up to 32% of the total terrestrial ecosystem damage. With the proposed approach, effects of groundwater extraction on terrestrial ecosystems can be systematically included in LCA.

Towards Clinical Application of Neurotrophic Factors to the Auditory Nerve; Assessment of Safety and Efficacy by a Systematic Review of Neurotrophic Treatments in Humans.

PubMed

Bezdjian, Aren; Kraaijenga, Véronique J C; Ramekers, Dyan; Versnel, Huib; Thomeer, Hans G X M; Klis, Sjaak F L; Grolman, Wilko

2016-11-26

Animal studies have evidenced protection of the auditory nerve by exogenous neurotrophic factors. In order to assess clinical applicability of neurotrophic treatment of the auditory nerve, the safety and efficacy of neurotrophic therapies in various human disorders were systematically reviewed. Outcomes of our literature search included disorder, neurotrophic factor, administration route, therapeutic outcome, and adverse event. From 2103 articles retrieved, 20 randomized controlled trials including 3974 patients were selected. Amyotrophic lateral sclerosis (53%) was the most frequently reported indication for neurotrophic therapy followed by diabetic polyneuropathy (28%). Ciliary neurotrophic factor (50%), nerve growth factor (24%) and insulin-like growth factor (21%) were most often used. Injection site reaction was a frequently occurring adverse event (61%) followed by asthenia (24%) and gastrointestinal disturbances (20%). Eighteen out of 20 trials deemed neurotrophic therapy to be safe, and six out of 17 studies concluded the neurotrophic therapy to be effective. Positive outcomes were generally small or contradicted by other studies. Most non-neurodegenerative diseases treated by targeted deliveries of neurotrophic factors were considered safe and effective. Hence, since local delivery to the cochlea is feasible, translation from animal studies to human trials in treating auditory nerve degeneration seems promising.

Elevated post-void residual volume in a geriatric post-hip fracture assessment in women-associated factors and risk of mortality.

PubMed

Nuotio, Maria S; Luukkaala, Tiina; Tammela, Teuvo

2018-04-09

Multiple factors contribute to elevated post-void residual urine volumes (PVR), but they may indicate detrusor underactivity (DU), especially in older women. The aim here was to examine factors associated with and prognostic significance of elevated PVR in a geriatric post-hip fracture assessment in a female population. Consecutive female hip fracture patients (n = 409) aged 65 years and older were included. PVR was measured by bladder scanner. PVR of 160 ml or more was deemed elevated. Age-adjusted univariate logistic regression analyses were conducted to examine the association of the domains of the comprehensive geriatric assessment (CGA) with elevated PVR. Cox proportional hazards model was used to determine the age-adjusted association of an elevated PVR with 1-year mortality. Of the patients, 64 (15.6%) had elevated PVR. Having urinary or fecal incontinence, difficulties in physical activities of daily living, malnutrition, poor performance on Timed Up and Go and Elderly Mobility Scale were significantly associated with elevated PVR. Difficulties in instrumental activities of daily living, renal dysfunction, constipation, polypharmacy, nocturia, cognitive impairment and depressive mood were not associated with elevated PVR. Elevated PVR significantly increased the risk of mortality 1 year post hip fracture. Elevated PVR is relatively common in older female hip fracture patients and associated with physical functioning, malnutrition and risk of mortality. Even though a causal relationship cannot be confirmed, the findings may suggest a relationship between DU and physical frailty. PVR deserves to be included in the CGA of frail older patients including women.

Should Student Evaluation of Teaching Play a Significant Role in the Formal Assessment of Dental Faculty? Two Viewpoints: Viewpoint 1: Formal Faculty Assessment Should Include Student Evaluation of Teaching and Viewpoint 2: Student Evaluation of Teaching Should Not Be Part of Formal Faculty Assessment.

PubMed

Rowan, Susan; Newness, Elmer J; Tetradis, Sotirios; Prasad, Joanne L; Ko, Ching-Chang; Sanchez, Arlene

2017-11-01

Student evaluation of teaching (SET) is often used in the assessment of faculty members' job performance and promotion and tenure decisions, but debate over this use of student evaluations has centered on the validity, reliability, and application of the data in assessing teaching performance. Additionally, the fear of student criticism has the potential of influencing course content delivery and testing measures. This Point/Counterpoint article reviews the potential utility of and controversy surrounding the use of SETs in the formal assessment of dental school faculty. Viewpoint 1 supports the view that SETs are reliable and should be included in those formal assessments. Proponents of this opinion contend that SETs serve to measure a school's effectiveness in support of its core mission, are valid measures based on feedback from the recipients of educational delivery, and provide formative feedback to improve faculty accountability to the institution. Viewpoint 2 argues that SETs should not be used for promotion and tenure decisions, asserting that higher SET ratings do not correlate with improved student learning. The advocates of this viewpoint contend that faculty members may be influenced to focus on student satisfaction rather than pedagogy, resulting in grade inflation. They also argue that SETs are prone to gender and racial biases and that SET results are frequently misinterpreted by administrators. Low response rates and monotonic response patterns are other factors that compromise the reliability of SETs.

Immunological Assays as an Opportunity of Assessment of Health Risks of Airborne Particle Mixture Including Nanoparticles

NASA Astrophysics Data System (ADS)

Brzicová, Táňa; Lochman, Ivo; Danihelka, Pavel; Lochmanová, Alexandra; Lach, Karel; Mička, Vladimír

2013-04-01

The aim of this pilot study was to evaluate perspectives of the assessment of nonspecific biological effects of airborne particulate matter including nanoparticles using appropriate immunological assays. We have selected various in vitro immunological assays to establish an array allowing us to monitor activation of the cell-mediated and humoral response of both the innate and adaptive immunity. To assess comprehensive interactions and effects, the assays were performed in whole blood cultures from healthy volunteers and we used an original airborne particle mixture from high pollution period in Ostrava region representing areas with one of the most polluted air in Europe. Even if certain effects were observed, the results of the immunological assays did not prove significant effects of airborne particles on immune cells' functions of healthy persons. However, obtained data do not exclude health risks of long-term exposure to airborne particles, especially in case of individuals with genetic predisposition to certain diseases or already existing disease. This study emphasizes the in vitro assessment of complex effects of airborne particles in conditions similar to actual ones in an organism exposed to particle mixture present in the polluted air.

Potency factors for risk assessment at Libby, Montana.

PubMed

Moolgavkar, Suresh H; Turim, Jay; Alexander, Dominik D; Lau, Edmund C; Cushing, Colleen A

2010-08-01

We reanalyzed the Libby vermiculite miners' cohort assembled by Sullivan to estimate potency factors for lung cancer, mesothelioma, nonmalignant respiratory disease (NMRD), and all-cause mortality associated with exposure to Libby fibers. Our principal statistical tool for analyses of lung cancer, NMRD, and total mortality in the cohort was the time-dependent proportional hazards model. For mesothelioma, we used an extension of the Peto formula. For a cumulative exposure to Libby fiber of 100 f/mL-yr, our estimates of relative risk (RR) are as follows: lung cancer, RR = 1.12, 95% confidence interval (CI) =[1.06, 1.17]; NMRD, RR = 1.14, 95% CI =[1.09, 1.18]; total mortality, RR = 1.06, 95% CI =[1.04, 1.08]. These estimates were virtually identical when analyses were restricted to the subcohort of workers who were employed for at least one year. For mesothelioma, our estimate of potency is K(M) = 0.5 x 10(-8), 95% CI =[0.3 x 10(-8), 0.8 x 10(-8)]. Finally, we estimated the mortality ratios standardized against the U.S. population for lung cancer, NMRD, and total mortality and obtained estimates that were in good agreement with those reported by Sullivan. The estimated potency factors form the basis for a quantitative risk assessment at Libby.

Assessment of family functioning in Caucasian and Hispanic Americans: reliability, validity, and factor structure of the Family Assessment Device.

PubMed

Aarons, Gregory A; McDonald, Elizabeth J; Connelly, Cynthia D; Newton, Rae R

2007-12-01

The purpose of this study was to examine the factor structure, reliability, and validity of the Family Assessment Device (FAD) among a national sample of Caucasian and Hispanic American families receiving public sector mental health services. A confirmatory factor analysis conducted to test model fit yielded equivocal findings. With few exceptions, indices of model fit, reliability, and validity were poorer for Hispanic Americans compared with Caucasian Americans. Contrary to our expectation, an exploratory factor analysis did not result in a better fitting model of family functioning. Without stronger evidence supporting a reformulation of the FAD, we recommend against such a course of action. Findings highlight the need for additional research on the role of culture in measurement of family functioning.

Empirical Assessment of Spatial Prediction Methods for Location Cost Adjustment Factors

PubMed Central

Migliaccio, Giovanni C.; Guindani, Michele; D'Incognito, Maria; Zhang, Linlin

2014-01-01

In the feasibility stage, the correct prediction of construction costs ensures that budget requirements are met from the start of a project's lifecycle. A very common approach for performing quick-order-of-magnitude estimates is based on using Location Cost Adjustment Factors (LCAFs) that compute historically based costs by project location. Nowadays, numerous LCAF datasets are commercially available in North America, but, obviously, they do not include all locations. Hence, LCAFs for un-sampled locations need to be inferred through spatial interpolation or prediction methods. Currently, practitioners tend to select the value for a location using only one variable, namely the nearest linear-distance between two sites. However, construction costs could be affected by socio-economic variables as suggested by macroeconomic theories. Using a commonly used set of LCAFs, the City Cost Indexes (CCI) by RSMeans, and the socio-economic variables included in the ESRI Community Sourcebook, this article provides several contributions to the body of knowledge. First, the accuracy of various spatial prediction methods in estimating LCAF values for un-sampled locations was evaluated and assessed in respect to spatial interpolation methods. Two Regression-based prediction models were selected, a Global Regression Analysis and a Geographically-weighted regression analysis (GWR). Once these models were compared against interpolation methods, the results showed that GWR is the most appropriate way to model CCI as a function of multiple covariates. The outcome of GWR, for each covariate, was studied for all the 48 states in the contiguous US. As a direct consequence of spatial non-stationarity, it was possible to discuss the influence of each single covariate differently from state to state. In addition, the article includes a first attempt to determine if the observed variability in cost index values could be, at least partially explained by independent socio-economic variables. PMID

Assessing Stress in Cancer Patients: A Second-Order Factor Analysis Model for the Perceived Stress Scale

ERIC Educational Resources Information Center

Golden-Kreutz, Deanna M.; Browne, Michael W.; Frierson, Georita M.; Andersen, Barbara L.

2004-01-01

Using the Perceived Stress Scale (PSS), perceptions of global stress were assessed in 111women following breast cancer surgery and at 12 and 24 months later. This is the first study to factor analyze the PSS. The PSS data were factor analyzed each time using exploratory factor analysis with oblique direct quartimin rotation. Goodness-of-fit…

A cross-sectional study on factors associated with patient-physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective.

PubMed

Wang, Charmaine Tze May; Fong, Warren; Kwan, Yu Heng; Phang, Jie Kie; Lui, Nai Lee; Leung, Ying Ying; Thumboo, Julian; Cheung, Peter P

2018-06-19

To identify the factors associated with patient-physician discordance in patients with axial spondyloarthritis (axSpA) in an Asian population. A cross-sectional study was conducted in two tertiary referral centers in Singapore. Patients with axSpA who fulfilled Assessment in Ankylosing Spondylitis International Working Group 2009 criteria for axSpA were included in the study. Socio-demographics, clinical, laboratory and patient-reported outcomes data were collected during study visits from 2014 to 2015. We performed univariate and multivariate linear regression analyses to evaluate the factors associated with patient-physician discordance, which we defined as the difference between Patient Global Assessment and Physician Global Assessment. Included in the study were 298 axSpA patients: 82% male, 81% Chinese, median age 40 (20-78) years, median disease duration 9 (0.1-48) years. 80% were on non-steroidal anti-inflammatory drugs and 23% on biologics. In univariate analysis, current age (β: 0.18, ρ = 0.06), duration of disease (β: 0.34, ρ = 0.03), post-secondary education level (β: -10.82, ρ = 0.03), global pain score (β: 0.33, ρ < 0.01), Bath Ankylosing Spondylitis Functional Index (β: 2.80, ρ < 0.01), Ankylosing Spondylitis Disease Activity Score C-reactive protein (β: 4.63, ρ < 0.01) and current use of biologics (β: 10.97, ρ < 0.01) were associated with patient-physician discordance. In multivariate analysis, global pain score (β: 0.32, ρ < 0.01), post-secondary education level (β: -12.80, ρ = 0.01) and current biologics use (β: 16.21, ρ < 0.01) were associated with patient-physician discordance. Higher global pain score, lower educational level and current biologics use were associated with greater patient-physician discordance. These factors should be considered during shared decision making. © 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Assessing cadmium exposure risks of vegetables with plant uptake factor and soil property.

PubMed

Yang, Yang; Chang, Andrew C; Wang, Meie; Chen, Weiping; Peng, Chi

2018-07-01

Plant uptake factors (PUFs) are of great importance in human cadmium (Cd) exposure risk assessment while it has been often treated in a generic way. We collected 1077 pairs of vegetable-soil samples from production fields to characterize Cd PUFs and demonstrated their utility in assessing Cd exposure risks to consumers of locally grown vegetables. The Cd PUFs varied with plant species and pH and organic matter content of soils. Once normalized PUFs against soil parameters, the PUFs distributions were log-normal in nature. In this manner, the PUFs were represented by definable probability distributions instead of a deterministic figure. The Cd exposure risks were then assessed using the normalized PUF based on the Monte Carlo simulation algorithm. Factors affecting the extent of Cd exposures were isolated through sensitivity analyses. Normalized PUF would illustrate the outcomes for uncontaminated and slightly contaminated soils. Among the vegetables, lettuce was potentially hazardous for residents due to its high Cd accumulation but low Zn concentration. To protect 95% of the lettuce production from causing excessive Cd exposure risks, pH of soils needed to be 5.9 and above. Copyright © 2018 Elsevier Ltd. All rights reserved.

Factors influencing the retention of midwives in the public sector in Afghanistan: a qualitative assessment of midwives in eight provinces.

PubMed

Wood, Molly E; Mansoor, G Farooq; Hashemy, Pashton; Namey, Emily; Gohar, Fatima; Ayoubi, Saadia Fayeq; Todd, Catherine S

2013-10-01

to examine factors that affect retention of public sector midwives throughout their career in Afghanistan. qualitative assessment using semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). health clinics in eight provinces in Afghanistan, midwifery education schools in three provinces, and stakeholder organisations in Kabul. purposively sampled midwifery profession stakeholders in Kabul (n=14 IDIs); purposively selected community midwifery students in Kabul (n=3 FGDs), Parwan (n=1 FGD) and Wardak (n=1 FGD) provinces (six participants per FGD); public sector midwives, health facility managers, and community health workers from randomly selected clinics in eight provinces (n=48 IDIs); midwives who had left the public sector midwifery service (n=5 IDIs). several factors affect a midwife throughout her career in the public sector, including her selection as a trainee, the training itself, deployment to her pre-assigned post, and working in clinics. Overall, appropriate selection is the key to ensuring deployment and retention later on in a midwife's career. Other factors that affect retention of midwives include civil security concerns in rural areas, support of family and community, salary levels, professional development opportunities and workplace support, and inefficient human resources planning in the public sector. Factors affecting midwife retention are linked to problems within the community midwifery education (CME) programme and those reflecting the wider Afghan context. Civil insecurity and traditional attitudes towards women were major factors identified that negatively affect midwifery retention. Factors such as civil insecurity and traditional attitudes towards women require a multisectoral response and innovative strategies to reduce their impact. However, factors inherent to midwife career development also impact retention and may be more readily modified. © 2013 Elsevier Ltd. All rights reserved.

Consideration of the FQPA Safety Factor and Other Uncertainty Factors in Cumulative Risk Assessment of Chemicals Sharing a Common Mechanism of Toxicity

EPA Pesticide Factsheets

This guidance document provides OPP's current thinking on application of the provision in FFDCA about an additional safety factor for the protection of infants and children in the context of cumulative risk assessments.

Incentives and other factors associated with employee participation in health risk assessments.

PubMed

Taitel, Michael S; Haufle, Vincent; Heck, Debi; Loeppke, Ronald; Fetterolf, Donald

2008-08-01

Investigate factors associated with employee participation rates in health risk assessments. This cross-sectional study using multiple regression analyzed data from 124 employers with 882,275 eligible employees who completed 344,825 health and productivity assessments (HPAs). Incentive value and Communications and Organizational Commitment Level (Com/Org Level) were the strongest predictors of HPA completion rates. Employer size and a Gateway Model were also significant predictors. In addition, a correlation of variables showed other important relationships. To achieve a 50% HPA completion rate, employers with a low Com/Org Level will need an incentive value of approximately $120 whereas employers with a high Com/Org Level only need approximately $40--a difference of $80 dollars. This applied study offers empirical evidence to help employers increase their employees' participation in health risk assessments.

Threat Assessment and Targeted Violence at Institutions of Higher Education: Implications for Policy and Practice Including Unique Considerations for Community Colleges

ERIC Educational Resources Information Center

Bennett, Laura; Bates, Michael

2015-01-01

This article provides an overview of the research on targeted violence, including campus violence, and the implications for policy and practice at institutions of higher education. Unique challenges of threat assessment in the community college setting are explored, and an overview of an effective threat assessment policy and team at William…

Do fungi need to be included within environmental radiation protection assessment models?

PubMed

Guillén, J; Baeza, A; Beresford, N A; Wood, M D

2017-09-01

Fungi are used as biomonitors of forest ecosystems, having comparatively high uptakes of anthropogenic and naturally occurring radionuclides. However, whilst they are known to accumulate radionuclides they are not typically considered in radiological assessment tools for environmental (non-human biota) assessment. In this paper the total dose rate to fungi is estimated using the ERICA Tool, assuming different fruiting body geometries, a single ellipsoid and more complex geometries considering the different components of the fruit body and their differing radionuclide contents based upon measurement data. Anthropogenic and naturally occurring radionuclide concentrations from the Mediterranean ecosystem (Spain) were used in this assessment. The total estimated weighted dose rate was in the range 0.31-3.4 μGy/h (5 th -95 th percentile), similar to natural exposure rates reported for other wild groups. The total estimated dose was dominated by internal exposure, especially from 226 Ra and 210 Po. Differences in dose rate between complex geometries and a simple ellipsoid model were negligible. Therefore, the simple ellipsoid model is recommended to assess dose rates to fungal fruiting bodies. Fungal mycelium was also modelled assuming a long filament. Using these geometries, assessments for fungal fruiting bodies and mycelium under different scenarios (post-accident, planned release and existing exposure) were conducted, each being based on available monitoring data. The estimated total dose rate in each case was below the ERICA screening benchmark dose, except for the example post-accident existing exposure scenario (the Chernobyl Exclusion Zone) for which a dose rate in excess of 35 μGy/h was estimated for the fruiting body. Estimated mycelium dose rate in this post-accident existing exposure scenario was close to the 400 μGy/h benchmark for plants, although fungi are generally considered to be less radiosensitive than plants. Further research on appropriate

Assessment of the Etiologic Factors of Gingival Recession in a Group of Patients in Northwest Iran

PubMed Central

Lafzi, Ardeshir; Abolfazli, Nader; Eskandari, Amir

2009-01-01

Background and aims Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. Materials and methods In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. Results Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05). The type of occlusion, axial inclination of teeth, existence of prosthesis, high frenal attachment, radiotherapy, systemic diseases and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05). Conclusion Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR. PMID:23230492

Assessment of the etiologic factors of gingival recession in a group of patients in northwest iran.

PubMed

Lafzi, Ardeshir; Abolfazli, Nader; Eskandari, Amir

2009-01-01

Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05). The type of occlusion, axial inclination of teeth, existence of prosthesis, high frenal attachment, radiotherapy, systemic diseases and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05). Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

Assessment of neuromuscular risk factors for anterior cruciate ligament injury through tensiomyography in male soccer players.

PubMed

Alentorn-Geli, Eduard; Alvarez-Diaz, Pedro; Ramon, Silvia; Marin, Miguel; Steinbacher, Gilbert; Boffa, Juan José; Cuscó, Xavier; Ballester, Jordi; Cugat, Ramon

2015-09-01

To investigate the role of mechanical and contractile properties of skeletal muscles of the thigh, assessed through tensiomyography (TMG), as risk factors for anterior cruciate ligament (ACL) injury in male soccer players. Male soccer players with confirmed ACL tear included in this study underwent resting TMG assessment of thigh muscles of the uninjured side. The same values were obtained from a sex-, sports level-matched control group in both sides. The maximal displacement (Dm), delay time (Td), contraction time (Tc), sustained time (Ts), and half-relaxation time (Tr) were obtained for the following muscles in all subjects: vastus medialis (VM), vastus laterals (VL), rectus femoris (RF), semitendinosus (ST), and biceps femoris (BF). TMG values of the uninjured side in ACL-injured group were compared to mean values between both sides in the control subjects. There were 40 ACL-injured and 38 control individuals. The vast majority of TMG parameters were higher in the uninjured side of ACL-injured individuals compared to the control group. The VL-Tr, RF-Tc, RF-Ts, RF-Tr, and BF-Dm values were significantly higher in the uninjured side compared to the control group. Quadriceps muscles demonstrated more significant between-group differences than hamstring muscles. Specifically, RF was the muscle where most significant between-group differences were found. Resistance to fatigue and muscle stiffness in the hamstring muscles may be risk factors for ACL injury in male soccer players. In addition, a predominant impairment in TMG characteristics of the quadriceps over hamstrings may indicate an altered muscular co-contraction (imbalance) between both muscle groups, which might be another risk factor for ACL injury in this population. These findings should be taken into account when screening athletes at high risk of ACL injury and also to design adequate prevention programs for ACL injury in male soccer players.

FACTORS INFLUENCING TOTAL DIETARY EXPOSURE OF YOUNG CHILDREN

EPA Science Inventory

A deterministic model was developed to identify critical input parameters to assess dietary intake of young children. The model was used as a framework for understanding important factors in data collection and analysis. Factors incorporated included transfer efficiencies of pest...

Development and External Validation of a Melanoma Risk Prediction Model Based on Self-assessed Risk Factors.

