Quantification of increased flood risk due to global climate change for urban river management planning.

PubMed

Morita, M

2011-01-01

Global climate change is expected to affect future rainfall patterns. These changes should be taken into account when assessing future flooding risks. This study presents a method for quantifying the increase in flood risk caused by global climate change for use in urban flood risk management. Flood risk in this context is defined as the product of flood damage potential and the probability of its occurrence. The study uses a geographic information system-based flood damage prediction model to calculate the flood damage caused by design storms with different return periods. Estimation of the monetary damages these storms produce and their return periods are precursors to flood risk calculations. The design storms are developed from modified intensity-duration-frequency relationships generated by simulations of global climate change scenarios (e.g. CGCM2A2). The risk assessment method is applied to the Kanda River basin in Tokyo, Japan. The assessment provides insights not only into the flood risk cost increase due to global warming, and the impact that increase may have on flood control infrastructure planning.

Mental correlates of neuromotoric deviation in 6-year-olds at heightened risk for schizophrenia.

PubMed

McNeil, Thomas F; Cantor-Graae, Elizabeth; Blennow, Gösta

2003-04-01

The meaning and relevance of the increased rates of neuromotoric deviation (ND) observed in patients with schizophrenia and their biological relatives remain unclear. ND could represent free-floating, independent characteristics of individuals in these families vs. signs of an increased risk for current or future mental disorder. The co-temporaneous relationship between ND and mental disorder at 6 years of age was investigated among 31 children with an increased risk for schizophrenia and similar psychoses, defined as having a mother with a history of schizophrenia or unspecified functional psychosis. As compared with high-risk cases with a low level of ND, the subgroup of 10 high-risk offspring showing notably increased rates of ND had significantly more frequent psychiatric diagnoses (typically language disorders and enuresis), poor functioning on global assessment, poor interpersonal competency and high anxiety proneness. Neuromotoric items representing "overflow" (e.g., choreatic movements, tremor) were significantly positively related to each of these mental characteristics. Among high-risk offspring, an increased rate of ND is very clearly associated with increased rates of current mental disorder, and might potentially identify a subgroup with an especially high risk for serious mental disorder in the future.

Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990-2020.

PubMed

Journy, Neige M Y; Lee, Choonsik; Harbron, Richard W; McHugh, Kieran; Pearce, Mark S; Berrington de González, Amy

2017-01-03

To project risks of developing cancer and the number of cases potentially induced by past, current, and future computed tomography (CT) scans performed in the United Kingdom in individuals aged <20 years. Organ doses were estimated from surveys of individual scan parameters and CT protocols used in the United Kingdom. Frequencies of scans were estimated from the NHS Diagnostic Imaging Dataset. Excess lifetime risks (ELRs) of radiation-related cancer were calculated as cumulative lifetime risks, accounting for survival probabilities, using the RadRAT risk assessment tool. In 2000-2008, ELRs ranged from 0.3 to 1 per 1000 head scans and 1 to 5 per 1000 non-head scans. ELRs per scan were reduced by 50-70% in 2000-2008 compared with 1990-1995, subsequent to dose reduction over time. The 130 750 scans performed in 2015 in the United Kingdom were projected to induce 64 (90% uncertainty interval (UI): 38-113) future cancers. Current practices would lead to about 300 (90% UI: 230-680) future cancers induced by scans performed in 2016-2020. Absolute excess risks from single exposures would be low compared with background risks, but even small increases in annual CT rates over the next years would substantially increase the number of potential subsequent cancers.

Preeclampsia and the Future Risk of Hypertension: The Pregnant Evidence

PubMed Central

Garovic, Vesna D.; August, Phyllis

2013-01-01

Cardiovascular death rates continue to rise for women under age 55, underlying the importance of focusing on female-specific conditions that may increase cardiovascular risk, including pregnancy-related disorders. Hypertension complicates about 5–10% of pregnancies. Preeclampsia, a pregnancy-specific condition, is characterized by hypertension and proteinuria after 20 weeks of gestation and remains one of the major causes of maternal deaths in the United States. In addition, preeclampsia may have an impact on women’s health beyond their pregnancies, and has been associated with increased risks for future hypertension and cardiovascular disease, such as coronary heart disease and stroke. In this review, we discuss the evidence supporting the association between preeclampsia and future hypertension; possible mechanisms that underlie this association; current approach to women with a history of preeclampsia; and future research that is needed in this field in order to deliver optimal and timely medical care to the affected women. PMID:23397213

Projected Flood Risks in China based on CMIP5

NASA Astrophysics Data System (ADS)

Xu, Ying

2016-04-01

Based on the simulations from 22 CMIP5 models and in combination with data on population, GDP, arable land, and terrain elevation, the spatial distributions of the flood risk levels are calculated and analyzed under RCP8.5 for the baseline period (1986-2005), the near term future period (2016-2035), the middle term future period (2046-2065), and the long term future period (2080-2099). (1) Areas with higher flood hazard risk levels in the future are concentrated in southeastern China, and the areas with the risk level III continue to expand. The major changes in flood hazard risks will occur in the middle and long term future. (2) In future, the areas of high vulnerability to flood hazards will be located in China's eastern region. In the middle and late 21st century, the extent of the high vulnerability area will expand eastward and its intensity will gradually increase. The highest vulnerability values are found in the provinces of Beijing, Tianjin, Hebei, Henan, Anhui, Shandong, Shanghai, Jiangsu, and in parts of the Pearl River Delta. Furthermore, the major cities in northeast China, as well as Wuhan, Changsha and Nanchang are highly vulnerable. (3) The regions with high flood risk levels will be located in eastern China, in the middle and lower reaches of Yangtze River and stretching northward to Beijing and Tianjin. High-risk flood areas are also occurring in major cities in Northeast China, in some parts of Shaanxi and Shanxi, and in some coastal areas in Southeast China. (4) Compared to the baseline period, the high flood risks will increase on a regional level towards the end of the 21st century, although the areas of flood hazards show little variation. In this paper, the projected future flood risks for different periods were analyzed under the RCP8.5 emission scenarios. By comparing the results with the simulations under the RCP 2.6 and RCP 4.5 scenarios, both scenarios show no differences in the spatial distribution, but in the intensity of flood hazard risks, which are weaker than for the RCP8.5 scenarios. By using the simulations from climate model ensembles to project future flood risks, uncertainty exists for various factors, such as the coarse resolution of global climate models, different approaches to flood assessments, the selection of the weighting coefficients, as well as the used greenhouse gas emission scheme, and the estimations of future population, GDP, and arable land. Therefore, further analysis is needed to reduce the uncertainties of future flood risks.

Fire risk in San Diego County, California: A weighted Bayesian model approach

USGS Publications Warehouse

Kolden, Crystal A.; Weigel, Timothy J.

2007-01-01

Fire risk models are widely utilized to mitigate wildfire hazards, but models are often based on expert opinions of less understood fire-ignition and spread processes. In this study, we used an empirically derived weights-of-evidence model to assess what factors produce fire ignitions east of San Diego, California. We created and validated a dynamic model of fire-ignition risk based on land characteristics and existing fire-ignition history data, and predicted ignition risk for a future urbanization scenario. We then combined our empirical ignition-risk model with a fuzzy fire behavior-risk model developed by wildfire experts to create a hybrid model of overall fire risk. We found that roads influence fire ignitions and that future growth will increase risk in new rural development areas. We conclude that empirically derived risk models and hybrid models offer an alternative method to assess current and future fire risk based on management actions.

Forecasting the future risk of Barmah Forest virus disease under climate change scenarios in Queensland, Australia.

PubMed

Naish, Suchithra; Mengersen, Kerrie; Hu, Wenbiao; Tong, Shilu

2013-01-01

Mosquito-borne diseases are climate sensitive and there has been increasing concern over the impact of climate change on future disease risk. This paper projected the potential future risk of Barmah Forest virus (BFV) disease under climate change scenarios in Queensland, Australia. We obtained data on notified BFV cases, climate (maximum and minimum temperature and rainfall), socio-economic and tidal conditions for current period 2000-2008 for coastal regions in Queensland. Grid-data on future climate projections for 2025, 2050 and 2100 were also obtained. Logistic regression models were built to forecast the otential risk of BFV disease distribution under existing climatic, socio-economic and tidal conditions. The model was applied to estimate the potential geographic distribution of BFV outbreaks under climate change scenarios. The predictive model had good model accuracy, sensitivity and specificity. Maps on potential risk of future BFV disease indicated that disease would vary significantly across coastal regions in Queensland by 2100 due to marked differences in future rainfall and temperature projections. We conclude that the results of this study demonstrate that the future risk of BFV disease would vary across coastal regions in Queensland. These results may be helpful for public health decision making towards developing effective risk management strategies for BFV disease control and prevention programs in Queensland.

Climate Change and Crop Exposure to Adverse Weather: Changes to Frost Risk and Grapevine Flowering Conditions.

PubMed

Mosedale, Jonathan R; Wilson, Robert J; Maclean, Ilya M D

2015-01-01

The cultivation of grapevines in the UK and many other cool climate regions is expected to benefit from the higher growing season temperatures predicted under future climate scenarios. Yet the effects of climate change on the risk of adverse weather conditions or events at key stages of crop development are not always captured by aggregated measures of seasonal or yearly climates, or by downscaling techniques that assume climate variability will remain unchanged under future scenarios. Using fine resolution projections of future climate scenarios for south-west England and grapevine phenology models we explore how risks to cool-climate vineyard harvests vary under future climate conditions. Results indicate that the risk of adverse conditions during flowering declines under all future climate scenarios. In contrast, the risk of late spring frosts increases under many future climate projections due to advancement in the timing of budbreak. Estimates of frost risk, however, were highly sensitive to the choice of phenology model, and future frost exposure declined when budbreak was calculated using models that included a winter chill requirement for dormancy break. The lack of robust phenological models is a major source of uncertainty concerning the impacts of future climate change on the development of cool-climate viticulture in historically marginal climatic regions.

Climate Change and Crop Exposure to Adverse Weather: Changes to Frost Risk and Grapevine Flowering Conditions

PubMed Central

Mosedale, Jonathan R.; Wilson, Robert J.; Maclean, Ilya M. D.

2015-01-01

The cultivation of grapevines in the UK and many other cool climate regions is expected to benefit from the higher growing season temperatures predicted under future climate scenarios. Yet the effects of climate change on the risk of adverse weather conditions or events at key stages of crop development are not always captured by aggregated measures of seasonal or yearly climates, or by downscaling techniques that assume climate variability will remain unchanged under future scenarios. Using fine resolution projections of future climate scenarios for south-west England and grapevine phenology models we explore how risks to cool-climate vineyard harvests vary under future climate conditions. Results indicate that the risk of adverse conditions during flowering declines under all future climate scenarios. In contrast, the risk of late spring frosts increases under many future climate projections due to advancement in the timing of budbreak. Estimates of frost risk, however, were highly sensitive to the choice of phenology model, and future frost exposure declined when budbreak was calculated using models that included a winter chill requirement for dormancy break. The lack of robust phenological models is a major source of uncertainty concerning the impacts of future climate change on the development of cool-climate viticulture in historically marginal climatic regions. PMID:26496127

Hypertension in Pregnancy and Future Cardiovascular Event Risk in Siblings.

PubMed

Weissgerber, Tracey L; Turner, Stephen T; Mosley, Thomas H; Kardia, Sharon L R; Hanis, Craig L; Milic, Natasa M; Garovic, Vesna D

2016-03-01

Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan-Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27-2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension. Copyright © 2016 by the American Society of Nephrology.

Hypertension in Pregnancy and Future Cardiovascular Event Risk in Siblings

PubMed Central

Turner, Stephen T.; Mosley, Thomas H.; Kardia, Sharon L.R.; Hanis, Craig L.; Milic, Natasa M.; Garovic, Vesna D.

2016-01-01

Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan–Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27–2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension. PMID:26315531

The durations of past sickness absences predict future absence episodes.

PubMed

Laaksonen, Mikko; He, Liang; Pitkäniemi, Janne

2013-01-01

To determine whether preceding absence episodes increase the risk of future sickness absence, we examined recurrence of short (1 to 3 days), intermediate (4 to 14 days), and long (>2 weeks) sickness-absence episodes. Data from 6934 municipal employees of the City of Helsinki were analyzed using proportional hazards models. Preceding sickness absence increased the risk of new sickness-absence episodes. The association was stronger for longer sickness absence spells and for men. Shorter absence spells also predicted longer absence spells. Working conditions and health behaviors did not modify the associations. The risk of recurrent sickness absences is higher for longer sickness-absence spells, which are often recurrent in nature. In addition, short absence spells predict future longer spells, suggesting that short absences are not trivial for health.

High fractional exhaled nitric oxide and sputum eosinophils are associated with an increased risk of future virus-induced exacerbations: A prospective cohort study.

PubMed

Bjerregaard, A; Laing, I A; Backer, V; Sverrild, A; Khoo, S-K; Chidlow, G; Sikazwe, C; Smith, D W; Le Souëf, P; Porsbjerg, C

2017-08-01

The major trigger of asthma exacerbations is infection with a respiratory virus, most commonly rhinovirus. Type 2 inflammation is known to be associated with an increased risk of exacerbations in general. Whether type 2 inflammation at baseline increases the risk of future virus-induced exacerbations is unknown. To assess whether type 2 inflammation is associated with an increased risk of virus-induced exacerbations of asthma. Stable asthmatics had spirometry, skin prick test, measurement of FeNO and sputum induced for differential cell counts. Patients were followed up for 18 months, during which they were assessed at the research unit when they had symptoms of an exacerbation. Nasal swabs collected at these assessments underwent viral detection by PCR. A total of 81 asthma patients were recruited, of which 22 (27%) experienced an exacerbation during the follow-up period. Of these, 15 (68%) had a respiratory virus detected at exacerbation. Sputum eosinophils >1% at baseline increased the risk of having a subsequent virus-induced exacerbation (HR 7.6 95% CI: 1.6-35.2, P=.010) as did having FeNO >25 ppb (HR 3.4 95% CI: 1.1-10.4, P=.033). Established type 2 inflammation during stable disease is a risk factor for virus-induced exacerbations in a real-life setting. Measures of type 2 inflammation, such as sputum eosinophils and FeNO, could be included in the risk assessment of patients with asthma in future studies. © 2017 John Wiley & Sons Ltd.

Impacts of representing sea-level rise uncertainty on future flood risks: An example from San Francisco Bay

PubMed Central

Oddo, Perry C.; Keller, Klaus

2017-01-01

Rising sea levels increase the probability of future coastal flooding. Many decision-makers use risk analyses to inform the design of sea-level rise (SLR) adaptation strategies. These analyses are often silent on potentially relevant uncertainties. For example, some previous risk analyses use the expected, best, or large quantile (i.e., 90%) estimate of future SLR. Here, we use a case study to quantify and illustrate how neglecting SLR uncertainties can bias risk projections. Specifically, we focus on the future 100-yr (1% annual exceedance probability) coastal flood height (storm surge including SLR) in the year 2100 in the San Francisco Bay area. We find that accounting for uncertainty in future SLR increases the return level (the height associated with a probability of occurrence) by half a meter from roughly 2.2 to 2.7 m, compared to using the mean sea-level projection. Accounting for this uncertainty also changes the shape of the relationship between the return period (the inverse probability that an event of interest will occur) and the return level. For instance, incorporating uncertainties shortens the return period associated with the 2.2 m return level from a 100-yr to roughly a 7-yr return period (∼15% probability). Additionally, accounting for this uncertainty doubles the area at risk of flooding (the area to be flooded under a certain height; e.g., the 100-yr flood height) in San Francisco. These results indicate that the method of accounting for future SLR can have considerable impacts on the design of flood risk management strategies. PMID:28350884

Impacts of representing sea-level rise uncertainty on future flood risks: An example from San Francisco Bay.

PubMed

Ruckert, Kelsey L; Oddo, Perry C; Keller, Klaus

2017-01-01

Rising sea levels increase the probability of future coastal flooding. Many decision-makers use risk analyses to inform the design of sea-level rise (SLR) adaptation strategies. These analyses are often silent on potentially relevant uncertainties. For example, some previous risk analyses use the expected, best, or large quantile (i.e., 90%) estimate of future SLR. Here, we use a case study to quantify and illustrate how neglecting SLR uncertainties can bias risk projections. Specifically, we focus on the future 100-yr (1% annual exceedance probability) coastal flood height (storm surge including SLR) in the year 2100 in the San Francisco Bay area. We find that accounting for uncertainty in future SLR increases the return level (the height associated with a probability of occurrence) by half a meter from roughly 2.2 to 2.7 m, compared to using the mean sea-level projection. Accounting for this uncertainty also changes the shape of the relationship between the return period (the inverse probability that an event of interest will occur) and the return level. For instance, incorporating uncertainties shortens the return period associated with the 2.2 m return level from a 100-yr to roughly a 7-yr return period (∼15% probability). Additionally, accounting for this uncertainty doubles the area at risk of flooding (the area to be flooded under a certain height; e.g., the 100-yr flood height) in San Francisco. These results indicate that the method of accounting for future SLR can have considerable impacts on the design of flood risk management strategies.

Exposure to Experimental Preeclampsia in Mice Enhances the Vascular Response to Future Injury

PubMed Central

Pruthi, Dafina; Khankin, Eliyahu V.; Blanton, Robert M.; Aronovitz, Mark; Burke, Suzanne D.; McCurley, Amy; Karumanchi, S. Ananth; Jaffe, Iris Z.

2015-01-01

Cardiovascular disease (CVD) remains the leading killer of women in developed nations. One gender-specific risk factor is preeclampsia (PE), a syndrome of hypertension and proteinuria that complicates 5% of pregnancies. Although PE resolves after delivery, exposed women are at increased long term risk of premature CVD and mortality. Preexisting CVD risk factors are associated with increased risk of developing PE but whether PE merely uncovers risk or contributes directly to future CVD remains a critical unanswered question. A mouse PE model was used to test the hypothesis that PE causes an enhanced vascular response to future vessel injury. A PE-like state was induced in pregnant CD1 mice by overexpressing soluble fms-like tyrosine kinase-1 (sFlt-1), a circulating anti-angiogenic protein that induces hypertension and glomerular disease resembling human PE. Two months post-partum, sFlt-1 levels and blood pressure normalized and cardiac size and function by echocardiography and renal histology were indistinguishable in PE-exposed compared to control mice. Mice were then challenged with unilateral carotid injury. PE-exposed mice had significantly enhanced vascular remodeling with increased vascular smooth muscle cell proliferation (180% increase, P<0.01) and vessel fibrosis (216% increase, P<0.001) compared to control pregnancy. In the contralateral uninjured vessel, there was no difference in remodeling after exposure to PE. These data support a new model in which vessels exposed to PE retain a persistently enhanced vascular response to injury despite resolution of PE after delivery. This new paradigm may contribute to the substantially increased risk of CVD in woman exposed to PE. PMID:25712723

Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990–2020

PubMed Central

Journy, Neige M Y; Lee, Choonsik; Harbron, Richard W; McHugh, Kieran; Pearce, Mark S; Berrington de González, Amy

2017-01-01

Background: To project risks of developing cancer and the number of cases potentially induced by past, current, and future computed tomography (CT) scans performed in the United Kingdom in individuals aged <20 years. Methods: Organ doses were estimated from surveys of individual scan parameters and CT protocols used in the United Kingdom. Frequencies of scans were estimated from the NHS Diagnostic Imaging Dataset. Excess lifetime risks (ELRs) of radiation-related cancer were calculated as cumulative lifetime risks, accounting for survival probabilities, using the RadRAT risk assessment tool. Results: In 2000–2008, ELRs ranged from 0.3 to 1 per 1000 head scans and 1 to 5 per 1000 non-head scans. ELRs per scan were reduced by 50–70% in 2000–2008 compared with 1990–1995, subsequent to dose reduction over time. The 130 750 scans performed in 2015 in the United Kingdom were projected to induce 64 (90% uncertainty interval (UI): 38–113) future cancers. Current practices would lead to about 300 (90% UI: 230–680) future cancers induced by scans performed in 2016–2020. Conclusions: Absolute excess risks from single exposures would be low compared with background risks, but even small increases in annual CT rates over the next years would substantially increase the number of potential subsequent cancers. PMID:27824812

Estimating cancer risk from 99mTc pyrophosphate imaging for transthyretin cardiac amyloidosis.

PubMed

Einstein, Andrew J; Shuryak, Igor; Castaño, Adam; Mintz, Akiva; Maurer, Mathew S; Bokhari, Sabahat

2018-05-30

Increasing recognition that transthyretin cardiac amyloidosis (ATTR-CA) is much more common than previously appreciated and the emergence of novel disease-modifying therapeutic agents have led to a paradigm shift in which ATTR-CA screening is considered in high-risk populations, such as patients with heart failure with preserved ejection fraction (HFpEF) or aortic stenosis. Radiation risk from 99m Tc-pyrophosphate ( 99m Tc-PYP) scintigraphy, a test with very high sensitivity and specificity for ATTR-CA, has not been previously determined. Radiation doses to individual organs from 99m Tc-PYP were estimated using models developed by the Medical Internal Radiation Dose Committee and the International Commission on Radiological Protection. Excess future cancer risks were estimated from organ doses, using risk projection models developed by the National Academies and extended by the National Cancer Institute. Excess future risks were estimated for men and women aged 40-80 and compared to total (excess plus baseline) future risks. All-organ excess cancer risks (90% uncertainty intervals) ranged from 5.88 (2.45,11.4) to 12.2 (4.11,26.0) cases per 100,000 patients undergoing 99m Tc-PYP testing, were similar for men and women, and decreased with increasing age at testing. Cancer risks were highest to the urinary bladder, and bladder risk varied nearly twofold depending on which model was used. Excess 99m Tc-PYP-related cancers constituted < 1% of total future cancers to the critical organs. Very low cancer risks associated with 99m Tc-PYP testing suggest a favorable benefit-risk profile for 99m Tc-PYP as a screening test for ATTR-CA in high-risk populations, such as such as patients with HFpEF or aortic stenosis.

Oil prices and long-run risk

NASA Astrophysics Data System (ADS)

Ready, Robert Clayton

I show that relative levels of aggregate consumption and personal oil consumption provide an excellent proxy for oil prices, and that high oil prices predict low future aggregate consumption growth. Motivated by these facts, I add an oil consumption good to the long-run risk model of Bansal and Yaron [2004] to study the asset pricing implications of observed changes in the dynamic interaction of consumption and oil prices. Empirically I observe that, compared to the first half of my 1987--2010 sample, oil consumption growth in the last 10 years is unresponsive to levels of oil prices, creating an decrease in the mean-reversion of oil prices, and an increase in the persistence of oil price shocks. The model implies that the change in the dynamics of oil consumption generates increased systematic risk from oil price shocks due to their increased persistence. However, persistent oil prices also act as a counterweight for shocks to expected consumption growth, with high expected growth creating high expectations of future oil prices which in turn slow down growth. The combined effect is to reduce overall consumption risk and lower the equity premium. The model also predicts that these changes affect the riskiness of of oil futures contracts, and combine to create a hump shaped term structure of oil futures, consistent with recent data.

Future Forest Cover Change Scenarios with Implications for Landslide Risk: An Example from Buzau Subcarpathians, Romania

NASA Astrophysics Data System (ADS)

Malek, Žiga; Boerboom, Luc; Glade, Thomas

2015-11-01

This study focuses on future forest cover change in Buzau Subcarpathians, a landslide prone region in Romania. Past and current trends suggest that the area might expect a future increase in deforestation. We developed spatially explicit scenarios until 2040 to analyze the spatial pattern of future forest cover change and potential changes to landslide risk. First, we generated transition probability maps using the weights of evidence method, followed by a cellular automata allocation model. We performed expert interviews, to develop two future forest management scenarios. The Alternative scenario (ALT) was defined by 67 % more deforestation than the Business as Usual scenario (BAU). We integrated the simulated scenarios with a landslide susceptibility map. In both scenarios, most of deforestation was projected in areas where landslides are less likely to occur. Still, 483 (ALT) and 276 (BAU) ha of deforestation were projected on areas with a high-landslide occurrence likelihood. Thus, deforestation could lead to a local-scale increase in landslide risk, in particular near or adjacent to forestry roads. The parallel process of near 10 % forest expansion until 2040 was projected to occur mostly on areas with high-landslide susceptibility. On a regional scale, forest expansion could so result in improved slope stability. We modeled two additional scenarios with an implemented landslide risk policy, excluding high-risk zones. The reduction of deforestation on high-risk areas was achieved without a drastic decrease in the accessibility of the areas. Together with forest expansion, it could therefore be used as a risk reduction strategy.