PubMed

Vuong, Kylie; Armstrong, Bruce K; Weiderpass, Elisabete; Lund, Eiliv; Adami, Hans-Olov; Veierod, Marit B; Barrett, Jennifer H; Davies, John R; Bishop, D Timothy; Whiteman, David C; Olsen, Catherine M; Hopper, John L; Mann, Graham J; Cust, Anne E; McGeechan, Kevin

2016-08-01

Identifying individuals at high risk of melanoma can optimize primary and secondary prevention strategies. To develop and externally validate a risk prediction model for incident first-primary cutaneous melanoma using self-assessed risk factors. We used unconditional logistic regression to develop a multivariable risk prediction model. Relative risk estimates from the model were combined with Australian melanoma incidence and competing mortality rates to obtain absolute risk estimates. A risk prediction model was developed using the Australian Melanoma Family Study (629 cases and 535 controls) and externally validated using 4 independent population-based studies: the Western Australia Melanoma Study (511 case-control pairs), Leeds Melanoma Case-Control Study (960 cases and 513 controls), Epigene-QSkin Study (44 544, of which 766 with melanoma), and Swedish Women's Lifestyle and Health Cohort Study (49 259 women, of which 273 had melanoma). We validated model performance internally and externally by assessing discrimination using the area under the receiver operating curve (AUC). Additionally, using the Swedish Women's Lifestyle and Health Cohort Study, we assessed model calibration and clinical usefulness. The risk prediction model included hair color, nevus density, first-degree family history of melanoma, previous nonmelanoma skin cancer, and lifetime sunbed use. On internal validation, the AUC was 0.70 (95% CI, 0.67-0.73). On external validation, the AUC was 0.66 (95% CI, 0.63-0.69) in the Western Australia Melanoma Study, 0.67 (95% CI, 0.65-0.70) in the Leeds Melanoma Case-Control Study, 0.64 (95% CI, 0.62-0.66) in the Epigene-QSkin Study, and 0.63 (95% CI, 0.60-0.67) in the Swedish Women's Lifestyle and Health Cohort Study. Model calibration showed close agreement between predicted and observed numbers of incident melanomas across all deciles of predicted risk. In the external validation setting, there was higher net benefit when using the risk prediction

Research on factors allowing a risk assessment of spore-forming pathogenic bacteria in cooked chilled foods containing vegetables: a FAIR collaborative project.

PubMed

Carlin, F; Girardin, H; Peck, M W; Stringer, S C; Barker, G C; Martinez, A; Fernandez, A; Fernandez, P; Waites, W M; Movahedi, S; van Leusden, F; Nauta, M; Moezelaar, R; Torre, M D; Litman, S

2000-09-25

Vegetables are frequent ingredients of cooked chilled foods and are frequently contaminated with spore-forming bacteria (SFB). Therefore, risk assessment studies have been carried out, including the following: hazard identification and characterisation--from an extensive literature review and expertise of the participants, B. cereus and C. botulinum were identified as the main hazards; exposure assessment--consisting of determination of the prevalence of hazardous SFB in cooked chilled foods containing vegetables and in unprocessed vegetables, and identification of SFB representative of the bacterial community in cooked chilled foods containing vegetables, determination of heat-resistance parameters and factors affecting heat resistance of SFB, determination of the growth kinetics of SFB in vegetable substrate and of the influence of controlling factors, validation of previous work in complex food systems and by challenge testing and information about process and storage conditions of cooked chilled foods containing vegetables. The paper illustrates some original results obtained in the course of the project. The results and information collected from scientific literature or from the expertise of the participants are integrated into the microbial risk assessment, using both a Bayesian belief network approach and a process risk model approach, previously applied to other foodborne hazards.

Cumulative Risk Assessment (CRA): Transforming the Way We Assess Health Risks

PubMed Central

Williams, Pamela R. D.; Dotson, G. Scott; Maier, Andrew

2016-01-01

Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors. PMID:22938698

Equine peripheral dental caries: An epidemiological survey assessing prevalence and possible risk factors in Western Australian horses.

PubMed

Jackson, K; Kelty, E; Tennant, M

2018-01-01

Peripheral dental caries is defined as macroscopic destruction of the calcified dental tissues and can cause considerable dental pathology and pain. It appears to occur at a high prevalence in Western Australian horses. At present, risk factors for the condition are poorly understood, making treatment and prevention difficult. To assess the prevalence of and potential risk factors for peripheral caries in Western Australian horses. Cross-sectional, epidemiological study. A survey of 500 Western Australian horses was administered in two sections. The first section was completed by the owner and referred to the horse's signalment, diet and husbandry conditions. The second section was completed by veterinarians and focused on the horse's oral health. A multivariable logistic regression model was used to assess risk factors associated with peripheral caries. Peripheral caries was present in 58.8% (95% confidence interval [CI] 54.5-63.1%) of surveyed horses. Breed was significantly associated with peripheral caries, with Warmbloods (odds ratio [OR] 0.44, 95% CI 0.24-0.82; P = 0.009) and Western breeds (OR 0.38, 95% CI 0.19-0.78; P = 0.008) being less likely to have peripheral caries than Thoroughbreds. Dietary risk factors included oaten hay (OR 2.90, 95% CI 1.87-4.53; P<0.001). A meadow hay-based diet was protective (OR 0.47, 95% CI 0.27-0.80; P = 0.005). Horses with access to quality pasture all year were less likely to have peripheral caries than horses without access to grazing (OR 0.31, 95% CI 0.15-0.66; P = 0.002), as were horses on groundwater compared with horses on rainwater (OR 3.35, 95% CI 1.65-6.78; P = 0.001), drinking water (OR 2.03, 95% CI 1.14-3.62; P = 0.016) or dam water (OR 3.53, 95% CI 1.08-11.53; P = 0.037). Peripheral caries was positively correlated with periodontal disease (OR 4.53, 95% CI 2.91-7.06; P<0.001) and feed packing (feed present between the teeth without significant periodontal pocketing) (OR 1.94, 95% CI 1.32-2.85; P = 0.001). Not

Assessing the Attitudes of Administrators to Include Students with Disabilities

ERIC Educational Resources Information Center

Abernathy, Frederick Douglas

2012-01-01

The purpose of this research was to assess the attitudes of administrators in a medium sized school district in the Southeastern region of the United States. The researcher used a quantitative descriptive comparative pre-test and post-test design with a convenience sampling of the district administrators. There were 21 administrators at the…

[ASSESSMENT OF EXTREME FACTORS OF SHIFT WORK IN ARCTIC CONDITIONS BY WORKERS WITH DIFFERENT REGULATORY PROCESSES].

PubMed

Korneeva, Ya A; Simonova, N N

2016-01-01

A man working on a shift basis in the Arctic, every day is under the influence of various extreme factors which are inevitable for oil and gas indudtry. To adapt to shift work employees use various resources of the individual. The purpose of research is the determination of personal resources of shift workers to overcome the adverse factors of the environment in the Arctic. The study involved 191 builder of main gas pipelines, working in shifts in the Tyumen region (the length of the shift 52 days of arrival) at the age of 23 to 59 (mean age 34.9 ± 8.1) years. Methods: psychological testing, questioning, observation, descriptive statistics, discriminant step by step analysis. There was revealed the correlation between the subjective assessment of the majority of adverse climatic factors in the regulatory process "assessment of results"; production factors--regulatory processes such as flexibility, autonomy, simulation, and the general level of self-regulation; social factors are more associated with the severity of such regulatory processes, flexibility and evaluation of results.

[Outcome assessment in the Spanish young offenders' law. Recidivism and associated factors].

PubMed

Bravo, Amaia; Sierra, María Jesús; del Valle, Jorge F

2009-11-01

The present study aims to assess the impact of the Spanish young offenders law (LO/2000). Recidivism and its associated risk factors were used as indicators of impact. Data were collected from young offenders' reports opened after 2001 and closed before 2005. The final sample consisted of 382 young offenders (327 males and 55 females). Results indicated that 70% had not re-offended in an average period of 1.6 years. Most of the youngsters with fewer risk factors, usually start their criminal careers with less serious offences and the interventions seemed to be fairly effective. In the cases of young offenders with a higher number of risk factors, the interventions (custodial and non-custodial) were less effective, as recidivism rates were higher. Interventions must focus on family and community contexts in order to achieve adequate social integration of young delinquents.

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

PubMed

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

2013-07-01

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

Rescue workers and trauma: Assessing interaction among risk factors after a firework factory explosion.

PubMed

Romano, Eugenia; Elklit, Ask

This study investigates which factors had the biggest impact on developing distress in rescue workers who were involved in a firework factory explosion. Four hundred sixty-five rescuers were assessed using items investigating demographic factors, organizational variables, social support, personality variables, and distress symptoms. Correlation and regression analyses were performed. Our final model provided 70 percent of the predictive model for post-traumatic stress disorder (PTSD) severity. Waiting time, lack of rest, problems at work, and perceived level of danger seemed to have the highest impact on protective factors. In addition to perceived life danger and personality, small organizational factors seem to play an important role in the prediction of PTSD. The importance of such factors needs further investigation in future research, contributing to a better organization in the field of disaster management.

Assessment of the Appalachian Basin Geothermal Field: Combining Risk Factors to Inform Development of Low Temperature Projects

NASA Astrophysics Data System (ADS)

Smith, J. D.; Whealton, C.; Camp, E. R.; Horowitz, F.; Frone, Z. S.; Jordan, T. E.; Stedinger, J. R.

2015-12-01

Exploration methods for deep geothermal energy projects must primarily consider whether or not a location has favorable thermal resources. Even where the thermal field is favorable, other factors may impede project development and success. A combined analysis of these factors and their uncertainty is a strategy for moving geothermal energy proposals forward from the exploration phase at the scale of a basin to the scale of a project, and further to design of geothermal systems. For a Department of Energy Geothermal Play Fairway Analysis we assessed quality metrics, which we call risk factors, in the Appalachian Basin of New York, Pennsylvania, and West Virginia. These included 1) thermal field variability, 2) productivity of natural reservoirs from which to extract heat, 3) potential for induced seismicity, and 4) presence of thermal utilization centers. The thermal field was determined using a 1D heat flow model for 13,400 bottomhole temperatures (BHT) from oil and gas wells. Steps included the development of i) a set of corrections to BHT data and ii) depth models of conductivity stratigraphy at each borehole based on generalized stratigraphy that was verified for a select set of wells. Wells are control points in a spatial statistical analysis that resulted in maps of the predicted mean thermal field properties and of the standard error of the predicted mean. Seismic risk was analyzed by comparing earthquakes and stress orientations in the basin to gravity and magnetic potential field edges at depth. Major edges in the potential fields served as interpolation boundaries for the thermal maps (Figure 1). Natural reservoirs were identified from published studies, and productivity was determined based on the expected permeability and dimensions of each reservoir. Visualizing the natural reservoirs and population centers on a map of the thermal field communicates options for viable pilot sites and project designs (Figure 1). Furthermore, combining the four risk

A two-factor theory for concussion assessment using ImPACT: memory and speed.

PubMed

Schatz, Philip; Maerlender, Arthur

2013-12-01

We present the initial validation of a two-factor structure of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) using ImPACT composite scores and document the reliability and validity of this factor structure. Factor analyses were conducted for baseline (N = 21,537) and post-concussion (N = 560) data, yielding "Memory" (Verbal and Visual) and "Speed" (Visual Motor Speed and Reaction Time) Factors; inclusion of Total Symptom Scores resulted in a third discrete factor. Speed and Memory z-scores were calculated, and test-retest reliability (using intra-class correlation coefficients) at 1 month (0.88/0.81), 1 year (0.85/0.75), and 2 years (0.76/0.74) were higher than published data using Composite scores. Speed and Memory scores yielded 89% sensitivity and 70% specificity, which was higher than composites (80%/62%) and comparable with subscales (91%/69%). This emergent two-factor structure has improved test-retest reliability with no loss of sensitivity/specificity and may improve understanding and interpretability of ImPACT test results.

Reliability assessment of fiber optic communication lines depending on external factors and diagnostic errors

NASA Astrophysics Data System (ADS)

Bogachkov, I. V.; Lutchenko, S. S.

2018-05-01

The article deals with the method for the assessment of the fiber optic communication lines (FOCL) reliability taking into account the effect of the optical fiber tension, the temperature influence and the built-in diagnostic equipment errors of the first kind. The reliability is assessed in terms of the availability factor using the theory of Markov chains and probabilistic mathematical modeling. To obtain a mathematical model, the following steps are performed: the FOCL state is defined and validated; the state graph and system transitions are described; the system transition of states that occur at a certain point is specified; the real and the observed time of system presence in the considered states are identified. According to the permissible value of the availability factor, it is possible to determine the limiting frequency of FOCL maintenance.

75 FR 5317 - Exposure Factors Handbook: 2009 Update

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... chemicals. These factors include: Drinking water consumption; mouthing behavior; soil ingestion rates... document solely for the purpose of pre- dissemination peer review under applicable information quality... various factors used in assessing human exposure. This Handbook is aimed at exposure assessors inside the...

Utilizing interview and self-report assessment of the Five-Factor Model to examine convergence with the alternative model for personality disorders.

PubMed

Helle, Ashley C; Trull, Timothy J; Widiger, Thomas A; Mullins-Sweatt, Stephanie N

2017-07-01

An alternative model for personality disorders is included in Section III (Emerging Models and Measures) of Diagnostic and Statistical Manual of Mental Disorders, (5th ed.; DSM-5). The DSM-5 dimensional trait model is an extension of the Five-Factor Model (FFM; American Psychiatric Association, 2013). The Personality Inventory for DSM-5 (PID-5) assesses the 5 domains and 25 traits in the alternative model. The current study expands on recent research to examine the relationship of the PID-5 with an interview measure of the FFM. The Structured Interview for the Five Factor Model of Personality (SIFFM) assesses the 5 bipolar domains and 30 facets of the FFM. Research has indicated that the SIFFM captures maladaptive aspects of personality (as well as adaptive). The SIFFM, NEO PI-R, and PID-5 were administered to participants to examine their respective convergent and discriminant validity. Results provide evidence for the convergence of the 2 models using self-report and interview measures of the FFM. Clinical implications and future directions are discussed, particularly a call for the development of a structured interview for the assessment of the DSM-5 dimensional trait model. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Environmental impact and risk assessments and key factors contributing to the overall uncertainties.

PubMed

Salbu, Brit

2016-01-01

There is a significant number of nuclear and radiological sources that have contributed, are still contributing, or have the potential to contribute to radioactive contamination of the environment in the future. To protect the environment from radioactive contamination, impact and risk assessments are performed prior to or during a release event, short or long term after deposition or prior and after implementation of countermeasures. When environmental impact and risks are assessed, however, a series of factors will contribute to the overall uncertainties. To provide environmental impact and risk assessments, information on processes, kinetics and a series of input variables is needed. Adding problems such as variability, questionable assumptions, gaps in knowledge, extrapolations and poor conceptual model structures, a series of factors are contributing to large and often unacceptable uncertainties in impact and risk assessments. Information on the source term and the release scenario is an essential starting point in impact and risk models; the source determines activity concentrations and atom ratios of radionuclides released, while the release scenario determine the physico-chemical forms of released radionuclides such as particle size distribution, structure and density. Releases will most often contain other contaminants such as metals, and due to interactions, contaminated sites should be assessed as a multiple stressor scenario. Following deposition, a series of stressors, interactions and processes will influence the ecosystem transfer of radionuclide species and thereby influence biological uptake (toxicokinetics) and responses (toxicodynamics) in exposed organisms. Due to the variety of biological species, extrapolation is frequently needed to fill gaps in knowledge e.g., from effects to no effects, from effects in one organism to others, from one stressor to mixtures. Most toxtests are, however, performed as short term exposure of adult organisms

[Prevalence of Risk Factors of Non-Communicable Disease in Kyrgyzstan: Assessment using WHO STEPS Approach].

PubMed

A, T A; Makhmutkhodzhaev, S A; Kydyralieva, R B; Altymysheva, A T; Dzhakipova, R S; Zhorupbekova, K S; Ryskulova, S T; Knyazeva, V G; Kaliev, M T; Dzhumagulova, A S

2016-12-01

Assessment of prevalence of risk factors for non-communicable diseases (NCD) based on WHO "STEPS" approach was conducted in Kyrgyzstan. Results of this study demonstrated high prevalence of NCD risk factors: 94.2% of subjects aged 24-64 years had risk factors. Prevalence of elevated blood pressure was 48.7, smoking - 25.7, hypercholesterolemia - 23.6, excessive alcohol consumption - 31.4, physical inactivity 11.4, obesity - 23.1, elevated glucose level - 4.5, diabetes - 8.8, inadequate intake of fruits and vegetables - 74%. The data obtained would allow to draft effective preventive measures to combat NCD risk factors at the national level.

Risk Factors for Opioid-Use Disorder and Overdose.

PubMed

Webster, Lynn R

2017-11-01

Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression. Risk factors for opioid misuse or addiction include past or current substance abuse, untreated psychiatric disorders, younger age, and social or family environments that encourage misuse. Opioid mortality prevalence is higher in people who are middle aged and have substance abuse and psychiatric comorbidities. Suicides are probably undercounted or frequently misclassified in reports of opioid-related poisoning deaths. Greater understanding and better assessment are needed of the risk associated with suicide risk in patients with pain. Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids.

Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital.

PubMed

Osegbe, Ifeyinwa Dorothy; Soriyan, Oyetunji Olukayode; Ogbenna, Abiola Ann; Okpara, Henry Chima; Azinge, Elaine Chinyere

2016-01-01

Cardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy. This was a cross-sectional study of HIV-positive patients attending the Lagos University Teaching Hospital, Nigeria. Anthropometric and blood pressure measurements were performed; fasting lipid profile, plasma glucose, homocysteine and hsCRP were determined, as well as prevalences and risk assessments. Statistical tests were used to compare the groups and p-value <0.05 was considered to be significant. 283 subjects were recruited for this study (100 HIV-positive treatment-naive, 100 HIV-positive treated and 83 HIV negative controls). Compared to the controls, mean (sd) values were significantly higher among HIV-treated subjects: waist circumference = 88.7 (10.4), p = 0.035; systolic bp= 124.9 (20.7), p = 0.014; glucose= 5.54 (1.7), p = 0.015; triglyceride= 2.0 (1.2), p < 0.001; homocysteine= 10.9 (8.9-16.2), p = 0.0003; while hsCRP= 2.9 (1.4-11.6), p = 0.002 and HDL-C = 0.9 (0.4), p = < 0.0001 were higher among the HIV-naïve subjects. Likewise, higher prevalences of the risk factors were noted among the HIV-treated subjects except low HDL-C (p < 0.001) and hsCRP (p = 0.03) which were higher in the HIV-naïve group. Risk assessment using ratios showed high risk for CVD especially in the HIV-naïve group. The median range for Framingham risk assessment was 1.0 - 7.5%. Risk factors and risk assessment for CVD are increased in HIV-positive patients with and without antiretroviral therapy. Routine evaluation and risk assessment for CVD irrespective of therapy status is necessary to prevent future cardiovascular events.

Maximizing Learning Using Online Student Assessment

ERIC Educational Resources Information Center

Boyles, Patrice C.

2011-01-01

As the technological age reaches its peak, so does the need to improve assessment for online instruction. Assessment includes all activities that teachers and students undertake to get information that can be used to improve teaching and learning (Black and William,1998b). Assessment is a critical factor of the learning environment. The popularity…

Context factors in consultations of general practitioner trainees and their impact on communication assessment in the authentic setting.

PubMed

Essers, Geurt; van Dulmen, Sandra; van Es, Judy; van Weel, Chris; van der Vleuten, Cees; Kramer, Anneke

2013-12-01

Acquiring adequate communication skills is an essential part of general practice (GP) specialty training. In assessing trainee proficiency, the context in which trainees communicate is usually not taken into account. The present paper aims to explore what context factors can be found in regular GP trainee consultations and how these influence their communication performance. In a randomly selected sample of 44 videotaped, real-life GP trainee consultations, we searched for context factors previously identified in GP consultations and explored how trainee ratings change if context factors are taken into account. Trainee performance was rated twice using the MAAS-Global, first without and then with incorporating context factors. Item score differences were calculated using a paired samples t-test and effect sizes were computed. All previously identified context factors were again observed in GP trainee consultations. In communication assessment scores, we found a significant difference in 5 out of 13 MAAS-Global items, mostly in a positive direction. The effect size was moderate (0.57). GP trainee communication is influenced by contextual factors; they seem to adapt to context in a professional way. GP specialty training needs to focus on a context-specific application of communication skills. Communication raters need to be taught how to incorporate context factors into their assessments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Assessment of Labor Behavior Factors and Selecting Line Managers' Lines of Development at Russian Industrial Enterprises

ERIC Educational Resources Information Center

Zavyalova, Elena K.; Kosheleva, Sofia V.

2009-01-01

Purpose: The paper investigates personal and environmental factors providing for the efficiency of line managers' activity and contributing to their professional and career advancement. The paper studies the prognostic value of the assessment of personal and environmental factors providing for the efficiency of line managers' activity according to…

Groundwater Quality Assessment Plan: Dickson County Landfill, Dickson County, Tennessee, including Application for Authorization for Class V Underground Injection Well

EPA Pesticide Factsheets

Contains site investigation plan & data for assessment of groundwater quality at Dickson County Landfill, Dickson, Tennessee, with figures, tables, appendices, November 1994, including Application for Authorization for Class V Underground Injection Well.

Building predictive gene signatures through simultaneous assessment of transcription factor activation and gene expression.

EPA Science Inventory

Building predictive gene signatures through simultaneous assessment of transcription factor activation and gene expression Exposure to many drugs and environmentally-relevant chemicals can cause adverse outcomes. These adverse outcomes, such as cancer, have been linked to mol...

Assessing the contribution of different factors in RegCM4.3 regional climate model projections using the Factor Separation method over the Med-CORDEX domain

NASA Astrophysics Data System (ADS)

Zsolt Torma, Csaba; Giorgi, Filippo

2014-05-01

A set of regional climate model (RCM) simulations applying dynamical downscaling of global climate model (GCM) simulations over the Mediterranean domain specified by the international initiative Coordinated Regional Downscaling Experiment (CORDEX) were completed with the Regional Climate Model RegCM, version RegCM4.3. Two GCMs were selected from the Coupled Model Intercomparison Project Phase 5 (CMIP5) ensemble to provide the driving fields for the RegCM: HadGEM2-ES (HadGEM) and MPI-ESM-MR (MPI). The simulations consist of an ensemble including multiple physics configurations and different "Reference Concentration Pathways" (RCP4.5 and RCP8.5). In total 15 simulations were carried out with 7 model physics configurations with varying convection and land surface schemes. The horizontal grid spacing of the RCM simulations is 50 km and the simulated period in all cases is 1970-2100 (1970-2099 in case of HadGEM driven simulations). This ensemble includes a combination of experiments in which different model components are changed individually and in combination, and thus lends itself optimally to the application of the Factor Separation (FS) method. This study applies the FS method to investigate the contributions of different factors, along with their synergy, on a set of regional climate model (RCM) projections for the Mediterranean region. The FS method is applied to 6 projections for the period 1970-2100 performed with the regional model RegCM4.3 over the Med-CORDEX domain. Two different sets of factors are intercompared, namely the driving global climate model (HadGEM and MPI) boundary conditions against two model physics settings (convection scheme and irrigation). We find that both the GCM driving conditions and the model physics provide important contributions, depending on the variable analyzed (surface air temperature and precipitation), season (winter vs. summer) and time horizon into the future, while the synergy term mostly tends to counterbalance the

41 CFR 302-7.21 - If my HHG shipment includes an item for which a weight additive is assessed by the HHG carrier (e...

Code of Federal Regulations, 2012 CFR

2012-07-01

... includes an item for which a weight additive is assessed by the HHG carrier (e.g., boat, trailer...) General Rules § 302-7.21 If my HHG shipment includes an item for which a weight additive is assessed by... will not be responsible for the shipping charges that result from a weight additive so long as the...