Future Forest Cover Change Scenarios with Implications for Landslide Risk: An Example from Buzau Subcarpathians, Romania.

PubMed

Malek, Žiga; Boerboom, Luc; Glade, Thomas

2015-11-01

This study focuses on future forest cover change in Buzau Subcarpathians, a landslide prone region in Romania. Past and current trends suggest that the area might expect a future increase in deforestation. We developed spatially explicit scenarios until 2040 to analyze the spatial pattern of future forest cover change and potential changes to landslide risk. First, we generated transition probability maps using the weights of evidence method, followed by a cellular automata allocation model. We performed expert interviews, to develop two future forest management scenarios. The Alternative scenario (ALT) was defined by 67% more deforestation than the Business as Usual scenario (BAU). We integrated the simulated scenarios with a landslide susceptibility map. In both scenarios, most of deforestation was projected in areas where landslides are less likely to occur. Still, 483 (ALT) and 276 (BAU) ha of deforestation were projected on areas with a high-landslide occurrence likelihood. Thus, deforestation could lead to a local-scale increase in landslide risk, in particular near or adjacent to forestry roads. The parallel process of near 10% forest expansion until 2040 was projected to occur mostly on areas with high-landslide susceptibility. On a regional scale, forest expansion could so result in improved slope stability. We modeled two additional scenarios with an implemented landslide risk policy, excluding high-risk zones. The reduction of deforestation on high-risk areas was achieved without a drastic decrease in the accessibility of the areas. Together with forest expansion, it could therefore be used as a risk reduction strategy.

Chemical Mixtures and Epidemiologic Fundamentals for Risk Assessment Applications

EPA Science Inventory

Risk management options are increasingly being considered early in the risk assessment process to help scope the considerations and bound the inherent complexities related to potential exposures, risk and future clean-up decisions (including acceptable pollutant levels) related t...

Cancer Risks Associated with External Radiation From Diagnostic Imaging Procedures

PubMed Central

Linet, Martha S.; Slovis, Thomas L.; Miller, Donald L.; Kleinerman, Ruth; Lee, Choonsik; Rajaraman, Preetha; de Gonzalez, Amy Berrington

2012-01-01

The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate widespread use of evidence-based appropriateness criteria for decisions about imaging procedures, oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives, development of electronic lifetime records of imaging procedures for patients and their physicians, and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures. PMID:22307864

Forecasting the Future Risk of Barmah Forest Virus Disease under Climate Change Scenarios in Queensland, Australia

PubMed Central

Naish, Suchithra; Mengersen, Kerrie; Hu, Wenbiao; Tong, Shilu

2013-01-01

Background Mosquito-borne diseases are climate sensitive and there has been increasing concern over the impact of climate change on future disease risk. This paper projected the potential future risk of Barmah Forest virus (BFV) disease under climate change scenarios in Queensland, Australia. Methods/Principal Findings We obtained data on notified BFV cases, climate (maximum and minimum temperature and rainfall), socio-economic and tidal conditions for current period 2000–2008 for coastal regions in Queensland. Grid-data on future climate projections for 2025, 2050 and 2100 were also obtained. Logistic regression models were built to forecast the otential risk of BFV disease distribution under existing climatic, socio-economic and tidal conditions. The model was applied to estimate the potential geographic distribution of BFV outbreaks under climate change scenarios. The predictive model had good model accuracy, sensitivity and specificity. Maps on potential risk of future BFV disease indicated that disease would vary significantly across coastal regions in Queensland by 2100 due to marked differences in future rainfall and temperature projections. Conclusions/Significance We conclude that the results of this study demonstrate that the future risk of BFV disease would vary across coastal regions in Queensland. These results may be helpful for public health decision making towards developing effective risk management strategies for BFV disease control and prevention programs in Queensland. PMID:23690959

Placing Antismoking Graphic Warning Posters at Retail Point-of-Sale Locations Increases Some Adolescents' Susceptibility to Future Smoking.

PubMed

Shadel, William G; Martino, Steven C; Setodji, Claude; Dunbar, Michael; Kusuke, Daniela; Lanna, Serafina; Meyer, Amanda

2017-12-13

This experiment tested whether introducing graphic antitobacco posters at point-of-sale (POS) had any effect on adolescents' susceptibility to future cigarette smoking and whether these effects were moderated by adolescents' baseline risk of cigarette smoking. The study was conducted in the RAND StoreLab, a life-sized replica of a convenience store that was developed to experimentally evaluate how changing aspects of tobacco advertising displays in retail POS environments influence tobacco use risk and behavior during simulated shopping experiences. In this study, 441 adolescents were randomized to one of the four conditions in a 2 (graphic antismoking poster placed near the tobacco power wall: no, yes) × 2 (graphic antismoking poster placed near the cash register: no, yes) experimental design. The outcome of interest was susceptibility to future cigarette smoking. The addition of antismoking posters at POS led to a significant increase in future smoking susceptibility among those adolescents who already were at high risk for smoking in the future (p < .045). The introduction of graphic antismoking posters had no impact on committed never smokers, regardless of poster location; never smokers' susceptibility to future smoking was uniformly low across experimental conditions. Introducing graphic antismoking posters at POS may have the unintended effect of further increasing cigarette smoking susceptibility among adolescents already at risk. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Future property damage from flooding: sensitivities to economy and climate change

DOE PAGES

Liu, Jing; Hertel, Thomas; Diffenbaugh, Noah; ...

2015-08-09

Using a unique dataset for Indiana counties during the period 1995-2012, we estimate the effects of flood hazard, asset exposure, and social vulnerability on property damage. This relationship then is combined with the expected level of future flood risks to project property damage from flooding in 2030 under various scenarios. We compare these scenario projections to identify which risk management strategy offers the greatest potential to mitigate flooding loss. Results show that by 2030, county level flooding hazard measured by extreme flow volume and frequency will increase by an average of 16.2% and 7.4%, respectively. The total increase in propertymore » damages projected under different model specifications range from 13.3% to 20.8%. Across models future damages consistently exhibit the highest sensitivity to future increases in asset exposure, reinforcing the importance of non-structural measures in managing floodplain development.« less

Cognitive impairment and risk of future stroke: a systematic review and meta-analysis

PubMed Central

Lee, Meng; Saver, Jeffrey L.; Hong, Keun-Sik; Wu, Yi-Ling; Liu, Hsing-Cheng; Rao, Neal M.; Ovbiagele, Bruce

2014-01-01

Background: Several studies have assessed the link between cognitive impairment and risk of future stroke, but results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies to determine the association between cognitive impairment and risk of future stroke. Methods: We searched MEDLINE and Embase (1966 to November 2013) and conducted a manual search of bibliographies of relevant retrieved articles and reviews. We included cohort studies that reported multivariable adjusted relative risks and 95% confidence intervals or standard errors for stroke with respect to baseline cognitive impairment. Results: We identified 18 cohort studies (total 121 879 participants) and 7799 stroke events. Pooled analysis of results from all studies showed that stroke risk increased among patients with cognitive impairment at baseline (relative risk [RR] 1.39, 95% confidence interval [CI] 1.24–1.56). The results were similar when we restricted the analysis to studies that used a widely adopted definition of cognitive impairment (i.e., Mini-Mental State Examination score < 25 or nearest equivalent) (RR 1.64, 95% CI 1.46–1.84). Cognitive impairment at baseline was also associated with an increased risk of fatal stroke (RR 1.68, 95% CI 1.21–2.33) and ischemic stroke (RR 1.65, 95% CI 1.41–1.93). Interpretation: Baseline cognitive impairment was associated with a significantly higher risk of future stroke, especially ischemic and fatal stroke. PMID:25157064

Flood Risk and Global Change: Future Prospects

NASA Astrophysics Data System (ADS)

Serra-Llobet, A.

2014-12-01

Global flood risk is increasing in response to population growth in flood-prone areas, human encroachment into natural flood paths (exacerbating flooding in areas formerly out of harm's way), and climate change (which alters variables driving floods). How will societies respond to and manage flood risk in coming decades? Analysis of flood policy evolution in the EU and US demonstrates that changes occurred in steps, in direct response to disasters. After the flood produced by the collapse of Tous Dam in 1982, Spain initiated a systematic assessment of areas of greatest flood risk and civil protection response. The devastating floods on the Elbe and elsewhere in central Europe in 2002 motivated adoption of the EU Floods Directive (2007), which requires member states to develop systematic flood risk maps (now due) and flood risk management plans (due in 2015). The flooding of New Orleans by Hurricane Katrina in 2005 resulted in a nationwide levee-safety assessment and improvements in communicating risk, but overall less fundamental change in US flood management than manifest in the EU since 2007. In the developing world, large (and increasing) concentrations of populations in low-lying floodplains, deltas, and coasts are increasingly vulnerable, and governments mostly ill-equipped to implement fundamental changes in land use to prevent future increases in exposure, nor to develop responses to the current threats. Even in the developed world, there is surprisingly little research on how well residents of flood-prone lands understand their true risk, especially when they are 'protected' by '100-year' levees. Looking ahead, researchers and decision makers should prioritize improvements in flood risk perception, river-basin-scale assessment of flood runoff processes (under current and future climate and land-use conditions) and flood management alternatives, and bridging the disconnect between national and international floodplain management policies and local land-use decisions.

Benign Breast Disease: Toward Molecular Prediction of Breast Cancer Risk

DTIC Science & Technology

2008-06-01

of benign histology in predicting risk of future breast cancer, examining in detail the role of proliferative disease, atypia , papillomas, radial...who had proliferative disease with atypia , especially those of younger age. • We identified a marked increased risk of breast cancer in women with...imparts an increased risk of developing a subsequent carcinoma similar to other forms of proliferative breast disease without atypia . Atypical

Exploration Spacecraft and Space Suit Internal Atmosphere Pressure and Composition

NASA Technical Reports Server (NTRS)

Lange, Kevin; Duffield, Bruce; Jeng, Frank; Campbell, Paul

2005-01-01

The design of habitat atmospheres for future space missions is heavily driven by physiological and safety requirements. Lower EVA prebreathe time and reduced risk of decompression sickness must be balanced against the increased risk of fire and higher cost and mass of materials associated with higher oxygen concentrations. Any proposed increase in space suit pressure must consider impacts on space suit mass and mobility. Future spacecraft designs will likely incorporate more composite and polymeric materials both to reduce structural mass and to optimize crew radiation protection. Narrowed atmosphere design spaces have been identified that can be used as starting points for more detailed design studies and risk assessments.

Mammographic density and breast cancer risk: current understanding and future prospects

PubMed Central

2011-01-01

Variations in percent mammographic density (PMD) reflect variations in the amounts of collagen and number of epithelial and non-epithelial cells in the breast. Extensive PMD is associated with a markedly increased risk of invasive breast cancer. The PMD phenotype is important in the context of breast cancer prevention because extensive PMD is common in the population, is strongly associated with risk of the disease, and, unlike most breast cancer risk factors, can be changed. Work now in progress makes it likely that measurement of PMD will be improved in the near future and that understanding of the genetics and biological basis of the association of PMD with breast cancer risk will also improve. Future prospects for the application of PMD include mammographic screening, risk prediction in individuals, breast cancer prevention research, and clinical decision making. PMID:22114898

Exercise blood pressure and the risk of future hypertension.

PubMed

Holmqvist, L; Mortensen, L; Kanckos, C; Ljungman, C; Mehlig, K; Manhem, K

2012-12-01

The aim of this prospective cohort study was to identify which blood pressure measurement during exercise is the best predictor of future hypertension. Further we aimed to create a risk chart to facilitate the evaluation of blood pressure reaction during exercise testing. A number (n=1047) of exercise tests by bicycle ergometry, performed in 1996 and 1997 were analysed. In 2007-2008, 606 patients without hypertension at the time of the exercise test were sent a questionnaire aimed to identify current hypertension. The response rate was 58% (n=352). During the 10-12 years between exercise test and questionnaire, 23% developed hypertension. The strongest predictors of future hypertension were systolic blood pressure (SBP) before exercise (odds ratios (OR) 1.63 (1.31-2.01) for 10 mm Hg difference) in combination with the increase of SBP over time during exercise testing (OR 1.12 (1.01-1.24) steeper increase for every 1 mm Hg min(-1)). A high SBP before exercise and a steep rise in SBP over time represented a higher risk of developing hypertension. A risk chart based on SBP before exercise, increase of SBP over time and body mass index was created. SBP before exercise, maximal SBP during exercise and SBP at 100 W were significant single predictors of future hypertension and the prediction by maximal SBP was improved by adjusting for time/power at which SBP max was reached during exercise testing. Recovery ratio (maximal SBP/SBP 4 min after exercise) was not predictive of future hypertension.

Status and future of Quantitative Microbiological Risk Assessment in China

PubMed Central

Dong, Q.L.; Barker, G.C.; Gorris, L.G.M.; Tian, M.S.; Song, X.Y.; Malakar, P.K.

2015-01-01

Since the implementation of the Food Safety Law of the People's Republic of China in 2009 use of Quantitative Microbiological Risk Assessment (QMRA) has increased. QMRA is used to assess the risk posed to consumers by pathogenic bacteria which cause the majority of foodborne outbreaks in China. This review analyses the progress of QMRA research in China from 2000 to 2013 and discusses 3 possible improvements for the future. These improvements include planning and scoping to initiate QMRA, effectiveness of microbial risk assessment utility for risk management decision making, and application of QMRA to establish appropriate Food Safety Objectives. PMID:26089594

Exposure to experimental preeclampsia in mice enhances the vascular response to future injury.

PubMed

Pruthi, Dafina; Khankin, Eliyahu V; Blanton, Robert M; Aronovitz, Mark; Burke, Suzanne D; McCurley, Amy; Karumanchi, S Ananth; Jaffe, Iris Z

2015-04-01

Cardiovascular disease (CVD) remains the leading killer of women in developed nations. One sex-specific risk factor is preeclampsia, a syndrome of hypertension and proteinuria that complicates 5% of pregnancies. Although preeclampsia resolves after delivery, exposed women are at increased long-term risk of premature CVD and mortality. Pre-existing CVD risk factors are associated with increased risk of developing preeclampsia but whether preeclampsia merely uncovers risk or contributes directly to future CVD remains a critical unanswered question. A mouse preeclampsia model was used to test the hypothesis that preeclampsia causes an enhanced vascular response to future vessel injury. A preeclampsia-like state was induced in pregnant CD1 mice by overexpressing soluble fms-like tyrosine kinase-1, a circulating antiangiogenic protein that induces hypertension and glomerular disease resembling human preeclampsia. Two months postpartum, soluble fms-like tyrosine kinase-1 levels and blood pressure normalized and cardiac size and function by echocardiography and renal histology were indistinguishable in preeclampsia-exposed compared with control mice. Mice were then challenged with unilateral carotid injury. Preeclampsia-exposed mice had significantly enhanced vascular remodeling with increased vascular smooth muscle cell proliferation (180% increase; P<0.01) and vessel fibrosis (216% increase; P<0.001) compared with control pregnancy. In the contralateral uninjured vessel, there was no difference in remodeling after exposure to preeclampsia. These data support a new model in which vessels exposed to preeclampsia retain a persistently enhanced vascular response to injury despite resolution of preeclampsia after delivery. This new paradigm may contribute to the substantially increased risk of CVD in woman exposed to preeclampsia. © 2015 American Heart Association, Inc.

Flood Risk in the Danube basin under climate change

NASA Astrophysics Data System (ADS)

Schröter, Kai; Wortmann, Michel; del Rocio Rivas Lopez, Maria; Liersch, Stefan; Viet Nguyen, Dung; Hardwick, Stephen; Hattermann, Fred

2017-04-01

The projected increase in temperature is expected to intensify the hydrological cycle, and thus more intense precipitation is likely to increase hydro-meteorological extremes and flood hazard. However to assess the future dynamics of hazard and impact induced by these changes it is necessary to consider extreme events and to take a spatially differentiated perspective. The Future Danube Model is a multi-hazard and risk model suite for the Danube region which has been developed in the OASIS project. The model comprises modules for estimating potential perils from heavy precipitation, heat-waves, floods, droughts, and damage risk considering hydro-climatic extremes under current and climate change conditions. Web-based open Geographic Information Systems (GIS) technology allows customers to graphically analyze and overlay perils and other spatial information such as population density or assets exposed. The Future Danube Model combines modules for weather generation, hydrological and hydrodynamic processes, and supports risk assessment and adaptation planning support. This contribution analyses changes in flood hazard in the Danube basin and in flood risk for the German part of the Danube basin. As climate change input, different regionalized climate ensemble runs of the newest IPCC generation are used, the so-called Representative Concentration Pathways (RCPs). They are delivered by the CORDEX initiative (Coordinated Downscaling Experiments). The CORDEX data sample is extended using the statistical weather generator (IMAGE) in order to also consider extreme events. Two time slices are considered: near future 2020-2049 and far future 2050-2079. This data provides the input for the hydrological, hydraulic and flood loss model chain. Results for RCP4.5 and RCP8.5 indicate an increase in intensity and frequency of peak discharges and thus in flood hazard for many parts of the Danube basin.

Declining vulnerability to river floods and the global benefits of adaptation

NASA Astrophysics Data System (ADS)

Jongman, Brenden; Winsemius, Hessel; Aerts, Jeroen; Coughlan de Perez, Erin; Van Aalst, Maarten; Kron, Wolfgang; Ward, Philip

2016-04-01

The global impacts of river floods are substantial and rising. Effective adaptation to the increasing risks requires an in-depth understanding of the physical and socioeconomic drivers of risk. Whilst the modeling of flood hazard and exposure has improved greatly, compelling evidence on spatiotemporal patterns in vulnerability of societies around the world is lacking. Hence, the effects of vulnerability on global flood risk are not fully understood, and future projections of fatalities and losses available today are based on simplistic assumptions or do not include vulnerability. In this study, we show that trends and fluctuations in vulnerability to river floods around the world can be estimated by dynamic high-resolution modeling of flood hazard and exposure. We show that fatalities and losses as a share of exposed population and gross domestic product are decreasing with rising income. We also show that there is a tendency of convergence in vulnerability levels between low- and high-income countries. Based on these findings, we simulate future flood impacts per country using traditional assumptions of static vulnerability through time, but also using future assumptions on reduced vulnerability in the future. We show that future risk increases can be largely contained using effective disaster risk reduction strategies, including a reduction of vulnerability. The study was carried out using the global flood risk model, GLOFRIS, combined with high-resolution time-series maps of hazard and exposure at the global scale. Based on: Jongman et al., 2015. Proceedings of the National Academy of Sciences of the United States of America, doi:10.1073/pnas.1414439112.

Associations between extreme precipitation and acute gastro-intestinal illness due to cryptosporidiosis and giardiasis in an urban Canadian drinking water system (1997-2009).

PubMed

Chhetri, Bimal K; Takaro, Tim K; Balshaw, Robert; Otterstatter, Michael; Mak, Sunny; Lem, Marcus; Zubel, Marc; Lysyshyn, Mark; Clarkson, Len; Edwards, Joanne; Fleury, Manon D; Henderson, Sarah B; Galanis, Eleni

2017-10-01

Drinking water related infections are expected to increase in the future due to climate change. Understanding the current links between these infections and environmental factors is vital to understand and reduce the future burden of illness. We investigated the relationship between weekly reported cryptosporidiosis and giardiasis (n = 7,422), extreme precipitation (>90th percentile), drinking water turbidity, and preceding dry periods in a drinking water system located in greater Vancouver, British Columbia, Canada (1997-2009) using distributed lag non-linear Poisson regression models adjusted for seasonality, secular trend, and the effect of holidays on reporting. We found a significant increase in cryptosporidiosis and giardiasis 4-6 weeks after extreme precipitation. The effect was greater following a dry period. Similarly, extreme precipitation led to significantly increased turbidity only after prolonged dry periods. Our results suggest that the risk of cryptosporidiosis and giardiasis increases with extreme precipitation, and that the effects are more pronounced after a prolonged dry period. Given that extreme precipitation events are expected to increase with climate change, it is important to further understand the risks from these events, develop planning tools, and build resilience to these future risks.

Does Predation Risk Affect Mating Behavior? An Experimental Test in Dumpling Squid (Euprymna tasmanica)

PubMed Central

Franklin, Amanda M.; Squires, Zoe E.; Stuart-Fox, Devi

2014-01-01

Introduction One of the most important trade-offs for many animals is that between survival and reproduction. This is particularly apparent when mating increases the risk of predation, either by increasing conspicuousness, reducing mobility or inhibiting an individual's ability to detect predators. Individuals may mitigate the risk of predation by altering their reproductive behavior (e.g. increasing anti-predator responses to reduce conspicuousness). The degree to which individuals modulate their reproductive behavior in relation to predation risk is difficult to predict because both the optimal investment in current and future reproduction (due to life-history strategies) and level of predation risk may differ between the sexes and among species. Here, we investigate the effect of increased predation risk on the reproductive behavior of dumpling squid (Euprymna tasmanica). Results Females, but not males, showed a substantial increase in the number of inks (an anti-predator behavior) before mating commenced in the presence of a predator (sand flathead Platycephalus bassensis). However, predation risk did not affect copulation duration, the likelihood of mating, female anti-predator behavior during or after mating or male anti-predator behavior at any time. Conclusions Inking is a common anti-predator defense in cephalopods, thought to act like a smokescreen, decoy or distraction. Female dumpling squid are probably using this form of defense in response to the increase in predation risk prior to mating. Conversely, males were undeterred by the increase in predation risk. A lack of change in these variables may occur if the benefit of completing mating outweighs the risk of predation. Prioritizing current reproduction, even under predation risk, can occur when the chance of future reproduction is low, there is substantial energetic investment into mating, or the potential fitness payoffs of mating are high. PMID:25551378

76 FR 16587 - Risk Management Requirements for Derivatives Clearing Organizations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

... COMMODITY FUTURES TRADING COMMISSION 17 CFR Part 39 RIN 3038-AC98 Risk Management Requirements for... other things, would implement DCO Core Principle D (Risk Management) and would establish a related... framework to reduce risk, increase transparency, and promote market integrity within the financial system...

Coral bleaching pathways under the control of regional temperature variability

NASA Astrophysics Data System (ADS)

Langlais, C. E.; Lenton, A.; Heron, S. F.; Evenhuis, C.; Sen Gupta, A.; Brown, J. N.; Kuchinke, M.

2017-11-01

Increasing sea surface temperatures (SSTs) are predicted to adversely impact coral populations worldwide through increasing thermal bleaching events. Future bleaching is unlikely to be spatially uniform. Therefore, understanding what determines regional differences will be critical for adaptation management. Here, using a cumulative heat stress metric, we show that characteristics of regional SST determine the future bleaching risk patterns. Incorporating observed information on SST variability, in assessing future bleaching risk, provides novel options for management strategies. As a consequence, the known biases in climate model variability and the uncertainties in regional warming rate across climate models are less detrimental than previously thought. We also show that the thresholds used to indicate reef viability can strongly influence a decision on what constitutes a potential refugia. Observing and understanding the drivers of regional variability, and the viability limits of coral reefs, is therefore critical for making meaningful projections of coral bleaching risk.

Sleep and youth suicidal behavior: a neglected field.

PubMed

Liu, Xianchen; Buysse, Daniel J

2006-05-01

Sleep undergoes substantial changes during adolescence and suicide risk begins to increase during this period as well. This review focuses on recent literature on the relationship between sleep and suicidal behavior and proposes directions for future research. Adolescent sleep is characterized by widespread sleep restriction, irregular sleep schedules, daytime sleepiness, and elevated risk for sleep disturbances. More research on adolescent sleep and psychosocial impairment, psychiatric disorders, and suicidal behavior has been conducted. Suicidal psychiatric patients had more sleep disturbances including insomnia, hypersomnia, or nightmares than nonsuicidal patients. Shorter rapid eye movement latency and increased rapid eye movement activity have been noted to be a marker of suicidality in psychiatric patients. Epidemiological studies have demonstrated that insomnia, nightmares, and sleep insufficiency are associated with elevated risk for suicide. Although the link between insomnia and suicidal behavior appears to be mediated by depression, existing data suggest an independent predictive role of nightmares in future suicidal behavior. Sleep loss or disturbances are likely to signal an increased risk of future suicidal action in adolescents. Large-scale prospective studies and neurobiological studies are needed for a better understanding of the complex relationship between sleep, psychopathology, and youth suicidal behavior.