41 CFR 302-7.21 - If my HHG shipment includes an item for which a weight additive is assessed by the HHG carrier (e...

Code of Federal Regulations, 2013 CFR

2013-07-01

... includes an item for which a weight additive is assessed by the HHG carrier (e.g., boat, trailer...) General Rules § 302-7.21 If my HHG shipment includes an item for which a weight additive is assessed by... will not be responsible for the shipping charges that result from a weight additive so long as the...

Assessment and prevention of behavioural and social risk factors associated with oral cancer: protocol for a systematic review of clinical guidelines and systematic reviews to inform Primary Care dental professionals.

PubMed

Mathur, Sweta; Conway, David I; Worlledge-Andrew, Heather; Macpherson, Lorna M D; Ross, Alastair J

2015-12-22

Tobacco and alcohol are recognised as the major risk factors for both oral cavity (mouth) and oropharyngeal (throat) cancers, with increasing acceptance of the role of human papillomavirus (HPV) in the aetiology of oropharyngeal cancers. In addition, there is a significant increased risk for oral cancer among lower socioeconomic groups, males and older age groups. There is a growing evidence for the potential role of primary care professionals in smoking cessation and reducing alcohol-related harm. However, there are uncertainties about the best approaches/strategies to assess risk factors associated with oral cancer, effective components of preventive interventions for behaviour change and implementation strategies in primary care dental settings. Thus, in order to contribute to the prevention of oral cancer effectively, dental professionals need to assess patients on the major risk factors (tobacco, alcohol and HPV/sexual behaviours) and deliver appropriate prevention, taking into account the patient's sociodemographic context. The study aims to synthesise evidence on the best practice for undertaking an assessment of major behavioural risk factors associated with oral cancer and delivering effective behaviour change preventive interventions (e.g. advice, counselling, patient recall, signposting/referral to preventive services) by dental professionals in primary care dental settings. The study involves a systematic review and evidence appraisal. We will search for clinical guidelines and systematic reviews from the following databases: Cochrane Library, Ovid MEDLINE, EMBASE, Web of Science, PsychINFO, PubMed, TRIP and Google Scholar. We will also search websites of professional organisations/agencies and bibliographies/reference lists of selected papers. Quality will be assessed with the AGREE II (Appraisal of Guidelines for Research & Evaluation II) instrument for included clinical guidelines and the AMSTAR (A Measurement Tool to Assess Systematic Reviews) and

Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

PubMed

Steele, Ian H; Thrower, Natasha; Noroian, Paul; Saleh, Fabian M

2018-01-01

Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety. © 2017 American Academy of Forensic Sciences.

Caseworker Assessments of Risk for Recurrent Maltreatment: Association with Case-Specific Risk Factors and Re-Reports

ERIC Educational Resources Information Center

Dorsey, Shannon; Mustillo, Sarah A.; Farmer, Elizabeth M. Z.; Elbogen, Eric

2008-01-01

Objective: This article focuses on caseworkers' assessments of risk of maltreatment recurrence among families in contact with social services. Specifically, the article has two primary goals: (1) to examine the association between caseworkers' risk assessments and demographic, child, parent and family-level risk factors; and (2) to examine…

Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?

PubMed

Hemphälä, Malin; Hodgins, Sheilagh

2014-01-01

To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD). Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist-Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records. The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar. Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment.

An assessment of individual-level factors associated with alcohol treatment utilization among Mexican Americans.

PubMed

Reingle Gonzalez, Jennifer M; Caetano, Raul; Mills, Britain A; Vaeth, Patrice A C

2014-01-01

The purpose of this study is to identify enabling factors for treatment utilization for alcohol-related problems, and to evaluate how enabling factors vary by need for treatment, among two samples of Mexican American adults. These two distinct samples included 2,595 current and former drinkers (one sample included 787 U.S./Mexico border residents; the other sample included 740 Mexican Americans living in U.S. cities not proximal to the border). Need for treatment (alcohol disorder severity) and (male) gender were the primary correlates of treatment utilization; and there was no moderation in the enabling factors by need for treatment as "enablers" of utilization. Further theoretical and empirical research is necessary to determine which mechanisms are driving disparities in treatment utilization across racial/ethnic groups generally, and Hispanic national groups specifically. Copyright © 2014 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-12-01

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

Perinatal risk factors and social withdrawal behaviour.

PubMed

Guedeney, Antoine; Marchand-Martin, Laetitia; Cote, Sylvana J; Larroque, Béatrice

2012-04-01

The objectives of the study were (1) to assess prevalence of social withdrawal behaviour in infants aged 12 months included in the French Perinatal Risk Factor Study Eden; (2) To study the correlation between relational withdrawal and several perinatal and parental factors assessed in the EDEN study. A longitudinal study using the ADBB scale was conducted within the Eden Cohort in the year 2008. 1,586 infants were included in the study. Fourteen percent of the children who had an ADBB assessment had a score at 5 and over on the ADBB, a scale designed to assess social withdrawal behaviour at age 0-24 months. Social withdrawal at 12 months was associated with low birth weight, low gestational age and with intra uterine growth retardation. Social withdrawal was independently associated with several maternal and paternal risk factors. The level of social withdrawal behaviour increased with a score of maternal difficulties. This study on a large longitudinally followed volunteer sample demonstrate a clear association of social withdrawal behaviour at age one with low birth weight and preterm birth, possibly mediated by parental vulnerabilities. Social withdrawal behaviour seems to be an important alarm signal to detect early on particularly in premature and small for date babies. © Springer-Verlag 2012

Assessing experiential education factors contributing to a PGY1 residency match: Pharmacy residency program director and comparative student survey.

PubMed

Prisco, Jennifer L; Hritcko, Philip M; Feret, Brett; Yorra, Mark L; Todd, Noreen E; Kim Tanzer; Basile, Cathy; Bonaceto, Kara; Morelli, Rita; Carace, Nicole; Szumita, Andrew

2018-02-01

To compare and contrast experiential education perceptions of pharmacy residency program directors (RPDs) and doctor of pharmacy students in their last year of the curriculum for residency application considerations. The New England Regional Departments of Experiential Education (NERDEE) consortium developed a 17-question survey to assess residency factors, including those related to experiential education. The survey was dispersed to advanced pharmacy practice experience (APPE) students from six colleges/schools of pharmacy and RPDs nationwide. Students have different values on experiential preferences compared to RPDs. Sample findings include internal medicine and specialty clinical elective experiences prior to American Society of Health-System Pharmacists (ASHP) Midyear were extremely important to important for students, while RPDs viewed these experiences as somewhat important at best (p < 0.02). The majority of RPDs (67%) have no APPE schedule preference, while most students (77%) feel that certain APPE schedules may influence acceptance into residency. Based on findings, information outlined can be used to dispel and/or validate common beliefs held by students regarding experiential factors that help or hinder a successful postgraduate year 1 (PGY1) residency match. Copyright © 2017 Elsevier Inc. All rights reserved.

ECETOC Florence workshop on risk assessment of endocrine substances, including the potency concept.

PubMed

Fegert, Ivana

2013-12-16

The European regulation on plant protection products (1107/2009) and the Biocidal Products Regulation (EC Regulation 528/2012) only support the marketing and use of chemicals if they do not cause endocrine disruption in humans or wildlife species. Also, substances with endocrine properties are subject to authorization under the European regulation on the registration, evaluation, authorization and restriction of chemicals (REACH; 1907/2006). Therefore, the regulatory consequences of identifying a substance as an endocrine disrupting chemical are severe. In contrast to that, basic scientific criteria, necessary to define endocrine disrupting properties, are not described in any of these legislative documents. Thus, the European Center for Ecotoxicology and Toxicology of Chemicals (ECETOC) established a task force to provide scientific criteria for the identification and assessment of chemicals with endocrine disrupting properties that may be used within the context of these three legislative texts (ECETOC, 2009a). In 2009, ECETOC introduced a scientific framework as a possible concept for identifying endocrine disrupting properties within a regulatory context (ECETOC, 2009b; Bars et al., 2011a,b). The proposed scientific criteria integrated, in a weight of evidence approach, information from regulatory (eco)toxicity studies and mechanistic/screening studies by combining evidence for adverse effects detected in apical whole-organism studies with an understanding of the mode of action (MoA) of endocrine toxicity. However, since not all chemicals with endocrine disrupting properties are of equal hazard, an adequate concept should also be able to differentiate between chemicals with endocrine properties of low concern from those of higher concern (for regulatory purposes). For this purpose, the task force refined this part of their concept. Following an investigation of the key factors at a second workshop of invited regulatory, academic and industry scientists, the

The risk assessment score in acute whiplash injury predicts outcome and reflects biopsychosocial factors.

PubMed

Kasch, Helge; Qerama, Erisela; Kongsted, Alice; Bach, Flemming W; Bendix, Tom; Jensen, Troels S

2011-12-01

One-year prospective study of 141 acute whiplash patients (WLP) and 40 acute ankle-injured controls. This study investigates a priori determined potential risk factors to develop a risk assessment tool, for which the expediency was examined. The whiplash-associated disorders (WAD) grading system that emerged from The Quebec Task-Force-on-Whiplash has been of limited value for predicting work-related recovery and for explaining biopsychosocial disability after whiplash and new predictive factors, for example, risk criteria that comprehensively differentiate acute WLP in a biopsychosocial manner are needed. Consecutively, 141 acute WLP and 40 ankle-injured recruited from emergency units were examined after 1 week, 1, 3, 6, and 12 months obtaining neck/head visual analog scale score, number of nonpainful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, and strength and duration of neck muscles. Risk factors derived (reduced cervical range of motion, intense neck pain/headache, multiple nonpain complaints) were applied in a risk assessment score and divided into seven risk strata. A receiver operating characteristics curve for the Risk Assessment Score and 1-year work disability showed an area of 0.90. Risk strata and number of sick days showed a log-linear relationship. In stratum 1 full recovery was encountered, but for high-risk patients in stratum 6 only 50% and 7 only 20% had returned to work after 1 year (P < 5.4 × 10). Strength measures, psychophysical pain measurements, and psychological and social data (reported elsewhere) showed significant relation to risk strata. The Risk Assessment score is suggested as a valuable tool for grading WLP early after injury. It has reasonable screening power for encountering work disability and reflects the biopsychosocial nature of whiplash injuries.

Predictors, Including Blood, Urine, Anthropometry, and Nutritional Indices, of All-Cause Mortality among Institutionalized Individuals with Intellectual Disability

ERIC Educational Resources Information Center

Ohwada, Hiroko; Nakayama, Takeo; Tomono, Yuji; Yamanaka, Keiko

2013-01-01

As the life expectancy of people with intellectual disability (ID) increases, it is becoming necessary to understand factors affecting survival. However, predictors that are typically assessed among healthy people have not been examined. Predictors of all-cause mortality, including blood, urine, anthropometry, and nutritional indices, were…

Computed tomographic assessment of the causal factors of unsuccessful medialization thyroplasty.

PubMed

Iwahashi, Toshihiko; Ogawa, Makoto; Hosokawa, Kiyohito; Mochizuki, Ryuichi; Inohara, Hidenori

2015-03-01

The present results demonstrate that a small implant size, undercorrection of the vocal fold, antero-posterior implant malposition, and the use of expanded polytetrafluoroethylene (ePTFE) are the primary factors that cause a poor outcome of medialization thyroplasty (MT). To assess the postoperative laryngeal condition using computed tomography (CT) in patients with unilateral vocal fold paralysis who underwent MT alone, and to identify the primary causal factors in terms of the surgical procedures that affect the outcomes of MT. Twenty-two patients who underwent MT alone were divided into two groups based on either the maximal phonation time or the perceived vocal breathiness. Two laryngologists assessed the postoperative laryngeal CT images during sustained vowel phonation and judged whether there were abnormalities of the arytenoid cartilage position, window position, implant size, and implant position, as well as the degree of correction of the vocal fold. As implant material, a silicone block, ePTFE, and hydroxyapatite had been inserted in 2, 9, and 11 patients, respectively. Comparisons of the prevalence of abnormalities in the abovementioned factors between the different outcomes and between the types of material used for the implant were performed. Twelve patients with a poor outcome and 10 with a good outcome showed 36 and 18 abnormal findings identified by either of the two laryngologists, respectively. In the poor outcome group, a smaller implant size and undercorrection of the vocal fold showed both high kappa values and a significantly higher prevalence than those in the good outcome group (p < 0.001 and p < 0.05), respectively. The comparison between material types demonstrated that the sheet-like material (ePTFE) group exhibited a significantly higher prevalence of undercorrection than the block-like material group (p < 0.05).

Therapist Competence in Global Mental Health: Development of the Enhancing Assessment of Common Therapeutic Factors (ENACT) Rating Scale

PubMed Central

Kohrt, Brandon A.; Jordans, Mark J.D.; Rai, Sauharda; Shrestha, Pragya; Luitel, Nagendra P.; Ramaiya, Megan; Singla, Daisy; Patel, Vikram

2015-01-01

Lack of reliable and valid measures of therapist competence is a barrier to dissemination and implementation of psychological treatments in global mental health. We developed the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale for training and supervision across settings varied by culture and access to mental health resources. We employed a four-step process in Nepal: (1) Item generation: We extracted 1,081 items (grouped into 104 domains) from 56 existing tools; role-plays with Nepali therapists generated 11 additional domains. (2) Item relevance: From the 115 domains, Nepali therapists selected 49 domains of therapeutic importance and high comprehensibility. (3) Item utility: We piloted the ENACT scale through rating role-play videotapes, patient session transcripts, and live observations of primary care workers in trainings for psychological treatments and the Mental Health Gap Action Programme (mhGAP). (4) Inter-rater reliability was acceptable for experts (intraclass correlation coefficient, ICC(2,7)=0.88 (95% confidence interval (CI) 0.81—0.93), N=7) and non-specialists (ICC(1,3)=0.67 (95% CI 0.60—0.73), N=34). In sum, the ENACT scale is an 18-item assessment for common factors in psychological treatments, including task-sharing initiatives with non-specialists across cultural settings. Further research is needed to evaluate applications for therapy quality and association with patient outcomes. PMID:25847276

Modelling the pre-assessment learning effects of assessment: evidence in the validity chain

PubMed Central

Cilliers, Francois J; Schuwirth, Lambert W T; van der Vleuten, Cees P M

2012-01-01

OBJECTIVES We previously developed a model of the pre-assessment learning effects of consequential assessment and started to validate it. The model comprises assessment factors, mechanism factors and learning effects. The purpose of this study was to continue the validation process. For stringency, we focused on a subset of assessment factor–learning effect associations that featured least commonly in a baseline qualitative study. Our aims were to determine whether these uncommon associations were operational in a broader but similar population to that in which the model was initially derived. METHODS A cross-sectional survey of 361 senior medical students at one medical school was undertaken using a purpose-made questionnaire based on a grounded theory and comprising pairs of written situational tests. In each pair, the manifestation of an assessment factor was varied. The frequencies at which learning effects were selected were compared for each item pair, using an adjusted alpha to assign significance. The frequencies at which mechanism factors were selected were calculated. RESULTS There were significant differences in the learning effect selected between the two scenarios of an item pair for 13 of this subset of 21 uncommon associations, even when a p-value of < 0.00625 was considered to indicate significance. Three mechanism factors were operational in most scenarios: agency; response efficacy, and response value. CONCLUSIONS For a subset of uncommon associations in the model, the role of most assessment factor–learning effect associations and the mechanism factors involved were supported in a broader but similar population to that in which the model was derived. Although model validation is an ongoing process, these results move the model one step closer to the stage of usefully informing interventions. Results illustrate how factors not typically included in studies of the learning effects of assessment could confound the results of interventions aimed

Introduction of risk size in the determination of uncertainty factor UFL in risk assessment

NASA Astrophysics Data System (ADS)

Xue, Jinling; Lu, Yun; Velasquez, Natalia; Yu, Ruozhen; Hu, Hongying; Liu, Zhengtao; Meng, Wei

2012-09-01

The methodology for using uncertainty factors in health risk assessment has been developed for several decades. A default value is usually applied for the uncertainty factor UFL, which is used to extrapolate from LOAEL (lowest observed adverse effect level) to NAEL (no adverse effect level). Here, we have developed a new method that establishes a linear relationship between UFL and the additional risk level at LOAEL based on the dose-response information, which represents a very important factor that should be carefully considered. This linear formula makes it possible to select UFL properly in the additional risk range from 5.3% to 16.2%. Also the results remind us that the default value 10 may not be conservative enough when the additional risk level at LOAEL exceeds 16.2%. Furthermore, this novel method not only provides a flexible UFL instead of the traditional default value, but also can ensure a conservative estimation of the UFL with fewer errors, and avoid the benchmark response selection involved in the benchmark dose method. These advantages can improve the estimation of the extrapolation starting point in the risk assessment.

Factors controlling volume errors through 2D gully erosion assessment: guidelines for optimal survey design

NASA Astrophysics Data System (ADS)

Castillo, Carlos; Pérez, Rafael

2017-04-01

The assessment of gully erosion volumes is essential for the quantification of soil losses derived from this relevant degradation process. Traditionally, 2D and 3D approaches has been applied for this purpose (Casalí et al., 2006). Although innovative 3D approaches have recently been proposed for gully volume quantification, a renewed interest can be found in literature regarding the useful information that cross-section analysis still provides in gully erosion research. Moreover, the application of methods based on 2D approaches can be the most cost-effective approach in many situations such as preliminary studies with low accuracy requirements or surveys under time or budget constraints. The main aim of this work is to examine the key factors controlling volume error variability in 2D gully assessment by means of a stochastic experiment involving a Monte Carlo analysis over synthetic gully profiles in order to 1) contribute to a better understanding of the drivers and magnitude of gully erosion 2D-surveys uncertainty and 2) provide guidelines for optimal survey designs. Owing to the stochastic properties of error generation in 2D volume assessment, a statistical approach was followed to generate a large and significant set of gully reach configurations to evaluate quantitatively the influence of the main factors controlling the uncertainty of the volume assessment. For this purpose, a simulation algorithm in Matlab® code was written, involving the following stages: - Generation of synthetic gully area profiles with different degrees of complexity (characterized by the cross-section variability) - Simulation of field measurements characterised by a survey intensity and the precision of the measurement method - Quantification of the volume error uncertainty as a function of the key factors In this communication we will present the relationships between volume error and the studied factors and propose guidelines for 2D field surveys based on the minimal survey

45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

Code of Federal Regulations, 2014 CFR

2014-10-01

... assessment of the impact of the TANF program(s) in the State on the increase in child poverty? 284.30 Section... TANF PROGRAM § 284.30 What information must the State include in its assessment of the impact of the... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES METHODOLOGY...

45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

Code of Federal Regulations, 2012 CFR

2012-10-01

... assessment of the impact of the TANF program(s) in the State on the increase in child poverty? 284.30 Section... TANF PROGRAM § 284.30 What information must the State include in its assessment of the impact of the... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES METHODOLOGY...

45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

Code of Federal Regulations, 2013 CFR

2013-10-01

... assessment of the impact of the TANF program(s) in the State on the increase in child poverty? 284.30 Section... TANF PROGRAM § 284.30 What information must the State include in its assessment of the impact of the... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES METHODOLOGY...

45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

Code of Federal Regulations, 2011 CFR

2011-10-01

... assessment of the impact of the TANF program(s) in the State on the increase in child poverty? 284.30 Section... TANF PROGRAM § 284.30 What information must the State include in its assessment of the impact of the... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES METHODOLOGY...

The Readiness to Change for Bariatric Surgery Assessment Tool: Validity, Factor Structure, and Reliability.

PubMed

Carlson, Susan M S

2017-11-01

Currently, there is no guideline or standard of practice for performing the psychiatric/psychological evaluation that is a requirement for approval for bariatric surgery. The Readiness to Change for Bariatric Surgery Assessment Tool (RCB-SAT) establishes a means for psychiatric evaluators to objectively assess the patient's cognition, beliefs, and motivation around the bariatric diet and lifestyle changes. Development of a clinical decision-making tool for assessing readiness to change in bariatric patients will be useful regarding The Strategic Plan for NIH Obesity Research. The strategic plan outlines 6 overarching themes, with the last 3 centering around creation of such a clinical decision-making tool to assess a bariatric patient's readiness to change: evaluate promising strategies for obesity prevention and treatment in realworld settings and diverse populations, harness technology and tools to advance obesity research and improve health care delivery, and facilitate integration of research results into community programs and medical practice (National Institutes of Health, 2011). The pilot tool was administered to 153 potential bariatric patients, with 61 patients completing the survey a second time. Face and content validity of the items were established through an expert review process. Principle axis factoring by means of varimax rotation with Kaiser normalization identified 15 items loading on 3 factors associated with Prochaska and DiClemente's transtheoretical model of health behavior change: precontemplation, contemplation, and action (DiClemente & Prochaska, 1998). Test-retest reliability was also established for the tool. The proposed RCB-SAT demonstrates potential for assessing a patient's readiness to change regarding the bariatric diet and lifestyle.

Service factors causing delay in specialist assessment for TIA and minor stroke: a qualitative study of GP and patient perspectives.

PubMed

Wilson, Andrew; Coleby, Dawn; Regen, Emma; Phelps, Kay; Windridge, Kate; Willars, Janet; Robinson, Tom

2016-05-17

To understand how service factors contribute to delays to specialist assessment following transient ischaemic attack (TIA) or minor stroke. Qualitative study using semistructured interviews, analysis by constant comparison. Leicester, UK. Patients diagnosed with TIA or minor stroke, at hospital admission or in a rapid-access TIA clinic (n=42), general practitioners (GPs) of participating patients if they had been involved in the patients' care (n=18). Accounts from patients and GPs of factors contributing to delay following action to seek help from a healthcare professional (HCP). The following categories of delay were identified. First, delay in assessment in general practice following contact with the service; this related to availability of same day appointments, and the role of the receptionist in identifying urgent cases. Second, delays in diagnosis by the HCP first consulted, including GPs, optometrists, out-of-hours services, walk-in centres and the emergency department. Third, delays in referral after a suspected diagnosis; these included variable use of the ABCD(2) (Age, Blood pressure, Clinical features, Duration, Diabetes) risk stratification score and referral templates in general practice, and referral back to the patients' GP in cases where he/she was not the first HCP consulted. Primary and emergency care providers need to review how they can best handle patients presenting with symptoms that could be due to stroke or TIA. In general practice, this may include receptionist training and/or triage by a nurse or doctor. Mechanisms need to be established to enable direct referral to the TIA clinic when patients whose symptoms have resolved present to other agencies. Further work is needed to improve diagnostic accuracy by non-specialists. 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/

Assessing the Basic Traits Associated with Psychopathy: Development and Validation of the Elemental Psychopathy Assessment

ERIC Educational Resources Information Center

Lynam, Donald R.; Gaughan, Eric T.; Miller, Joshua D.; Miller, Drew J.; Mullins-Sweatt, Stephanie; Widiger, Thomas A.