Conceptualising the Surveillance of Teachers

ERIC Educational Resources Information Center

Page, Damien

2017-01-01

Schools are risky places: the risk of a poor Ofsted report, the risk of sliding down league tables, the risk of teachers abusing children, the risk of teachers being falsely accused of abuse. As a result of risk anxiety and the ever-increasing sophistication of technology, the surveillance of teachers has proliferated, becoming a future-oriented…

Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study.

PubMed

Timmins, Ryan G; Bourne, Matthew N; Shield, Anthony J; Williams, Morgan D; Lorenzen, Christian; Opar, David A

2016-12-01

To investigate the role of eccentric knee flexor strength, between-limb imbalance and biceps femoris long head (BFlh) fascicle length on the risk of future hamstring strain injury (HSI). Elite soccer players (n=152) from eight different teams participated. Eccentric knee flexor strength during the Nordic hamstring exercise and BFlh fascicle length were assessed at the beginning of preseason. The occurrences of HSIs following this were recorded by the team medical staff. Relative risk (RR) was determined for univariate data, and logistic regression was employed for multivariate data. Twenty seven new HSIs were reported. Eccentric knee flexor strength below 337 N (RR=4.4; 95% CI 1.1 to 17.5) and possessing BFlh fascicles shorter than 10.56 cm (RR=4.1; 95% CI 1.9 to 8.7) significantly increased the risk of a HSI. Multivariate logistic regression revealed significant effects when combinations of age, history of HSI, eccentric knee flexor strength and BFlh fascicle length were explored. From these analyses the likelihood of a future HSI in older athletes or those with a HSI history was reduced if high levels of eccentric knee flexor strength and longer BFlh fascicles were present. The presence of short BFlh fascicles and low levels of eccentric knee flexor strength in elite soccer players increases the risk of future HSI. The greater risk of a future HSI in older players or those with a previous HSI is reduced when they have longer BFlh fascicles and high levels of eccentric strength. 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/.

Space Nuclear Power Public and Stakeholder Risk Communication

NASA Technical Reports Server (NTRS)

Dawson, Sandra M.; Sklar, Maria

2005-01-01

The 1986 Challenger accident coupled with the Chernobyl nuclear reactor accident increased public concern about the safety of spacecraft using nuclear technology. While three nuclear powered spacecraft had been launched before 1986 with little public interest, future nuclear powered missions would see significantly more public concern and require NASA to increase its efforts to communicate mission risks to the public. In 1987 a separate risk communication area within the Launch Approval Planning Group of the Jet Propulsion Laboratory was created to address public concern about the health, environmental, and safety risks of NASA missions. The lessons learned from the risk communication strategies developed for the nuclear powered Galileo, Ulysses, and Cassini missions are reviewed in this paper and recommendations are given as to how these lessons can be applied to future NASA missions that may use nuclear power systems and other potentially controversial NASA missions.

Risk of Skin Cancer from Space Radiation. Chapter 11

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Kim, Myung-Hee Y.; George, Kerry A.; Wu, Hong-Lu

2003-01-01

We review the methods for estimating the probability of increased incidence of skin cancers from space radiation exposure, and describe some of the individual factors that may contribute to risk projection models, including skin pigment, and synergistic effects of combined ionizing and UV exposure. The steep dose gradients from trapped electrons, protons, and heavy ions radiation during EVA and limitations in EVA dosimetry are important factors for projecting skin cancer risk of astronauts. We estimate that the probability of increased skin cancer risk varies more than 10-fold for individual astronauts and that the risk of skin cancer could exceed 1 % for future lunar base operations for astronauts with light skin color and hair. Limitations in physical dosimetry in estimating the distribution of dose at the skin suggest that new biodosimetry methods be developed for responding to accidental overexposure of the skin during future space missions.

Climate change risk to forests in China associated with warming.

PubMed

Yin, Yunhe; Ma, Danyang; Wu, Shaohong

2018-01-11

Variations in forest net primary productivity (NPP) reflects the combined effects of key climate variables on ecosystem structure and function, especially on the carbon cycle. We performed risk analysis indicated by the magnitude of future negative anomalies in NPP in comparison with the natural interannual variability to investigate the impact of future climatic projections on forests in China. Results from the multi-model ensemble showed that climate change risk of decreases in forest NPP would be more significant in higher emission scenario in China. Under relatively low emission scenarios, the total area of risk was predicted to decline, while for RCP8.5, it was predicted to first decrease and then increase after the middle of 21st century. The rapid temperature increases predicted under the RCP8.5 scenario would be probably unfavorable for forest vegetation growth in the long term. High-level risk area was likely to increase except RCP2.6. The percentage area at high risk was predicted to increase from 5.39% (2021-2050) to 27.62% (2071-2099) under RCP8.5. Climate change risk to forests was mostly concentrated in southern subtropical and tropical regions, generally significant under high emission scenario of RCP8.5, which was mainly attributed to the intensified dryness in south China.

Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football.

PubMed

Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K

2016-08-01

Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (< 80 points) were chosen as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P < 0.001]. Risk of time-loss knee injury was also significantly increased in players with low KOOS subscale scores (< 80 points) in Activities of Daily Living (RR: 5.0), Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P < 0.05). In conclusion, self-reported previous knee injury and low scores in three KOOS subscales significantly increase the risk of future time-loss knee injury in adolescent female football. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

78 FR 66613 - National Diabetes Month, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... increasingly being diagnosed in younger Americans and is associated with obesity and inactivity. The risk is... Lady Michelle Obama's Let's Move! initiative has taken on the staggering rise in childhood obesity our... put children on a path to healthier futures. Obese children face an increased risk of adult obesity...

D-Dimer Levels before HIV Seroconversion Remain Elevated Even after Viral Suppression and Are Associated with an Increased Risk of Non-AIDS Events.

PubMed

Freiberg, Matthew S; Bebu, Ionut; Tracy, Russell; So-Armah, Kaku; Okulicz, Jason; Ganesan, Anuradha; Armstrong, Adam; O'Bryan, Thomas; Rimland, David; Justice, Amy C; Agan, Brian K

2016-01-01

The mechanism underlying the excess risk of non-AIDS diseases among HIV infected people is unclear. HIV associated inflammation/hypercoagulability likely plays a role. While antiretroviral therapy (ART) may return this process to pre-HIV levels, this has not been directly demonstrated. We analyzed data/specimens on 249 HIV+ participants from the US Military HIV Natural History Study, a prospective, multicenter observational cohort of >5600 active duty military personnel and beneficiaries living with HIV. We used stored blood specimens to measure D-dimer and Interleukin-6 (IL-6) at three time points: pre-HIV seroconversion, ≥6 months post-HIV seroconversion but prior to ART initiation, and ≥6 months post-ART with documented HIV viral suppression on two successive evaluations. We evaluated the changes in biomarker levels between time points, and the association between these biomarker changes and future non-AIDS events. During a median follow-up of 3.7 years, there were 28 incident non-AIDS diseases. At ART initiation, the median CD4 count was 361cells/mm3; median duration of documented HIV infection 392 days; median time on ART was 354 days. Adjusted mean percent increase in D-dimer levels from pre-seroconversion to post-ART was 75.1% (95% confidence interval 24.6-148.0, p = 0.002). This increase in D-dimer was associated with a significant 22% increase risk of future non-AIDS events (p = 0.03). Changes in IL-6 levels across time points were small and not associated with future non-AIDS events. In conclusion, ART initiation and HIV viral suppression does not eliminate HIV associated elevation in D-dimer levels. This residual pathology is associated with an increased risk of future non-AIDS diseases.

Managing Programmatic Risk for Complex Space System Developments

NASA Technical Reports Server (NTRS)

Panetta, Peter V.; Hastings, Daniel; Brumfield, Mark (Technical Monitor)

2001-01-01

Risk management strategies have become a recent important research topic to many aerospace organizations as they prepare to develop the revolutionary complex space systems of the future. Future multi-disciplinary complex space systems will make it absolutely essential for organizations to practice a rigorous, comprehensive risk management process, emphasizing thorough systems engineering principles to succeed. Project managers must possess strong leadership skills to direct high quality, cross-disciplinary teams for successfully developing revolutionary space systems that are ever increasing in complexity. Proactive efforts to reduce or eliminate risk throughout a project's lifecycle ideally must be practiced by all technical members in the organization. This paper discusses some of the risk management perspectives that were collected from senior managers and project managers of aerospace and aeronautical organizations by the use of interviews and surveys. Some of the programmatic risks which drive the success or failure of projects are revealed. Key findings lead to a number of insights for organizations to consider for proactively approaching the risks which face current and future complex space systems projects.

Assessing and managing breast cancer risk: clinicians' current practice and future needs.

PubMed

Collins, Ian M; Steel, Emma; Mann, G Bruce; Emery, Jon D; Bickerstaffe, Adrian; Trainer, Alison; Butow, Phyllis; Pirotta, Marie; Antoniou, Antonis C; Cuzick, Jack; Hopper, John; Phillips, Kelly-Anne; Keogh, Louise A

2014-10-01

Decision support tools for the assessment and management of breast cancer risk may improve uptake of prevention strategies. End-user input in the design of such tools is critical to increase clinical use. Before developing such a computerized tool, we examined clinicians' practice and future needs. Twelve breast surgeons, 12 primary care physicians and 5 practice nurses participated in 4 focus groups. These were recorded, coded, and analyzed to identify key themes. Participants identified difficulties assessing risk, including a lack of available tools to standardize practice. Most expressed confidence identifying women at potentially high risk, but not moderate risk. Participants felt a tool could especially reassure young women at average risk. Desirable features included: evidence-based, accessible (e.g. web-based), and displaying absolute (not relative) risks in multiple formats. The potential to create anxiety was a concern. Development of future tools should address these issues to optimize translation of knowledge into clinical practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of prescription drugs and future delinquency among adolescent offenders.

PubMed

Drazdowski, Tess K; Jäggi, Lena; Borre, Alicia; Kliewer, Wendy L

2015-01-01

Non-medical use of prescription drugs (NMUPD) by adolescents is a significant public health concern. The present study investigated the profile of NMUPD in 1349 adolescent offenders from the Pathways to Desistance project, and whether NMUPD predicted future delinquency using longitudinal data. Results indicated that increased frequency and recency of NMUPD in adolescent offenders are related to some demographic factors, as well as increased risk for violence exposure, mental health diagnoses, other drug use, and previous delinquency, suggesting that severity of NMUPD is important to consider. However, ANCOVA analyses found that NMUPD was not a significant predictor of drug-related, non-aggressive, or aggressive delinquency 12 months later beyond other known correlates of delinquency. Age, sex, exposure to violence, lower socioeconomic status, more alcohol use, and having delinquency histories were more important than NMUPD in predicting future delinquency. These findings suggest that although NMUPD is an important risk factor relating to many correlates of delinquency, it does not predict future delinquency beyond other known risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

The importance of hot drought in providing more useful, and higher confidence, projections of future climatic, hydrologic, and ecosystem impacts.

NASA Astrophysics Data System (ADS)

Overpeck, J. T.; Udall, B. H.

2017-12-01

Often cited as a general guide to future climatic change, "the wet get wetter, and the dry get drier" is a misleading way to look towards the future for many regions of the globe, just as the simple use of multi-model ensemble projections of temperature and precipitation change averaged over many years can also be quite misleading for real-world planning and decision-making. Factors that support these assertions are multi-fold. First, we know with high confidence that warming will continue as long as greenhouse gas emissions continue. Second, continued warming will act to make droughts more frequent, longer and more severe in many regions. Even in the absence of precipitation declines, increases in evaporation and evapotranspiration, among other things, will drive regional drying. It is misleading to suggest to decision-makers that although the future may see an increase in drought risk, a projected increase in mean precipitation will counter-balance the increased drought risk. This counter-balancing will be absent during periods of precipitation-dominated drought. Moreover, projections of precipitation change are usually associated with much less confidence than projections of warming. For example, in places like the headwaters of the Colorado and Rio Grande Rivers, or East Africa, many models suggest we should be seeing an increase in precipitation, when in fact we are only seeing significant warming. Moreover, paleoclimatic evidence suggests that state-of-the-art Earth System Models may underestimate the risk of future multi-decadal droughts, even though these droughts have occurred in many regions during the last 2000 years. This reality suggests that even in regions that do see modest increases in mean precipitation, there will likely be periods in the future characterized by decades of below 20th century mean precipitation coupled with unprecedented warmth. Hot drought may be a much more widespread and serious threat than widely recognized.

Advancing flood risk analysis by integrating adaptive behaviour in large-scale flood risk assessments

NASA Astrophysics Data System (ADS)

Haer, T.; Botzen, W.; Aerts, J.

2016-12-01

In the last four decades the global population living in the 1/100 year-flood zone has doubled from approximately 500 million to a little less than 1 billion people. Urbanization in low lying -flood prone- cities further increases the exposed assets, such as buildings and infrastructure. Moreover, climate change will further exacerbate flood risk in the future. Accurate flood risk assessments are important to inform policy-makers and society on current- and future flood risk levels. However, these assessment suffer from a major flaw in the way they estimate flood vulnerability and adaptive behaviour of individuals and governments. Current flood risk projections commonly assume that either vulnerability remains constant, or try to mimic vulnerability through incorporating an external scenario. Such a static approach leads to a misrepresentation of future flood risk, as humans respond adaptively to flood events, flood risk communication, and incentives to reduce risk. In our study, we integrate adaptive behaviour in a large-scale European flood risk framework through an agent-based modelling approach. This allows for the inclusion of heterogeneous agents, which dynamically respond to each other and a changing environment. We integrate state-of-the-art flood risk maps based on climate scenarios (RCP's), and socio-economic scenarios (SSP's), with government and household agents, which behave autonomously based on (micro-)economic behaviour rules. We show for the first time that excluding adaptive behaviour leads to a major misrepresentation of future flood risk. The methodology is applied to flood risk, but has similar implications for other research in the field of natural hazards. While more research is needed, this multi-disciplinary study advances our understanding of how future flood risk will develop.

How to manage future groundwater resource of China under climate change and urbanization: An optimal stage investment design from modern portfolio theory.

PubMed

Hua, Shanshan; Liang, Jie; Zeng, Guangming; Xu, Min; Zhang, Chang; Yuan, Yujie; Li, Xiaodong; Li, Ping; Liu, Jiayu; Huang, Lu

2015-11-15

Groundwater management in China has been facing challenges from both climate change and urbanization and is considered as a national priority nowadays. However, unprecedented uncertainty exists in future scenarios making it difficult to formulate management planning paradigms. In this paper, we apply modern portfolio theory (MPT) to formulate an optimal stage investment of groundwater contamination remediation in China. This approach generates optimal weights of investment to each stage of the groundwater management and helps maximize expected return while minimizing overall risk in the future. We find that the efficient frontier of investment displays an upward-sloping shape in risk-return space. The expected value of groundwater vulnerability index increases from 0.6118 to 0.6230 following with the risk of uncertainty increased from 0.0118 to 0.0297. If management investment is constrained not to exceed certain total cost until 2050 year, the efficient frontier could help decision makers make the most appropriate choice on the trade-off between risk and return. Copyright © 2015 Elsevier Ltd. All rights reserved.

Self-report of stroke, transient ischemic attack, or stroke symptoms and risk of future stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

PubMed Central

Judd, Suzanne E; Kleindorfer, Dawn O; McClure, Leslie A; Rhodes, J. David; Howard, George; Cushman, Mary; Howard, Virginia J.

2013-01-01

Background and Purpose History of stroke and Transient Ischemic Attack (TIA) are documented risk factors for subsequent stroke and all-cause mortality. Recent reports suggest increased risk among those reporting stroke symptoms absent stroke or TIA. However, the relative magnitude of increased stroke risk has not been described across the symptomatic spectrum: 1) asymptomatic (Asx), 2) stroke symptoms only (SS), 3) TIA, 4) stroke in the distant past (DS), and 5) recent stroke (RS). Methods Between 2003–2007 the REasons for Geographic And Racial Differences in Stroke (REGARDS) study enrolled 30,239 black and white Americans aged 45+. DS and RS were defined as self-report of physician diagnosis of stroke >5 or <5 years before baseline, respectively. SS was defined as a history of any of six sudden onset stroke symptoms absent TIA/stroke diagnosis. Kaplan-Meier and proportional hazards analysis were used to contrast stroke risk differences. Results Over 5.0 ± 1.72 years of follow up, 737 strokes were validated. Compared to Asx persons, those with SS, TIA, DS and RS all had increased risk of future stroke. After adjustment for age, race, sex, income, education, alcohol intake, current smoking, and a history of diabetes, hypertension, myocardial infarction, atrial fibrillation, and dyslipidemia, there was 1.20-fold (not statistically significant) increased stroke risk for SS (95% CI 0.96, 1.51), 1.73-fold for TIA (95% CI 1.27, 2.36), 2.23-fold for DS (95% CI 1.61, 3.09) and 2.85-fold for RS (95% CI 2.16, 3.76). Discussion Results suggest a spectrum of risk from stroke symptoms to TIA, distant stroke, and recent stroke, and imply a need for establishing these categories in health screenings to manage risk for future stroke, reinforcing the clinical importance of stroke history including the presence of stroke symptoms. PMID:23233382

Self-report of stroke, transient ischemic attack, or stroke symptoms and risk of future stroke in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

PubMed

Judd, Suzanne E; Kleindorfer, Dawn O; McClure, Leslie A; Rhodes, J David; Howard, George; Cushman, Mary; Howard, Virginia J

2013-01-01

History of stroke and transient ischemic attack (TIA) are documented risk factors for subsequent stroke and all-cause mortality. Recent reports suggest increased risk among those reporting stroke symptoms absent stroke or TIA. However, the relative magnitude of increased stroke risk has not been described across the symptomatic spectrum: (1) asymptomatic, (2) stroke symptoms (SS) only, (3) TIA, (4) distant stroke (DS), and (5) recent stroke (RS). Between 2003 and 2007, the REasons for Geographic And Racial Differences in Stroke (REGARDS) study enrolled 30 239 black and white Americans ≥45 years of age. DS and RS were defined as self-report of physician diagnosis of stroke >5 or <5 years before baseline, respectively. SS was defined as a history of any of 6 sudden onset stroke symptoms absent TIA/stroke diagnosis. Kaplan-Meier and proportional hazards analysis were used to contrast stroke risk differences. Over 5.0±1.72 years of follow-up, 737 strokes were validated. Compared with asymptomatic persons, those with SS, TIA, DS, and RS all had increased risk of future stroke. After adjustment for age, race, sex, income, education, alcohol intake, current smoking, and a history of diabetes mellitus, hypertension, myocardial infarction, atrial fibrillation, and dyslipidemia, there was 1.20-fold (not statistically significant) increased stroke risk for SS (95% CI, 0.96-1.51), 1.73-fold for TIA (95% CI, 1.27-2.36), 2.23-fold for DS (95% CI, 1.61- 3.09), and 2.85-fold for RS (95% CI, 2.16-3.76). Results suggest a spectrum of risk from stroke symptoms to TIA, DS, and RS, and imply a need for establishing these categories in health screenings to manage risk for future stroke, reinforcing the clinical importance of stroke history including the presence of stroke symptoms.

Methodology for Developing a Probabilistic Risk Assessment Model of Spacecraft Rendezvous and Dockings

NASA Technical Reports Server (NTRS)

Farnham, Steven J., II; Garza, Joel, Jr.; Castillo, Theresa M.; Lutomski, Michael

2011-01-01

In 2007 NASA was preparing to send two new visiting vehicles carrying logistics and propellant to the International Space Station (ISS). These new vehicles were the European Space Agency s (ESA) Automated Transfer Vehicle (ATV), the Jules Verne, and the Japanese Aerospace and Explorations Agency s (JAXA) H-II Transfer Vehicle (HTV). The ISS Program wanted to quantify the increased risk to the ISS from these visiting vehicles. At the time, only the Shuttle, the Soyuz, and the Progress vehicles rendezvoused and docked to the ISS. The increased risk to the ISS was from an increase in vehicle traffic, thereby, increasing the potential catastrophic collision during the rendezvous and the docking or berthing of the spacecraft to the ISS. A universal method of evaluating the risk of rendezvous and docking or berthing was created by the ISS s Risk Team to accommodate the increasing number of rendezvous and docking or berthing operations due to the increasing number of different spacecraft, as well as the future arrival of commercial spacecraft. Before the first docking attempt of ESA's ATV and JAXA's HTV to the ISS, a probabilistic risk model was developed to quantitatively calculate the risk of collision of each spacecraft with the ISS. The 5 rendezvous and docking risk models (Soyuz, Progress, Shuttle, ATV, and HTV) have been used to build and refine the modeling methodology for rendezvous and docking of spacecrafts. This risk modeling methodology will be NASA s basis for evaluating the addition of future ISS visiting spacecrafts hazards, including SpaceX s Dragon, Orbital Science s Cygnus, and NASA s own Orion spacecraft. This paper will describe the methodology used for developing a visiting vehicle risk model.

Increased risk of snoring and adenotonsillectomy in children referred for tympanostomy tube insertion.

PubMed

Tauman, Riva; Derowe, Ari; Ophir, Orna; Greenfeld, Michal; Sivan, Yakov

2010-02-01

Eustachian tube dysfunction and sleep-disordered breathing (SDB) share common pathophysiologic mechanisms. Our objective was to investigate whether children referred for isolated TTI (tympanostomy tube insertion) are at increased risk for snoring and upper airway procedures. Telephone interviews to parents of children who underwent isolated TTI and to age- and gender-matched controls were conducted. Four hundred fifty-seven children were included in the study; 352 had isolated TTI (study group) and 105 children were controls. Twenty-two percent of children in the study group were reported to snore compared with 7.6% in the controls (p=0.001). Eighteen percent of children in the study group were reported to have undergone adenotonsillectomy compared with 4.8% in the controls (p=0.0005). Future SDB, i.e., either snoring or adenotonsillectomy following TTI, was found in 34% of children in the study group compared with 11% in the controls (p=0.0004). Children who underwent isolated TTI were at increased risk for future snoring (OR=3.4, CI: 1.6-7.2) and future adenotonsillectomy (OR=4.4, CI: 1.7-11.2). Children who undergo isolated TTI are at increased risk for snoring and for adenotonsillectomy. We suggest that these children be followed for symptoms of SDB on a scheduled basis to allow for early diagnosis and intervention. 2009 Elsevier B.V. All rights reserved.

Metabolomic Footprints of Lethal Versus Indolent Prostate Cancer

DTIC Science & Technology

2013-10-01

along this line of research. This technology has identified a clear metabolic profiling of branch chain amino acids for risk of future pancreatic...mortality. The manuscript has been submitted to JNCI. c. Elevation of circulating branched - chain amino acids is an early event in human pancreatic...elevated plasma levels of branched - chain amino acids (BCAAs) are associated with a greater than twofold increased risk of future pancreatic cancer

Harnessing landscape heterogeneity for managing future disturbance risks in forest ecosystems.