2011-01-01

A new self-report assessment of the basic traits of psychopathy was developed with a general trait model of personality (five-factor model [FFM]) as a framework. Scales were written to assess maladaptive variants of the 18 FFM traits that are robustly related to psychopathy across a variety of perspectives including empirical correlations, expert…

Detrimental effect of systemic vascular risk factors on brain hemodynamic function assessed with MRI.

PubMed

King, Kevin S; Sheng, Min; Liu, Peiying; Maroules, Christopher D; Rubin, Craig D; Peshock, Ron M; McColl, Roderick W; Lu, Hanzhang

2018-06-01

Background and purpose Vascular risk factors have been associated with decreased cerebral blood flow (CBF) but this is etiologically nonspecific and may result from vascular insufficiency or a response to decreased brain metabolic activity. We apply new MRI techniques to measure oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen consumption (CMRO 2 ), hypothesizing that decreased CBF related to these vascular risk factors will be associated with increased OEF, confirming a primary vascular insufficiency. Methods 3T MRI was obtained on 70 community-based participants in this IRB-approved study with informed consent, with previous assessment of systolic blood pressure, hypertension medication, elevated serum triglycerides, low serum HDL, and diabetes mellitus. CBF was measured using phase contrast adjusted for brain volume (ml/100 g/min), OEF (%) was obtained from T2-Relaxation-Under-Spin-Tagging (TRUST), and CMRO 2 (μmol/100 g/min) was derived using the Fick principle. Stepwise linear regression identified optimal predictors of CBF with age, sex, and hematocrit included for adjustment. This predictive model was then evaluated against OEF and CMRO 2 . Results Hypertriglyceridemia was associated with low CBF and high OEF. High systolic blood pressure was associated with high CBF and low OEF, which was primarily attributable to those with pressures above 160 mmHg. Neither risk factor was associated with significant differences in cerebral metabolic rate. Conclusion Low CBF related to hypertriglyceridemia was accompanied by high OEF with no significant difference in CMRO 2 , confirming subclinical vascular insufficiency. High CBF related to high systolic blood pressure likely reflected limitations of autoregulation at higher blood pressures.

Social factors matter in cancer risk and survivorship.

PubMed

Dean, Lorraine T; Gehlert, Sarah; Neuhouser, Marian L; Oh, April; Zanetti, Krista; Goodman, Melody; Thompson, Beti; Visvanathan, Kala; Schmitz, Kathryn H

2018-07-01

Greater attention to social factors, such as race/ethnicity, socioeconomic position, and others, are needed across the cancer continuum, including breast cancer, given differences in tumor biology and genetic variants have not completely explained the persistent Black/White breast cancer mortality disparity. In this commentary, we use examples in breast cancer risk assessment and survivorship to demonstrate how the failure to appropriately incorporate social factors into the design, recruitment, and analysis of research studies has resulted in missed opportunities to reduce persistent cancer disparities. The conclusion offers recommendations for how to better document and use information on social factors in cancer research and care by (1) increasing education and awareness about the importance of inclusion of social factors in clinical research; (2) improving testing and documentation of social factors by incorporating them into journal guidelines and reporting stratified results; and (3) including social factors to refine extant tools that assess cancer risk and assign cancer care. Implementing the recommended changes would enable more effective design and implementation of interventions and work toward eliminating cancer disparities by accounting for the social and environmental contexts in which cancer patients live and are treated.

Assessment and management of risk factors for the prevention of lifestyle-related disease: a cross-sectional survey of current activities, barriers and perceived training needs of primary care physiotherapists in the Republic of Ireland.

PubMed

O'Donoghue, G; Cunningham, C; Murphy, F; Woods, C; Aagaard-Hansen, J

2014-06-01

To provide a snapshot of current activities, barriers and perceived training needs for the assessment and management of behavioural risk factors in physiotherapy practice in primary care settings in the Republic of Ireland. Cross-sectional survey of primary care physiotherapists. Two hundred and twenty primary care physiotherapists were invited to participate. Each received a questionnaire, consisting of 23 questions, within five key sections. Its main focus was the risk factor management practices of physiotherapists. Descriptive statistics and frequencies were used to analyse the data. A response rate of 74% (163/220) was achieved. Level of physical activity was the most common risk factor assessed at initial and follow-up visits (78%, 127/163), followed by dietary status (55%, 90/163). Few respondents included smoking status and alcohol consumption in their assessment; however, the majority considered them as risk factors that should be addressed. The main reasons why smoking status and alcohol consumption were not assessed were lack of time, limited knowledge and expertise, not traditionally viewed as the physiotherapist's role, and patient's lack of interest in changing their unhealthy behaviour. The findings highlight an untapped potential in relation to physiotherapists addressing lifestyle-related risk factors. A number of strategies are required to improve the systematic assessment and management of these risk factors. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice.

PubMed

Essers, Geurt; van Dulmen, Sandra; van Weel, Chris; van der Vleuten, Cees; Kramer, Anneke

2011-12-13

Communication is a key competence for health care professionals. Analysis of registrar and GP communication performance in daily practice, however, suggests a suboptimal application of communication skills. The influence of context factors could reveal why communication performance levels, on average, do not appear adequate. The context of daily practice may require different skills or specific ways of handling these skills, whereas communication skills are mostly treated as generic. So far no empirical analysis of the context has been made. Our aim was to identify context factors that could be related to GP communication. A purposive sample of real-life videotaped GP consultations was analyzed (N = 17). As a frame of reference we chose the MAAS-Global, a widely used assessment instrument for medical communication. By inductive reasoning, we analyzed the GP behaviour in the consultation leading to poor item scores on the MAAS-Global. In these cases we looked for the presence of an intervening context factor, and how this might explain the actual GP communication behaviour. We reached saturation after having viewed 17 consultations. We identified 19 context factors that could potentially explain the deviation from generic recommendations on communication skills. These context factors can be categorized into doctor-related, patient-related, and consultation-related factors. Several context factors seem to influence doctor-patient communication, requiring the GP to apply communication skills differently from recommendations on communication. From this study we conclude that there is a need to explicitly account for context factors in the assessment of GP (and GP registrar) communication performance. The next step is to validate our findings.

Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment.

PubMed

Dong, Jingmei; Zhang, Su; Xia, Li; Yu, Yi; Hu, Shuangshuang; Sun, Jingyu; Zhou, Ping; Chen, Peijie

2018-01-23

It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents' health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA) which conducts supervision of environmental pollution and survey of adolescents' activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children's and adolescents' activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively.

Assessment of awareness of connectedness as a culturally-based protective factor for Alaska native youth.

PubMed

Mohatt, Nathaniel V; Fok, Carlotta Ching Ting; Burket, Rebekah; Henry, David; Allen, James

2011-10-01

Research with Native Americans has identified connectedness as a culturally based protective factor against substance abuse and suicide. Connectedness refers to the interrelated welfare of the individual, one's family, one's community, and the natural environment. We developed an 18-item quantitative assessment of awareness of connectedness and tested it with 284 Alaska Native youth. Evaluation with confirmatory factor analysis and item response theory identified a 12-item subset that functions satisfactorily in a second-order four-factor model. The proposed Awareness of Connectedness Scale (ACS) displays good convergent and discriminant validity, and correlates positively with hypothesized protective factors such as reasons for living and communal mastery. The measure has utility in the study of culture-specific protective factors and as an outcomes measure for behavioral health programs with Native American youth.

Assessment of Awareness of Connectedness as a Culturally-based Protective Factor for Alaska Native Youth

PubMed Central

Mohatt, Nathaniel V.; Fok, Carlotta Ching Ting; Burket, Rebekah; Henry, David; Allen, James

2011-01-01

Research with Native Americans has identified connectedness as a culturally-based protective factor against substance abuse and suicide. Connectedness refers to the interrelated welfare of the individual, one’s family, one’s community, and the natural environment. We developed an 18-item quantitative assessment of awareness of connectedness and tested it with 284 Alaska Native youth. Evaluation with confirmatory factor analysis and item response theory identified a 12-item subset that functions satisfactorily in a second-order, four-factor model. The proposed Awareness of Connectedness Scale displays good convergent and discriminant validity and correlates positively with hypothesized protective factors such as reasons for living and communal mastery. The measure has utility in the study of culture-specific protective factors and as an outcomes measure for behavioral health programs with Native American youth. PMID:21988583

Inter-observer reliability of animal-based welfare indicators included in the Animal Welfare Indicators welfare assessment protocol for dairy goats.

PubMed

Vieira, A; Battini, M; Can, E; Mattiello, S; Stilwell, G

2018-01-08

This study was conducted within the context of the Animal Welfare Indicators (AWIN) project and the underlying scientific motivation for the development of the study was the scarcity of data regarding inter-observer reliability (IOR) of welfare indicators, particularly given the importance of reliability as a further step for developing on-farm welfare assessment protocols. The objective of this study is therefore to evaluate IOR of animal-based indicators (at group and individual-level) of the AWIN welfare assessment protocol (prototype) for dairy goats. In the design of the study, two pairs of observers, one in Portugal and another in Italy, visited 10 farms each and applied the AWIN prototype protocol. Farms in both countries were visited between January and March 2014, and all the observers received the same training before the farm visits were initiated. Data collected during farm visits, and analysed in this study, include group-level and individual-level observations. The results of our study allow us to conclude that most of the group-level indicators presented the highest IOR level ('substantial', 0.85 to 0.99) in both field studies, pointing to a usable set of animal-based welfare indicators that were therefore included in the first level of the final AWIN welfare assessment protocol for dairy goats. Inter-observer reliability of individual-level indicators was lower, but the majority of them still reached 'fair to good' (0.41 to 0.75) and 'excellent' (0.76 to 1) levels. In the paper we explore reasons for the differences found in IOR between the group and individual-level indicators, including how the number of individual-level indicators to be assessed on each animal and the restraining method may have affected the results. Furthermore, we discuss the differences found in the IOR of individual-level indicators in both countries: the Portuguese pair of observers reached a higher level of IOR, when compared with the Italian observers. We argue how the

USGS world petroleum assessment 2000; new estimates of undiscovered oil and natural gas, including reserve growth, outside the United States

USGS Publications Warehouse

,

2000-01-01

Oil and natural gas account for approximately 63 percent of the world’s total energy consumption. The U.S. Geological Survey periodically estimates the amount of oil and gas remaining to be found in the world. Since 1981, each of the last four of these assessments has shown a slight increase in the combined volume of identified reserves and undiscovered resources. The latest assessment estimates the volume of technically recoverable conventional oil and gas that may be added to the world's reserves, exclusive of the United States, in the next 30 years. The USGS World Petroleum Assessment 2000 reports an increase in global petroleum resources, including a 20-percent increase in undiscovered oil and a 14-percent decrease in undiscovered natural gas compared to the previous assessment (table 1). These results have important implications for energy prices, policy, security, and the global resource balance.

Risk factors for Dandy-Walker malformation: a population-based assessment.

PubMed

Reeder, Matthew R; Botto, Lorenzo D; Keppler-Noreuil, Kim M; Carey, John C; Byrne, Janice L B; Feldkamp, Marcia L

2015-09-01

Dandy-Walker malformation (DWM) is the most common congenital malformation of the cerebellum, but its causes are largely unknown. An increasing number of genes associated with congenital cerebellar malformations have been identified; however, few studies have examined the potential role of non-genetic, potentially modifiable risk factors. From the National Birth Defects Prevention Study, we examined maternal, paternal, and infant characteristics and maternal conditions and periconceptional exposures (from 1 month before to 3 months after conception) among infants with DWM (n = 160) and unaffected controls (n = 10,200), delivered between 1997 and 2009. Odds ratios, crude (cOR) and adjusted (aOR) were computed using logistic regression. Maternal factors associated with DWM included non-Hispanic black race/ethnicity (aOR = 2.0, 95%CI: 1.3-3.2). Among maternal conditions, a history of infertility increased the risk for DWM (all: aOR = 2.4, 95%CI: 1.3-4.6; multiple: aOR = 3.9, 95%CI: 1.7-8.9). The lack of association with many maternal exposures supports the hypothesis of a major contribution of genetic factors to the risk for DWM; however, the observed associations with maternal non-Hispanic black race/ethnicity and maternal history of infertility indicate that further research into factors underlying these characteristics may uncover potentially modifiable risk factors, acting alone or as a component of gene-environment interactions. © 2015 Wiley Periodicals, Inc.

Solar technology assessment project. Volume 6: Photovoltaic technology assessment

NASA Astrophysics Data System (ADS)

Backus, C. E.

1981-04-01

Industrial production of photovoltaic systems and volume of sales are reviewed. Low cost silicon production techniques are reviewed, including the Czochralski process, heat exchange method, edge defined film fed growth, dentritic web growth, and silicon on ceramic process. Semicrystalline silicon, amorphous silicon, and low cost poly-silicon are discussed as well as advanced materials and concentrator systems. Balance of system components beyond those needed to manufacture the solar panels are included. Nontechnical factors are assessed. The 1986 system cost goals are briefly reviewed.

Development and evaluation of the McKnight Risk Factor Survey for assessing potential risk and protective factors for disordered eating in preadolescent and adolescent girls.

PubMed

Shisslak, C M; Renger, R; Sharpe, T; Crago, M; McKnight, K M; Gray, N; Bryson, S; Estes, L S; Parnaby, O G; Killen, J; Taylor, C B

1999-03-01

To describe the development, test-retest reliability, internal consistency, and convergent validity of the McKnight Risk Factor Survey-III (MRFS-III). The MRFS-III was designed to assess a number of potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls. Several versions of the MRFS were pilot tested before the MRFS-III was administered to a sample of 651 4th through 12th- grade girls to establish its psychometric properties. Most of the test-retest reliability coefficients of individual items on the MRFS-III were r > .40. Alpha coefficients for each risk and protective factor domain on the MRFS-III were also computed. The majority of these coefficients were r > .60. High convergent validity coefficients were obtained for specific items on the MRFS-III and measures of self-esteem (Rosenberg Self-Esteem Scale) and weight concerns (Weight Concerns Scale). The test-retest reliability, internal consistency, and convergent validity of the MRFS-III suggest that it is a useful new instrument to assess potential risk and protective factors for the development of disordered eating in preadolescent and adolescent girls.

MR arthrography including abduction and external rotation images in the assessment of atraumatic multidirectional instability of the shoulder.

PubMed

Schaeffeler, Christoph; Waldt, Simone; Bauer, Jan S; Kirchhoff, Chlodwig; Haller, Bernhard; Schröder, Michael; Rummeny, Ernst J; Imhoff, Andreas B; Woertler, Klaus

2014-06-01

To evaluate diagnostic signs and measurements in the assessment of capsular redundancy in atraumatic multidirectional instability (MDI) of the shoulder on MR arthrography (MR-A) including abduction/external rotation (ABER) images. Twenty-one MR-A including ABER position of 20 patients with clinically diagnosed MDI and 17 patients without instability were assessed by three radiologists. On ABER images, presence of a layer of contrast between the humeral head (HH) and the anteroinferior glenohumeral ligament (AIGHL) (crescent sign) and a triangular-shaped space between the HH, AIGHL and glenoid (triangle sign) were evaluated; centring of the HH was measured. Anterosuperior herniation of the rotator interval (RI) capsule and glenoid version were determined on standard imaging planes. The crescent sign had a sensitivity of 57 %/62 %/48 % (observers 1/2/3) and specificity of 100 %/100 %/94 % in the diagnosis of MDI. The triangle sign had a sensitivity of 48 %/57 %/48 % and specificity of 94 %/94 %/100 %. The combination of both signs had a sensitivity of 86 %/90 %/81 % and specificity of 94 %/94 %/94 %. A positive triangle sign was significantly associated with decentring of the HH. Measurements of RI herniation, RI width and glenoid were not significantly different between both groups. Combined assessment of redundancy signs on ABER position MR-A allows for accurate differentiation between patients with atraumatic MDI and patients with clinically stable shoulders; measurements on standard imaging planes appear inappropriate. MR arthrography has the possibility to accurately identify patients with atraumatic MDI. Imaging of the shoulder in abduction and external rotation provides additive information. Capsular enlargement of the shoulder can be diagnosed on MR arthrography.

The Development and Validation of the Inventory of Family Protective Factors: A Brief Assessment for Family Counseling

ERIC Educational Resources Information Center

Gardner, Deborah L.; Huber, Charles H.; Steiner, Robert; Vazquez, Luis A.; Savage, Todd A.

2008-01-01

This article describes the three-stage protocol employed in development and validation of the Inventory of Family Protective Factors (IFPF), a brief-form formal instrument intended to assess the primary protective factors that contribute to family resilience. Following construction of the instrument, data collections and analyses of a total sample…

Chemical alternatives assessment of different flame retardants - A case study including multi-walled carbon nanotubes as synergist.

PubMed

Aschberger, Karin; Campia, Ivana; Pesudo, Laia Quiros; Radovnikovic, Anita; Reina, Vittorio

2017-04-01

Flame retardants (FRs) are a diverse group of chemicals used as additives in a wide range of products to inhibit, suppress, or delay ignition and to prevent the spread of fire. Halogenated FRs (HFRs) are widely used because of their low impact on other material properties and the low loading levels necessary to meet the required flame retardancy. Health and environmental hazards associated with some halogenated FRs have driven research for identifying safer alternatives. A variety of halogen-free FRs are available on the market, including organic (phosphorus and nitrogen based chemicals) and inorganic (metals) materials. Multi-walled carbon nanotubes (MWCNT) have been demonstrated to act as an effective/synergistic co-additive in some FR applications and could thereby contribute to reducing the loading of FRs in products and improving their performance. As part of the FP7 project DEROCA we carried out a chemical alternatives assessment (CAA). This is a methodology for identifying, comparing and selecting safer alternatives to chemicals of concern based on criteria for categorising human and environmental toxicity as well as environmental fate. In the project we assessed the hazard data of different halogen-free FRs to be applied in 5 industrial and consumer products and here we present the results for MWCNT, aluminium diethylphosphinate, aluminium trihydroxide, N-alkoxy hindered amines and red phosphorus compared to the HFR decabromodiphenylether. We consulted the REACH guidance, the criteria of the U.S.-EPA Design for Environment (DfE) and the GreenScreen® Assessment to assess and compare intrinsic properties affecting the hazard potential. A comparison/ranking of exposure reference values such as Derived No Effect Levels (DNELs) showed that FRs of concern are not identified by a low DNEL. A comparison based on hazard designations according to the U.S.-EPA DfE and GreenScreen® for human health endpoints, aquatic toxicity and environmental fate showed that the

Expanding Health Technology Assessments to Include Effects on the Environment.

PubMed

Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

2016-01-01

There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The dyad palindromic glutathione transferase P enhancer binds multiple factors including AP1.

PubMed Central

Diccianni, M B; Imagawa, M; Muramatsu, M

1992-01-01

Glutathione Transferase P (GST-P) gene expression is dominantly regulated by an upstream enhancer (GPEI) consisting of a dyad of palindromically oriented imperfect TPA (12-O-tetradecanoyl-phorbol-13-acetate)-responsive elements (TRE). GPEI is active in AP1-lacking F9 cells as well in AP1-containing HeLa cells. Despite GPEI's similarity to a TRE, c-jun co-transfection has only a minimal effect on transactivation. Antisense c-jun and c-fos co-transfection experiments further demonstrate the lack of a role for AP1 in GPEI mediated trans-activation in F9 cells, although endogenously present AP1 can influence GPEI in HeLa cells. Co-transfection of delta fosB with c-jun, which forms an inactive c-Jun/delta FosB heterodimer that binds TRE sequences, inhibits GPEI-mediated transcription in AP1-lacking F9 cells as well as AP1-containing HeLa cells. These data suggest novel factor(s) other than AP1 are influencing GPEI. Binding studies reveal multiple nucleoproteins bind to GPEI. These factors are likely responsible for the high level of GPEI-mediated transcription observed in the absence of AP1 and during hepatocarcinogenesis. Images PMID:1408831

The dyad palindromic glutathione transferase P enhancer binds multiple factors including AP1.

PubMed

Diccianni, M B; Imagawa, M; Muramatsu, M

1992-10-11

Glutathione Transferase P (GST-P) gene expression is dominantly regulated by an upstream enhancer (GPEI) consisting of a dyad of palindromically oriented imperfect TPA (12-O-tetradecanoyl-phorbol-13-acetate)-responsive elements (TRE). GPEI is active in AP1-lacking F9 cells as well in AP1-containing HeLa cells. Despite GPEI's similarity to a TRE, c-jun co-transfection has only a minimal effect on transactivation. Antisense c-jun and c-fos co-transfection experiments further demonstrate the lack of a role for AP1 in GPEI mediated trans-activation in F9 cells, although endogenously present AP1 can influence GPEI in HeLa cells. Co-transfection of delta fosB with c-jun, which forms an inactive c-Jun/delta FosB heterodimer that binds TRE sequences, inhibits GPEI-mediated transcription in AP1-lacking F9 cells as well as AP1-containing HeLa cells. These data suggest novel factor(s) other than AP1 are influencing GPEI. Binding studies reveal multiple nucleoproteins bind to GPEI. These factors are likely responsible for the high level of GPEI-mediated transcription observed in the absence of AP1 and during hepatocarcinogenesis.

Risk factors for suicide attempts in methamphetamine-dependent patients.

PubMed

Glasner-Edwards, Suzette; Mooney, Larissa J; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Rawson, Richard

2008-01-01

The purpose of this study was to identify risk factors for suicide attempts (SA) in methamphetamine (MA)-dependent patients. MA-dependent adults (N = 526) who participated in the Methamphetamine Treatment Project were interviewed before and three years after treatment. Baseline psychiatric, medical, demographic, and substance use characteristics were assessed using the Addiction Severity Index and the Beck Depression Inventory (BDI). Lifetime history of SA was assessed at follow-up. Risk factors for SA included gender, intravenous MA use, BDI > 20 at baseline, and clinically significant psychiatric history. Psychiatric characteristics of MA users are strongly associated with SA, warranting careful assessment of psychiatric history.

An assessment study of CVD related risk factors in a tribal population of India.

PubMed

Kandpal, Vani; Sachdeva, M P; Saraswathy, K N

2016-05-25

Non communicable diseases (NCDs) have become a major concern for global health. Cardiovascular diseases (CVDs) contribute 48 % towards the deaths due to NCDs in India. Though studies have been conducted in urban and rural areas, data related to tribal communities is limited. The present study aims to examine various CVD related risk factors including hypertension, elevated fasting blood glucose, obesity and metabolic syndrome among a tribal population. The present study was an observational, cross- sectional study conducted on Rang Bhotias, a tribal population of India. The participants were adults of age between 20 and 60 years. Prior to blood sample collection, interview schedule was administered which included relevant information like age, lifestyle, socio-economic status, education and occupation In addition to this, various anthropometric and physiological measurements were taken. Logistic regression was used to examine the association of the various health disorders related to CVDs with age, gender and behavioural factors (smoking, alcohol consumption and physical activity). A total of 288 participants were surveyed for the study including 104 males and 184 females. High BMI (56.6 %), hypertension (43.4 %), metabolic syndrome (39.2 %) and abdominal obesity (33.7 %) were the most prevalent CVD risk factors observed in the population. The multivariate logistic regression analysis, conducted to examine the contribution of risk factors including behavioural risk factors on the studied abnormalities, revealed age to be a significant risk factor for all the abnormalities except elevated fasting blood glucose. Gender and physical inactivity contributed significantly towards development of hypertension. Physical inactivity was also found to be associated with high BMI levels. In the present study, hypertension, high BMI levels, MS and abdominal obesity have been found to be high among the studied population. The status of the population with respect to these

Geographical scenario uncertainty in generic fate and exposure factors of toxic pollutants for life-cycle impact assessment

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

Huijbregts, Mark A.J.; Lundi, Sven; McKone, Thomas E.

In environmental life-cycle assessments (LCA), fate and exposure factors account for the general fate and exposure properties of chemicals under generic environmental conditions by means of 'evaluative' multi-media fate and exposure box models. To assess the effect of using different generic environmental conditions, fate and exposure factors of chemicals emitted under typical conditions of (1) Western Europe, (2) Australia and (3) the United States of America were compared with the multi-media fate and exposure box model USES-LCA. Comparing the results of the three evaluative environments, it was found that the uncertainty in fate and exposure factors for ecosystems and humansmore » due to choice of an evaluative environment, as represented by the ratio of the 97.5th and 50th percentile, is between a factor 2 and 10. Particularly, fate and exposure factors of emissions causing effects in fresh water ecosystems and effects on human health have relatively high uncertainty. This uncertainty i s mainly caused by the continental difference in the average soil erosion rate, the dimensions of the fresh water and agricultural soil compartment, and the fraction of drinking water coming from ground water.« less

Assessing the factor structure of the Chinese conformity to masculine norms inventory.

PubMed

Rochelle, Tina L; Yim, K H

2015-01-01

The purpose of the present study was to examine the factor structure and assess the reliability of the Chinese Conformity to Masculine Norms Inventory-46 (CCMNI-46). Using a cohort of 254 Hong Kong-born Chinese males, scale reliability determination involved the internal consistencies of the entire instrument. Ages of respondents ranged from 18 to 81 years (M = 38.05; SD = 17.3). Confirmatory factor analysis provided support for the psychometric properties of the CCMNI-46, thus confirming the multidimensional structure of the CMNI-46 and the replicability of the CMNI using a Hong Kong Chinese sample. All items loaded onto the corresponding factor with the exception of one item from the emotional control subscale. The overall reliability of the CCMNI-46 was lower than previous Western studies and may well reflect the subtle diversity of masculinity across cultures. The findings offered psychometric support for use of the CCMNI-46 in research and practice regarding Hong Kong Chinese masculinity. The CCMNI-46 provides a useful template for the operationalization of masculine norms in Chinese society.

A Subjective Assessment of the Prevalence and Factors Associated with Poor Sleep Quality Amongst Elite Japanese Athletes.

PubMed

Hoshikawa, Masako; Uchida, Sunao; Hirano, Yuichi

2018-02-26

The amount, quality, and timing of sleep are considered important for athletes' ability to train, maximize training responses, and recover. However, some research has shown that elite athletes do not obtain sufficient sleep. Based on this background, researchers recently started to assess and manage sleep in elite athletes. The purpose of this study was to clarify the prevalence of poor sleep quality and its associated factors amongst elite Japanese athletes. Eight hundred and ninety-one candidates for the 17th Asian Games Incheon 2014, who were over 20 years old, participated in this study. They completed a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, two-question case-finding instruments, and a checklist for sleep hygiene. Data from 817 of the 891 athletes (91.7%) with no missing values were analyzed. The mean time in bed was 7 h and 29 min. Two hundred and twenty-nine (28.0%) athletes showed a PSQI global score above the clinical criteria. A multiple logistic analysis revealed that sleep quality was significantly associated with five factors: "time in bed," "eating breakfast every morning," "avoiding the use of electronic devices (PC, smartphone, etc.) just before bedtime," "depressive mood", and "not thinking about troubles while in bed." Forty percent of athletes reported they had been informed by someone about "snoring loudly" and/or "leg twitching or jerking during sleep." The results of this study demonstrate that 28% of the athletes showed the PSQI score above the cutoff for poor sleep quality (> 5.5), which suggests that there may be a high prevalence of poor sleep quality in this population of athletes. To improve athletes' sleep, the five factors associated with sleep quality should be emphasized in athletes' sleep education. Furthermore, in medical evaluations of athletes, it may be desirable to include screening for sleep disorders.

Physical Activity, a Critical Exposure Factor of Environmental Pollution in Children and Adolescents Health Risk Assessment

PubMed Central

Zhang, Su; Xia, Li; Yu, Yi; Hu, Shuangshuang; Sun, Jingyu; Zhou, Ping; Chen, Peijie

2018-01-01

It is an extremely urgent problem that physical fitness promotion must face not only the increasing air pollution but also the decline of physical activity level of children and adolescents worldwide at present, which is the major reason that forms an inactive lifestyle and does harm to adolescents’ health. Thus, it is necessary to focus on the exposure factor in environmental health risk assessment (EHRA) which conducts supervision of environmental pollution and survey of adolescents’ activity patterns according to the harmful characteristics of air pollutant and relationship between dose and response. Some countries, such as USA, Canada and Australia, regard both respiratory rate and physical activity pattern as main exposure factors for adolescents in both air pollution health risk assessment and exercise risk assessment to forecast a safe exposing condition of pollutant for adolescents while they are doing exercise outdoors. In addition, it suggests that the testing indexes and testing methods of these two exposure factors, such as investigating the time of daily physical activity, strength, and characteristic of frequency, help to set up the quantitative relationship between environmental pollution index and the time, strength, frequency of daily activities, and formulate children’s and adolescents’ activity instructions under different levels of environmental pollutions. As smog becomes increasingly serious at present, it is meaningful to take physical activity as a critical composition of exposure factor and establish physical activity guideline, so as to reduce the risk of air pollution, and promote physical health of children and adolescents effectively. PMID:29360730

The assessment of cyberstalking: an expanded examination including social networking, attachment, jealousy, and anger in relation to violence and abuse.

PubMed

Strawhun, Jenna; Adams, Natasha; Huss, Matthew T

2013-01-01

Because the first antistalking statute was enacted in California in 1990, stalking research has been expanded immensely, yet been largely confined to exploring traditional pursuit tactics. This study instead examined the prevalence and correlates of cyberstalking behaviors while examining the phenomenon in a more inclusive manner than previous studies focusing on cyberstalking by including social networking avenues. In addition to a measure assessing cyberstalking-related behaviors, questionnaires assessing pathological aspects of personality, including attachment style, interpersonal jealousy, interpersonal violence, and anger were also provided to participants. Results indicate that, given preliminary evidence, cyberstalking-related behaviors are related to past measures of traditional stalking and cyberstalking, although prior attachment, jealousy, and violence issues within relationships are significant predictors of cyberstalking-related behaviors. In addition, unexpected gender differences emerged. For example, women admitted greater frequencies of cyberstalking perpetration than males, signaling that further research on frequency and motivation for cyberstalking among the sexes is necessary.

Effects of psychosocial work factors and psychological distress on self-assessed work ability: A 7-year follow-up in a general working population.

PubMed

Leijon, Ola; Balliu, Natalja; Lundin, Andreas; Vaez, Marjan; Kjellberg, Katarina; Hemmingsson, Tomas

2017-01-01

Toinvestigate the effects of psychosocial work factors (PWF) and psychological distress (PD) on self-assessed work ability. This follow-up study included 7,810 individuals (55%women) with good work ability at baseline. PWFandPD (measured by GHQ-12) were assessed at baseline and work ability at 7-year follow-up. Effects of PWF and PD on work ability were analyzed by logistic regression, odds ratios (OR) with 95% CI, and by mediation analysisusing 4-way decomposition. Low support was associated with poor work ability for both women and men (OR 1.78 and 1.89). For men, also low skill discretion was associated with poor work ability (OR 2.07). For both women and men, PD was associated with poor work ability (OR 3.41 and 1.84). PD did not act as an intermediate variablein the association between PWF and work ability. Strategies for sustainable work ability should focus on both working conditions and health factors. Am. J. Ind. Med. 60:121-130, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Independent Confirmatory Factor Analysis of the Cognitive Assessment System (CAS): What Does CAS Measure?

ERIC Educational Resources Information Center

Kranzler, John H.; Keith, Timothy Z.

1999-01-01

Uses confirmatory factor analysis (CFA) to address unresolved issues concerning the structure of the Cognitive Assessment System, a test of intelligence based upon the planning, attention, and simultaneous-successive (PASS) processes theory of human cognition. Results reveal that the CFA of the standardization data do not support use of the CAS…

Effective Factors in Enhancing School Manager's Job Motivation

PubMed Central

Mirzamani, S. Mahmoud; Esfahani, Hamideh Darb

2011-01-01

Objective This study examines the effective factors in enhancing school manager's job motivation from viewpoint of school mangers, teachers, education department managerial and staff experts in teaching, and also identifies and prioritizes each of these factors and indicators. Method For selecting a representative sample and increasing measurement precision, 587 people were selected using classified random sampling. The measurement tool was a 79-questionnaire made by the researcher. The questionnaire was collected using motivation theories and observing the findings of previous researches. Then, according to the three-stage Delphi technique, the questionnaire was sent to experts in education. The reliability of instruments was measured by calculating Cronbach's Alpha coefficient, and total reliability of the test was 0.99; the validity of the instrument was assessed by factor analysis (Construct Validity) and its load factor was 0.4 which was high. Results The results from factor analysis shows that the effective factors in enhancing manager's job motivation are as follows: self- actualization (51%) including 28 indices; social factor (7/9%) including 22 indices; self-esteem (3.2%) including 17 indices; job desirable features (2.2%) including 4 indices; physiologic (1.8%) including 4 indices; and job richness (1.6%) including 4 indices. Conclusions The results show that the six mentioned factors determine 68% of the total variance of manager's motivation. PMID:22952541

Examining the Factors That Promote Long-Term Change in Elementary Teachers' Instructional Practices: Sustaining Formative Assessment Reform

ERIC Educational Resources Information Center

Sherbinko, Thomas, Jr.

2011-01-01

The purpose of this holistic case study with a mixed methods approach was two-fold: first, to investigate the extent to which elementary teachers in the BTSD sustained the use of formative assessment reform to regulate instruction, and second, to explore the factors that promoted fidelity to formative assessment reform. Although this study…

Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

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

Kelsey, Chris R., E-mail: kelse003@mc.duke.edu; Horwitz, Mitchell E.; Chino, Junzo P.

2011-11-01

Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meiermore » method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.« less

MyPyramid.gov: assessment of literacy, cultural and linguistic factors in the USDA food pyramid web site.

PubMed

Neuhauser, Linda; Rothschild, Rebeccah; Rodríguez, Fátima M

2007-01-01

MyPyramid.gov, a major national Web site about healthful eating and physical activity, was analyzed for literacy, cultural, and linguistic factors relevant to consumers. The assessment used 4 standardized readability tests, 1 navigational test, availability of non-English content, and new criteria for cultural factors. Readability scores averaged between grade levels 8.8 and 10.8, and half the navigation criteria were met. The Web site was available in Spanish, but it had little cultural tailoring for English speakers. It is recommended that MyPyramid's readability, navigation, and cultural tailoring be improved. References are provided to help educators learn more about assessing and using Internet communication with diverse audiences.

Assessment of Factors Related to Auto-PEEP.

PubMed

Natalini, Giuseppe; Tuzzo, Daniele; Rosano, Antonio; Testa, Marco; Grazioli, Michele; Pennestrì, Vincenzo; Amodeo, Guido; Marsilia, Paolo F; Tinnirello, Andrea; Berruto, Francesco; Fiorillo, Marialinda; Filippini, Matteo; Peratoner, Alberto; Minelli, Cosetta; Bernardini, Achille

2016-02-01

Previous physiological studies have identified factors that are involved in auto-PEEP generation. In our study, we examined how much auto-PEEP is generated from factors that are involved in its development. One hundred eighty-six subjects undergoing controlled mechanical ventilation with persistent expiratory flow at the beginning of each inspiration were enrolled in the study. Volume-controlled continuous mandatory ventilation with PEEP of 0 cm H2O was applied while maintaining the ventilator setting as chosen by the attending physician. End-expiratory and end-inspiratory airway occlusion maneuvers were performed to calculate respiratory mechanics, and tidal flow limitation was assessed by a maneuver of manual compression of the abdomen. The variable with the strongest effect on auto-PEEP was flow limitation, which was associated with an increase of 2.4 cm H2O in auto-PEEP values. Moreover, auto-PEEP values were directly related to resistance of the respiratory system and body mass index and inversely related to expiratory time/time constant. Variables that were associated with the breathing pattern (tidal volume, frequency minute ventilation, and expiratory time) did not show any relationship with auto-PEEP values. The risk of auto-PEEP ≥5 cm H2O was increased by flow limitation (adjusted odds ratio 17; 95% CI: 6-56.2), expiratory time/time constant ratio <1.85 (12.6; 4.7-39.6), respiratory system resistance >15 cm H2O/L s (3; 1.3-6.9), age >65 y (2.8; 1.2-6.5), and body mass index >26 kg/m(2) (2.6; 1.1-6.1). Flow limitation, expiratory time/time constant, resistance of the respiratory system, and obesity are the most important variables that affect auto-PEEP values. Frequency expiratory time, tidal volume, and minute ventilation were not independently associated with auto-PEEP. Therapeutic strategies aimed at reducing auto-PEEP and its adverse effects should be primarily oriented to the variables that mainly affect auto-PEEP values. Copyright © 2016 by

Links between behavioral factors and inflammation

PubMed Central

O’Connor, Mary-Frances; Irwin, Michael R.

2010-01-01

This review focuses on those biobehavioral factors that show robust associations with markers of inflammation, including discussion of the following variables: diet, smoking, coffee, alcohol, exercise and sleep disruption. Each of these variables has been assessed in large-scale epidemiological studies, and many in clinical and experimental studies as well. Treatment strategies that target biobehavioral factors have the potential to complement and add to the benefit of anti-inflammatory medicines. PMID:20130566

Human Factors Assessment of Vibration Effects on Visual Performance During Launch

NASA Technical Reports Server (NTRS)

Holden, Kritina

2009-01-01

The Human Factors Assessment of Vibration Effects on Visual Performance During Launch (Visual Performance) investigation will determine visual performance limits during operational vibration and g-loads on the Space Shuttle, specifically through the determination of minimum readable font size during ascent using planned Orion display formats. Research Summary: The aim of the Human Factors Assessment of Vibration Effects on Visual Performance during Launch (Visual Performance) investigation is to provide supplementary data to that collected by the Thrust Oscillation Seat Detailed Technical Objective (DTO) 695 (Crew Seat DTO) which will measure seat acceleration and vibration from one flight deck and two middeck seats during ascent. While the Crew Seat DTO data alone are important in terms of providing a measure of vibration and g-loading, human performance data are required to fully interpret the operational consequences of the vibration values collected during Space Shuttle ascent. During launch, crewmembers will be requested to view placards with varying font sizes and indicate the minimum readable size. In combination with the Crew Seat DTO, the Visual Performance investigation will: Provide flight-validated evidence that will be used to establish vibration limits for visual performance during combined vibration and linear g-loading. o Provide flight data as inputs to ongoing ground-based simulations, which will further validate crew visual performance under vibration loading in a controlled environment. o Provide vibration and performance metrics to help validate procedures for ground tests and analyses of seats, suits, displays and controls, and human-in-the-loop performance.

Objective assessment of facial skin aging and the associated environmental factors in Japanese monozygotic twins

PubMed Central

Ichibori, Ryoko; Fujiwara, Takashi; Tanigawa, Tomoko; Kanazawa, Shigeyuki; Shingaki, Kenta; Torii, Kosuke; Tomita, Koichi; Yano, Kenji; Sakai, Yasuo; Hosokawa, Ko

2014-01-01

Twin studies, especially those involving monozygotic (MZ) twins, facilitate the analysis of factors affecting skin aging while controlling for age, gender, and genetic susceptibility. The purpose of this study was to objectively assess various features of facial skin and analyze the effects of environmental factors on these features in MZ twins. At the Osaka Twin Research Center, 67 pairs of MZ twins underwent medical interviews and photographic assessments, using the VISIA® Complexion Analysis System. First, the average scores of the right and left cheek skin spots, wrinkles, pores, texture, and erythema were calculated; the differences between the scores were then compared in each pair of twins. Next, using the results of medical interviews and VISIA data, we investigated the effects of environmental factors on skin aging. The data were analyzed using Pearson's correlation coefficient test and the Wilcoxon signed-rank test. The intrapair differences in facial texture scores significantly increased as the age of the twins increased (P = 0.03). Among the twin pairs who provided answers to the questions regarding history differences in medical interviews, the twins who smoked or did not use skin protection showed significantly higher facial texture or wrinkle scores compared with the twins not exposed to cigarettes or protectants (P = 0.04 and 0.03, respectively). The study demonstrated that skin aging among Japanese MZ twins, especially in terms of facial texture, was significantly influenced by environmental factors. In addition, smoking and skin protectant use were important environmental factors influencing skin aging. PMID:24910280

Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner.

PubMed

Nishimura, Akiko; Fujita, Yuichi; Katsuta, Mayumi; Ishihara, Aya; Ohashi, Kazutomo

2015-05-31

A negative effect of paternal depression on child development has been revealed in several previous studies. The aims of this study were to examine the prevalence and relevant factors associated with paternal postnatal depression at four months postpartum, including age, part-time work or unemployment, experience of visiting a medical institution due to a mental health problem, economic anxiety, unexpected pregnancy, pregnancy with infertility treatment, first child, partner's depression, and lower marital relationship satisfaction. We distributed 2032 self-report questionnaires to couples (one mother and one father) with a 4-month old infant between January and April 2013. Data from 807 couples (39.7 %) were analyzed. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). In order to clarify the factors related with paternal depression, a logistic regression analysis was conducted. One hundred and ten fathers (13.6 %) and 83 mothers (10.3 %) were depressed. According to the logistic regression analysis, paternal depression was positively associated with partner's depression (adjusted odds ratio (AOR) 1.91, 95 % confidence interval (CI) 1.05-3.47), and negatively with marital relationship satisfaction (AOR 0.83, 95 % CI 0.77-0.89). History of infertility treatment (AOR 2.37, 95 % CI 1.32-4.24), experience of visiting a medical institution due to a mental health problem (AOR 4.56, 95 % CI 2.06-10.08), and economic anxiety (AOR 2.15, 95 % CI 1.34-3.45) were also correlated with paternal depression. This study showed that the prevalence of paternal depression at four months after childbirth was 13.6 % in Japan. The presence of partner's depression and low marital relationship satisfaction were significantly correlated with paternal postpartum depression, suggesting that health professionals need to pay attention to the mental status of both fathers and mothers, and to their relationship.

Methods of dietary and nutritional assessment and intervention and other methods in the Multiple Risk Factor Intervention Trial.

PubMed

Dolecek, T A; Stamler, J; Caggiula, A W; Tillotson, J L; Buzzard, I M

1997-01-01

Various dietary assessment instruments were used in the Multiple Risk Factor Intervention Trial (MRFIT), either to assist with the special intervention program or to assess trial outcomes. For the latter purpose, the 24-h recall was the main method and was selected with the understanding that the single recall collected at baseline and at most annual visits--considered by itself--would be useful mainly for assessing groups rather than individuals. Major components of the data collection and analysis system developed for the 24-h recall included central training and certification of nutritionists, a central nutrient coding system, and a food grouping system to assist interventionists in using recall data for counseling. Several additional nutritional assessment methods were used for men in the special intervention group only to assist them in attaining the dietary goals. These goals consisted chiefly of reduced intake of saturated fat and cholesterol and a modest increase in intake of polyunsaturated fat; total fat intake was also decreased, primarily for control of energy intake. Short-term success at attainment of these nutritional goals was evaluated by means of 3-d food records collected before the intervention and after the initial 10-wk intensive intervention period. The MRFIT nutrient goals, which became more vigorous at certain points in the trial, were translated into food patterns. Adherence to these food patterns was also assessed by scoring of 3-d records and by subjective evaluation by nutritionists throughout the trial. Methods of collecting other trial data are also described in this chapter.

The Chinese Family Assessment Instrument (C-FAI): Hierarchical Confirmatory Factor Analyses and Factorial Invariance

ERIC Educational Resources Information Center

Shek, Daniel T. L.; Ma, Cecilia M. S.

2010-01-01

Objective: This paper examines the dimensionality and factorial invariance of the Chinese Family Assessment Instrument (C-FAI) using multigroup confirmatory factor analyses (MCFAs). Method: A total of 3,649 students responded to the C-FAI in a community survey. Results: Results showed that there are five dimensions of the C-FAI (communication,…

Assessment of water, sanitation, and hygiene practices and associated factors in a Buruli ulcer endemic district in Benin (West Africa).

PubMed

Johnson, Roch Christian; Boni, Gratien; Barogui, Yves; Sopoh, Ghislain Emmanuel; Houndonougbo, Macaire; Anagonou, Esai; Agossadou, Didier; Diez, Gabriel; Boko, Michel

2015-08-19

Control of neglected tropical diseases (NTDs) requires multiple strategic approaches including water, sanitation and hygiene services (WASH). Buruli ulcer (BU), one of the 17 NTDs, remains a public health issue in Benin particularly in the district of Lalo. The availability of water as well as good hygiene are important for the management of Buruli ulcer particularly in the area of wound care one of the main component of the treatment of BU lesions. Given the growing importance of WASH in controlling NTDs and in order to assess the baseline for future cross-cutting interventions, we report here on the first study evaluating the level of WASH and associated factors in Lalo, one of the most BU-endemic districts in Benin. A cross-sectional study was carried to assess WASH practices and associated factors in the district of Lalo. Data were collected from 600 heads of household using structured pretested questionnaire and observations triangulated with qualitative information obtained from in-depth interviews of patients, care-givers and community members. Univariate and multivariate analysis were carried to determine the relationships between the potential associated factors and the sanitation as well as hygiene status. BU is an important conditions in the district of Lalo with 917 new cases detected from 2006 to 2012. More than 49 % of the household surveyed used unimproved water sources for their daily needs. Only 8.7 % of the investigated household had improved sanitation facilities at home and 9.7 % had improved hygiene behavior. The type of housing as an indicator of the socioeconomic status, the permanent availability of soap and improved hygiene practices were identified as the main factors positively associated with improved sanitation status. In the district of Lalo in Benin, one of the most endemic for BU, the WASH indicators are very low. This study provides baseline informations for future cross-cutting interventions in this district.

Brief report: Assessing dispositional optimism in adolescence--factor structure and concurrent validity of the Life Orientation Test--Revised.