PubMed

Seidl, Rupert; Albrich, Katharina; Thom, Dominik; Rammer, Werner

2018-03-01

In order to prevent irreversible impacts of climate change on the biosphere it is imperative to phase out the use of fossil fuels. Consequently, the provisioning of renewable resources such as timber and biomass from forests is an ecosystem service of increasing importance. However, risk factors such as changing disturbance regimes are challenging the continuous provisioning of ecosystem services, and are thus a key concern in forest management. We here used simulation modeling to study different risk management strategies in the context of timber production under changing climate and disturbance regimes, focusing on a 8127 ha forest landscape in the Northern Front Range of the Alps in Austria. We show that under a continuation of historical management, disturbances from wind and bark beetles increase by +39.5% on average over 200 years in response to future climate change. Promoting mixed forests and climate-adapted tree species as well as increasing management intensity effectively reduced future disturbance risk. Analyzing the spatial patterns of disturbance on the landscape, we found a highly uneven distribution of risk among stands (Gini coefficients up to 0.466), but also a spatially variable effectiveness of silvicultural risk reduction measures. This spatial variability in the contribution to and control of risk can be used to inform disturbance management: Stands which have a high leverage on overall risk and for which risks can effectively be reduced (24.4% of the stands in our simulations) should be a priority for risk mitigation measures. In contrast, management should embrace natural disturbances for their beneficial effects on biodiversity in areas which neither contribute strongly to landscape-scale risk nor respond positively to risk mitigation measures (16.9% of stands). We here illustrate how spatial heterogeneity in forest landscapes can be harnessed to address both positive and negative effects of changing natural disturbance regimes in ecosystem management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Harnessing landscape heterogeneity for managing future disturbance risks in forest ecosystems

PubMed Central

Seidl, Rupert; Albrich, Katharina; Thom, Dominik; Rammer, Werner

2018-01-01

In order to prevent irreversible impacts of climate change on the biosphere it is imperative to phase out the use of fossil fuels. Consequently, the provisioning of renewable resources such as timber and biomass from forests is an ecosystem service of increasing importance. However, risk factors such as changing disturbance regimes are challenging the continuous provisioning of ecosystem services, and are thus a key concern in forest management. We here used simulation modeling to study different risk management strategies in the context of timber production under changing climate and disturbance regimes, focusing on a 8127 ha forest landscape in the Northern Front Range of the Alps in Austria. We show that under a continuation of historical management, disturbances from wind and bark beetles increase by +39.5% on average over 200 years in response to future climate change. Promoting mixed forests and climate-adapted tree species as well as increasing management intensity effectively reduced future disturbance risk. Analyzing the spatial patterns of disturbance on the landscape, we found a highly uneven distribution of risk among stands (Gini coefficients up to 0.466), but also a spatially variable effectiveness of silvicultural risk reduction measures. This spatial variability in the contribution to and control of risk can be used to inform disturbance management: Stands which have a high leverage on overall risk and for which risks can effectively be reduced (24.4% of the stands in our simulations) should be a priority for risk mitigation measures. In contrast, management should embrace natural disturbances for their beneficial effects on biodiversity in areas which neither contribute strongly to landscape-scale risk nor respond positively to risk mitigation measures (16.9% of stands). We here illustrate how spatial heterogeneity in forest landscapes can be harnessed to address both positive and negative effects of changing natural disturbance regimes in ecosystem management. PMID:29275284

Mandibular bone changes in 24 years and skeletal fracture prediction.

PubMed

Jonasson, G; Sundh, V; Hakeberg, M; Hassani-Nejad, A; Lissner, L; Ahlqwist, M

2013-03-01

The objectives of the investigation were to describe changes in mandibular bone structure with aging and to compare the usefulness of cortical and trabecular bone for fracture prediction. From 1968 to 1993, 1,003 women were examined. With the help of panoramic radiographs, cortex thickness was measured and cortex was categorized as: normal, moderately, or severely eroded. The trabeculation was assessed as sparse, mixed, or dense. Visually, the mandibular compact and trabecular bone transformed gradually during the 24 years. The compact bone became more porous, the intertrabecular spaces increased, and the radiographic image of the trabeculae seemed less mineralized. Cortex thickness increased up to the age of 50 and decreased significantly thereafter. At all examinations, the sparse trabeculation group had more fractures (71-78 %) than the non-sparse group (27-31 %), whereas the severely eroded compact group showed more fractures than the less eroded groups only in 1992/1993, 24 years later. Sparse trabecular pattern was associated with future fractures both in perimenopausal and older women (relative risk (RR), 1.47-4.37) and cortical erosion in older women (RR, 1.35-1.55). RR for future fracture associated with a severely eroded cortex increased to 4.98 for cohort 1930 in 1992/1993. RR for future fracture associated with sparse trabeculation increased to 11.43 for cohort 1922 in 1992/1993. Dental radiographs contain enough information to identify women most at risk of future fracture. When observing sparse mandibular trabeculation, dentists can identify 40-69 % of women at risk for future fractures, depending on participant age at examination.

Development and validation of a risk assessment tool for gastric cancer in a general Japanese population.

PubMed

Iida, Masahiro; Ikeda, Fumie; Hata, Jun; Hirakawa, Yoichiro; Ohara, Tomoyuki; Mukai, Naoko; Yoshida, Daigo; Yonemoto, Koji; Esaki, Motohiro; Kitazono, Takanari; Kiyohara, Yutaka; Ninomiya, Toshiharu

2018-05-01

There have been very few reports of risk score models for the development of gastric cancer. The aim of this study was to develop and validate a risk assessment tool for discerning future gastric cancer risk in Japanese. A total of 2444 subjects aged 40 years or over were followed up for 14 years from 1988 (derivation cohort), and 3204 subjects of the same age group were followed up for 5 years from 2002 (validation cohort). The weighting (risk score) of each risk factor for predicting future gastric cancer in the risk assessment tool was determined based on the coefficients of a Cox proportional hazards model in the derivation cohort. The goodness of fit of the established risk assessment tool was assessed using the c-statistic and the Hosmer-Lemeshow test in the validation cohort. During the follow-up, gastric cancer developed in 90 subjects in the derivation cohort and 35 subjects in the validation cohort. In the derivation cohort, the risk prediction model for gastric cancer was established using significant risk factors: age, sex, the combination of Helicobacter pylori antibody and pepsinogen status, hemoglobin A1c level, and smoking status. The incidence of gastric cancer increased significantly as the sum of risk scores increased (P trend < 0.001). The risk assessment tool was validated internally and showed good discrimination (c-statistic = 0.76) and calibration (Hosmer-Lemeshow test P = 0.43) in the validation cohort. We developed a risk assessment tool for gastric cancer that provides a useful guide for stratifying an individual's risk of future gastric cancer.

Discotheques and the Risk of Hearing Loss among Youth: Risky Listening Behavior and Its Psychosocial Correlates

ERIC Educational Resources Information Center

Vogel, Ineke; Brug, Johannes; Van Der Ploeg, Catharina P. B.; Raat, Hein

2010-01-01

There is an increasing population at risk of hearing loss and tinnitus due to increasing high-volume music listening. To inform prevention strategies and interventions, this study aimed to identify important protection motivation theory-based constructs as well as the constructs "consideration of future consequences" and "habit…

Language and Narrative Skills in Young Children with Special Health Care Needs

ERIC Educational Resources Information Center

Ergül, Cevriye

2012-01-01

Problem Statement: Previous studies showed that children with special health care needs are at increased risk for future linguistic problems and deficits in narrative abilities. Despite this evidence of increased risk, there has been limited research on the impact of young children's health problems on specific aspects of linguistic development.…

Contributing factors for drought in United States forest ecosystems under projected future climates and their uncertainty

Treesearch

Charlie Luce; James M. Vose; Neil Pederson; John Campbell; Connie Millar; Patrick Kormos; Ross Woods

2016-01-01

Observations of increasing global forest die-off related to drought are leading to more questions about potential increases in drought occurrence, severity, and ecological consequence in the future. Dry soils and warm temperatures interact to affect trees during drought; so understanding shifting risks requires some understanding of changes in both temperature...

Aviation Security: A Case for Risk-Based Passenger Screening

DTIC Science & Technology

2011-12-01

5 3. Threat Uncertainty ..............................................................................7 4. Increased Risk and Cost ...Airport Checkpoints .....................................131 ix 2. Technology Integration and Implementation Costs .....................131 3...Background Investigations and Sustaining Program Costs ........133 D. AREAS FOR FUTURE RESEARCH

Projecting Sexual and Injecting HIV Risks into Future Outcomes with Agent-Based Modeling

NASA Astrophysics Data System (ADS)

Bobashev, Georgiy V.; Morris, Robert J.; Zule, William A.

Longitudinal studies of health outcomes for HIV could be very costly cumbersome and not representative of the risk population. Conversely, cross-sectional approaches could be representative but rely on the retrospective information to estimate prevalence and incidence. We present an Agent-based Modeling (ABM) approach where we use behavioral data from a cross-sectional representative study and project the behavior into the future so that the risks of acquiring HIV could be studied in a dynamical/temporal sense. We show how the blend of behavior and contact network factors (sexual, injecting) play the role in the risk of future HIV acquisition and time till obtaining HIV. We show which subjects are the most likely persons to get HIV in the next year, and whom they are likely to infect. We examine how different behaviors are related to the increase or decrease of HIV risks and how to estimate the quantifiable risk measures such as survival HIV free.

Soccer and stock market risk: empirical evidence from the Istanbul Stock Exchange.

PubMed

Berument, M Hakan; Ceylan, Nildag Basak

2013-06-01

There is an emerging but important literature on the effects of sport events such as soccer on stock market returns. After a soccer team's win, agents discount future events more favorably and increase risk tolerance. Similarly, after a loss, risk tolerance decreases. This paper directly assesses risk tolerance after a sports event by using daily data from the three major soccer teams in Turkey (Beşiktaşç Fenerbahge and Galatasaray). Results provide evidence that risk tolerance increases after a win, but similar patterns were not found after a loss.

Perinatal exposure to high-fat diet programs energy balance, metabolism and behavior in adulthood.

PubMed

Sullivan, Elinor L; Smith, M Susan; Grove, Kevin L

2011-01-01

The perinatal environment plays an important role in programming many aspects of physiology and behavior including metabolism, body weight set point, energy balance regulation and predisposition to mental health-related disorders such as anxiety, depression and attention deficit hyperactivity disorder. Maternal health and nutritional status heavily influence the early environment and have a long-term impact on critical central pathways, including the melanocortinergic, serotonergic system and dopaminergic systems. Evidence from a variety of animal models including rodents and nonhuman primates indicates that exposure to maternal high-fat diet (HFD) consumption programs offspring for increased risk of adult obesity. Hyperphagia and increased preference for fatty and sugary foods are implicated as mechanisms for the increased obesity risk. The effects of maternal HFD consumption on energy expenditure are unclear, and future studies need to address the impact of perinatal HFD exposure on this important component of energy balance regulation. Recent evidence from animal models also indicates that maternal HFD consumption increases the risk of offspring developing mental health-related disorders such as anxiety. Potential mechanisms for perinatal HFD programming of neural pathways include circulating factors, such as hormones (leptin, insulin), nutrients (fatty acids, triglycerides and glucose) and inflammatory cytokines. As maternal HFD consumption and obesity are common and rapidly increasing, we speculate that future generations will be at increased risk for both metabolic and mental health disorders. Thus, it is critical that future studies identify therapeutic strategies that are effective at preventing maternal HFD-induced malprogramming. Copyright © 2010 S. Karger AG, Basel.

Role of imaging in testicular cancer: current and future practice.

PubMed

Barrisford, Glen W; Kreydin, Evgeniy I; Preston, Mark A; Rodriguez, Dayron; Harisighani, Mukesh G; Feldman, Adam S

2015-09-01

The article provides a summary of the epidemiologic and clinical aspects of testicular malignancy. Current standard imaging and novel techniques are reviewed. Present data and clinical treatment trends have favored surveillance protocols over adjuvant radiation or chemotherapy for low-stage testicular malignancy. This has resulted in increasing numbers of imaging studies and the potential for increased long-term exposure risks. Understanding imaging associated risks as well as strategies to minimize these risks is of increasing importance. The development, validation and incorporation of alternative lower risk highly efficacious and cost-effective imaging techniques is essential.

Silent Brain Infarction and Risk of Future Stroke: A Systematic Review and Meta-Analysis

PubMed Central

Gupta, Ajay; Giambrone, Ashley E.; Gialdini, Gino; Finn, Caitlin; Delgado, Diana; Gutierrez, Jose; Wright, Clinton; Beiser, Alexa S.; Seshadri, Sudha; Pandya, Ankur; Kamel, Hooman

2016-01-01

Background and Purpose Silent brain infarction (SBI) on magnetic resonance imaging (MRI) has been proposed as a subclinical risk marker for future symptomatic stroke. We performed a systematic review and meta-analysis to summarize the association between MRI-defined SBI and future stroke risk. Methods We searched the medical literature to identify cohort studies involving adults with MRI detection of SBI who were subsequently followed for incident clinically-defined stroke. Study data and quality assessment were recorded in duplicate with disagreements in data extraction resolved by a third reader. Strength association between MRI detected SBI and future symptomatic stroke measured by a hazard ratio (HR). Results The meta-analysis included 13 studies (14,764 subjects) with a mean follow-up ranging from 25.7 to 174 months. SBI predicted the occurrence of stroke with a random effects crude relative risk of 2.94 (95% CI 2.24–3.86, P<0.001; Q=39.65, P<0.001). In the eight studies of 10,427 subjects providing HR adjusted for cardiovascular risk factors, SBI was an independent predictor of incident stroke (HR 2.08 [95% CI 1.69–2.56, P<0.001]; Q=8.99, P=0.25). In a subgroup analysis pooling 9,483 stroke-free individuals from large population-based studies, SBI was present in ~18% of participants and remained a strong predictor of future stroke (HR 2.06 [95% CI 1.64–2.59], p<0.01). Conclusions SBI is present in approximately one in five stroke-free older adults and is associated with a 2-fold increased risk of future stroke. Future studies of in-depth stroke risk evaluations and intensive prevention measures are warranted in patients with clinically unrecognized radiologically evident brain infarctions. PMID:26888534

Head Trauma with or without Mild Brain Injury Increases the Risk of Future Traumatic Death: A Controlled Prospective 15-Year Follow-Up Study.

PubMed

Vaaramo, Kalle; Puljula, Jussi; Tetri, Sami; Juvela, Seppo; Hillbom, Matti

2015-10-15

Patients who have recovered from traumatic brain injury (TBI) show an increased risk of premature death. To investigate long-term mortality rates in a population admitted to the hospital for head injury (HI), we conducted a population-based prospective case-control, record-linkage study, All subjects who were living in Northern Ostrobothnia, and who were admitted to Oulu University Hospital in 1999 because of HI (n=737), and 2196 controls matched by age, gender, and residence randomly drawn from the population of Northern Ostrobothnia were included. Death rate and causes of death in HI subjects during 15 years of follow-up was compared with the general population controls. The crude mortality rates were 56.9, 18.6, and 23.8% for subjects having moderate-to-severe traumatic brain injury (TBI), mild TBI, and head injury without TBI, respectively. The corresponding approximate annual mortality rates were 6.7%, 1.4%, and 1.9%. All types of index HI predicted a significant risk of traumatic death in the future. Subjects who had HI without TBI had an increased risk of both death from all causes (hazard ratio 2.00; 95% confidence interval 1.57-2.55) and intentional or unintentional traumatic death (4.01, 2.20-7.30), compared with controls. The main founding was that even HI without TBI carries an increased risk of future traumatic death. The reason for this remains unknown and further studies are needed. To prevent such premature deaths, post-traumatic therapy should include an interview focusing on lifestyle factors.

Present and Potential Future Distribution of Common Vampire Bats in the Americas and the Associated Risk to Cattle

PubMed Central

Lee, Dana N.; Papeş, Monica; Van Den Bussche, Ronald A.

2012-01-01

Success of the cattle industry in Latin America is impeded by the common vampire bat, Desmodus rotundus, through decreases in milk production and mass gain and increased risk of secondary infection and rabies. We used ecological niche modeling to predict the current potential distribution of D. rotundus and the future distribution of the species for the years 2030, 2050, and 2080 based on the A2, A1B, and B1 climate scenarios from the Intergovernmental Panel on Climate Change. We then combined the present day potential distribution with cattle density estimates to identify areas where cattle are at higher risk for the negative impacts due to D. rotundus. We evaluated our risk prediction by plotting 17 documented outbreaks of cattle rabies. Our results indicated highly suitable habitat for D. rotundus occurs throughout most of Mexico and Central America as well as portions of Venezuela, Guyana, the Brazilian highlands, western Ecuador, northern Argentina, and east of the Andes in Peru, Bolivia, and Paraguay. With future climate projections suitable habitat for D. rotundus is predicted in these same areas and additional areas in French Guyana, Suriname, Venezuela and Columbia; however D. rotundus are not likely to expand into the U.S. because of inadequate ‘temperature seasonality.’ Areas with large portions of cattle at risk include Mexico, Central America, Paraguay, and Brazil. Twelve of 17 documented cattle rabies outbreaks were represented in regions predicted at risk. Our present day and future predictions can help authorities focus rabies prevention efforts and inform cattle ranchers which areas are at an increased risk of cattle rabies because it has suitable habitat for D. rotundus. PMID:22900023

Land use planning and wildfire: development policies influence future probability of housing loss

USGS Publications Warehouse

Syphard, Alexandra D.; Massada, Avi Bar; Butsic, Van; Keeley, Jon E.

2013-01-01

Increasing numbers of homes are being destroyed by wildfire in the wildland-urban interface. With projections of climate change and housing growth potentially exacerbating the threat of wildfire to homes and property, effective fire-risk reduction alternatives are needed as part of a comprehensive fire management plan. Land use planning represents a shift in traditional thinking from trying to eliminate wildfires, or even increasing resilience to them, toward avoiding exposure to them through the informed placement of new residential structures. For land use planning to be effective, it needs to be based on solid understanding of where and how to locate and arrange new homes. We simulated three scenarios of future residential development and projected landscape-level wildfire risk to residential structures in a rapidly urbanizing, fire-prone region in southern California. We based all future development on an econometric subdivision model, but we varied the emphasis of subdivision decision-making based on three broad and common growth types: infill, expansion, and leapfrog. Simulation results showed that decision-making based on these growth types, when applied locally for subdivision of individual parcels, produced substantial landscape-level differences in pattern, location, and extent of development. These differences in development, in turn, affected the area and proportion of structures at risk from burning in wildfires. Scenarios with lower housing density and larger numbers of small, isolated clusters of development, i.e., resulting from leapfrog development, were generally predicted to have the highest predicted fire risk to the largest proportion of structures in the study area, and infill development was predicted to have the lowest risk. These results suggest that land use planning should be considered an important component to fire risk management and that consistently applied policies based on residential pattern may provide substantial benefits for future risk reduction.

Present and potential future distribution of common vampire bats in the Americas and the associated risk to cattle.

PubMed

Lee, Dana N; Papeş, Monica; Van den Bussche, Ronald A

2012-01-01

Success of the cattle industry in Latin America is impeded by the common vampire bat, Desmodus rotundus, through decreases in milk production and mass gain and increased risk of secondary infection and rabies. We used ecological niche modeling to predict the current potential distribution of D. rotundus and the future distribution of the species for the years 2030, 2050, and 2080 based on the A2, A1B, and B1 climate scenarios from the Intergovernmental Panel on Climate Change. We then combined the present day potential distribution with cattle density estimates to identify areas where cattle are at higher risk for the negative impacts due to D. rotundus. We evaluated our risk prediction by plotting 17 documented outbreaks of cattle rabies. Our results indicated highly suitable habitat for D. rotundus occurs throughout most of Mexico and Central America as well as portions of Venezuela, Guyana, the Brazilian highlands, western Ecuador, northern Argentina, and east of the Andes in Peru, Bolivia, and Paraguay. With future climate projections suitable habitat for D. rotundus is predicted in these same areas and additional areas in French Guyana, Suriname, Venezuela and Columbia; however D. rotundus are not likely to expand into the U.S. because of inadequate 'temperature seasonality.' Areas with large portions of cattle at risk include Mexico, Central America, Paraguay, and Brazil. Twelve of 17 documented cattle rabies outbreaks were represented in regions predicted at risk. Our present day and future predictions can help authorities focus rabies prevention efforts and inform cattle ranchers which areas are at an increased risk of cattle rabies because it has suitable habitat for D. rotundus.

Plaque Echolucency and Stroke Risk in Asymptomatic Carotid Stenosis: A Systematic Review and Meta-Analysis

PubMed Central

Gupta, Ajay; Kesavabhotla, Kartik; Baradaran, Hediyeh; Kamel, Hooman; Pandya, Ankur; Giambrone, Ashley E.; Wright, Drew; Pain, Kevin J.; Mtui, Edward E.; Suri, Jasjit S.; Sanelli, Pina C.; Mushlin, Alvin I.

2014-01-01

Background and Purpose Ultrasonographic plaque echolucency has been studied as a stroke risk marker in carotid atherosclerotic disease. We performed a systematic review and meta-analysis to summarize the association between ultrasound determined carotid plaque echolucency and future ipsilateral stroke risk. Methods We searched the medical literature for studies evaluating the association between carotid plaque echolucency and future stroke in asymptomatic patients. We included prospective observational studies with stroke outcome ascertainment after baseline carotid plaque echolucency assessment. We performed a meta-analysis and assessed study heterogeneity and publication bias. We also performed subgroup analyses limited to patients with stenosis ≥50%, studies in which plaque echolucency was determined via subjective visual interpretation, studies with a relatively lower risk of bias, and studies published after the year 2000. Results We analyzed data from 7 studies on 7557 subjects with a mean follow up of 37.2 months. We found a significant positive relationship between predominantly echolucent (compared to predominantly echogenic) plaques and the risk of future ipsilateral stroke across all stenosis severities (0-99%) (relative risk [RR], 2.31, 95% CI, 1.58-3.39, P<.001) and in subjects with ≥50% stenosis (RR, 2.61 95% CI, 1.47-4.63, P=.001). A statistically significant increased RR for future stroke was preserved in all additional subgroup analyses. No statistically significant heterogeneity or publication bias was present in any of the meta-analyses. Conclusions The presence of ultrasound-determined carotid plaque echolucency provides predictive information in asymptomatic carotid artery stenosis beyond luminal stenosis. However, the magnitude of the increased risk is not sufficient on its own to identify patients likely to benefit from surgical revascularization. PMID:25406150

Risk of Obstructive Sleep Apnea and Its Association with Cardiovascular and Noncardiac Vascular Risk in Patients with Rheumatoid Arthritis: A Population-based Study.

PubMed

Wilton, Katelynn M; Matteson, Eric L; Crowson, Cynthia S

2018-01-01

To define the incidence of obstructive sleep apnea (OSA) in patients with rheumatoid arthritis (RA) and determine whether OSA diagnosis predicts future cardiovascular disease (CVD) and noncardiac vascular events. Medical information pertaining to RA, OSA, CVD, and vascular diagnoses was extracted from a comprehensive medical record system for a geographically defined population of 813 patients previously diagnosed with RA and 813 age- and sex-matched comparator subjects. The risk for OSA in persons with RA versus comparators was elevated, although not reaching statistical significance (HR 1.32, 95% CI 0.98-1.77; p = 0.07). Patients with RA were more likely to be diagnosed with OSA if they had traditional risk factors for OSA, including male sex, current smoking status, hypertension, diabetes, dyslipidemia, and increased body mass index. Features of RA disease associated with OSA included large joint swelling and joint surgery. Patients with RA with decreased renal function were also at higher risk of OSA. The increased risk of overall CVD among patients with RA who have OSA was similar to the increased CVD risk associated with OSA in the comparator cohort (interaction p = 0.86). OSA diagnosis was associated with an increased risk of both CVD (HR 1.9, 95% CI 1.08-3.27), and cerebrovascular disease (HR 2.4, 95% CI 1.14-5.26) in patients with RA. Patients with RA may be at increased risk of OSA secondary to both traditional and RA-related risk factors. Diagnosis with OSA predicts future CVD in RA and may provide an opportunity for CVD intervention.

VTE Risk assessment - a prognostic Model: BATER Cohort Study of young women.