PubMed

Monzani, Dario; Steca, Patrizia; Greco, Andrea

2014-02-01

Dispositional optimism is an individual difference promoting psychosocial adjustment and well-being during adolescence. Dispositional optimism was originally defined as a one-dimensional construct; however, empirical evidence suggests two correlated factors in the Life Orientation Test - Revised (LOT-R). The main aim of the study was to evaluate the dimensionality of the LOT-R. This study is the first attempt to identify the best factor structure, comparing congeneric, two correlated-factor, and two orthogonal-factor models in a sample of adolescents. Concurrent validity was also assessed. The results demonstrated the superior fit of the two orthogonal-factor model thus reconciling the one-dimensional definition of dispositional optimism with the bi-dimensionality of the LOT-R. Moreover, the results of correlational analyses proved the concurrent validity of this self-report measure: optimism is moderately related to indices of psychosocial adjustment and well-being. Thus, the LOT-R is a useful, valid, and reliable self-report measure to properly assess optimism in adolescence. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

The Kimberley assessment of depression of older Indigenous Australians: prevalence of depressive disorders, risk factors and validation of the KICA-dep scale.

PubMed

Almeida, Osvaldo P; Flicker, Leon; Fenner, Stephen; Smith, Kate; Hyde, Zoe; Atkinson, David; Skeaf, Linda; Malay, Roslyn; LoGiudice, Dina

2014-01-01

This study aimed to develop a culturally acceptable and valid scale to assess depressive symptoms in older Indigenous Australians, to determine the prevalence of depressive disorders in the older Kimberley community, and to investigate the sociodemographic, lifestyle and clinical factors associated with depression in this population. Cross-sectional survey of adults aged 45 years or over from six remote Indigenous communities in the Kimberley and 30% of those living in Derby, Western Australia. The 11 linguistic and culturally sensitive items of the Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep) scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the DSM-IV-TR and ICD-10 criteria, and their frequency was rated on a 4-point scale ranging from 'never' to 'all the time' (range of scores: 0 to 33). The diagnosis of depressive disorder was established after a face-to-face assessment with a consultant psychiatrist. Other measures included sociodemographic and lifestyle factors, and clinical history. The study included 250 participants aged 46 to 89 years (mean±SD = 60.9±10.7), of whom 143 (57.2%) were women. The internal reliability of the KICA-dep was 0.88 and the cut-point 7/8 (non-case/case) was associated with 78% sensitivity and 82% specificity for the diagnosis of a depressive disorder. The point-prevalence of a depressive disorder in this population was 7.7%; 4.0% for men and 10.4% for women. Heart problems were associated with increased odds of depression (odds ratio = 3.3, 95% confidence interval = 1.2,8.8). The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians. Depressive disorders are common in this population, possibly because of increased stressors and health morbidities.

[Cardiovascular Risk Assessment: preliminary results].

PubMed

Palmieri, Luigi; Rielli, Rita; Demattè, Luca; Donfrancesco, Chiara; La Terza, Giampaolo; De Sanctis Caiola, Patrizia; Dima, Francesco; Lo Noce, Cinzia; Giannelli, Anna Maria; Brignoli, Ovidio; Cuffari, Alfredo; De Rosa, Marisa; Addis, Antonio; Laurendi, Giovanna; Giampaoli, Simona

2010-02-01

The Italian National Prevention plan includes 10-year cardiovascular risk (CR) assessment of the Italian general population aged 35-69 years using the CUORE Project risk score. A national training program for general practitioners (GPs) was launched by the Ministry of Health in 2003. GPs were encouraged to collect data on risk factors and risk assessment and to contribute to the CUORE Project Cardiovascular Risk Observatory (CRO). The aim of this analysis is to demonstrate the feasibility and effectiveness of risk assessment in primary care. The cuore.exe software, free of charge for GPs and easily downloadable from the CUORE Project web site (www.cuore.iss.it), is the frame for the GP data collection. The CRO provides a platform to analyze data collected on risk assessment and risk factors, and compare results at regional and national level in order to support health policy makers in their decision process. From January 2007 to April 2009, 2858 GPs have downloaded the cuore.exe software; 102,113 risk assessments were sent to the CRO based on risk factors profile of 87,556 persons (3617 persons had more than 1 risk assessment). Mean level of CR was 3.1% in women and 8.4% in men; 30% of men and 65% of women were at low risk (CR < 3%), 9% of men and 0.4% of women were found at high risk (CR > or = 20%). Among those with at least 2 risk assessments, 8% shifted to a lower class of risk after 1 year. Mean level of systolic and diastolic blood pressure decreased by about 1% in 1 year; total cholesterol more than 2%, and prevalence of smokers decreased by about 3% in the second risk assessment. These data demonstrate that risk assessment can be included as a first step of prevention in primary care. The CUORE Project individual score is expected to become an important tool for GPs to assess their patients' CR, to promote primary prevention, and to focus attention to healthy lifestyle adoption.

LIFE CYCLE IMPACT ASSESSMENT SOPHISTICATION

EPA Science Inventory

An international workshop was held in Brussels on 11/29-30/1998, to discuss LCIA Sophistication. LCA experts from North America, Europs, and Asia attended. Critical reviews of associated factors, including current limitations of available assessment methodologies, and comparison...

Assessment and clinical factors associated with pain in patients undergoing transrectal prostate biopsy.

PubMed

Gómez-Gómez, E; Ramírez, M; Gómez-Ferrer, A; Rubio-Briones, J; Iborra, I; J Carrasco-Valiente; Campos, J P; Ruiz-García, J; Requena-Tapia, M J; Solsona, E

2015-09-01

To quantify the degree of pain experienced by patients who undergo ultrasound-guided transrectal prostate biopsy in standard clinical practice and assess the clinical factors associated with increased pain. Analysis of a multicenter series of patients with prostate biopsy according to standard clinical practice. The biopsy was performed transrectally with a protocol of local anesthesia on the posterolateral nerve bundle. The pain was assessed at 20minutes into the procedure using the visual analog scale (0-10). The degree of pain was analyzed, and the association was studied using a univariate/multivariate analysis of selected clinical variables and the degree of pain. A total of 1188 patients with a median age of 64 years were analyzed. Thirty percent of the biopsies were diagnosed with a tumor. The median pain score was 2, with 65% of the patients reporting a pain score ≤2. The multivariate analysis showed that the prostate volume (RR, 1.34; 95% CI 1.01-1.77; P=.04), having a previous biopsy (RR, 2.25; 95% CI 1.44-3.52; P<.01), age (RR, .63; 95% CI .47-.85; P<.01) and feel palpation (RR, 1.95; 95% CI 1.28-2.96; P<.01) were factors independently associated with greater pain during the procedure. Transrectal biopsy with local anesthesia is a relatively painless technique. Factors such as age, a previous biopsy, pain on being touched and prostate volume were associated with the presence of greater pain during the procedure. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Using bioavailable soil fraction to assess the bioconcentration factor of plants in phytoremediation of mine soils

NASA Astrophysics Data System (ADS)

Roca, Núria; Rodríguez-Bocanegra, Javier; Bech, Jaume

2017-04-01

Polluted soils by heavy metals are characterized to present great concentrations of these pollutants. Ure wrote the following in 1996: "For understanding the chemistry of the heavy metals in their interaction with other soil components such as the clay minerals, organic matter and the soil solution, or to assess their mobility and retention as well as their availability to plants, the usual approach is to use selective chemical extraction". However, nowadays to assess the bioconcentration factor of plants in phytoremediation, the pseudototal or total concentration has been used. Strong mineral acids attack part of the silicate soil matrix and as consequence part of the heavy metals obtained are included in the structures of the mineral fraction. A different approach may, therefore, be more productive in the study of phytoremediation and the use of extractants, as EDTA or DTPA, can perhaps best be exploited by considering them in their role of bioconcentration factor. Moreover, EDTA and DTPA, which form strong complexes with many metals, can extract also organically complex metals. Properties of the soils collected in mining areas presented great variability, as they depend on materials where soils were developed, the complex mixture of heterogeneous wastes and the mining age. In the case of Caroline Mine in Hualgayoc (Perú), the mining is relatively modern and the available fraction of heavy metals of mine soils is low. The small available fraction concentration is due partly to both a few developed soil structure and low organic matter content. The only exception was the copper, with ranging from 1.2 to 36.2 % of total soil fraction. All plant species that were investigated in previous studies have a good ability to transport potential hazardous elements from the roots to the shoots and they have the ability to accumulate more than 1000 mg•kg-1 of heavy metals in the shoots. However, the bioconcentration factor was smaller than one for all the studied plants in

Development and Preliminary Testing of the Food Choice Priorities Survey (FCPS): Assessing the Importance of Multiple Factors on College Students' Food Choices.

PubMed

Vilaro, Melissa J; Zhou, Wenjun; Colby, Sarah E; Byrd-Bredbenner, Carol; Riggsbee, Kristin; Olfert, Melissa D; Barnett, Tracey E; Mathews, Anne E

2017-12-01

Understanding factors that influence food choice may help improve diet quality. Factors that commonly affect adults' food choices have been described, but measures that identify and assess food choice factors specific to college students are lacking. This study developed and tested the Food Choice Priorities Survey (FCPS) among college students. Thirty-seven undergraduates participated in two focus groups ( n = 19; 11 in the male-only group, 8 in the female-only group) and interviews ( n = 18) regarding typical influences on food choice. Qualitative data informed the development of survey items with a 5-point Likert-type scale (1 = not important, 5 = extremely important). An expert panel rated FCPS items for clarity, relevance, representativeness, and coverage using a content validity form. To establish test-retest reliability, 109 first-year college students completed the 14-item FCPS at two time points, 0-48 days apart ( M = 13.99, SD = 7.44). Using Cohen's weighted κ for responses within 20 days, 11 items demonstrated moderate agreement and 3 items had substantial agreement. Factor analysis revealed a three-factor structure (9 items). The FCPS is designed for college students and provides a way to determine the factors of greatest importance regarding food choices among this population. From a public health perspective, practical applications include using the FCPS to tailor health communications and behavior change interventions to factors most salient for food choices of college students.

Content and factor validation of the Sieloff-King-Friend Assessment of Group Empowerment within Educational Organizations.

PubMed

Friend, Mary Louanne; Sieloff, Christina Leibold; Murphy, Shannon; Leeper, James

2016-07-01

Nursing education programs have responsibilities to their stakeholders to prepare graduates who can provide safe, effective patient centered care while leading health care changes. Empowered nurses have been associated with low nurse turnover and higher patient satisfaction; however, less is currently known about group empowerment in nursing education. In order to examine group empowerment in schools of nursing, the Sieloff-King Assessment of Group Empowerment in Organizations (SKAGEO©) was adapted and tested for content validity and confirmatory factor analysis. The adapted instrument, the Sieloff-King-Friend Assessment of Group Empowerment within Educational Organizations (SKFAGEEO) was first reviewed by nurse experts who provided quantitative and qualitative data regarding each item. A total of 320 nurse deans and faculty comprised the final sample for the second order confirmatory 8 factor analysis. Findings revealed factor loadings ranging from .455 to .960.The overall fit of the propose model was Chi Square=1383. 24, df=566, p<.001; GFI=.786, RMSEA=0.69. The study results indicated that the SKFAGEEO has acceptable psychometric properties. Copyright © 2016 Elsevier Ltd. All rights reserved.

The assessment of science: the relative merits of post-publication review, the impact factor, and the number of citations.

PubMed

Eyre-Walker, Adam; Stoletzki, Nina

2013-10-01

The assessment of scientific publications is an integral part of the scientific process. Here we investigate three methods of assessing the merit of a scientific paper: subjective post-publication peer review, the number of citations gained by a paper, and the impact factor of the journal in which the article was published. We investigate these methods using two datasets in which subjective post-publication assessments of scientific publications have been made by experts. We find that there are moderate, but statistically significant, correlations between assessor scores, when two assessors have rated the same paper, and between assessor score and the number of citations a paper accrues. However, we show that assessor score depends strongly on the journal in which the paper is published, and that assessors tend to over-rate papers published in journals with high impact factors. If we control for this bias, we find that the correlation between assessor scores and between assessor score and the number of citations is weak, suggesting that scientists have little ability to judge either the intrinsic merit of a paper or its likely impact. We also show that the number of citations a paper receives is an extremely error-prone measure of scientific merit. Finally, we argue that the impact factor is likely to be a poor measure of merit, since it depends on subjective assessment. We conclude that the three measures of scientific merit considered here are poor; in particular subjective assessments are an error-prone, biased, and expensive method by which to assess merit. We argue that the impact factor may be the most satisfactory of the methods we have considered, since it is a form of pre-publication review. However, we emphasise that it is likely to be a very error-prone measure of merit that is qualitative, not quantitative.

The Assessment of Science: The Relative Merits of Post-Publication Review, the Impact Factor, and the Number of Citations

PubMed Central

Eyre-Walker, Adam; Stoletzki, Nina

2013-01-01

The assessment of scientific publications is an integral part of the scientific process. Here we investigate three methods of assessing the merit of a scientific paper: subjective post-publication peer review, the number of citations gained by a paper, and the impact factor of the journal in which the article was published. We investigate these methods using two datasets in which subjective post-publication assessments of scientific publications have been made by experts. We find that there are moderate, but statistically significant, correlations between assessor scores, when two assessors have rated the same paper, and between assessor score and the number of citations a paper accrues. However, we show that assessor score depends strongly on the journal in which the paper is published, and that assessors tend to over-rate papers published in journals with high impact factors. If we control for this bias, we find that the correlation between assessor scores and between assessor score and the number of citations is weak, suggesting that scientists have little ability to judge either the intrinsic merit of a paper or its likely impact. We also show that the number of citations a paper receives is an extremely error-prone measure of scientific merit. Finally, we argue that the impact factor is likely to be a poor measure of merit, since it depends on subjective assessment. We conclude that the three measures of scientific merit considered here are poor; in particular subjective assessments are an error-prone, biased, and expensive method by which to assess merit. We argue that the impact factor may be the most satisfactory of the methods we have considered, since it is a form of pre-publication review. However, we emphasise that it is likely to be a very error-prone measure of merit that is qualitative, not quantitative. PMID:24115908

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

PubMed Central

2012-01-01

Background As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. Methods This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. Results The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011). Conclusions Addressing knowledge of smoking risks

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey.

PubMed

Passey, Megan E; D'Este, Catherine A; Sanson-Fisher, Robert W

2012-03-07

As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011). Addressing knowledge of smoking risks and cessation counselling is a priority

Assessment of postmenopausal women and significant risk factors for osteoporosis.

PubMed

Schnatz, Peter F; Marakovits, Kimberly A; O'Sullivan, David M

2010-09-01

The assessment of osteoporosis risk factors can help guide early intervention. The objective of this study was to analyze numerous potential risk factors to see which were associated with postmenopausal osteoporosis. Women aged 49 or greater presenting for dual-energy x-ray absorptiometry bone scans were recruited from radiology sites in the Hartford, Connecticut, area between January 2007 and March 2009, inclusive. Information was collected regarding primary and secondary risk factors for osteoporosis development, as well as family history and history of pregnancy and breast-feeding. Survey results were subsequently correlated with each woman's dual-energy x-ray absorptiometry scan results. In a sample of 619 women, history of fracture (odds ratio [OR], 12.49), weight less than 127 pounds (OR, 3.50), and use of anticoagulants (OR, 5.40) increased the chance of developing osteoporosis. In contrast, multiparity (OR, 0.45) and history of breast-feeding (OR, 0.38) decreased the development of osteoporosis in postmenopausal women. In women aged 49 to 54, breast-feeding was significantly protective, while low body mass index was most indicative of osteoporosis in women ages 55 to 64. Both previous fracture and low body mass index were associated with osteoporosis in women over age 64. The current results are consistent with other studies suggesting that previous fracture, low body weight, and use of anticoagulants increase the risk of osteoporosis. Our results also suggest that a history of pregnancy and breast-feeding protects against the development of postmenopausal osteoporosis, especially in women aged 49 to 54.

Predictors of the On-Road Driving Assessment After Traumatic Brain Injury: Comparing Cognitive Tests, Injury Factors, and Demographics.

PubMed

McKay, Adam; Liew, Carine; Schönberger, Michael; Ross, Pamela; Ponsford, Jennie

(1) To examine the relations between performance on cognitive tests and on-road driving assessment in a sample of persons with traumatic brain injury (TBI). (2) To compare cognitive predictors of the on-road assessment with demographic and injury-related predictors. Ninety-nine people with mild-severe TBI who completed an on-road driving assessment in an Australian rehabilitation setting. Retrospective case series. Wechsler Test of Adult Reading or National Adult Reading Test-Revised; 4 subtests from the Wechsler Adult Intelligence Scale-III; Rey Auditory Verbal Leaning Test; Rey Complex Figure Test; Trail Making Test; demographic factors (age, sex, years licensed); and injury-related factors (duration of posttraumatic amnesia; time postinjury). Participants who failed the driving assessment did worse on measures of attention, visual memory, and executive processing; however, cognitive tests were weak correlates (r values <0.3) and poor predictors of the driving assessment. Posttraumatic amnesia duration mediated by time postinjury was the strongest predictor of the driving assessment-that is, participants with more severe TBIs had later driving assessments and were more likely to fail. Cognitive tests are not reliable predictors of the on-road driving assessment outcome. Traumatic brain injury severity may be a better predictor of on-road driving; however, further research is needed to identify the best predictors of driving behavior after TBI.

Hand function evaluation: a factor analysis study.

PubMed

Jarus, T; Poremba, R

1993-05-01

The purpose of this study was to investigate hand function evaluations. Factor analysis with varimax rotation was used to assess the fundamental characteristics of the items included in the Jebsen Hand Function Test and the Smith Hand Function Evaluation. The study sample consisted of 144 subjects without disabilities and 22 subjects with Colles fracture. Results suggest a four factor solution: Factor I--pinch movement; Factor II--grasp; Factor III--target accuracy; and Factor IV--activities of daily living. These categories differentiated the subjects without Colles fracture from the subjects with Colles fracture. A hand function evaluation consisting of these four factors would be useful. Such an evaluation that can be used for current clinical purposes is provided.

Factors Predicting Compliance to Ecological Momentary Assessment Among Adolescent Smokers

PubMed Central

2014-01-01

Introduction: Ecological momentary assessments (EMAs) are increasingly used in smoking research to understand contextual and individual differences related to smoking and changes in smoking. To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under investigation and introduce sources of bias in results. The purpose of this study was to investigate predictors of compliance to random prompts among a sample of adolescents who had ever smoked. Methods: Data for this study were drawn from a sample of 461 adolescents (9th and 10th graders at baseline) participating in a longitudinal study of smoking escalation. We examined 2 outcomes: subject-level EMA compliance (overall rate of compliance over a week-long EMA wave), and in-the-moment prompt-level compliance to the most proximal random prompt. We investigated several covariates including gender, race, smoking rate, alcohol use, psychological symptomatology, home composition, mood, social context, time in study, inter-prompt interval, and location. Results: At the overall subject level, higher mean negative affect, smoking rate, alcohol use, and male gender predicted lower compliance with random EMA prompts. At the prompt level, after controlling for significant subject-level predictors of compliance, increased positive affect, being outside of the home, and longer inter-prompt interval predicted lower momentary compliance. Conclusions: This study identifies several factors associated with overall and momentary EMA compliance among a sample of adolescents participating in a longitudinal study of smoking. We also propose a conceptual framework for investigating the contextual and momentary predictors of compliance within EMA studies. PMID:24097816

Validity of a questionnaire measuring motives for choosing foods including sustainable concerns.

PubMed

Sautron, Valérie; Péneau, Sandrine; Camilleri, Géraldine M; Muller, Laurent; Ruffieux, Bernard; Hercberg, Serge; Méjean, Caroline

2015-04-01

Since the 1990s, sustainability of diet has become an increasingly important concern for consumers. However, there is no validated multidimensional measurement of motivation in the choice of foods including a concern for sustainability currently available. In the present study, we developed a questionnaire that measures food choice motives during purchasing, and we tested its psychometric properties. The questionnaire included 104 items divided into four predefined dimensions (environmental, health and well-being, economic and miscellaneous). It was administered to 1000 randomly selected subjects participating in the Nutrinet-Santé cohort study. Among 637 responders, one-third found the questionnaire complex or too long, while one-quarter found it difficult to fill in. Its underlying structure was determined by exploratory factor analysis and then internally validated by confirmatory factor analysis. Reliability was also assessed by internal consistency of selected dimensions and test-retest repeatability. After selecting the most relevant items, first-order analysis highlighted nine main dimensions: labeled ethics and environment, local and traditional production, taste, price, environmental limitations, health, convenience, innovation and absence of contaminants. The model demonstrated excellent internal validity (adjusted goodness of fit index = 0.97; standardized root mean square residuals = 0.07) and satisfactory reliability (internal consistency = 0.96, test-retest repeatability coefficient ranged between 0.31 and 0.68 over a mean 4-week period). This study enabled precise identification of the various dimensions in food choice motives and proposed an original, internally valid tool applicable to large populations for assessing consumer food motivation during purchasing, particularly in terms of sustainability. Copyright © 2014 Elsevier Ltd. All rights reserved.

Assessment of iodine status and associated factors in vulnerable populations in Henan Province, China, in 2012.

PubMed

Yang, Jin; Zheng, Heming; Li, Xiaofeng; Zhu, Lin; Hao, Zongyu; Chen, Gan; Liu, Yang; Wang, Yanli

2014-01-01

Iodine content in table salt was adjusted from 30-50 mg/kg to 21-39 mg/kg from March of 2012 in Henan Province, China. The vulnerable population may be at risk of iodine deficiency. To determine whether the iodine intake was sufficient in vulnerable populations and to investigate what factors may be associated with iodine status in these vulnerable populations in Henan Province, China. A cross-sectional survey was conducted in 17 cities in Henan Province, China, from April 2012 to December 2012 to assess the iodine status in vulnerable populations, including women of reproductive-age (n=2648), pregnant women (n=39684), lactating women (n=6859), infants <2 years of age (n=16481), and children aged 8-10 years (n=3198). Questionnaires (n=4865) related to demographic and dietary factors were collected from the investigated women to identify factors that were related to iodine intake and iodine status. The median urinary iodine concentrations (mUICs) were 205 μg/L, 198 μg/L, 167 μg/L, 205 μg/L and 200 μg/L, respectively, in reproductiveage, pregnant and lactating women, infants <2 years of age and children aged 8-10 years. Higher income, and consuming more poultry and fish in the diet had positive impact on UIC levels. Low salt intake, consuming more rice and vegetables in the diet were negative factors for UIC. Iodine status of the vulnerable populations was generally adequate in Henan Province, China, according to WHO criteria. But the mUICs were slightly above the adequate level in reproductive-age women and children aged 8-10 years. It's important to monitor the iodine status in vulnerable populations after the adjustment on iodine content in table salt.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

PubMed

Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Mohd Hanafiah, Khayriyyah; Mokdad, Ali A; Morawska, Lidia; Mozaffarian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid; AlMazroa, Mohammad A; Memish, Ziad A

2012-12-15

Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved

Hypoglycemia incidence and risk factors assessment in hospitalized neonates.

PubMed

Zhou, Wei; Yu, Jun; Wu, Yiqi; Zhang, Huawei

2015-03-01

To assess the incidence and risk factors of hypoglycemia in hospitalized neonates in China. Blood glucose level in hospitalized neonates was monitored routinely. Also, in high-risk newborns and neonates with abnormal blood glucose levels in initial detection, the blood sugar level was monitored daily until it was back to normal and stable. Hypoglycemia was detected in 113 out of 668 hospitalized neonates, and the incidence of hypoglycemia was 16.9%. The statistical analysis also showed that hypoglycemia always occurred within one week after birth, especially within three days after birth. Neonates with premature birth, low birth weight and perinatal asphyxia were susceptible to hypoglycemia. Active and continuous monitoring of blood glucose level should be performed in the early newborns, especially in high-risk children, and attention should be paid to timely feeding for the early diagnosis and treatment of neonatal hypoglycemia to reduce its impact on the newborns.

Level of agreement between physician and patient assessment of non-medical health factors.

PubMed

Ludovic, Casanova; Virginie, Ringa; Sophia, Chatelard; Sylvain, Paquet; Isabelle, Pendola-Luchel; Henri, Panjo; Camille, Bideau; Eric, Deflesselle; Raphaëlle, Delpech; Géraldine, Bloy; Laurent, Rigal

2018-01-29

GPs need to consider assorted relevant non-medical factors, such as family or work situations or health insurance coverage, to determine appropriate patient care. If GPs' knowledge of these factors varies according to patients' social position, less advantaged patients might receive poorer care, resulting in the perpetuation of social inequalities in health. To assess social disparities in GPs' knowledge of non-medical factors relevant to patient care. Observational survey of GPs who supervise internships in the Paris metropolitan area. Each of the 52 enrolled GPs randomly selected 70 patients from their patient list. Their knowledge of five relevant factors (coverage by publicly funded free health insurance, or by supplementary health insurance, living with a partner, social support and employment status) was analysed as the agreement between the patients' and GPs' answers to matching questions. Occupational, educational and financial disparities were estimated with multilevel models adjusted for age, sex, chronic disease and GP-patient relationship. Agreement varied according to the factor considered from 66% to 91%. The global agreement score (percentage of agreement for all five factors) was 72%. Social disparities and often gradients, disfavouring the less well-off patients, were observed for each factor considered. Social gradients were most marked according to perceived financial situation and for health insurance coverage. GPs must be particularly attentive toward their least advantaged patients, to be aware of the relevant non-medical factors that affect these patients' health and care, and thus provide management adapted to each individual's personal situation. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Percent Mammographic Density and Dense Area as Risk Factors for Breast Cancer.

PubMed

Rauh, C; Hack, C C; Häberle, L; Hein, A; Engel, A; Schrauder, M G; Fasching, P A; Jud, S M; Ekici, A B; Loehberg, C R; Meier-Meitinger, M; Ozan, S; Schulz-Wendtland, R; Uder, M; Hartmann, A; Wachter, D L; Beckmann, M W; Heusinger, K

2012-08-01

Purpose: Mammographic characteristics are known to be correlated to breast cancer risk. Percent mammographic density (PMD), as assessed by computer-assisted methods, is an established risk factor for breast cancer. Along with this assessment the absolute dense area (DA) of the breast is reported as well. Aim of this study was to assess the predictive value of DA concerning breast cancer risk in addition to other risk factors and in addition to PMD. Methods: We conducted a case control study with hospital-based patients with a diagnosis of invasive breast cancer and healthy women as controls. A total of 561 patients and 376 controls with available mammographic density were included into this study. We describe the differences concerning the common risk factors BMI, parital status, use of hormone replacement therapy (HRT) and menopause between cases and controls and estimate the odds ratios for PMD and DA, adjusted for the mentioned risk factors. Furthermore we compare the prediction models with each other to find out whether the addition of DA improves the model. Results: Mammographic density and DA were highly correlated with each other. Both variables were as well correlated to the commonly known risk factors with an expected direction and strength, however PMD (ρ = -0.56) was stronger correlated to BMI than DA (ρ = -0.11). The group of women within the highest quartil of PMD had an OR of 2.12 (95 % CI: 1.25-3.62). This could not be seen for the fourth quartile concerning DA. However the assessment of breast cancer risk could be improved by including DA in a prediction model in addition to common risk factors and PMD. Conclusions: The inclusion of the parameter DA into a prediction model for breast cancer in addition to established risk factors and PMD could improve the breast cancer risk assessment. As DA is measured together with PMD in the process of computer-assisted assessment of PMD it might be considered to include it as one additional breast

Low bone mass prevalence and osteoporosis risk factor assessment in African American Wisconsin women.

PubMed

Kidambi, Srividya; Partington, Susan; Binkley, Neil

2005-11-01

Post-menopausal osteoporosis is seen in all racial groups. With the increasing population and longevity of minority groups, osteoporosis is becoming an important health concern. Data regarding risk factors for, and prevalence of, low bone mass and awareness of osteoporosis risk in African American (AA) women are limited. This article evaluates the risk factors for, and prevalence of, low bone mass in a population of urban AA women in Wisconsin and assesses this group's perceived risk for osteoporosis. One hundred fifty consecutive community-dwelling AA women > or = 45 years old from Milwaukee, Wis were asked to complete a questionnaire based on currently accepted osteoporosis risk factors. Additionally, their perception of osteoporosis risk was assessed using a Likert scale. All subjects underwent quantitative calcaneal ultrasound. Subject mean age was 54 +/- 7 years. Mean T- and Z-scores were 0.5 and 0.4, respectively. Applying World Health Organization criteria, osteopenia (bone mineral density T-score <-1.0) was present in 23.3% and osteoporosis (bone mineral density <-2.5) in 9.3%. Multivariate analysis of risk factors showed that lifetime incidence of at least 1 fracture, multiparity (>2 children), postmenopausal state, and current smoking were associated with lower calcaneal bone mass. Higher education and presence of diabetes were associated with a higher bone mass. Only 25% of the women surveyed thought they were at moderate to high risk for osteoporosis. Low bone mass was present in 33% of these AA women despite their relative young age. Many AA women do not perceive osteoporosis as a health risk. It is necessary to develop strategies to educate AA women regarding osteoporosis risk.

Turkish nurses' assessments of their power and the factors that affect it.

PubMed

Basaran, Seher; Duygulu, Sergul

2015-11-01

To explore nurses' self-assessments of power and their opinions regarding factors affecting power in Turkey using a cross-sectional, descriptive study. In order to safely and cost-effectively care for patients, nurses must perceive themselves as powerful and have the use and control of power resources. The study sample consisted of 297 nurses in six hospitals: two government hospitals, two university hospitals and two private hospitals. Data were collected using the Demographic Data Form and Power Question Form. Nurses regarded themselves as 'quite powerful' regarding persuasion (53.2%) and referent power (43.4%). Many nurses also regarded themselves as having positional power and 'quite powerful' regarding, reward (44.1%) and legitimate power (34.7%). Nurses saw themselves as least powerful in resource power (48.1%). Individual, educational and organisational factors were the main factors affecting personal and positional power sources. Turkish nurses regarded themselves as above average on being powerful in both the personal and positional power base but not in resource power. We recommend that nurses, educators and managers develop strategies to support nurses' power as a way to enhance the patient care outcomes. © 2014 John Wiley & Sons Ltd.

Climate Classification is an Important Factor in ­Assessing Hospital Performance Metrics

NASA Astrophysics Data System (ADS)

Boland, M. R.; Parhi, P.; Gentine, P.; Tatonetti, N. P.

2017-12-01

Context/Purpose: Climate is a known modulator of disease, but its impact on hospital performance metrics remains unstudied. Methods: We assess the relationship between Köppen-Geiger climate classification and hospital performance metrics, specifically 30-day mortality, as reported in Hospital Compare, and collected for the period July 2013 through June 2014 (7/1/2013 - 06/30/2014). A hospital-level multivariate linear regression analysis was performed while controlling for known socioeconomic factors to explore the relationship between all-cause mortality and climate. Hospital performance scores were obtained from 4,524 hospitals belonging to 15 distinct Köppen-Geiger climates and 2,373 unique counties. Results: Model results revealed that hospital performance metrics for mortality showed significant climate dependence (p<0.001) after adjusting for socioeconomic factors. Interpretation: Currently, hospitals are reimbursed by Governmental agencies using 30-day mortality rates along with 30-day readmission rates. These metrics allow Government agencies to rank hospitals according to their `performance' along these metrics. Various socioeconomic factors are taken into consideration when determining individual hospitals performance. However, no climate-based adjustment is made within the existing framework. Our results indicate that climate-based variability in 30-day mortality rates does exist even after socioeconomic confounder adjustment. Use of standardized high-level climate classification systems (such as Koppen-Geiger) would be useful to incorporate in future metrics. Conclusion: Climate is a significant factor in evaluating hospital 30-day mortality rates. These results demonstrate that climate classification is an important factor when comparing hospital performance across the United States.

Reliability, Validity, and Factor Structure of the Current Assessment Practice Evaluation-Revised (CAPER) in a National Sample.

PubMed

Lyon, Aaron R; Pullmann, Michael D; Dorsey, Shannon; Martin, Prerna; Grigore, Alexandra A; Becker, Emily M; Jensen-Doss, Amanda

2018-05-11

Measurement-based care (MBC) is an increasingly popular, evidence-based practice, but there are no tools with established psychometrics to evaluate clinician use of MBC practices in mental health service delivery. The current study evaluated the reliability, validity, and factor structure of scores generated from a brief, standardized tool to measure MBC practices, the Current Assessment Practice Evaluation-Revised (CAPER). Survey data from a national sample of 479 mental health clinicians were used to conduct exploratory and confirmatory factor analyses, as well as reliability and validity analyses (e.g., relationships between CAPER subscales and clinician MBC attitudes). Analyses revealed competing two- and three-factor models. Regardless of the model used, scores from CAPER subscales demonstrated good reliability and convergent and divergent validity with MBC attitudes in the expected directions. The CAPER appears to be a psychometrically sound tool for assessing clinician MBC practices. Future directions for development and application of the tool are discussed.

Exposure factors for cleaning, automotive care, and surface protection products for exposure assessments.

PubMed

Park, Ji Young; Lim, Miyoung; Yang, Wonho; Lee, Kiyoung

2017-01-01

Accurately measuring the usage patterns of consumer products (CPs) is important to conduct realistic exposure assessments. We determined the exposure factors for 18 consumer products: household bleach, mold stain remover, all-purpose cleaner, washing machine cleaner, air conditioner cleaner, glass cleaner, drain cleaner, adhesive remover, liquid snow chain, tire shine spray, wheel cleaner, rain repellent, car wax spray, leather polish, furniture polish, anti-fog product, fabric waterproofing spray, and rust inhibitor. Field survey staff visited homes and collected product use information via face-to-face interviews. In total, 10,000 participants (5010 men and 4990 women) aged 15 years and older completed the questionnaire. Household bleach had the highest use rate of 47.4% and use rates for the other products ranged from 0.8 to 21.7%. The use rates of many CPs differed by age group and gender. Many household cleaning products were used regularly, but some products, such as air conditioner cleaner and liquid snow chain, were used in specific seasons or for specific purposes; therefore, they were used less frequently compared to cleaning products. These exposure factor data will be useful as input data for exposure and risk assessments and setting safety guidelines. Copyright © 2016 Elsevier Ltd. All rights reserved.

Personality change following head injury: assessment with the NEO Five-Factor Inventory.

PubMed

Lannoo, E; de Deyne, C; Colardyn, F; de Soete, G; Jannes, C

1997-11-01

We evaluated personality change following head injury in 68 patients at 6 months postinjury using the NEO Five-Factor Inventory to assess the five personality dimensions of the Five-Factor Model of Personality. All items had to be rated twice, once for the preinjury and once for the current status. Twenty-eight trauma patients with injuries to other parts of the body than the head were used as controls. For the head-injured group, 63 relatives also completed the questionnaire. The results showed no differences between the ratings of head-injured patients and the ratings of trauma control patients. Both groups showed significant change in the personality dimensions Neuroticism, Extraversion, and Conscientiousness. Compared to their relatives, head-injured patients report a smaller change in Extraversion and Conscientiousness. Changes were not reported on the Openness and Agreeableness scales, by neither the head-injured or their relatives, nor by the trauma controls.

Organizational and provider level factors in implementation of trauma-informed care after a city-wide training: an explanatory mixed methods assessment.

PubMed

Damian, April Joy; Gallo, Joseph; Leaf, Philip; Mendelson, Tamar

2017-11-21

While there is increasing support for training youth-serving providers in trauma-informed care (TIC) as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers' professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Government workers and nonprofit professionals (N = 90) who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16) was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Analysis of survey data indicated significant improvements in participants' organizational culture and professional satisfaction at training completion. Participants' perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including "Implementation of more flexible, less-punitive policies towards clients," "Adoption of trauma-informed workplace design," "Heightened awareness of own traumatic stress and need for self-care," and "Greater sense of camaraderie and empathy for colleagues." Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and individual factors including providers' compassion satisfaction, burnout, and secondary

Using DTPA-extractable soil fraction to assess the bioconcentration factor of plants in phytoremediation of urban soils

NASA Astrophysics Data System (ADS)

Rodríguez-Bocanegra, Javier; Roca, Núria; Tume, Pedro; Bech, Jaume

2017-04-01

Urban soils may be highly contaminated with potentially toxic metals, as a result of intensive anthropogenic activities. Developing cities are increasing the number of lands where is practiced the urban agriculture. In this way, it is necessary to assess the part of heavy metals that is transferred to plants in order to a) know the potential health risk that represent soils and b) know the relation soil-plant to assess the ability of these plants to remove heavy metals from soil. Nowadays, to assess the bioconcentration factor (BF) of plants in phytoremediation, the pseudototal o total concentration has been used by many authors. Two different urban soils with similar pH and carbonates content but with different pollution degree were phytoremediated with different plant species. Urban soil from one Barcelona district (Spain), the most contaminated soil, showed an extractability of Cu, Pb and Zn of 9.6, 6.7 and 5.8% of the total fraction respectively. The soil from Talcahuano city (Chile), with contents of heavy metals slightly above the background upper limit, present values of 15.5, 13.5 and 12% of the total fraction of studied heavy metals. Furthermore, a peri-urban analysed soil from Azul (Argentina) also showed an elevated extractability with values of 24, 13.5 and 14% of the Cu, Pb and Zn contents respectively. These soils presented more extractability than other disturbed soils, like for example, soils from mine areas. The urban soils present more developed soil with an interaction between solution and solid phase in polluted systems. The most important soil surface functional groups include the basal plane of phyllosilicates and metal hydroxyls at edge sites of clay minerals, iron oxyhydroxides, manganese oxyhydroxides and organic matter. The interaction between solution and solid phase in polluted urban systems tends to form labile associations and pollutants are more readily mobilized because their bonds with soil particles are weaker. Clay and organic

Reproductive risk factors assessment for anaemia among pregnant women in India using a multinomial logistic regression model.

PubMed

Perumal, Vanamail

2014-07-01

To assess reproductive risk factors for anaemia among pregnant women in urban and rural areas of India. The International Institute of Population Sciences, India, carried out third National Family Health Survey in 2005-2006 to estimate a key indicator from a sample of ever-married women in the reproductive age group 15-49 years. Data on various dimensions were collected using a structured questionnaire, and anaemia was measured using a portable HemoCue instrument. Anaemia prevalence among pregnant women was compared between rural and urban areas using chi-square test and odds ratio. Multinomial logistic regression analysis was used to determine risk factors. Anaemia prevalence was assessed among 3355 pregnant women from rural areas and 1962 pregnant women from urban areas. Moderate-to-severe anaemia in rural areas (32.4%) is significantly more common than in urban areas (27.3%) with an excess risk of 30%. Gestational age specific prevalence of anaemia significantly increases in rural areas after 6 months. Pregnancy duration is a significant risk factor in both urban and rural areas. In rural areas, increasing age at marriage and mass media exposure are significant protective factors of anaemia. However, more births in the last five years, alcohol consumption and smoking habits are significant risk factors. In rural areas, various reproductive factors and lifestyle characteristics constitute significant risk factors for moderate-to-severe anaemia. Therefore, intensive health education on reproductive practices and the impact of lifestyle characteristics are warranted to reduce anaemia prevalence. © 2014 John Wiley & Sons Ltd.

A methodology to model causal relationships on offshore safety assessment focusing on human and organizational factors.

PubMed

Ren, J; Jenkinson, I; Wang, J; Xu, D L; Yang, J B

2008-01-01

Focusing on people and organizations, this paper aims to contribute to offshore safety assessment by proposing a methodology to model causal relationships. The methodology is proposed in a general sense that it will be capable of accommodating modeling of multiple risk factors considered in offshore operations and will have the ability to deal with different types of data that may come from different resources. Reason's "Swiss cheese" model is used to form a generic offshore safety assessment framework, and Bayesian Network (BN) is tailored to fit into the framework to construct a causal relationship model. The proposed framework uses a five-level-structure model to address latent failures within the causal sequence of events. The five levels include Root causes level, Trigger events level, Incidents level, Accidents level, and Consequences level. To analyze and model a specified offshore installation safety, a BN model was established following the guideline of the proposed five-level framework. A range of events was specified, and the related prior and conditional probabilities regarding the BN model were assigned based on the inherent characteristics of each event. This paper shows that Reason's "Swiss cheese" model and BN can be jointly used in offshore safety assessment. On the one hand, the five-level conceptual model is enhanced by BNs that are capable of providing graphical demonstration of inter-relationships as well as calculating numerical values of occurrence likelihood for each failure event. Bayesian inference mechanism also makes it possible to monitor how a safety situation changes when information flow travel forwards and backwards within the networks. On the other hand, BN modeling relies heavily on experts' personal experiences and is therefore highly domain specific. "Swiss cheese" model is such a theoretic framework that it is based on solid behavioral theory and therefore can be used to provide industry with a roadmap for BN modeling and

Assessing factors related to waist circumference and obesity: application of a latent variable model.

PubMed

Dalvand, Sahar; Koohpayehzadeh, Jalil; Karimlou, Masoud; Asgari, Fereshteh; Rafei, Ali; Seifi, Behjat; Niksima, Seyed Hassan; Bakhshi, Enayatollah

2015-01-01

Because the use of BMI (Body Mass Index) alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome) and obesity (binary outcome) among Iranian adults. Data included 18,990 Iranian individuals aged 20-65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity) with independent variables including age, gender, PR (Place of Residence), PA (physical activity), smoking status, SBP (Systolic Blood Pressure), DBP (Diastolic Blood Pressure), CHOL (cholesterol), FBG (Fasting Blood Glucose), diabetes, and FHD (family history of diabetes). All variables were related to both obesity and waist circumference (WC). Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.

Development of the Human Factors Skills for Healthcare Instrument: a valid and reliable tool for assessing interprofessional learning across healthcare practice settings.

PubMed

Reedy, Gabriel B; Lavelle, Mary; Simpson, Thomas; Anderson, Janet E

2017-10-01

A central feature of clinical simulation training is human factors skills, providing staff with the social and cognitive skills to cope with demanding clinical situations. Although these skills are critical to safe patient care, assessing their learning is challenging. This study aimed to develop, pilot and evaluate a valid and reliable structured instrument to assess human factors skills, which can be used pre- and post-simulation training, and is relevant across a range of healthcare professions. Through consultation with a multi-professional expert group, we developed and piloted a 39-item survey with 272 healthcare professionals attending training courses across two large simulation centres in London, one specialising in acute care and one in mental health, both serving healthcare professionals working across acute and community settings. Following psychometric evaluation, the final 12-item instrument was evaluated with a second sample of 711 trainees. Exploratory factor analysis revealed a 12-item, one-factor solution with good internal consistency (α=0.92). The instrument had discriminant validity, with newly qualified trainees scoring significantly lower than experienced trainees ( t (98)=4.88, p<0.001) and was sensitive to change following training in acute and mental health settings, across professional groups (p<0.001). Confirmatory factor analysis revealed an adequate model fit (RMSEA=0.066). The Human Factors Skills for Healthcare Instrument provides a reliable and valid method of assessing trainees' human factors skills self-efficacy across acute and mental health settings. This instrument has the potential to improve the assessment and evaluation of human factors skills learning in both uniprofessional and interprofessional clinical simulation training.

Fall Risk Assessment Through Automatic Combination of Clinical Fall Risk Factors and Body-Worn Sensor Data.

PubMed

Greene, Barry R; Redmond, Stephen J; Caulfield, Brian

2017-05-01

Falls are the leading global cause of accidental death and disability in older adults and are the most common cause of injury and hospitalization. Accurate, early identification of patients at risk of falling, could lead to timely intervention and a reduction in the incidence of fall-related injury and associated costs. We report a statistical method for fall risk assessment using standard clinical fall risk factors (N = 748). We also report a means of improving this method by automatically combining it, with a fall risk assessment algorithm based on inertial sensor data and the timed-up-and-go test. Furthermore, we provide validation data on the sensor-based fall risk assessment method using a statistically independent dataset. Results obtained using cross-validation on a sample of 292 community dwelling older adults suggest that a combined clinical and sensor-based approach yields a classification accuracy of 76.0%, compared to either 73.6% for sensor-based assessment alone, or 68.8% for clinical risk factors alone. Increasing the cohort size by adding an additional 130 subjects from a separate recruitment wave (N = 422), and applying the same model building and validation method, resulted in a decrease in classification performance (68.5% for combined classifier, 66.8% for sensor data alone, and 58.5% for clinical data alone). This suggests that heterogeneity between cohorts may be a major challenge when attempting to develop fall risk assessment algorithms which generalize well. Independent validation of the sensor-based fall risk assessment algorithm on an independent cohort of 22 community dwelling older adults yielded a classification accuracy of 72.7%. Results suggest that the present method compares well to previously reported sensor-based fall risk assessment methods in assessing falls risk. Implementation of objective fall risk assessment methods on a large scale has the potential to improve quality of care and lead to a reduction in associated hospital

[Ecological environmental quality assessment of Hangzhou urban area based on RS and GIS].

PubMed

Xu, Pengwei; Zhao, Duo

2006-06-01

In allusion to the shortage of traditional ecological environmental quality assessment, this paper studied the spatial distribution of assessing factors at a mid-small scale, and the conversion of integer character to girding assessing cells. The main assessing factors including natural environmental condition, environmental quality, natural landscape and urbanization pressure, which were classified into four types with about eleven assessing factors, were selected from RS images and GIS-spatial analyzing environmental quality vector graph. Based on GIS, a comprehensive assessment model for the ecological environmental quality in Hangzhou urban area was established. In comparison with observed urban heat island effects, the assessment results were in good agreement with the ecological environmental quality in the urban area of Hangzhou.

Characterisation factors for life cycle impact assessment of sound emissions.