PubMed

Heinemann, Lothar Aj; Dominh, Thai; Assmann, Anita; Schramm, Wolfgang; Schürmann, Rolf; Hilpert, Jan; Spannagl, Michael

2005-04-18

BACKGROUND: Community-based cohort studies are not available that evaluated the predictive power of both clinical and genetic risk factors for venous thromboembolism (VTE). There is, however, clinical need to forecast the likelihood of future occurrence of VTE, at least qualitatively, to support decisions about intensity of diagnostic or preventive measures. MATERIALS AND METHODS: A 10-year observation period of the Bavarian Thromboembolic Risk (BATER) study, a cohort study of 4337 women (18-55 years), was used to develop a predictive model of VTE based on clinical and genetic variables at baseline (1993). The objective was to prepare a probabilistic scheme that discriminates women with virtually no VTE risk from those at higher levels of absolute VTE risk in the foreseeable future. A multivariate analysis determined which variables at baseline were the best predictors of a future VTE event, provided a ranking according to the predictive power, and permitted to design a simple graphic scheme to assess the individual VTE risk using five predictor variables. RESULTS: Thirty-four new confirmed VTEs occurred during the observation period of over 32,000 women-years (WYs). A model was developed mainly based on clinical information (personal history of previous VTE and family history of VTE, age, BMI) and one composite genetic risk markers (combining Factor V Leiden and Prothrombin G20210A Mutation). Four levels of increasing VTE risk were arbitrarily defined to map the prevalence in the study population: No/low risk of VTE (61.3%), moderate risk (21.1%), high risk (6.0%), very high risk of future VTE (0.9%). In 10.6% of the population the risk assessment was not possible due to lacking VTE cases. The average incidence rates for VTE in these four levels were: 4.1, 12.3, 47.2, and 170.5 per 104 WYs for no, moderate, high, and very high risk, respectively. CONCLUSION: Our prognostic tool - containing clinical information (and if available also genetic data) - seems to be worthwhile testing in medical practice in order to confirm or refute the positive findings of this study. Our cohort study will be continued to include more VTE cases and to increase predictive value of the model.

Predictors associated with MRI surveillance screening in women with a personal history of unilateral breast cancer but without a genetic predisposition for future contralateral breast cancer.

PubMed

Hegde, John V; Wang, Xiaoyan; Attai, Deanna J; DiNome, Maggie L; Kusske, Amy; Hoyt, Anne C; Hurvitz, Sara A; Weidhaas, Joanne B; Steinberg, Michael L; McCloskey, Susan A

2017-11-01

For women with a personal history of breast cancer (PHBC), no validated mechanisms exist to calculate future contralateral breast cancer (CBC) risk. The Manchester risk stratification guidelines were developed to evaluate CBC risk in women with a PHBC, primarily for surgical decision making. This tool may be informative for the use of MRI screening, as CBC risk is an assumed consideration for high-risk surveillance. Three hundred twenty-two women with a PHBC were treated with unilateral surgery within our multidisciplinary breast clinic. We calculated lifetime CBC risk using the Manchester tool, which incorporates age at diagnosis, family history, genetic mutation status, estrogen receptor positivity, and endocrine therapy use. Univariate and multivariate logistic regression analyses (UVA/MVA) were performed, evaluating whether CBC risk predicted MRI surveillance. For women with invasive disease undergoing MRI surveillance, 66% had low, 23% above-average, and 11% moderate/high risk for CBC. On MVA, previous mammography-occult breast cancer [odds ratio (OR) 18.95, p < 0.0001], endocrine therapy use (OR 3.89, p = 0.009), dense breast tissue (OR 3.69, p = 0.0007), mastectomy versus lumpectomy (OR 3.12, p = 0.0041), and CBC risk (OR 3.17 for every 10% increase, p = 0.0002) were associated with MRI surveillance. No pathologic factors increasing ipsilateral breast cancer recurrence were significant on MVA. Although CBC risk predicted MRI surveillance, 89% with invasive disease undergoing MRI had <20% calculated CBC risk. Concerns related to future breast cancer detectability (dense breasts and/or previous mammography-occult disease) predominate decision making. Pathologic factors important for determining ipsilateral recurrence risk, aside from age, were not associated with MRI surveillance.

Increasing Risk Awareness: The Coastal Community Resilience Index

ERIC Educational Resources Information Center

Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

2012-01-01

As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

Flood risk and adaptation strategies under climate change and urban expansion: A probabilistic analysis using global data.

PubMed

Muis, Sanne; Güneralp, Burak; Jongman, Brenden; Aerts, Jeroen C J H; Ward, Philip J

2015-12-15

An accurate understanding of flood risk and its drivers is crucial for effective risk management. Detailed risk projections, including uncertainties, are however rarely available, particularly in developing countries. This paper presents a method that integrates recent advances in global-scale modeling of flood hazard and land change, which enables the probabilistic analysis of future trends in national-scale flood risk. We demonstrate its application to Indonesia. We develop 1000 spatially-explicit projections of urban expansion from 2000 to 2030 that account for uncertainty associated with population and economic growth projections, as well as uncertainty in where urban land change may occur. The projections show that the urban extent increases by 215%-357% (5th and 95th percentiles). Urban expansion is particularly rapid on Java, which accounts for 79% of the national increase. From 2000 to 2030, increases in exposure will elevate flood risk by, on average, 76% and 120% for river and coastal floods. While sea level rise will further increase the exposure-induced trend by 19%-37%, the response of river floods to climate change is highly uncertain. However, as urban expansion is the main driver of future risk, the implementation of adaptation measures is increasingly urgent, regardless of the wide uncertainty in climate projections. Using probabilistic urban projections, we show that spatial planning can be a very effective adaptation strategy. Our study emphasizes that global data can be used successfully for probabilistic risk assessment in data-scarce countries. Copyright © 2015 Elsevier B.V. All rights reserved.

A global framework for future costs and benefits of river-flood protection in urban areas

NASA Astrophysics Data System (ADS)

Ward, Philip J.; Jongman, Brenden; Aerts, Jeroen C. J. H.; Bates, Paul D.; Botzen, Wouter J. W.; Diaz Loaiza, Andres; Hallegatte, Stephane; Kind, Jarl M.; Kwadijk, Jaap; Scussolini, Paolo; Winsemius, Hessel C.

2017-09-01

Floods cause billions of dollars of damage each year, and flood risks are expected to increase due to socio-economic development, subsidence, and climate change. Implementing additional flood risk management measures can limit losses, protecting people and livelihoods. Whilst several models have been developed to assess global-scale river-flood risk, methods for evaluating flood risk management investments globally are lacking. Here, we present a framework for assessing costs and benefits of structural flood protection measures in urban areas around the world. We demonstrate its use under different assumptions of current and future climate change and socio-economic development. Under these assumptions, investments in dykes may be economically attractive for reducing risk in large parts of the world, but not everywhere. In some regions, economically efficient investments could reduce future flood risk below today’s levels, in spite of climate change and economic growth. We also demonstrate the sensitivity of the results to different assumptions and parameters. The framework can be used to identify regions where river-flood protection investments should be prioritized, or where other risk-reducing strategies should be emphasized.

Climate change, agricultural insecticide exposure, and risk for freshwater communities.

PubMed

Kattwinkel, Mira; Kühne, Jan-Valentin; Foit, Kaarina; Liess, Matthias

2011-09-01

Climate change exerts direct effects on ecosystems but has additional indirect effects due to changes in agricultural practice. These include the increased use of pesticides, changes in the areas that are cultivated, and changes in the crops cultivated. It is well known that pesticides, and in particular insecticides, affect aquatic ecosystems adversely. To implement effective mitigation measures it is necessary to identify areas that are affected currently and those that will be affected in the future. As a consequence, we predicted potential exposure to insecticide (insecticide runoff potential, RP) under current conditions (1990) and under a model scenario of future climate and land use (2090) using a spatially explicit model on a continental scale, with a focus on Europe. Space-for-time substitution was used to predict future levels of insecticide application, intensity of agricultural land use, and cultivated crops. To assess the indirect effects of climate change, evaluation of the risk of insecticide exposure was based on a trait-based, climate-insensitive indicator system (SPEAR, SPEcies At Risk). To this end, RP and landscape characteristics that are relevant for the recovery of affected populations were combined to estimate the ecological risk (ER) of insecticides for freshwater communities. We predicted a strong increase in the application of, and aquatic exposure to, insecticides under the future scenario, especially in central and northern Europe. This, in turn, will result in a severe increase in ER in these regions. Hence, the proportion of stream sites adjacent to arable land that do not meet the requirements for good ecological status as defined by the EU Water Framework Directive will increase (from 33% to 39% for the EU-25 countries), in particular in the Scandinavian and Baltic countries (from 6% to 19%). Such spatially explicit mapping of risk enables the planning of adaptation and mitigation strategies including vegetated buffer strips and nonagricultural recolonization zones along streams.

Future hurricane storm surge risk for the U.S. gulf and Florida coasts based on projections of thermodynamic potential intensity

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

Balaguru, Karthik; Judi, David R.; Leung, L. Ruby

Coastal populations in the global tropics and sub-tropics are vulnerable to the devastating impacts of hurricane storm surge and this risk is only expected to rise under climate change. In this study, we address this issue for the U.S. Gulf and Florida coasts. Using the framework of Potential Intensity, observations and output from coupled climate models, we show that the future large-scale thermodynamic environment may become more favorable for hurricane intensification. Under the RCP 4.5 emissions scenario and for the peak hurricane season months of August–October, we show that the mean intensities of Atlantic hurricanes may increase by 1.8–4.2 %more » and their lifetime maximum intensities may increase by 2.7–5.3 % when comparing the last two decades of the 20th and 21st centuries. We then combine our estimates of hurricane intensity changes with projections of sea-level rise to understand their relative impacts on future storm surge using simulations with the National Weather Service’s SLOSH (Sea, Lake, and Overland Surges from Hurricanes) model for five historical hurricanes that made landfall in the Gulf of Mexico and Florida. Considering uncertainty in hurricane intensity changes and sea-level rise, our results indicate a median increase in storm surge ranging between 25 and 47 %, with changes in hurricane intensity increasing future storm surge by about 10 % relative to the increase that may result from sea level rise alone, with highly non-linear response of population at risk.« less

Views of Low-Income Women of Color at Increased Risk for Breast Cancer.

PubMed

E Anderson, Emily; Tejada, Silvia; B Warnecke, Richard; Hoskins, Kent

2018-01-01

Individual risk assessment (IRA) for breast cancer may increase adherence to risk-appropriate screening and prevention measures. However, knowledge gaps exist regarding how best to communicate IRA results and support women at increased risk in future health care decisions, in part because patients conceptualize and make meaning of risk differently from the medical community. Better understanding the views of low-income women of color identified as being at increased risk for breast cancer can inform efforts to conduct IRA in an ethical and respectful manner. We conducted in-depth interviews with 13 low-income African American and Latina women who receive care at a federally qualified health center (FQHC) and had recently learned of their increased risk for breast cancer. These interviews explored their experience of the IRA process, their interpretation of what being at increased risk means, and their reactions to provider recommendations. Eight key themes were identified. We conclude with recommendations for the implementation of IRA for breast cancer in underserved primary care settings.

Metabolic syndrome and subsequent risk of type 2 diabetes and cardiovascular disease in elderly women: Challenging the current definition.

PubMed

Dragsbæk, Katrine; Neergaard, Jesper S; Laursen, Janne M; Hansen, Henrik B; Christiansen, Claus; Beck-Nielsen, Henning; Karsdal, Morten A; Brix, Susanne; Henriksen, Kim

2016-09-01

The prognostic value of the metabolic syndrome (MetS) is believed to vary with age. With an elderly population expecting to triple by 2060, it is important to evaluate the validity of MetS in this age group. We examined the association of MetS risk factors with later risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD) in elderly Caucasian women. We further investigated if stratification of individuals not defined with MetS would add predictive power in defining future disease prevalence of individuals with MetS.The Prospective Epidemiological Risk Factor Study, a community-based cohort study, followed 3905 Danish women since 2000 (age: 70.1 ± 6.5) with no previous diagnosis of T2DM or CVD, holding all measurements used for MetS definition; central obesity, hypertension, hyperlipidemia, and hyperglycemia combined with register-based follow-up information.Elderly women with defined MetS presented a 6.3-fold increased risk of T2DM (95% confidence interval: [3.74-10.50]) and 1.7-fold increased risk of CVD (1.44-2.05) compared to women with no MetS risk factors. Subdividing the control group without defined MetS revealed that both centrally obese controls and controls holding other MetS risk factors also had increased risk of T2DM (hazard ratio (HR) = 2.21 [1.25-3.93] and HR = 1.75 [1.04-2.96]) and CVD (HR = 1.51 [1.25-1.83] and HR = 1.36 [1.15-1.60]) when compared to controls with no MetS risk factors.MetS in elderly Caucasian women increased risk of future T2DM and CVD. While not defined with MetS, women holding only some risk factors for MetS were also at increased risk of T2DM or CVD compared to women with no MetS risk factors.

Metabolic syndrome and subsequent risk of type 2 diabetes and cardiovascular disease in elderly women

PubMed Central

Dragsbæk, Katrine; Neergaard, Jesper S.; Laursen, Janne M.; Hansen, Henrik B.; Christiansen, Claus; Beck-Nielsen, Henning; Karsdal, Morten A.; Brix, Susanne; Henriksen, Kim

2016-01-01

Abstract The prognostic value of the metabolic syndrome (MetS) is believed to vary with age. With an elderly population expecting to triple by 2060, it is important to evaluate the validity of MetS in this age group. We examined the association of MetS risk factors with later risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD) in elderly Caucasian women. We further investigated if stratification of individuals not defined with MetS would add predictive power in defining future disease prevalence of individuals with MetS. The Prospective Epidemiological Risk Factor Study, a community-based cohort study, followed 3905 Danish women since 2000 (age: 70.1 ± 6.5) with no previous diagnosis of T2DM or CVD, holding all measurements used for MetS definition; central obesity, hypertension, hyperlipidemia, and hyperglycemia combined with register-based follow-up information. Elderly women with defined MetS presented a 6.3-fold increased risk of T2DM (95% confidence interval: [3.74–10.50]) and 1.7-fold increased risk of CVD (1.44–2.05) compared to women with no MetS risk factors. Subdividing the control group without defined MetS revealed that both centrally obese controls and controls holding other MetS risk factors also had increased risk of T2DM (hazard ratio (HR) = 2.21 [1.25–3.93] and HR = 1.75 [1.04–2.96]) and CVD (HR = 1.51 [1.25–1.83] and HR = 1.36 [1.15–1.60]) when compared to controls with no MetS risk factors. MetS in elderly Caucasian women increased risk of future T2DM and CVD. While not defined with MetS, women holding only some risk factors for MetS were also at increased risk of T2DM or CVD compared to women with no MetS risk factors. PMID:27603394

Demographic controls of future global fire risk

NASA Astrophysics Data System (ADS)

Knorr, W.; Arneth, A.; Jiang, L.

2016-08-01

Wildfires are an important component of terrestrial ecosystem ecology but also a major natural hazard to societies, and their frequency and spatial distribution must be better understood. At a given location, risk from wildfire is associated with the annual fraction of burned area, which is expected to increase in response to climate warming. Until recently, however, only a few global studies of future fire have considered the effects of other important global environmental change factors such as atmospheric CO2 levels and human activities, and how these influence fires in different regions. Here, we contrast the impact of climate change and increasing atmospheric CO2 content on burned area with that of demographic dynamics, using ensembles of climate simulations combined with historical and projected population changes under different socio-economic development pathways for 1901-2100. Historically, humans notably suppressed wildfires. For future scenarios, global burned area will continue to decline under a moderate emissions scenario, except for low population growth and fast urbanization, but start to increase again from around mid-century under high greenhouse gas emissions. Contrary to common perception, we find that human exposure to wildfires increases in the future mainly owing to projected population growth in areas with frequent wildfires, rather than by a general increase in burned area.

Ultrasonographic measurements of subclinical carotid atherosclerosis in prediction of ischemic stroke.

PubMed

Mathiesen, E B; Johnsen, S H

2009-01-01

Carotid intima-media thickness (IMT) and plaque measurements are widely used to quantify atherosclerosis and assess the risk of future stroke, and are used as surrogate endpoints for clinical disease. In recent years, it has become clear that carotid IMT and plaque reflect biologically and genetically different aspects of the atherosclerotic process, and are differentially related to risk factors and cardiovascular disease. Plaques are focal manifestations of atherosclerosis while increased IMT represents mainly hypertensive medial hypertrophy. Several prospective studies have showed that IMT and plaque measurements, such as total plaque area and plaque number, are predictive of future stroke. Plaque echogenicity predicts future stroke independent of plaque size. The contribution of IMT and plaque measurements in individual stroke risk prediction in the general population seems to be limited, but may be useful as a tool for individual stratification of high-risk patients.

Risk management: Core principles and practices, and their relevance to wildland fire

Treesearch

Matthew P. Thompson; Donald G. MacGregor; Dave Calkin

2016-01-01

The Forest Service, U.S. Department of Agriculture faces a future of increasing complexity and risk, pressing financial issues, and the inescapable possibility of loss of human life. These issues are perhaps most acute for wildland fire management, the highest risk activity in which the Forest Service engages. Risk management (RM) has long been put forth as an...

Promoting "Healthy Futures" to Reduce Risk Behaviors in Urban Youth: A Randomized Controlled Trial.

PubMed

Lindstrom Johnson, Sarah; Jones, Vanya; Cheng, Tina L

2015-09-01

There is increasing evidence of the interconnection between educational and health outcomes. Unfortunately wide disparities exist by both socioeconomic status and race/ethnicity in educational and vocational success. This study sought to promote urban youths' career readiness as a way to reduce involvement in risk behaviors. Two hundred primarily African-American youth (ages 14-21) were recruited from a pediatric primary care clinic. Youth randomized to the intervention received three motivational interviewing sessions focused around expectations and planning for the future. Baseline and 6-month follow-up assessments included measures of career readiness and risk behavior involvement (i.e., physical fighting, alcohol and marijuana use). At 6-months, youth randomized to the intervention condition showed increased confidence in their ability to perform the behaviors needed to reach their college/career goals. Additionally, youth randomized to the intervention arm showed decreased fighting behavior (adjusted rate ratio: .27) and marijuana use (adjusted rate ratio: .61). Assisting urban youth in thinking and planning about their future holds promise as a way to reduce their involvement in risk behaviors. This study also demonstrated that motivational interviewing could be used to promote positive behaviors (i.e., career readiness).

Ozone risk for crops and pastures in present and future climates

NASA Astrophysics Data System (ADS)

Fuhrer, Jürg

2009-02-01

Ozone is the most important regional-scale air pollutant causing risks for vegetation and human health in many parts of the world. Ozone impacts on yield and quality of crops and pastures depend on precursor emissions, atmospheric transport and leaf uptake and on the plant’s biochemical defence capacity, all of which are influenced by changing climatic conditions, increasing atmospheric CO2 and altered emission patterns. In this article, recent findings about ozone effects under current conditions and trends in regional ozone levels and in climatic factors affecting the plant’s sensitivity to ozone are reviewed in order to assess implications of these developments for future regional ozone risks. Based on pessimistic IPCC emission scenarios for many cropland regions elevated mean ozone levels in surface air are projected for 2050 and beyond as a result of both increasing emissions and positive effects of climate change on ozone formation and higher cumulative ozone exposure during an extended growing season resulting from increasing length and frequency of ozone episodes. At the same time, crop sensitivity may decline in areas where warming is accompanied by drying, such as southern and central Europe, in contrast to areas at higher latitudes where rapid warming is projected to occur in the absence of declining air and soil moisture. In regions with rapid industrialisation and population growth and with little regulatory action, ozone risks are projected to increase most dramatically, thus causing negative impacts major staple crops such as rice and wheat and, consequently, on food security. Crop improvement may be a way to increase crop cross-tolerance to co-occurring stresses from heat, drought and ozone. However, the review reveals that besides uncertainties in climate projections, parameters in models for ozone risk assessment are also uncertain and model improvements are necessary to better define specific targets for crop improvements, to identify regions most at risk from ozone in a future climate and to set robust effect-based ozone standards.

Suicide Risk Associated with Experience of Violence and Impulsivity in Alcohol Dependent Patients.

PubMed

Khemiri, Lotfi; Jokinen, Jussi; Runeson, Bo; Jayaram-Lindström, Nitya

2016-01-19

Alcohol dependence (AD) and aggression-impulsivity are both associated with increased suicide risk. There is a need to evaluate clinical tools in order to improve suicide risk assessment of AD patients. The present study consisted of 95 individuals with a diagnosis of AD, consecutively admitted for addiction treatment, compared with 95 healthy controls. Suicidal risk was assessed together with exposure of violence and impulsivity. AD patients reported significantly higher rates of exposure to violence in childhood, as measured by the Karolinska Interpersonal Violence Scale (KIVS), compared to HC. Within the AD group, individuals with history of suicidal ideation and suicidal behavior reported higher levels of violence experience compared to AD individuals without such history. AD patients with previous suicidal ideation scored higher on self-reported impulsivity as assessed by the Barratt Impulsivity Scale (BIS). Our main finding was that experience of trauma and expression of violent behavior, coupled with increased impulsivity are associated with an elevated suicide risk in AD patients. Future longitudinal studies assessing these traits are needed to evaluate their potential role in identifying AD patients at risk of future suicide.

Suicide Risk Associated with Experience of Violence and Impulsivity in Alcohol Dependent Patients

PubMed Central

Khemiri, Lotfi; Jokinen, Jussi; Runeson, Bo; Jayaram-Lindström, Nitya

2016-01-01

Alcohol dependence (AD) and aggression-impulsivity are both associated with increased suicide risk. There is a need to evaluate clinical tools in order to improve suicide risk assessment of AD patients. The present study consisted of 95 individuals with a diagnosis of AD, consecutively admitted for addiction treatment, compared with 95 healthy controls. Suicidal risk was assessed together with exposure of violence and impulsivity. AD patients reported significantly higher rates of exposure to violence in childhood, as measured by the Karolinska Interpersonal Violence Scale (KIVS), compared to HC. Within the AD group, individuals with history of suicidal ideation and suicidal behavior reported higher levels of violence experience compared to AD individuals without such history. AD patients with previous suicidal ideation scored higher on self-reported impulsivity as assessed by the Barratt Impulsivity Scale (BIS). Our main finding was that experience of trauma and expression of violent behavior, coupled with increased impulsivity are associated with an elevated suicide risk in AD patients. Future longitudinal studies assessing these traits are needed to evaluate their potential role in identifying AD patients at risk of future suicide. PMID:26784730

Prognostic implications of serial risk score assessments in patients with pulmonary arterial hypertension: a Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) analysis.

PubMed

Benza, Raymond L; Miller, Dave P; Foreman, Aimee J; Frost, Adaani E; Badesch, David B; Benton, Wade W; McGoon, Michael D

2015-03-01

Data from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) were used previously to develop a risk score calculator to predict 1-year survival. We evaluated prognostic implications of changes in the risk score and individual risk-score parameters over 12 months. Patients were grouped by decreased, unchanged, or increased risk score from enrollment to 12 months. Kaplan-Meier estimates of subsequent 1-year survival were made based on change in the risk score during the initial 12 months of follow-up. Cox regression was used for multivariable analysis. Of 2,529 patients in the analysis cohort, the risk score was decreased in 800, unchanged in 959, and increased in 770 at 12 months post-enrollment. Six parameters (functional class, systolic blood pressure, heart rate, 6-minute walk distance, brain natriuretic peptide levels, and pericardial effusion) each changed sufficiently over time to improve or worsen risk scores in ≥5% of patients. One-year survival estimates in the subsequent year were 93.7%, 90.3%, and 84.6% in patients with a decreased, unchanged, and increased risk score at 12 months, respectively. Change in risk score significantly predicted future survival, adjusting for risk at enrollment. Considering follow-up risk concurrently with risk at enrollment, follow-up risk was a much stronger predictor, although risk at enrollment maintained a significant effect on future survival. Changes in REVEAL risk scores occur in most patients with pulmonary arterial hypertension over a 12-month period and are predictive of survival. Thus, serial risk score assessments can identify changes in disease trajectory that may warrant treatment modifications. Copyright © 2015 International Society for Heart and Lung Transplantation. All rights reserved.

Testing the effect of risk on intertemporal choice in the Chinese cultural context.

PubMed

Sun, Yan; Li, Shu

2011-01-01

Previous studies using Western samples have found that introducing uncertainty to an intertemporal choice decreases the degree of discounting future rewards. The authors of this article examined the effect of risk on intertemporal choice using Chinese participants and found that respondents preferred the smaller but sooner (SS) outcome to the larger but later (LL) one in the presence of risk, which indicates that risk increases rather than decreases the degree of discounting future rewards. Thus, variations in response patterns between different cultural groups suggest that culture may play an important role in intertemporal choice and researchers should delve into this topic from an emic rather than an etic perspective.

[Forest fire risk assessment for China under different climate scenarios.

PubMed

Tian, Xiao Rui; Dai, Xuan; Wang, Ming Yu; Zhao, Feng Jun; Shu, Li Fu

2016-03-01

Forest fire risk depends on the hazard factors, affected body, and hazard prevention and reduction ability. The integrated risk assessment is the foundation for developing scientific fire mana-gement policies and carrying out the forest fire prevention measures. A forest fire risk assessment model and index system were established based on the classic natural disaster risk model and available data, and the model was used to assess the forest fire risks in past and future. The future climate scenario data included outputs from five global climate models (GFDL-ESM2M, HadGEM2-ES, IPSL-CM5A-LR, MIROC-ESM-CHEM and NorESM1-M) for RCP 2.6, RCP 4.5, RCP 6.0 and RCP 8.5, respectively. Each component index of Fire Weather Index (FWI) system was calculated daily for each grid in 1987-2050 for the historical observations and future climate scenarios according to the maximum temperature, minimum relative humidity, wind speed and daily precipitation. The results showed that areas with high and very high fire danger ratings in 1987-2010 accounted for 21.2% and 6.2%, respectively, which were distributed in Greater Xing'an Mountains and the Changbai Mountain area, most parts of Yunnan, and many fragment areas in southern China. The areas with high and very high burn possibilities were mainly distributed in the northeast and southwest region, accounting for 13.1% and 4.0%, respectively. Compared with the observation period, the areas with high and very high fire danger ratings in 2021-2050 would increase by 0.6%, 5.5%, 2.3%, and 3.5% under RCP 2.6, RCP 4.5, RCP 6.0, and RCP 8.5 respectively, and North China would show significant increase. The regions with high-risk forest fires would also increase due to climate change, with the most significant increase under RCP 8.5 scenario (+1.6%).

Injuries caused by work-related violence: frequency, need for medical treatment and associations with adverse mental health and alcohol use among Finnish police officers.

PubMed

Leino, Tuula; Eskelinen, Kaisa; Summala, Heikki; Virtanen, Marianna

2012-08-01

We examined the associations of the frequency and the need for medical treatment caused by work-related violence with adverse mental health among Finnish police officers (n = 1,734). The data were collected via a questionnaire. Employees who had suffered more than one injury were at a 4.86-fold risk (95% CI = 2.72-8.66) of increased alcohol consumption, a 4.40-fold risk (95% CI = 2.87-6.76) of psychological distress symptoms, and a 2.49-fold risk (95% CI = 1.73-3.59) of fear of future violence compared to those who had suffered no injuries. Among those who had suffered injuries (n = 843), the need for medical treatment when injured was associated with a 2.33-fold risk (95% CI = 1.19-4.57) of psychological distress symptoms and with a 2.09-fold risk (95% CI = 1.08-4.03) of fear of future violence when compared to those who did not need medical care for their injury. Among police officers, high frequency and the need for medical treatment of injuries is associated with an increased risk of adverse mental health. High frequency of injuries may also increase alcohol consumption among police officers. Copyright © 2012 Wiley Periodicals, Inc.

Projected effect of increased active travel in German urban regions on the risk of type 2 diabetes.

PubMed

Brinks, Ralph; Hoyer, Annika; Kuss, Oliver; Rathmann, Wolfgang

2015-01-01

Future transportation policy is likely to reduce emissions in the cities and urban regions by strengthening active travel. Increased walking and cycling are known to have positive effects on health outcomes. This work estimates effects of increased active travel on type 2 diabetes in Germany, where 64% of the population live in urban regions. Based on the effect size of an increased active travel scenario reported from a recent meta-analysis, we project the change in the life time risk, the proportion of prevented cases and the change in diabetes free life time in a German birth cohort (born 1985) compared to business as usual. The absolute risk reduction of developing type 2 diabetes before the age of 80 is 6.4% [95% confidence interval: 3.7-9.7%] for men and 4.7% [2.2-7.7%] for women, respectively. Compared to business as usual, the increased active travel scenario prevents 14.0% [8.1-21.2%] of the future cases of diabetes in men and 15.8% [9.3-23.1%] in women. Diabetes free survival increases by 1.7 [1.0-2.7] years in men and 1.4 [0.6-2.3] in women. Our projection predicts a substantial impact of increased active travel on the future burden of type 2 diabetes. The most striking effect may be seen in the number of prevented cases. In all urban regions with an increased active travel transport policy, about one out of seven male and one out of six female cases can be prevented.

Scenarios for the risk of hunger in the twenty-first century using Shared Socioeconomic Pathways

NASA Astrophysics Data System (ADS)

Hasegawa, Tomoko; Fujimori, Shinichiro; Takahashi, Kiyoshi; Masui, Toshihiko

2015-01-01

Shared socioeconomic pathways (SSPs) are being developed internationally for cross-sectoral assessments of climate change impacts, adaptation, and mitigation. These are five scenarios that include both qualitative and quantitative information for mitigation and adaptation challenges to climate change. In this study, we quantified scenarios for the risk of hunger in the 21st century using SSPs, and clarified elements that influence future hunger risk. There were two primary findings: (1) risk of hunger in the 21st-century greatly differed among five SSPs; and (2) population growth, improvement in the equality of food distribution within a country, and increases in food consumption mainly driven by income growth greatly influenced future hunger risk and were important elements in its long-term assessment.

Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence

PubMed Central

2010-01-01

Background People with diabetes can suffer from diverse complications that seriously erode quality of life. Diabetes, costing the United States more than $174 billion per year in 2007, is expected to take an increasingly large financial toll in subsequent years. Accurate projections of diabetes burden are essential to policymakers planning for future health care needs and costs. Methods Using data on prediabetes and diabetes prevalence in the United States, forecasted incidence, and current US Census projections of mortality and migration, the authors constructed a series of dynamic models employing systems of difference equations to project the future burden of diabetes among US adults. A three-state model partitions the US population into no diabetes, undiagnosed diabetes, and diagnosed diabetes. A four-state model divides the state of "no diabetes" into high-risk (prediabetes) and low-risk (normal glucose) states. A five-state model incorporates an intervention designed to prevent or delay diabetes in adults at high risk. Results The authors project that annual diagnosed diabetes incidence (new cases) will increase from about 8 cases per 1,000 in 2008 to about 15 in 2050. Assuming low incidence and relatively high diabetes mortality, total diabetes prevalence (diagnosed and undiagnosed cases) is projected to increase from 14% in 2010 to 21% of the US adult population by 2050. However, if recent increases in diabetes incidence continue and diabetes mortality is relatively low, prevalence will increase to 33% by 2050. A middle-ground scenario projects a prevalence of 25% to 28% by 2050. Intervention can reduce, but not eliminate, increases in diabetes prevalence. Conclusions These projected increases are largely attributable to the aging of the US population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer. Effective strategies will need to be undertaken to moderate the impact of these factors on national diabetes burden. Our analysis suggests that widespread implementation of reasonably effective preventive interventions focused on high-risk subgroups of the population can considerably reduce, but not eliminate, future increases in diabetes prevalence. PMID:20969750

Plasma Free Amino Acid Profiles Predict Four-Year Risk of Developing Diabetes, Metabolic Syndrome, Dyslipidemia, and Hypertension in Japanese Population

PubMed Central

Yamakado, Minoru; Nagao, Kenji; Imaizumi, Akira; Tani, Mizuki; Toda, Akiko; Tanaka, Takayuki; Jinzu, Hiroko; Miyano, Hiroshi; Yamamoto, Hiroshi; Daimon, Takashi; Horimoto, Katsuhisa; Ishizaka, Yuko

2015-01-01

Plasma free amino acid (PFAA) profile is highlighted in its association with visceral obesity and hyperinsulinemia, and future diabetes. Indeed PFAA profiling potentially can evaluate individuals’ future risks of developing lifestyle-related diseases, in addition to diabetes. However, few studies have been performed especially in Asian populations, about the optimal combination of PFAAs for evaluating health risks. We quantified PFAA levels in 3,701 Japanese subjects, and determined visceral fat area (VFA) and two-hour post-challenge insulin (Ins120 min) values in 865 and 1,160 subjects, respectively. Then, models between PFAA levels and the VFA or Ins120 min values were constructed by multiple linear regression analysis with variable selection. Finally, a cohort study of 2,984 subjects to examine capabilities of the obtained models for predicting four-year risk of developing new-onset lifestyle-related diseases was conducted. The correlation coefficients of the obtained PFAA models against VFA or Ins120 min were higher than single PFAA level. Our models work well for future risk prediction. Even after adjusting for commonly accepted multiple risk factors, these models can predict future development of diabetes, metabolic syndrome, and dyslipidemia. PFAA profiles confer independent and differing contributions to increasing the lifestyle-related disease risks in addition to the currently known factors in a general Japanese population. PMID:26156880

Risk perceptions for avian influenza virus infection among poultry workers, China.

PubMed

Yu, Qi; Liu, Linqing; Pu, Juan; Zhao, Jingyi; Sun, Yipeng; Shen, Guangnian; Wei, Haitao; Zhu, Junjie; Zheng, Ruifeng; Xiong, Dongyan; Liu, Xiaodong; Liu, Jinhua

2013-02-01

To determine risk for avian influenza virus infection, we conducted serologic surveillance for H5 and H9 subtypes among poultry workers in Beijing, China, 2009-2010, and assessed workers' understanding of avian influenza. We found that poultry workers had considerable risk for infection with H9 subtypes. Increasing their knowledge could prevent future infections.

Perceived Barriers and Protective Factors of Juvenile Offenders on Their Developmental Pathway to Adulthood

ERIC Educational Resources Information Center

Unruh, Deanne; Povenmire-Kirk, Tiana; Yamamoto, Scott

2009-01-01

Adolescents involved in the juvenile justice system face multiple challenges on their pathway to adulthood. These adolescents not only have an increased risk of committing future crimes and are further at risk of not becoming healthy, productive adults. The purpose of this study was to examine the risk and protective factors and associations…

Development of a theoretical screening tool to assess caries risk in Nevada youth.

PubMed

Ditmyer, Marcia M; Mobley, Connie; Draper, Quinn; Demopoulos, Christina; Smith, E Steven

2008-01-01

One objective of this study was to determine the prevalence and severity of caries among Nevada youth, subsequently comparing these data with national statistics. A second objective was to identify the risk factors associated with caries prevalence and severity in order to develop and tailor a theoretical screening tool for this cohort for future validation. Researchers computed the prevalence rates of dental caries (D-score) and severity rates of decayed, missing, and filled teeth indices in a cohort of 9202 students, 13 to 18 years of age, attending public/private schools in the 2005/2006 academic year. Multiple regression established which of the 13 variables significantly contributed to caries risk, subsequently using logistic regression to ascertain the weight of contribution and odds ratios of significant variables. Living in counties with no municipal water fluoridation, increased exposure to environmental smoke, minority race, living in rural communities, and increasing age were the largest significant contributors (respectively). Exposure to tobacco, being female, lack of dental insurance, increased body mass index risk, and lack of dental sealants were also significant, but to a lesser extent. Nonsignificant factors included socioeconomic status, ethnicity, and family history of diabetes. This study confirmed high caries prevalence and severity and identified significant risk factors for inclusion in a theoretical risk screening tool for future validation and translation for use in the early detection of caries risk in Nevada youth.

Hip Strength as a Predictor of Ankle Sprains in Male Soccer Players: A Prospective Study.

PubMed

Powers, Christopher M; Ghoddosi, Navid; Straub, Rachel K; Khayambashi, Khalil

2017-11-01

  Diminished hip-abductor strength has been suggested to increase the risk of noncontact lateral ankle sprains.   To determine prospectively whether baseline hip-abductor strength predicts future noncontact lateral ankle sprains in competitive male soccer players.   Prospective cohort study.   Athletic training facilities and various athletic fields.   Two hundred ten competitive male soccer players.   Before the start of the sport season, isometric hip-abductor strength was measured bilaterally using a handheld dynamometer. Any previous history of ankle sprain, body mass index, age, height, and weight were documented. During the sport season (30 weeks), ankle injury status was recorded by team medical providers. Injured athletes were further classified based on the mechanism of injury. Only data from injured athletes who sustained noncontact lateral ankle sprains were used for analysis. Postseason, logistic regression was used to determine whether baseline hip strength predicted future noncontact lateral ankle sprains. A receiver operating characteristic curve was constructed for hip strength to determine the cutoff value for distinguishing between high-risk and low-risk outcomes.   A total of 25 noncontact lateral ankle sprains were confirmed, for an overall annual incidence of 11.9%. Baseline hip-abductor strength was lower in injured players than in uninjured players ( P = .008). Logistic regression indicated that impaired hip-abductor strength increased the future injury risk (odds ratio = 1.10 [95% confidence interval = 1.02, 1.18], P = .010). The strength cutoff to define high risk was ≤33.8% body weight, as determined by receiver operating characteristic curve analysis. For athletes classified as high risk, the probability of injury increased from 11.9% to 26.7%.   Reduced isometric hip-abductor strength predisposed competitive male soccer players to noncontact lateral ankle sprains.

The Intersection of Stalking and the Severity of Intimate Partner Abuse.

PubMed

Brady, Patrick Q; Hayes, Brittany E

2018-04-01

Using data from the Chicago Women's Health Risk Study (N = 464), this study examined the intersection of stalking and the severity of intimate partner abuse while controlling for previously identified risk factors of intimate partner homicide. Findings indicate that (a) victims of life-threatening abuse by an intimate partner were significantly more likely to experience stalking than victims of nonlethal abuse; (b) after controlling for key risk factors, stalking increased the risk of life-threatening abuse; and (c) threats to kill the victim if she left was the only significant stalking-related behavior that increased the risk for life-threatening abuse. In addition, an offender's prior record and a higher number of previous abusive incidents increased the risk of life-threatening abuse. Implications for prevention and future directions for research are discussed.

Evaluation of the productivity decrease risk due to a future increase in tropical cyclone intensity in Japan.

PubMed

Esteban, Miguel; Longarte-Galnares, Gorka

2010-12-01

A number of scientists have recently conducted research that shows that tropical cyclone intensity is likely to increase in the future. This would result in an increase in the damage along with a decrease in economic productivity due to precautionary cessation of the economic activity of the affected areas during the passage of the cyclone. The economic effect of this stop in economic activity is a phenomenon that has not received much attention in the past, and the cumulative effect that it can have on the Japanese economy over the next 75 years has never been evaluated. The starting point for the evaluation of the economic risks is the change in the patterns of tropical cyclone intensity suggested by Knutson and Tuleya. The results obtained show how a significant decrease in the overall productivity of the country could be expected, which could lower GDP by between 6% and 13% by 2085. © 2010 Society for Risk Analysis.

Predicting the Future Impact of Droughts on Ungulate Populations in Arid and Semi-Arid Environments

PubMed Central

Duncan, Clare; Chauvenet, Aliénor L. M.; McRae, Louise M.; Pettorelli, Nathalie

2012-01-01

Droughts can have a severe impact on the dynamics of animal populations, particularly in semi-arid and arid environments where herbivore populations are strongly limited by resource availability. Increased drought intensity under projected climate change scenarios can be expected to reduce the viability of such populations, yet this impact has seldom been quantified. In this study, we aim to fill this gap and assess how the predicted worsening of droughts over the 21st century is likely to impact the population dynamics of twelve ungulate species occurring in arid and semi-arid habitats. Our results provide support to the hypotheses that more sedentary, grazing and mixed feeding species will be put at high risk from future increases in drought intensity, suggesting that management intervention under these conditions should be targeted towards species possessing these traits. Predictive population models for all sedentary, grazing or mixed feeding species in our study show that their probability of extinction dramatically increases under future emissions scenarios, and that this extinction risk is greater for smaller populations than larger ones. Our study highlights the importance of quantifying the current and future impacts of increasing extreme natural events on populations and species in order to improve our ability to mitigate predicted biodiversity loss under climate change. PMID:23284700

Impact of climate change on global malaria distribution.

PubMed

Caminade, Cyril; Kovats, Sari; Rocklov, Joacim; Tompkins, Adrian M; Morse, Andrew P; Colón-González, Felipe J; Stenlund, Hans; Martens, Pim; Lloyd, Simon J

2014-03-04

Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate factors, as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution.

Impact of climate change on global malaria distribution

PubMed Central

Caminade, Cyril; Kovats, Sari; Rocklov, Joacim; Tompkins, Adrian M.; Morse, Andrew P.; Colón-González, Felipe J.; Stenlund, Hans; Martens, Pim; Lloyd, Simon J.

2014-01-01

Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate factors, as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution. PMID:24596427

[Ecological risk assessment of Taihu Lake basin based on landscape pattern].

PubMed

Xie, Xiao Ping; Chen, Zhi Cong; Wang, Fang; Bai, Mao Wei; Xu, Wen Yang

2017-10-01

Taihu Lake basin was selected as the study site. Based on the landscape data of 2000, 2005, 2010 and 2015, the Markov and CLUE-S models were used to simulate the landscape types with different scenarios in 2030, and landscape ecological risk index was constructed. The shift of gravity center and spatial statistics were used to reveal landscape ecological risk of Taihu Lake basin with temporal and spatial characteristics. The results showed that the ecological risk mainly was at medium and low levels in Taihu Lake basin, and the higher ecological risk areas were mainly distributed at the Taihu Lake area during 2000 to 2015, and the low ecological risk was transferred from the southwest and south of Taihu Lake to the developed areas in the northern part of Taihu Lake area. Spatial analysis showed that landscape ecological risk had negative correlation with natural factors, which was weakened gradually, while the correlation with socioeconomic factors trended to become stronger, with human disturbance affecting the landscape ecological risk significantly. The impact of socioeconomic factors on landscape ecological risks differed in different urbanization stages. In the developing area, with the economic development, the landscape was increasingly fragmented and the ecological risk was correspondingly increased. While in the developed area, with the further development of the economy, the aggregation index was increased, and fragmentation and separation indexes were decreased, ecological construction was restored, and the landscape ecological risk began to decline. CLUE-S model simulation showed that the ecological risk of Taihu Lake basin would be reduced in future, mainly on the low and relatively low levels. Taihu Lake area, both in history and the future, is a high ecological risk zone, and its management and protection should be strengthened.

Aeroallergen sensitization predicts acute chest syndrome in children with sickle cell anaemia.

PubMed

Willen, Shaina M; Rodeghier, Mark; Strunk, Robert C; Bacharier, Leonard B; Rosen, Carol L; Kirkham, Fenella J; DeBaun, Michael R; Cohen, Robyn T

2018-02-01

Asthma is associated with higher rates of acute chest syndrome (ACS) and vaso-occlusive pain episodes among children with sickle cell anaemia (SCA). Aeroallergen sensitization is a risk factor for asthma. We hypothesized that aeroallergen sensitization is associated with an increased incidence of hospitalizations for ACS and pain. Participants in a multicentre, longitudinal cohort study, aged 4-18 years with SCA, underwent skin prick testing to ten aeroallergens. ACS and pain episodes were collected from birth until the end of the follow-up period. The number of positive skin tests were tested for associations with prospective rates of ACS and pain. Multivariable models demonstrated additive effects of having positive skin tests on future rates of ACS (incidence rate ratio (IRR) for each positive test 1·23, 95% confidence interval [CI] 1·11-1·36, P < 0·001). Aeroallergen sensitization was not associated with future pain (IRR 1·14, 95%CI 0·97-1·33, P = 0·11). Our study demonstrated that children with SCA and aeroallergen sensitization are at increased risk for future ACS. Future research is needed to determine whether identification of specific sensitizations and allergen avoidance and treatment reduce the risk of ACS for children with SCA. © 2018 John Wiley & Sons Ltd.

Experimental evidence for adaptive personalities in a wild passerine bird

PubMed Central

Nicolaus, Marion; Tinbergen, Joost M.; Bouwman, Karen M.; Michler, Stephanie P. M.; Ubels, Richard; Both, Christiaan; Kempenaers, Bart; Dingemanse, Niels J.

2012-01-01

Individuals of the same species differ consistently in risky actions. Such ‘animal personality’ variation is intriguing because behavioural flexibility is often assumed to be the norm. Recent theory predicts that between-individual differences in propensity to take risks should evolve if individuals differ in future fitness expectations: individuals with high long-term fitness expectations (i.e. that have much to lose) should behave consistently more cautious than individuals with lower expectations. Consequently, any manipulation of future fitness expectations should result in within-individual changes in risky behaviour in the direction predicted by this adaptive theory. We tested this prediction and confirmed experimentally that individuals indeed adjust their ‘exploration behaviour’, a proxy for risk-taking behaviour, to their future fitness expectations. We show for wild great tits (Parus major) that individuals with experimentally decreased survival probability become faster explorers (i.e. increase risk-taking behaviour) compared to individuals with increased survival probability. We also show, using quantitative genetics approaches, that non-genetic effects (i.e. permanent environment effects) underpin adaptive personality variation in this species. This study thereby confirms a key prediction of adaptive personality theory based on life-history trade-offs, and implies that selection may indeed favour the evolution of personalities in situations where individuals differ in future fitness expectations. PMID:23097506

Future flood risk in the tropics as measured by changes in extreme runoff intensity is strongly influenced by plant-physiological responses to rising CO2

NASA Astrophysics Data System (ADS)

Kooperman, G. J.; Hoffman, F. M.; Koven, C.; Lindsay, K. T.; Swann, A. L. S.; Randerson, J. T.

2017-12-01

Climate change is expected to increase the frequency of intense flooding events, and thus the risk of flood-related mortality, infrastructure damage, and economic loss. Assessments of future flooding from global climate models based only on precipitation intensity and temperature neglect important processes that occur within the land-surface, particularly the impacts of plant-physiological responses to rising CO2. Higher CO2 reduces stomatal conductance, leading to less water loss through transpiration and higher soil moisture. For a given precipitation rate, higher soil moisture decreases the amount of rainwater that infiltrates the surface and increases runoff. Here we assess the relative impacts of plant-physiological and radiative-greenhouse effects on changes in extreme runoff intensity over tropical continents using the Community Earth System Model. We find that extreme percentile rates increase significantly more than mean runoff in response to higher CO2. Plant-physiological effects contribute to only a small increase in precipitation intensity, but are a dominant driver of runoff intensification, contributing to one-half of the 99th percentile runoff intensity change and one-third of the 99.9th percentile change. Comprehensive assessments of future flooding risk need to account for the physiological as well as radiative impacts of CO2 in order to better inform flood prediction and mitigation practices.

Cirrhotic portal hypertension: current and future medical therapy for primary and secondary prevention of variceal bleeding.

PubMed

Laleman, W; Nevens, F

2006-08-01

Portal hypertension (PHT) is the most common complication of chronic liver disease and develops in the vast majority of patients with cirrhosis. It is characterized by an increase of the portal vein pressure, and leads to the development of gastroesophageal varices, ascites, renal dysfunction and hepatic encephalopathy. Over the years, it has become clear that a decrease in portal pressure is not only protective against the risk of variceal (re)bleeding but is also associated with a lower long-term risk of developing other complications and with an improved long-term survival. At present, non-selective b-blockers remain the medical treatment of choice for both primary and secondary prophylaxis. However, recent advances in the knowledge of the pathophysiology of cirrhotic PHT have directed future therapy towards the increased intrahepatic vascular resistance, which in part is determined by an increased hepatic vascular tone. This increased vasculogenic component provides the motivation to the use of therapies aimed at increasing intrahepatic vasorelaxing capacity on the one hand and at antagonizing excessive intrahepatic vasoconstrictor force on the other hand. This review covers current and future developments in the treatment of PHT with regard to primary and secondary prophylaxis.

Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study.

PubMed

Butwicka, Agnieszka; Lichtenstein, Paul; Frisén, Louise; Almqvist, Catarina; Larsson, Henrik; Ludvigsson, Jonas F

2017-05-01

To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands. This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged <18 years) with celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression. Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders. Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Estimates of present and future flood risk in the conterminous United States

NASA Astrophysics Data System (ADS)

Wing, Oliver E. J.; Bates, Paul D.; Smith, Andrew M.; Sampson, Christopher C.; Johnson, Kris A.; Fargione, Joseph; Morefield, Philip

2018-03-01

Past attempts to estimate rainfall-driven flood risk across the US either have incomplete coverage, coarse resolution or use overly simplified models of the flooding process. In this paper, we use a new 30 m resolution model of the entire conterminous US with a 2D representation of flood physics to produce estimates of flood hazard, which match to within 90% accuracy the skill of local models built with detailed data. These flood depths are combined with exposure datasets of commensurate resolution to calculate current and future flood risk. Our data show that the total US population exposed to serious flooding is 2.6-3.1 times higher than previous estimates, and that nearly 41 million Americans live within the 1% annual exceedance probability floodplain (compared to only 13 million when calculated using FEMA flood maps). We find that population and GDP growth alone are expected to lead to significant future increases in exposure, and this change may be exacerbated in the future by climate change.