PubMed

Cucurachi, S; Heijungs, R

2014-01-15

Noise is a serious stressor affecting the health of millions of citizens. It has been suggested that disturbance by noise is responsible for a substantial part of the damage to human health. However, no recommended approach to address noise impacts was proposed by the handbook for life cycle assessment (LCA) of the European Commission, nor are characterisation factors (CFs) and appropriate inventory data available in commonly used databases. This contribution provides CFs to allow for the quantification of noise impacts on human health in the LCA framework. Noise propagation standards and international reports on acoustics and noise impacts were used to define the model parameters. Spatial data was used to calculate spatially-defined CFs in the form of 10-by-10-km maps. The results of this analysis were combined with data from the literature to select input data for representative archetypal situations of emission (e.g. urban day with a frequency of 63 Hz, rural night at 8000 Hz, etc.). A total of 32 spatial and 216 archetypal CFs were produced to evaluate noise impacts at a European level (i.e. EU27). The possibility of a user-defined characterisation factor was added to support the possibility of portraying the situation of full availability of information, as well as a highly-localised impact analysis. A Monte Carlo-based quantitative global sensitivity analysis method was applied to evaluate the importance of the input factors in determining the variance of the output. The factors produced are ready to be implemented in the available LCA databases and software. The spatial approach and archetypal approach may be combined and selected according to the amount of information available and the life cycle under study. The framework proposed and used for calculations is flexible enough to be expanded to account for impacts on target subjects other than humans and to continents other than Europe. © 2013 Elsevier B.V. All rights reserved.

Assessing Susceptibility to Age-Related Macular Degeneration With Genetic Markers and Environmental Factors

PubMed Central

Chen, Yuhong; Zeng, Jiexi; Zhao, Chao; Wang, Kevin; Trood, Elizabeth; Buehler, Jeanette; Weed, Matthew; Kasuga, Daniel; Bernstein, Paul S.; Hughes, Guy; Fu, Victoria; Chin, Jessica; Lee, Clara; Crocker, Maureen; Bedell, Matthew; Salasar, Francesca; Yang, Zhenglin; Goldbaum, Michael; Ferreyra, Henry; Freeman, William R.; Kozak, Igor; Zhang, Kang

2014-01-01

Objectives To evaluate the independent and joint effects of genetic factors and environmental variables on advanced forms of age-related macular degeneration (AMD), including geographic atrophy and choroidal neovascularization, and to develop a predictive model with genetic and environmental factors included. Methods Demographic information, including age at onset, smoking status, and body mass index, was collected for 1844 participants. Genotypes were evaluated for 8 variants in 5 genes related to AMD. Unconditional logistic regression analyses were performed to generate a risk predictive model. Results All genetic variants showed a strong association with AMD. Multivariate odds ratios were 3.52 (95% confidence interval, 2.08-5.94) for complement factor H, CFH rs1061170 CC, 4.21 (2.30-7.70) for CFH rs2274700 CC, 0.46 (0.27-0.80) for C2 rs9332739 CC/CG, 0.44 (0.30-0.66) for CFB rs641153 TT/CT, 10.99 (6.04-19.97) for HTRA1/LOC387715 rs10490924 TT, and 2.66 (1.43-4.96) for C3 rs2230199 GG. Smoking was independently associated with advanced AMD after controlling for age, sex, body mass index, and all genetic variants. Conclusion CFH confers more risk to the bilaterality of geographic atrophy, whereas HTRA1/LOC387715 contributes more to the bilaterality of choroidal neovascularization. C3 confers more risk for geographic atrophy than choroidal neovascularization. Risk models with combined genetic and environmental factors have notable discrimination power. Clinical Relevance Early detection and risk prediction of AMD could help to improve the prognosis of AMD and to reduce the outcome of blindness. Targeting high-risk individuals for surveillance and clinical interventions may help reduce disease burden. PMID:21402993

Evidence-Based Assessment of Obsessive–Compulsive Disorder

PubMed Central

Rapp, Amy M.; Bergman, R. Lindsay; Piacentini, John; McGuire, Joseph F.

2016-01-01

Obsessive–compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%–2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793

Special Education Placement Factors for Latino Students

ERIC Educational Resources Information Center

Kraemer, Robert J.

2010-01-01

The disproportionate representation of minority students in special education programs has been a problem for over forty years. Factors contributing to minority overrepresentation include the lack of primary prevention, inappropriate language and educational assessment, over-referral of minority students for suspected learning difficulties,…

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

PubMed Central

Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Hanafiah, Khayriyyah Mohd; Mokdad, Ali A; Morawska, Lidia; Mozaff arian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope III, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid

2014-01-01

Summary Background Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. Methods We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. Findings In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2–7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5–7·0]), and alcohol use (5·5% [5·0–5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8–9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6–8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4–6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2–10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect

Strategic environmental assessment performance factors and their interaction: An empirical study in China

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

Li, Tianwei, E-mail: li.tianwei@mep.gov.cn; Wang, Huizhi, E-mail: huizhiwangnk@163.com; Deng, Baole, E-mail: dengbaolekobe@126.com

Strategic Environmental Assessment (SEA) has been seen as a preventive and participatory environmental management tool designed to integrate environmental protection into the decision-making process. However, the debate about SEA performance and effectiveness has increased in recent decades. Two main challenges exist in relation to this issue. The first is identifying the key influencing factors that affect SEA effectiveness, and the second is analyzing the relationship between SEA and these influencing factors. In this study, influencing factors were investigated through questionnaire surveys in the Chinese context, and then a Structural Equation Model (SEM) was developed and tested to identify potential linksmore » and causal relationships among factors. The associations between the independent factors were divided into direct and indirect causal associations. The results indicate that the decision-making process and policy context directly affect SEA implementation, while information and data sharing, public participation, expertise and SEA institutions are indirectly related with SEA. The results also suggest that a lack of cooperation between different sectors is an obstacle to the implementation of SEA. These findings could potentially contribute to the future management and implementation of SEA or enhance existing knowledge of SEA. The results show that the proposed model has a degree of feasibility and applicability. - Highlights: • Influencing factors were identified and investigated through questionnaire surveys. • Structural Equation Model (SEM) was developed and tested to identify potential links and causal relationships among factors. • Decision-making process and policy context directly affect SEA implementation. • Lack of cooperation among different sectors is an obstacle to the implementation of SEA. • The proposed model has a degree of feasibility and applicability.« less

Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress.

PubMed

Briones-Buixassa, Laia; Milà, Raimon; Mª Aragonès, Josep; Bufill, Enric; Olaya, Beatriz; Arrufat, Francesc Xavier

2015-07-01

Research about the effects of stress on multiple sclerosis has yielded contradictory results. This study aims to systematically review the evidence focusing on two possible causes: the role of stress assessment and potential moderating and mediating factors. The Web of Knowledge (MEDLINE and Web of Science), Scopus, and PsycINFO databases were searched for relevant articles published from 1900 through December 2014 using the terms "stress*" AND "multiple sclerosis." Twenty-three articles were included. Studies focused on the effect of stress on multiple sclerosis onset ( n  = 9) were mostly retrospective, and semi-structured interviews and scales yielded the most consistent associations. Studies focused on multiple sclerosis progression ( n  = 14) were mostly prospective, and self-reported diaries yielded the most consistent results. The most important modifying factors were stressor duration, severity, and frequency; cardiovascular reactivity and heart rate; and social support and escitalopram intake. Future studies should consider the use of prospective design with self-reported evaluations and the study of moderators and mediators related to amount of stress and autonomic nervous system reactivity to determine the effects of stress on multiple sclerosis.

Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress

PubMed Central

Briones-Buixassa, Laia; Milà, Raimon; Mª Aragonès, Josep; Bufill, Enric; Olaya, Beatriz; Arrufat, Francesc Xavier

2015-01-01

Research about the effects of stress on multiple sclerosis has yielded contradictory results. This study aims to systematically review the evidence focusing on two possible causes: the role of stress assessment and potential moderating and mediating factors. The Web of Knowledge (MEDLINE and Web of Science), Scopus, and PsycINFO databases were searched for relevant articles published from 1900 through December 2014 using the terms “stress*” AND “multiple sclerosis.” Twenty-three articles were included. Studies focused on the effect of stress on multiple sclerosis onset (n = 9) were mostly retrospective, and semi-structured interviews and scales yielded the most consistent associations. Studies focused on multiple sclerosis progression (n = 14) were mostly prospective, and self-reported diaries yielded the most consistent results. The most important modifying factors were stressor duration, severity, and frequency; cardiovascular reactivity and heart rate; and social support and escitalopram intake. Future studies should consider the use of prospective design with self-reported evaluations and the study of moderators and mediators related to amount of stress and autonomic nervous system reactivity to determine the effects of stress on multiple sclerosis. PMID:28070374

Analysis of risk assessment factors of individuals in volcanic hazards: Review of the last decade

NASA Astrophysics Data System (ADS)

Favereau, Marcel; Robledo, Luis F.; Bull, Maria T.

2018-05-01

During the history of mankind, natural disasters have had severe repercussions on the different ecosystems, with volcanic eruptions being a clear example of this. This review is responsible for gathering the most important volatile hazards assessment research of the last decade with the objective of knowing the state of the art in relation to the studies of people's risk perception and acceptance in communities threatened by the danger of volcanic eruptions. In addition, this study includes the analysis of several cases across different countries. The results that this research offers serve as a frame of reference to determine and understand how resilient a community affected by the volatile hazards can be, since they are able to identify the main incident factors of risk that affect the communities to different degrees according to the context at the time of making the risk judgment. On the other hand, through this review, it is proposed as a future research topic to understand the levels of risk acceptance of individuals, due to the fact that the studies related to this subject are scarce.

Psychological Risk Factors and Outcomes of Dance Injury: A Systematic Review.

PubMed

Mainwaring, Lynda M; Finney, Caitlin

2017-09-15

Historically, dance medicine and science has focused on the physical aspects rather than the psychological aspects of dance injury. Psychological variables, however, have been shown to influence the occurrence of injury and post-injury outcomes. The purpose of this review was to examine the dance psychology literature and determine the specific psychological factors reported to be associated with the incidence, frequency, and outcome of dance injuries. A systematic literature search was conducted using SPORTDiscus, MEDLINE, CINAHL, and PsycINFO. All retrieved articles were screened based on criteria developed a priori, and selected articles were subsequently assessed for quality. Thirteen studies met the inclusion and quality assessment criteria. Psychological factors associated with both risk and outcome of dance injury included the following: stress, psychological distress, disordered eating, and coping. Factors associated only with risk of injury were sleep, personality, and social support. The results suggest that psychological variables can affect both the incidence and outcome of dance injury among dancers. Therefore, it is critical to gain a well-rounded, thorough understanding of all the factors, including psychological, that have a negative impact on dancers with respect to dance injury. The findings are discussed in terms of the utility of including psychological assessment and intervention, such as cognitive behavioral therapy, when implementing preventative and treatment measures in dance schools and companies.

Psychosocial Risk Factors and the Association With Carpal Tunnel Syndrome: A Systematic Review.

PubMed

Mansfield, Michael; Thacker, Michael; Sandford, Fiona

2017-10-01

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb. Research has shown that associative factors for CTS include occupational and biomechanical elements, gender, and age. To date, no systematic review has been undertaken to determine specifically whether there are any psychosocial risk factors in developing CTS. The objective is to determine whether psychosocial factors are associated with and/or predict the development of CTS. A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE, and CINAHL from inception to May 30, 2017. Quantitative studies must have investigated a minimum of 1 or more psychosocial factors-cognitive, affective, behavioral, vocational, or interpersonal processes (eg, social support)-and include a point or risk estimate. One reviewer conducted the search and 2 reviewers independently assessed eligibility and completed methodological quality assessment using a modified Downs and Black checklist. Data were analyzed narratively. Six moderate- to high-quality studies were included in the final review. Five studies reported a positive association between psychosocial factors and CTS, where psychosocial factors were more in those who reported CTS. One study reported no positive or negative association with CTS development. Four studies reported a negative association between psychosocial factors and CTS, where psychosocial factors were less in those who reported CTS. There is limited evidence for a positive association between psychosocial factors and CTS. However, this was not a consistent finding across all included studies. Further research is indicated in standardizing CTS diagnostic criteria and investigating other working environments.

Exploring the Factor Structure of a Recovery Assessment Measure among Substance-Abusing Youth.

PubMed

Gonzales, Rachel; Hernandez, Mayra; Douglas, Samantha B; Yu, Chong Ho

2015-01-01

To date, the measurement of recovery in the field of substance abuse is limited. Youth recovery from substance abuse is an important area to consider, given the complexities of such issues. The Recovery Assessment Scale (RAS) has been validated with mental health patient populations; however, its measurement characteristics have not been examined for individuals in substance abuse treatment. The current study explored the factor structure of the RAS with a sample of 80 substance-abusing youth who participated in a pilot aftercare study (Mage 20.5, SD=3.5; 71.3% male). Reliability analysis showed an internal consistency of α=.90 for the entire RAS measure among the youth sample. Results of exploratory factor analysis identified the following four factors: personal determination, skills for recovery, self-control in recovery, and social support/moving beyond recovery among the substance-abusing youth sample. The RAS also demonstrated sound convergent and divergent validity in comparison to other validated measures of functioning, sobriety, and well-being. Collectively, results support that the RAS has adequate psychometric properties for measuring recovery among substance-abusing youth.

Assessing posttraumatic stress disorder's latent structure in elderly bereaved European trauma survivors: evidence for a five-factor dysphoric and anxious arousal model.

PubMed

Armour, Cherie; O'Connor, Maja; Elklit, Ask; Elhai, Jon D

2013-10-01

The three-factor structure of posttraumatic stress disorder (PTSD) specified by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, is not supported in the empirical literature. Two alternative four-factor models have received a wealth of empirical support. However, a consensus regarding which is superior has not been reached. A recent five-factor model has been shown to provide superior fit over the existing four-factor models. The present study investigated the fit of the five-factor model against the existing four-factor models and assessed the resultant factors' association with depression in a bereaved European trauma sample (N = 325). The participants were assessed for PTSD via the Harvard Trauma Questionnaire and depression via the Beck Depression Inventory. The five-factor model provided superior fit to the data compared with the existing four-factor models. In the dysphoric arousal model, depression was equally related to both dysphoric arousal and emotional numbing, whereas depression was more related to dysphoric arousal than to anxious arousal.

Clinical assessment of bone quality of human extraction sockets after conversion with growth factors.

PubMed

Ntounis, Athanasios; Geurs, Nico; Vassilopoulos, Philip; Reddy, Michael

2015-01-01

The study was conducted to evaluate the effect of mineralized freeze-dried bone allograft (FDBA), alone or in combination with growth factors in extraction sockets, on subjective assessment of bone quality during implant placement. Forty-one patients whose treatment plan involved extraction of anterior or premolar teeth were randomized into four groups: Group 1, collagen plug (control); Group 2, FDBA/β-tricalcium phosphate (β-TCP)/collagen plug; Group 3, FDBA/β-TCP/platelet-rich plasma (PRP)/collagen plug; Group 4, FDBA/β-TCP/recombinant human platelet-derived growth factor BB (rhPDGF-BB)/collagen plug. After 8 weeks of healing, implants were placed. The clinicians assessed bone quality according to the Misch classification. A benchtop calibration exercise test was conducted to evaluate agreement and accuracy of operators in recognizing different bone qualities. Differences were analyzed using one-way analysis of variance (ANOVA) or chi-square tests for continuous and categorical data. Pairwise comparisons were tested using least squares means (LS means). Spearman correlation coefficients were used to evaluate the relationship of bone growth with potential confounders. P < .05 was considered statistically significant. A simple (not weighted) kappa statistic was used to assess the agreement between raters. To assess accuracy in identifying bone quality, a chi-square test was used to compare the percent correct for each rater. The benchtop calibration exercise test demonstrated agreement among clinicians (0.75 and 0.92 between raters 1 and 2 and raters 1 and 3, respectively). Raters were more likely to identify the correct bone quality (P > .05). Inclusion of bone grafting is associated with a shift from D4 quality to D3 quality bone. Inclusion of PRP in bone grafting eliminates the incidence of D4 bone, establishing D3 and D2 quality bone as prevalent (56% vs. 42%, respectively). Inclusion of rhPDGF-BB and β-TCP in combination with the bone grafting has the

Assessing social capacity and vulnerability of private households to natural hazards - integrating psychological and governance factors

NASA Astrophysics Data System (ADS)

Werg, J.; Grothmann, T.; Schmidt, P.

2013-06-01

People are unequally affected by extreme weather events in terms of mortality, morbidity and financial losses; this is the case not only for developing, but also for industrialized countries. Previous research has established indicators for identifying who is particularly vulnerable and why, focusing on socio-demographic factors such as income, age, gender, health and minority status. However, these factors can only partly explain the large disparities in the extent to which people are affected by natural hazards. Moreover, these factors are usually not alterable in the short to medium term, which limits their usefulness for strategies of reducing social vulnerability and building social capacity. Based on a literature review and an expert survey, we propose an approach for refining assessments of social vulnerability and building social capacity by integrating psychological and governance factors.

24 CFR 968.315 - Comprehensive Plan (including five-year action plan).

Code of Federal Regulations, 2011 CFR

2011-04-01

... comprehensive plan including, but not limited to, the physical and management needs assessments, viability...) Physical needs assessment—(i) Requirements. The physical needs assessment identifies all of the work that a... physical needs assessment is completed without regard to the availability of funds, and shall include the...

24 CFR 968.315 - Comprehensive Plan (including five-year action plan).

Code of Federal Regulations, 2012 CFR

2012-04-01

... comprehensive plan including, but not limited to, the physical and management needs assessments, viability...) Physical needs assessment—(i) Requirements. The physical needs assessment identifies all of the work that a... physical needs assessment is completed without regard to the availability of funds, and shall include the...

24 CFR 968.315 - Comprehensive Plan (including five-year action plan).

Code of Federal Regulations, 2013 CFR

2013-04-01

... comprehensive plan including, but not limited to, the physical and management needs assessments, viability...) Physical needs assessment—(i) Requirements. The physical needs assessment identifies all of the work that a... physical needs assessment is completed without regard to the availability of funds, and shall include the...

Solo and Multi-Offenders Who Commit Stranger Kidnapping: An Assessment of Factors That Correlate With Violent Events.

PubMed

Cunningham, Shannon N; Vandiver, Donna M

2016-03-06

Research has demonstrated that co-offending dyads and groups often use more violence than individual offenders. Despite the attention given to co-offending by the research community, kidnapping remains understudied. Stranger kidnappings are more likely than non-stranger kidnappings to involve the use of a weapon. Public fear of stranger kidnapping warrants further examination of this specific crime, including differences between those committed by solo and multi-offender groups. The current study uses National Incident-Based Reporting System (NIBRS) data to assess differences in use of violence among 4,912 stranger kidnappings by solo offenders and multi-offender groups using cross-tabulations, ordinal regression, and logistic regression. The results indicate that violent factors are significantly more common in multi-offender incidents, and that multi-offender groups have fewer arrests than solo offenders. The implications of these findings are discussed. © The Author(s) 2016.

Assessing Model Fit: Caveats and Recommendations for Confirmatory Factor Analysis and Exploratory Structural Equation Modeling

ERIC Educational Resources Information Center

Perry, John L.; Nicholls, Adam R.; Clough, Peter J.; Crust, Lee

2015-01-01

Despite the limitations of overgeneralizing cutoff values for confirmatory factor analysis (CFA; e.g., Marsh, Hau, & Wen, 2004), they are still often employed as golden rules for assessing factorial validity in sport and exercise psychology. The purpose of this study was to investigate the appropriateness of using the CFA approach with these…

Assessment of Snoring and obstructive sleep apnoea in a Nigerian university: Association with cardiovascular risk factors

PubMed Central

Akintunde, Adeseye A.; Salawu, Afolabi A.; Opadijo, Oladimeji G.

2014-01-01

Background: Snoring remains under diagnosed in general population. It however has significant morbidity and mortality risk factors with multiple effects on the cardiovascular system. The Berlin questionnaire is a worldwide validated instrument to identify those at increased risk for obstructive sleep apnoea (OSA). Materials and Methods: In all, 206 workers of LAUTECH were invited to participate in the study. The Berlin questionnaire was used for this study. It was a cross-sectional study. Socio-demographic and clinical data were taken with a data form. Statistical Package for the Social Sciences software (SPSS 17.0) was used for statistical analysis. P < 0.05 was taken as statistically significant value. Results: The study participants consisted of 96 males (46.6%) and 110 (53.4%) females. The mean age was 45.3 ± 7.9 years. The mean body mass index was 28.5 ± 6.0 kg/m². The frequency of occurrence of snoring was 91 (44.2%) including 50 males (54.9% and 41 females (37.3 %, P <0.05). Using the Berlin score, 63 (30.6%) including 34 females (30.9%) were assessed to be at high risk for OSA. Snorers were more likely to be at higher risk of OSA compared to non snorers: odd risk was 113.8, relative risk was 3.3. Snoring was most likely to be associated with obesity, elevated blood pressure and male gender in this study. Conclusion: We concluded that snoring and high risk for sleep apnoea is common among this unselected University population and they are closely related to many conventional cardiovascular risk factors. Appropriate interventional strategies are indicated to reduce the burden of the increased morbidity and mortality associated with sleep apnoea in our population. PMID:25538364

Factors that contribute to biomarker responses in humans including a study in individuals taking Vitamin C supplementation.

PubMed

Anderson, D

2001-09-01

It is possible in many situations to identify humans exposed to potentially toxic materials in the workplace and in the environment. As in most human studies, there tends to be a high degree of interindividual variability in response to chemical insults. Some non-exposed control individuals exhibit as high a level of damage as some exposed individuals and some of these have levels of damage as low as many of the controls. Thus, it is only the mean values of the groups that can substantiate an exposure-related problem; the data on an individual basis are still of limited use. While human lymphocytes remain the most popular cell type for monitoring purposes, sperm, buccal, nasal, epithelial and placental cells are also used. However, for interpretation of responses, the issue of confounding factors must be addressed. There are endogenous confounding factors, such as age, gender, and genetic make-up and exogenous ones, including lifestyle habits (smoking, drinking, etc.) There are biomarkers of exposure, effect/response and susceptibility and the last may be influenced by the genotype and polymorphism genes existing in a population. From our own studies, confounding effects on cytogenetic damage and ras oncoproteins will be considered in relation to workers exposed to vinyl chloride and petroleum emissions and to volunteers taking Vitamin C supplementation. Smoking history, exposure and duration of employment affected the worker studies. For petroleum emissions, so did gender and season of exposure. For the non-smoking volunteer Vitamin C supplementation study, cholesterol levels, plasma Vitamin C levels, lipid peroxidation products and DNA damage in the Comet assay were also measured. Gender affected differences in Vitamin C levels, antioxidant capacity and the number of chromosome aberrations induced by bleomycin challenge in vitro. The results were the same for both high and low cholesterol subjects. The relationship between biomarkers and the various factors which