Climate variability and demand growth as drivers of water scarcity in the Turkwel river basin: a bottom-up risk assessment of a data-sparse basin in Kenya

NASA Astrophysics Data System (ADS)

Hirpa, F. A.; Dyer, E.; Hope, R.; Dadson, S. J.

2017-12-01

Sustainable water management and allocation are essential for maintaining human well-being, sustaining healthy ecosystems, and supporting steady economic growth. The Turkwel river basin, located in north-western Kenya, experiences a high level of water scarcity due to its arid climate, high rainfall variability, and rapidly growing water demand. However, due to sparse hydro-climatic data and limited literature, the water resources system of the basin has been poorly understood. Here we apply a bottom-up climate risk assessment method to estimate the resilience of the basin's water resources system to growing demand and climate stressors. First, using a water resource system model and historical climate data, we construct a climate risk map that depicts the way in which the system responds to climate change and variability. Then we develop a set of water demand scenarios to identify the conditions that potentially lead to the risk of unmet water demand and groundwater depletion. Finally, we investigate the impact of climate change and variability by stress testing these development scenarios against historically strong El Niño/Southern Oscillation (ENSO) years and future climate projections from multiple Global Circulation Models (GCMs). The results reveal that climate variability and increased water demand are the main drivers of water scarcity in the basin. Our findings show that increases in water demand due to expanded irrigation and population growth exert the strongest influence on the ability of the system to meet water resource supply requirements, and in all cases considered increase the impacts of droughts caused by future climate variability. Our analysis illustrates the importance of combining analysis of future climate risks with other development decisions that affect water resources planning. Policy and investment decisions which maximise water use efficiency in the present day are likely to impart resilience to climate change and variability under a wide range of future scenarios and therefore constitute low regret measures for climate adaptation.

Biometric Screening and Future Employer Medical Costs: Is It Worth It to Know?

PubMed

Vanichkachorn, Greg; Marchese, Maya; Roy, Brad; Opel, Gordon

2017-12-01

To study the relationship between a biometric wellness data and future/actual medical costs. A relationship between total cholesterol to high density lipoprotein ratio, blood pressure, and blood glucose and medical costs, based on analysis of claims data, was explored in 1834 employees that had both wellness program biometric and claims data in 2016. Increased total cholesterol to HDL ratio is strongly associated with increased average costs (P < 0.01). Similarly, an increased glucose level is strongly associated with increased average costs (P = 0.001). There was no evidence of a relationship between elevated blood pressure and higher costs. By investing in an employer-sponsored biometric screening of full cholesterol and glucose profiles, medium-sized employers can identify high-risk employees who are expected to incur significantly higher healthcare costs, as compared with low-risk level employees, and improve treatment outcomes.

Increasing extreme water level flood risk as a result of future sea-level rise: A case study on a coastal city in China

NASA Astrophysics Data System (ADS)

Feng, A.; Wu, S.

2016-12-01

Extreme water levels, caused by the joint occurrence of storm surges and high tides, always lead to super floods along coastlines. In the context of climate change, this study explored the impact of future sea-level rise on the flood risk of extreme water levels. Using Rongcheng City in Shandong Province, China as a case study, flooded area, expected direct damage losses, and affected population and GDP were assessed for 2050 and 2100 under three greenhouse gas concentration Representative Concentration Pathways (RCP) scenarios, 2.6, 4.5, and 8.5. Results indicate that, as a result of sea-level rise induced by climate change, the flooded areas of Rongcheng City would increase by 3.23% to 10.64% in 2050 and by as much as 4.98% to 19.87% in 2100, compared with current recurrence periods. Residential land and farmland are at greatest risk of flooding in terms of exposure and losses than other land-use types, and under a high degree RCP 8.5 scenario, expected damage losses would be between 59.84 billion and 86.45 billion in 2050. Results show that the increase in total direct damage losses would reach an average of 60% in 2100 as a result of a 0.82 m sea-level rise. Similarly, affected population and GDP would increase by between 4.95% and 13.87% and between 3.66% and 10.95% in 2050, and by as much as 7.69% to 29.01% and 5.30% to 20.50% in 2100. This study shows that sea-level rise significantly shortens recurrence periods of extreme water levels, makes extreme flood events more frequent, and exacerbates the risk of future flooding. Our results suggest that, if there is no adaptation, sea-level rise will greatly increase the risk of flooding and severely impact human habitability along coastlines.

Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE.

PubMed

Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

2012-05-01

Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households' probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.

Land Use Planning and Wildfire: Development Policies Influence Future Probability of Housing Loss

PubMed Central

Syphard, Alexandra D.; Bar Massada, Avi; Butsic, Van; Keeley, Jon E.

2013-01-01

Increasing numbers of homes are being destroyed by wildfire in the wildland-urban interface. With projections of climate change and housing growth potentially exacerbating the threat of wildfire to homes and property, effective fire-risk reduction alternatives are needed as part of a comprehensive fire management plan. Land use planning represents a shift in traditional thinking from trying to eliminate wildfires, or even increasing resilience to them, toward avoiding exposure to them through the informed placement of new residential structures. For land use planning to be effective, it needs to be based on solid understanding of where and how to locate and arrange new homes. We simulated three scenarios of future residential development and projected landscape-level wildfire risk to residential structures in a rapidly urbanizing, fire-prone region in southern California. We based all future development on an econometric subdivision model, but we varied the emphasis of subdivision decision-making based on three broad and common growth types: infill, expansion, and leapfrog. Simulation results showed that decision-making based on these growth types, when applied locally for subdivision of individual parcels, produced substantial landscape-level differences in pattern, location, and extent of development. These differences in development, in turn, affected the area and proportion of structures at risk from burning in wildfires. Scenarios with lower housing density and larger numbers of small, isolated clusters of development, i.e., resulting from leapfrog development, were generally predicted to have the highest predicted fire risk to the largest proportion of structures in the study area, and infill development was predicted to have the lowest risk. These results suggest that land use planning should be considered an important component to fire risk management and that consistently applied policies based on residential pattern may provide substantial benefits for future risk reduction. PMID:23977120

Climate Envelope Modeling and Dispersal Simulations Show Little Risk of Range Extension of the Shipworm, Teredo navalis (L.), in the Baltic Sea

PubMed Central

Appelqvist, Christin; Al-Hamdani, Zyad K.; Jonsson, Per R.; Havenhand, Jon N.

2015-01-01

The shipworm, Teredo navalis, is absent from most of the Baltic Sea. In the last 20 years, increased frequency of T. navalis has been reported along the southern Baltic Sea coasts of Denmark, Germany, and Sweden, indicating possible range-extensions into previously unoccupied areas. We evaluated the effects of historical and projected near-future changes in salinity, temperature, and oxygen on the risk of spread of T. navalis in the Baltic. Specifically, we developed a simple, GIS-based, mechanistic climate envelope model to predict the spatial distribution of favourable conditions for adult reproduction and larval metamorphosis of T. navalis, based on published environmental tolerances to these factors. In addition, we used a high-resolution three-dimensional hydrographic model to simulate the probability of spread of T. navalis larvae within the study area. Climate envelope modeling showed that projected near-future climate change is not likely to change the overall distribution of T. navalis in the region, but will prolong the breeding season and increase the risk of shipworm establishment at the margins of the current range. Dispersal simulations indicated that the majority of larvae were philopatric, but those that spread over a wider area typically spread to areas unfavourable for their survival. Overall, therefore, we found no substantive evidence for climate-change related shifts in the distribution of T. navalis in the Baltic Sea, and no evidence for increased risk of spread in the near-future. PMID:25768305

Sizing Up a Superstorm: Exploring the Role of Recalled Experience and Attribution of Responsibility in Judgments of Future Hurricane Risk.

PubMed

Rickard, Laura N; Yang, Z Janet; Schuldt, Jonathon P; Eosco, Gina M; Scherer, Clifford W; Daziano, Ricardo A

2017-12-01

Research suggests that hurricane-related risk perception is a critical predictor of behavioral response, such as evacuation. Less is known, however, about the precursors of these subjective risk judgments, especially when time has elapsed from a focal event. Drawing broadly from the risk communication, social psychology, and natural hazards literature, and specifically from concepts adapted from the risk information seeking and processing model and the protective action decision model, we examine how individuals' distant recollections, including attribution of responsibility for the effects of a storm, attitude toward relevant information, and past hurricane experience, relate to risk judgment for a future, similar event. The present study reports on a survey involving U.S. residents in Connecticut, New Jersey, and New York (n = 619) impacted by Hurricane Sandy. While some results confirm past findings, such as that hurricane experience increases risk judgment, others suggest additional complexity, such as how various types of experience (e.g., having evacuated vs. having experienced losses) may heighten or attenuate individual-level judgments of responsibility. We suggest avenues for future research, as well as implications for federal agencies involved in severe weather/natural hazard forecasting and communication with public audiences. © 2017 Society for Risk Analysis.

Projecting future climate change impacts on heat-related mortality in large urban areas in China.

PubMed

Li, Ying; Ren, Ting; Kinney, Patrick L; Joyner, Andrew; Zhang, Wei

2018-05-01

Global climate change is anticipated to raise overall temperatures and has the potential to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world's largest developing country, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging and underexplored, particularly in developing countries. This is an exploratory study aimed at projecting future heat-related mortality risk in major urban areas in China. We focus on the 51 largest Chinese cities that include about one third of the total population in China, and project the potential changes in heat-related mortality based on 19 different global-scale climate models and three Representative Concentration Pathways (RCPs). City-specific risk estimates for high temperature and all-cause mortality were used to estimate annual heat-related mortality over two future twenty-year time periods. We estimated that for the 20-year period in Mid-21st century (2041-2060) relative to 1970-2000, incidence of excess heat-related mortality in the 51 cities to be approximately 37,800 (95% CI: 31,300-43,500), 31,700 (95% CI: 26,200-36,600) and 25,800 (95% CI: 21,300-29,800) deaths per year under RCP8.5, RCP4.5 and RCP2.6, respectively. Slowing climate change through the most stringent emission control scenario RCP2.6, relative to RCP8.5, was estimated to avoid 12,900 (95% CI: 10,800-14,800) deaths per year in the 51 cities in the 2050s, and 35,100 (95% CI: 29,200-40,100) deaths per year in the 2070s. The highest mortality risk is primarily in cities located in the North, East and Central regions of China. Population adaptation to heat is likely to reduce excess heat mortality, but the extent of adaptation is still unclear. Future heat mortality risk attributable to exposure to elevated warm season temperature is likely to be considerable in China's urban centers, with substantial geographic variations. Climate mitigation and heat risk management are needed to reduce such risk and produce substantial public health benefits. Copyright © 2018 Elsevier Inc. All rights reserved.

Susceptibility of SCADA systems and the energy sector

NASA Astrophysics Data System (ADS)

Goike, Lindsay

The research in this paper focused on analyzing SCADA systems in the energy sector for susceptibility to cyber attacks, in furtherance of providing suggestions to mitigate current and future cyber attacks. The research will be addressing the questions: how are SCADA systems susceptible to cyber attacks, and what are the suggested ways to mitigate both current and future cyber attacks. The five main categories of security vulnerabilities facing current SCADA systems were found to be: connectivity to the Internet, failure to plan, interdependency of sectors, numerous different types of threats, and outdated software. Some of the recommendations mentioned to mitigate current and future risks were: virtual private networks, risk assessments, increased physical security, updating of software, and firewalls.

Disability pension and symptoms of anxiety and depression: a prospective comparison of farmers and other occupational groups. The HUNT Study, Norway.

PubMed

Torske, Magnhild Oust; Hilt, Bjørn; Bjørngaard, Johan Håkon; Glasscock, David; Krokstad, Steinar

2015-11-02

Agriculture has undergone major changes, and farmers have been found to have a high prevalence of depression symptoms. We investigated the risk of work disability in Norwegian farmers compared with other occupational groups, as well as the associations between symptoms of anxiety and depression and future disability pension. We linked working participants of the HUNT2 Survey (1995-97) aged 20-61.9 years, of whom 3495 were farmers and 25,521 had other occupations, to national registry data on disability pension, with follow-up until 31 December 2010. We used Cox proportional hazards regression to estimate hazard ratios (HRs) of disability pension, and to investigate the associations between symptoms of anxiety and depression caseness at baseline (score on the anxiety or depression subscales of the Hospital Anxiety and Depression Scale (HADS) ≥8) and disability pension. Farmers had a twofold increased risk of disability pension (age-adjusted and sex-adjusted HR 2.07, 95% CI 1.80 to 2.38) compared with higher grade professionals. Farmers with symptoms of depression caseness had a 53% increased risk of disability pension (HR 1.53, 95% CI 1.25 to 1.87) compared with farmers below the cut-off point of depression caseness symptoms, whereas farmers with symptoms of anxiety caseness had a 51% increased risk (HR 1.51, 95% CI 1.23 to 1.86). Farmers have an increased risk of disability pension compared with higher grade professionals, but the risk is lower than in most other manual occupational groups. Farmers who report high levels of depression or anxiety symptoms are at substantially increased risk of future work disability, and the risk increase appears to be fairly similar across most occupational groups. 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/

Disability pension and symptoms of anxiety and depression: a prospective comparison of farmers and other occupational groups. The HUNT Study, Norway

PubMed Central

Torske, Magnhild Oust; Hilt, Bjørn; Bjørngaard, Johan Håkon; Glasscock, David; Krokstad, Steinar

2015-01-01

Objectives Agriculture has undergone major changes, and farmers have been found to have a high prevalence of depression symptoms. We investigated the risk of work disability in Norwegian farmers compared with other occupational groups, as well as the associations between symptoms of anxiety and depression and future disability pension. Methods We linked working participants of the HUNT2 Survey (1995–97) aged 20–61.9 years, of whom 3495 were farmers and 25 521 had other occupations, to national registry data on disability pension, with follow-up until 31 December 2010. We used Cox proportional hazards regression to estimate hazard ratios (HRs) of disability pension, and to investigate the associations between symptoms of anxiety and depression caseness at baseline (score on the anxiety or depression subscales of the Hospital Anxiety and Depression Scale (HADS) ≥8) and disability pension. Results Farmers had a twofold increased risk of disability pension (age-adjusted and sex-adjusted HR 2.07, 95% CI 1.80 to 2.38) compared with higher grade professionals. Farmers with symptoms of depression caseness had a 53% increased risk of disability pension (HR 1.53, 95% CI 1.25 to 1.87) compared with farmers below the cut-off point of depression caseness symptoms, whereas farmers with symptoms of anxiety caseness had a 51% increased risk (HR 1.51, 95% CI 1.23 to 1.86). Conclusions Farmers have an increased risk of disability pension compared with higher grade professionals, but the risk is lower than in most other manual occupational groups. Farmers who report high levels of depression or anxiety symptoms are at substantially increased risk of future work disability, and the risk increase appears to be fairly similar across most occupational groups. PMID:26525724

Does maternal body mass index during pregnancy influence risk of schizophrenia in the adult offspring?

PubMed Central

Khandaker, G M; Dibben, C R M; Jones, P B

2012-01-01

Summary Maternal obesity in pregnancy has been linked with several adverse outcomes in offspring including schizophrenia. The rising prevalence of obesity may contribute to an increase in the number of schizophrenia cases in the near future; therefore, it warrants further exploration. We reviewed current evidence regarding maternal body mass index (BMI) in pregnancy and risk of schizophrenia in adult offspring. We searched PubMed and Embase databases and included studies that were based on large and representative population-based datasets. A qualitative review was undertaken due to heterogeneity between studies. Four studies with 305 cases of schizophrenia and 24,442 controls were included. Maternal obesity (pre-pregnant BMI over 29 or 30 compared with mothers with low or average BMI) was associated with two- to threefold increased risk of schizophrenia in the adult offspring in two birth cohorts. High maternal BMI at both early and late pregnancy also increased risk of schizophrenia in the offspring. Discrepant findings from one study could be attributable to sample characteristics and other factors. The area needs more research. Future studies should take into account obstetric complications, diabetes, maternal infections and immune responses that might potentially mediate this association. PMID:22188548

'Weather Value at Risk': A uniform approach to describe and compare sectoral income risks from climate change.

PubMed

Prettenthaler, Franz; Köberl, Judith; Bird, David Neil

2016-02-01

We extend the concept of 'Weather Value at Risk' - initially introduced to measure the economic risks resulting from current weather fluctuations - to describe and compare sectoral income risks from climate change. This is illustrated using the examples of wheat cultivation and summer tourism in (parts of) Sardinia. Based on climate scenario data from four different regional climate models we study the change in the risk of weather-related income losses between some reference (1971-2000) and some future (2041-2070) period. Results from both examples suggest an increase in weather-related risks of income losses due to climate change, which is somewhat more pronounced for summer tourism. Nevertheless, income from wheat cultivation is at much higher risk of weather-related losses than income from summer tourism, both under reference and future climatic conditions. A weather-induced loss of at least 5% - compared to the income associated with average reference weather conditions - shows a 40% (80%) probability of occurrence in the case of wheat cultivation, but only a 0.4% (16%) probability of occurrence in the case of summer tourism, given reference (future) climatic conditions. Whereas in the agricultural example increases in the weather-related income risks mainly result from an overall decrease in average wheat yields, the heightened risk in the tourism example stems mostly from a change in the weather-induced variability of tourism incomes. With the extended 'Weather Value at Risk' concept being able to capture both, impacts from changes in the mean and the variability of the climate, it is a powerful tool for presenting and disseminating the results of climate change impact assessments. Due to its flexibility, the concept can be applied to any economic sector and therefore provides a valuable tool for cross-sectoral comparisons of climate change impacts, but also for the assessment of the costs and benefits of adaptation measures. Copyright © 2015 Elsevier B.V. All rights reserved.

Flood projections within the Niger River Basin under future land use and climate change.

PubMed

Aich, Valentin; Liersch, Stefan; Vetter, Tobias; Fournet, Samuel; Andersson, Jafet C M; Calmanti, Sandro; van Weert, Frank H A; Hattermann, Fred F; Paton, Eva N

2016-08-15

This study assesses future flood risk in the Niger River Basin (NRB), for the first time considering the simultaneous effects of both projected climate change and land use changes. For this purpose, an ecohydrological process-based model (SWIM) was set up and validated for past climate and land use dynamics of the entire NRB. Model runs for future flood risks were conducted with an ensemble of 18 climate models, 13 of them dynamically downscaled from the CORDEX Africa project and five statistically downscaled Earth System Models. Two climate and two land use change scenarios were used to cover a broad range of potential developments in the region. Two flood indicators (annual 90th percentile and the 20-year return flood) were used to assess the future flood risk for the Upper, Middle and Lower Niger as well as the Benue. The modeling results generally show increases of flood magnitudes when comparing a scenario period in the near future (2021-2050) with a base period (1976-2005). Land use effects are more uncertain, but trends and relative changes for the different catchments of the NRB seem robust. The dry areas of the Sahelian and Sudanian regions of the basin show a particularly high sensitivity to climatic and land use changes, with an alarming increase of flood magnitudes in parts. A scenario with continuing transformation of natural vegetation into agricultural land and urbanization intensifies the flood risk in all parts of the NRB, while a "regreening" scenario can reduce flood magnitudes to some extent. Yet, land use change effects were smaller when compared to the effects of climate change. In the face of an already existing adaptation deficit to catastrophic flooding in the region, the authors argue for a mix of adaptation and mitigation efforts in order to reduce the flood risk in the NRB. Copyright © 2016 Elsevier B.V. All rights reserved.

DNA methylation of loci within ABCG1 and PHOSPHO1 in blood DNA is associated with future type 2 diabetes risk.

PubMed

Dayeh, Tasnim; Tuomi, Tiinamaija; Almgren, Peter; Perfilyev, Alexander; Jansson, Per-Anders; de Mello, Vanessa D; Pihlajamäki, Jussi; Vaag, Allan; Groop, Leif; Nilsson, Emma; Ling, Charlotte

2016-07-02

Identification of subjects with a high risk of developing type 2 diabetes (T2D) is fundamental for prevention of the disease. Consequently, it is essential to search for new biomarkers that can improve the prediction of T2D. The aim of this study was to examine whether 5 DNA methylation loci in blood DNA (ABCG1, PHOSPHO1, SOCS3, SREBF1, and TXNIP), recently reported to be associated with T2D, might predict future T2D in subjects from the Botnia prospective study. We also tested if these CpG sites exhibit altered DNA methylation in human pancreatic islets, liver, adipose tissue, and skeletal muscle from diabetic vs. non-diabetic subjects. DNA methylation at the ABCG1 locus cg06500161 in blood DNA was associated with an increased risk for future T2D (OR = 1.09, 95% CI = 1.02-1.16, P-value = 0.007, Q-value = 0.018), while DNA methylation at the PHOSPHO1 locus cg02650017 in blood DNA was associated with a decreased risk for future T2D (OR = 0.85, 95% CI = 0.75-0.95, P-value = 0.006, Q-value = 0.018) after adjustment for age, gender, fasting glucose, and family relation. Furthermore, the level of DNA methylation at the ABCG1 locus cg06500161 in blood DNA correlated positively with BMI, HbA1c, fasting insulin, and triglyceride levels, and was increased in adipose tissue and blood from the diabetic twin among monozygotic twin pairs discordant for T2D. DNA methylation at the PHOSPHO1 locus cg02650017 in blood correlated positively with HDL levels, and was decreased in skeletal muscle from diabetic vs. non-diabetic monozygotic twins. DNA methylation of cg18181703 (SOCS3), cg11024682 (SREBF1), and cg19693031 (TXNIP) was not associated with future T2D risk in subjects from the Botnia prospective study.

Changes in future fire regimes under climate change

NASA Astrophysics Data System (ADS)

Thonicke, Kirsten; von Bloh, Werner; Lutz, Julia; Knorr, Wolfgang; Wu, Minchao; Arneth, Almut

2013-04-01

Fires are expected to change under future climate change, climatic fire is is increasing due to increase in droughts and heat waves affecting vegetation productivity and ecosystem function. Vegetation productivity influences fuel production, but can also limit fire spread. Vegetation-fire models allow investigating the interaction between wildfires and vegetation dynamics, thus non-linear effects between changes in fuel composition and production on fire as well as changes in fire regimes on fire-related plant mortality and fuel combustion. Here we present results from simulation experiments, where the vegetation-fire models LPJmL-SPITFIRE and LPJ-GUESS are applied to future climate change scenarios from regional climate models in Europe and Northern Africa. Climate change impacts on fire regimes, vegetation dynamics and carbon fluxes are quantified and presented. New fire-prone regions are mapped and changes in fire regimes of ecosystems with a long-fire history are analyzed. Fuel limitation is likely to increase in Mediterranean-type ecosystems, indicating non-linear connection between increasing fire risk and fuel production. Increased warming in temperate ecosystems in Eastern Europe and continued fuel production leads to increases not only in climatic fire risk, but also area burnt and biomass burnt. This has implications for fire management, where adaptive capacity to this new vulnerability might be limited.

Deep Uncertainty Surrounding Coastal Flood Risk Projections: A Case Study for New Orleans

NASA Astrophysics Data System (ADS)

Wong, Tony E.; Keller, Klaus

2017-10-01

Future sea-level rise drives severe risks for many coastal communities. Strategies to manage these risks hinge on a sound characterization of the uncertainties. For example, recent studies suggest that large fractions of the Antarctic ice sheet (AIS) may rapidly disintegrate in response to rising global temperatures, leading to potentially several meters of sea-level rise during the next few centuries. It is deeply uncertain, for example, whether such an AIS disintegration will be triggered, how much this would increase sea-level rise, whether extreme storm surges intensify in a warming climate, or which emissions pathway future societies will choose. Here, we assess the impacts of these deep uncertainties on projected flooding probabilities for a levee ring in New Orleans, LA. We use 18 scenarios, presenting probabilistic projections within each one, to sample key deeply uncertain future projections of sea-level rise, radiative forcing pathways, storm surge characterization, and contributions from rapid AIS mass loss. The implications of these deep uncertainties for projected flood risk are thus characterized by a set of 18 probability distribution functions. We use a global sensitivity analysis to assess which mechanisms contribute to uncertainty in projected flood risk over the course of a 50-year design life. In line with previous work, we find that the uncertain storm surge drives the most substantial risk, followed by general AIS dynamics, in our simple model for future flood risk for New Orleans.

Environmental and Developmental Risks and Stressors Impacting a 2050 Vision

EPA Science Inventory

A vision of what our water resources and environment may look like in the year 2050 must consider the increasing risks and stressors facing our planet. Recent papers, reports and books are used as the source and basis for identifying the range of future challenges facing the worl...

Comparing CMIP-3 and CMIP-5 climate projections on flooding estimation of Devils Lake of North Dakota, USA

PubMed Central

2018-01-01

Background Water level fluctuations in endorheic lakes are highly susceptible to even slight changes in climate and land use. Devils Lake (DL) in North Dakota, USA is an endorheic system that has undergone multi-decade flooding driven by changes in regional climate. Flooding mitigation strategies have centered on the release of lake water to a nearby river system through artificial outlets, resulting in legal challenges and environmental concerns related to water quality, downstream flooding, species migration, stakeholder opposition, and transboundary water conflicts between the US and Canada. Despite these drawbacks, running outlets would result in low overspill risks in the next 30 years. Methods In this study we evaluated the efficacy of this outlet-based mitigation strategy under scenarios based on the latest IPCC future climate projections. We used the Coupled Model Intercomparison Project CMIP-5 weather patterns from 17 general circulation models (GCMs) obtained under four representative concentration pathways (RCP) scenarios and downscaled to the DL region. Then, we simulated the changes in lake water levels using the soil and water assessment tool based hydrological model of the watershed. We estimated the probability of future flood risks under those scenarios and compared those with previously estimated overspill risks under the CMIP-3 climate. Results The CMIP-5 ensemble projected a mean annual temperature of 5.78 °C and mean daily precipitation of 1.42 mm/day; both are higher than the existing CMIP-3 future estimates of 4.98 °C and 1.40 mm/day, respectively. The increased precipitation and higher temperature resulted in a significant increase of DL’s overspill risks: 24.4–47.1% without release from outlets and 3.5–14.4% even if the outlets are operated at their combined full 17 m3/s capacity. Discussion The modeled increases in overspill risks indicate a greater frequency of water releases through the artificial outlets. Future risk mitigation management should include providing a flood warning signal to local resource managers, and tasking policy makers to identify additional solution measures such as land use management in the upper watershed to mitigate DL’s flooding. PMID:29736343

Comparing CMIP-3 and CMIP-5 climate projections on flooding estimation of Devils Lake of North Dakota, USA.

PubMed

Kharel, Gehendra; Kirilenko, Andrei

2018-01-01

Water level fluctuations in endorheic lakes are highly susceptible to even slight changes in climate and land use. Devils Lake (DL) in North Dakota, USA is an endorheic system that has undergone multi-decade flooding driven by changes in regional climate. Flooding mitigation strategies have centered on the release of lake water to a nearby river system through artificial outlets, resulting in legal challenges and environmental concerns related to water quality, downstream flooding, species migration, stakeholder opposition, and transboundary water conflicts between the US and Canada. Despite these drawbacks, running outlets would result in low overspill risks in the next 30 years. In this study we evaluated the efficacy of this outlet-based mitigation strategy under scenarios based on the latest IPCC future climate projections. We used the Coupled Model Intercomparison Project CMIP-5 weather patterns from 17 general circulation models (GCMs) obtained under four representative concentration pathways (RCP) scenarios and downscaled to the DL region. Then, we simulated the changes in lake water levels using the soil and water assessment tool based hydrological model of the watershed. We estimated the probability of future flood risks under those scenarios and compared those with previously estimated overspill risks under the CMIP-3 climate. The CMIP-5 ensemble projected a mean annual temperature of 5.78 °C and mean daily precipitation of 1.42 mm/day; both are higher than the existing CMIP-3 future estimates of 4.98 °C and 1.40 mm/day, respectively. The increased precipitation and higher temperature resulted in a significant increase of DL's overspill risks: 24.4-47.1% without release from outlets and 3.5-14.4% even if the outlets are operated at their combined full 17 m 3 /s capacity. The modeled increases in overspill risks indicate a greater frequency of water releases through the artificial outlets. Future risk mitigation management should include providing a flood warning signal to local resource managers, and tasking policy makers to identify additional solution measures such as land use management in the upper watershed to mitigate DL's flooding.

Flooding in the future--predicting climate change, risks and responses in urban areas.

PubMed

Ashley, R M; Balmforth, D J; Saul, A J; Blanskby, J D

2005-01-01

Engineering infrastructure is provided at high cost and is expected to have a useful operational life of decades. However, it is clear that the future is uncertain. Traditional approaches to designing and operating urban storm drainage assets have relied on past performance of natural systems and the ability to extrapolate this performance, together with that of the assets across the usable lifetime. Whether or not climate change is going to significantly alter future weather patterns in Europe, it is clear that it is now incumbent on designers and operators of storm drainage systems to prepare for greater uncertainty in the effectiveness of storm drainage systems. A recent U.K. Government study considered the potential effects of climate and socio-economic change in the U.K. in terms of four future scenarios and what the implications are for the performance of existing storm drainage facilities. In this paper the modelling that was undertaken to try to quantify the changes in risk, together with the effectiveness of responses in managing that risk, are described. It shows that flood risks may increase by a factor of almost 30 times and that traditional engineering measures alone are unlikely to be able to provide protection.

Assessing environmental risks for high intensity agriculture using the material flow analysis method--a case study of the Dongting Lake basin in South Central China.

PubMed

Yin, Guanyi; Liu, Liming; Yuan, Chengcheng

2015-07-01

This study primarily examined the assessment of environmental risk in high intensity agricultural areas. Dongting Lake basin was taken as a case study, which is one of the major grain producing areas in China. Using data obtained from 1989 to 2012, we applied Material Flow Analysis (MFA) to show the material consumption, pollutant output and production storage in the agricultural-environmental system and assessed the environmental risk index on the basis of the MFA results. The results predicted that the status of the environmental quality of the Dongting Lake area is unsatisfactory for the foreseeable future. The direct material input (DMI) declined by 13.9%, the domestic processed output (DPO) increased by 28.21%, the intensity of material consumption (IMC) decreased by 36.7%, the intensity of material discharge (IMD) increased by 10%, the material productivity (MP) increased by 27 times, the environmental efficiency (EE) increased by 15.31 times, and the material storage (PAS) increased by 0.23%. The DMI and DPO was higher at rural places on the edge of cities, whereas the risk of urban agriculture has arisen due to the higher increasing rate of DMI and DPO in cities compared with the counties. The composite environmental risk index increased from 0.33 to 0.96, indicating that the total environmental risk changed gradually but seriously during the 24 years assessed. The driving factors that affect environmental risk in high intensity agriculture can be divided into five classes: social, economic, human, natural and disruptive incidents. This study discussed a number of effective measures for protecting the environment while ensuring food production yields. Additional research in other areas and certain improvements of this method in future studies may be necessary to develop a more effective method of managing and controlling agricultural-environmental interactions.

Inspiring Students to Create the Future

ERIC Educational Resources Information Center

Shepard, Cynthia; Vespia, Kristin M.; Fitzpatrick, Colleen

2007-01-01

An exemplary program based at the University of Wisconsin-Green Bay greatly increases the odds that at-risk youngsters will not only graduate from high school, but will go on to higher education. The program is also a model of university/community collaboration. ["Inspiring Students to Create the Future" was written with Timothy U.…

A 6-year longitudinal study of predictors for suicide attempts in major depressive disorder.

PubMed

Eikelenboom, Merijn; Beekman, Aartjan T F; Penninx, Brenda W J H; Smit, Johannes H

2018-06-13

Major depressive disorder (MDD), represent a major source of risk for suicidality. However, knowledge about risk factors for future suicide attempts (SAs) within MDD is limited. The present longitudinal study examined a wide range of putative non-clinical risk factors (demographic, social, lifestyle, personality) and clinical risk factors (depressive and suicidal indicators) for future SAs among persons with MDD. Furthermore, we examined the relationship between a number of significant predictors and the incidence of a future SA. Data are from 1713 persons (18-65 years) with a lifetime MDD at the baseline measurement of the Netherlands Study of Depression and Anxiety who were subsequently followed up 2, 4 and 6 years. SAs were assessed in the face-to-face measurements. Cox proportional hazard regression analyses were used to examine a wide range of possible non-clinical and clinical predictors for subsequent SAs during 6-year follow-up. Over a period of 6 years, 3.4% of the respondents attempted suicide. Younger age, lower education, unemployment, insomnia, antidepressant use, a previous SA and current suicidal thoughts independently predicted a future SA. The number of significant risk factors (ranging from 0 to 7) linearly predicted the incidence of future SAs: in those with 0 predictors the SA incidence was 0%, which increased to 32% incidence in those with 6+ predictors. Of the non-clinical factors, particularly socio-economic factors predicted a SA independently. Furthermore, preexisting suicidal ideation and insomnia appear to be important clinical risk factors for subsequent SA that are open to preventative intervention.

Adolescent Cellphone Use While Driving: An Overview of the Literature and Promising Future Directions for Prevention.

PubMed

Delgado, M Kit; Wanner, Kathryn J; McDonald, Catherine

2016-06-16

Motor vehicle crashes are the leading cause of death in adolescents, and drivers aged 16-19 are the most likely to die in distracted driving crashes. This paper provides an overview of the literature on adolescent cellphone use while driving, focusing on the crash risk, incidence, risk factors for engagement, and the effectiveness of current mitigation strategies. We conclude by discussing promising future approaches to prevent crashes related to cellphone use in adolescents. Handheld manipulation of the phone while driving has been shown to have a 3 to 4-fold increased risk of a near crash or crash, and eye glance duration greater than 2 seconds increases crash risk exponentially. Nearly half of U.S. high school students admit to texting while driving in the last month, but the frequency of use according to vehicle speed and high-risk situations remains unknown. Several risk factors are associated with cell phone use while driving including: parental cellphone use while driving, social norms for quick responses to text messages, and higher levels of temporal discounting. Given the limited effectiveness of current mitigation strategies such as educational campaigns and legal bans, a multi-pronged behavioral and technological approach addressing the above risk factors will be necessary to reduce this dangerous behavior in adolescents.

Escalating heat-stress mortality risk due to global warming in the Middle East and North Africa (MENA).

PubMed

Ahmadalipour, Ali; Moradkhani, Hamid

2018-08-01

Climate change will substantially exacerbate extreme temperature and heatwaves. The impacts will be more intense across the Middle East and North Africa (MENA), a region mostly characterized by hot and arid climate, already intolerable for human beings in many parts. In this study, daily climate data from 17 fine-resolution Regional Climate Models (RCMs) are acquired to calculate wet-bulb temperature and investigate the mortality risk for people aged over 65 years caused by excessive heat stress across the MENA region. Spatially adaptive temperature thresholds are implemented for quantifying the mortality risk, and the analysis is conducted for the historical period of 1951-2005 and two future scenarios of RCP4.5 and RCP8.5 during the 2006-2100 period. Results show that the mortality risk will increase in distant future to 8-20 times higher than that of the historical period if no climate change mitigation is implemented. The coastal regions of the Red sea, Persian Gulf, and Mediterranean Sea indicate substantial increase in mortality risk. Nonetheless, the risk ratio will be limited to 3-7 times if global warming is limited to 2 °C. Climate change planning and adaptation is imperative for mitigating heat-related mortality risk across the region. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adolescent Cellphone Use While Driving: An Overview of the Literature and Promising Future Directions for Prevention

PubMed Central

Delgado, M. Kit; Wanner, Kathryn J.; McDonald, Catherine

2016-01-01

Motor vehicle crashes are the leading cause of death in adolescents, and drivers aged 16–19 are the most likely to die in distracted driving crashes. This paper provides an overview of the literature on adolescent cellphone use while driving, focusing on the crash risk, incidence, risk factors for engagement, and the effectiveness of current mitigation strategies. We conclude by discussing promising future approaches to prevent crashes related to cellphone use in adolescents. Handheld manipulation of the phone while driving has been shown to have a 3 to 4-fold increased risk of a near crash or crash, and eye glance duration greater than 2 seconds increases crash risk exponentially. Nearly half of U.S. high school students admit to texting while driving in the last month, but the frequency of use according to vehicle speed and high-risk situations remains unknown. Several risk factors are associated with cell phone use while driving including: parental cellphone use while driving, social norms for quick responses to text messages, and higher levels of temporal discounting. Given the limited effectiveness of current mitigation strategies such as educational campaigns and legal bans, a multi-pronged behavioral and technological approach addressing the above risk factors will be necessary to reduce this dangerous behavior in adolescents. PMID:27695663

Global projections of drought hazard in a warming climate: a prime for disaster risk management

NASA Astrophysics Data System (ADS)

Carrão, Hugo; Naumann, Gustavo; Barbosa, Paulo

2018-03-01

Projections of drought hazard ( dH) changes have been mapped from five bias-corrected climate models and analyzed at the global level under three representative concentration pathways (RCPs). The motivation for this study is the observation that drought risk is increasing globally and the effective regulation of prevention and adaptation measures depends on dH magnitude and its distribution for the future. Based on the Weighted Anomaly of Standardized Precipitation index, dH changes have been assessed for mid-(2021-2050) and late-century (2071-2099). With a few exceptions, results show a likely increase in global dH between the historical years (1971-2000) and both future time periods under all RCPs. Notwithstanding this worsening trend, it was found that projections of dH changes for most regions are neither robust nor significant in the near-future. By the end of the century, greater increases are projected for RCPs describing stronger radiative forcing. Under RCP8.5, statistically significant dH changes emerge for global Mediterranean ecosystems and the Amazon region, which are identified as possible hotspots for future water security issues. Taken together, projections of dH changes point towards two dilemmas: (1) in the near-term, stake-holders are left worrying about projected increasing dH over large regions, but lack of actionable model agreement to take effective decisions related to local prevention and adaptation initiatives; (2) in the long-term, models demonstrate remarkable agreement, but stake-holders lack actionable knowledge to manage potential impacts far distant from actual human-dominated environments. We conclude that the major challenge for risk management is not to adapt human populations or their activities to dH changes, but to progress on global initiatives that mitigate their impacts in the whole carbon cycle by late-century.

Current and future strategies for the nutritional management of cardiometabolic complications of androgen deprivation therapy for prostate cancer.

PubMed

Turner, Lauren; Poole, Karen; Faithfull, Sara; Griffin, Bruce A

2017-12-01

Androgen deprivation therapy (ADT) is used widely as part of a combined modality for the treatment of prostate cancer. However, ADT has also been associated with the development of cardiometabolic complications that can increase mortality from cardiovascular events. There is emerging evidence to suggest that ADT-related cardiometabolic risk can be mitigated by diet and lifestyle modification. While the clinical focus for a nutritional approach for achieving this effect is unclear, it may depend upon the timely assessment and targeting of dietary changes to the specific risk phenotype of the patient. The present review aims to address the metabolic origins of ADT-related cardiometabolic risk, existing evidence for the effects of dietary intervention in modifying this risk, and the priorities for future dietary strategies.

Study on Market Stability and Price Limit of Chinese Stock Index Futures Market: An Agent-Based Modeling Perspective.

PubMed

Xiong, Xiong; Nan, Ding; Yang, Yang; Yongjie, Zhang

2015-01-01

This paper explores a method of managing the risk of the stock index futures market and the cross-market through analyzing the effectiveness of price limits on the Chinese Stock Index 300 futures market. We adopt a cross-market artificial financial market (include the stock market and the stock index futures market) as a platform on which to simulate the operation of the CSI 300 futures market by changing the settings of price limits. After comparing the market stability under different price limits by appropriate liquidity and volatility indicators, we find that enhancing price limits or removing price limits both play a negative impact on market stability. In contrast, a positive impact exists on market stability if the existing price limit is maintained (increase of limit by10%, down by 10%) or it is broadened to a proper extent. Our study provides reasonable advice for a price limit setting and risk management for CSI 300 futures.

Study on Market Stability and Price Limit of Chinese Stock Index Futures Market: An Agent-Based Modeling Perspective

PubMed Central

2015-01-01

This paper explores a method of managing the risk of the stock index futures market and the cross-market through analyzing the effectiveness of price limits on the Chinese Stock Index 300 futures market. We adopt a cross-market artificial financial market (include the stock market and the stock index futures market) as a platform on which to simulate the operation of the CSI 300 futures market by changing the settings of price limits. After comparing the market stability under different price limits by appropriate liquidity and volatility indicators, we find that enhancing price limits or removing price limits both play a negative impact on market stability. In contrast, a positive impact exists on market stability if the existing price limit is maintained (increase of limit by10%, down by 10%) or it is broadened to a proper extent. Our study provides reasonable advice for a price limit setting and risk management for CSI 300 futures. PMID:26571135

The association between urinary calculi and increased risk of future cardiovascular events: A nationwide population-based study.

PubMed

Hsu, Chien-Yi; Chen, Yung-Tai; Huang, Po-Hsun; Leu, Hsin-Bang; Su, Yu-Wen; Chiang, Chia-Hung; Chen, Jaw-Wen; Chen, Tzeng-Ji; Lin, Shing-Jong; Chan, Wan-Leong

2016-05-01

Although accumulating evidence suggests urinary calculi may be associated with an increased risk of cardiovascular disease (CVD), the number of longitudinal studies linking urolithiasis to CVD events is limited. We investigated the association between urinary calculi and the risk of development of myocardial infarction (MI) and/or stroke in a nationwide, population-based cohort database in Taiwan. Our analyses were conducted using information from a random sample of 1 million people enrolled in the nationally representative Taiwan National Health Insurance Research Database. A total of 81,546 subjects aged 18 years or above, including 40,773 subjects diagnosed with urinary calculi during the study period and a propensity score-matched 40,773 subjects without urinary calculi were enrolled in our study. During a 10-year follow-up period, 501 MI events and 1295 stroke events were identified. By comparison, the urinary calculi group had a higher incidence rate of MI occurrence (11.79 vs 8.94 per 10,000 person-years) and stroke (31.41 vs 22.45 per 10,000 person-years). Cox proportional hazard regression model analysis showed that development of urinary calculi was independently associated with higher risk of developing future MI (HR, 1.31; 95% CI, 1.09-1.56, p=0.003), stroke (HR, 1.39; 95% CI, 1.24-1.55, p<0.001), and total cardiovascular events (HR, 1.38; 95% CI, 1.25-1.51, p<0.001). Urinary calculi were associated with an increased risk of future cardiovascular events in the Asian population, which was consistent with the recent epidemiologic evidence in Western countries. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Cortical superficial siderosis and first-ever cerebral hemorrhage in cerebral amyloid angiopathy

PubMed Central

Boulouis, Gregoire; Xiong, Li; Jessel, Michel J.; Roongpiboonsopit, Duangnapa; Ayres, Alison; Schwab, Kristin M.; Rosand, Jonathan; Gurol, M. Edip; Greenberg, Steven M.; Viswanathan, Anand

2017-01-01

Objective: To investigate whether cortical superficial siderosis (cSS) is associated with increased risk of future first-ever symptomatic lobar intracerebral hemorrhage (ICH) in patients with cerebral amyloid angiopathy (CAA) presenting with neurologic symptoms and without ICH. Methods: Consecutive patients meeting modified Boston criteria for probable CAA in the absence of ICH from a single-center cohort were analyzed. cSS and other small vessel disease MRI markers were assessed according to recent consensus recommendations. Patients were followed prospectively for future incident symptomatic lobar ICH. Prespecified Cox proportional hazard models were used to investigate cSS and first-ever lobar ICH risk adjusting for potential confounders. Results: The cohort included 236 patients with probable CAA without lobar ICH at baseline. cSS prevalence was 34%. During a median follow-up of 3.26 years (interquartile range 1.42–5.50 years), 27 of 236 patients (11.4%) experienced a first-ever symptomatic lobar ICH. cSS was a predictor of time until first ICH (p = 0.0007, log-rank test). The risk of symptomatic ICH at 5 years of follow-up was 19% (95% confidence interval [CI] 11%–32%) for patients with cSS at baseline vs 6% (95% CI 3%–12%) for patients without cSS. In multivariable Cox regression models, cSS presence was the only independent predictor of increased symptomatic ICH risk during follow-up (HR 4.04; 95% CI 1.73–9.44, p = 0.001), after adjusting for age, lobar cerebral microbleeds burden, and white matter hyperintensities. Conclusions: cSS is consistently associated with an increased risk of future lobar ICH in CAA with potentially important clinical implications for patient care decisions such as antithrombotic use. PMID:28356458

Risk, Robustness and Water Resources Planning Under Uncertainty

NASA Astrophysics Data System (ADS)

Borgomeo, Edoardo; Mortazavi-Naeini, Mohammad; Hall, Jim W.; Guillod, Benoit P.

2018-03-01

Risk-based water resources planning is based on the premise that water managers should invest up to the point where the marginal benefit of risk reduction equals the marginal cost of achieving that benefit. However, this cost-benefit approach may not guarantee robustness under uncertain future conditions, for instance under climatic changes. In this paper, we expand risk-based decision analysis to explore possible ways of enhancing robustness in engineered water resources systems under different risk attitudes. Risk is measured as the expected annual cost of water use restrictions, while robustness is interpreted in the decision-theoretic sense as the ability of a water resource system to maintain performance—expressed as a tolerable risk of water use restrictions—under a wide range of possible future conditions. Linking risk attitudes with robustness allows stakeholders to explicitly trade-off incremental increases in robustness with investment costs for a given level of risk. We illustrate the framework through a case study of London's water supply system using state-of-the -art regional climate simulations to inform the estimation of risk and robustness.

Aerobic capacity and future cardiovascular risk in Indian community from a low-income area in Cauca, Colombia.

PubMed

Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique; Ramos-Sepúlveda, Jeison Alexander; Piñeros-Álvarez, Carlos Andrés; Giraldo, Lorena Isabel; Izquierdo, Mikel; García-Hermoso, Antonio; Rodríguez-Rodríguez, Fernando; Cristi-Montero, Carlos

2017-03-07

Several studies indicates that children's aerobic capacity levels are predictors of the future risk of non-communicable diseases. Therefore, the aim of this study was to establish the proportion of subjects whose aerobic capacity is indicative of future cardiovascular risk in Indian-Nasa community from a low-income area in Cauca, Colombia. We performed a cross-sectional analysis of morphological component (height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat percent [BF%]), and the cardiorespiratory component (course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption by indirect VO 2 max) from 576 participants (319 boys and 257 girls) aged 10 to 17.9 years, using the standardized FUPRECOL test battery. We showed that the boys performed better than the girls in cardiorespiratory fitness. The proportion of subjects with an aerobic capacity indicative of future cardiovascular risk was 7.3%. By sex, 3.8% of boys and 11.7% of girls (X 2 p = 0.001) displayed an unhealthy aerobic capacity in this study. The findings of this study that provide the first data on aerobic capacity health for Colombian Nasa Indian children and adolescents aged 10-17.9 years. Although the known loss of aerobic capacity is a serious consequence of the future risk of non-communicable diseases, the deterioration of physical fitness deserves increased attention among indigenous population.

Eccentric Knee Flexor Strength and Risk of Hamstring Injuries in Rugby Union: A Prospective Study.

PubMed

Bourne, Matthew N; Opar, David A; Williams, Morgan D; Shield, Anthony J

2015-11-01

Hamstring strain injuries (HSIs) represent the most common cause of lost playing time in rugby union. Eccentric knee flexor weakness and between-limb imbalance in eccentric knee flexor strength are associated with a heightened risk of HSIs in other sports; however, these variables have not been explored in rugby union. To determine if lower levels of eccentric knee flexor strength or greater between-limb imbalance in this parameter during the Nordic hamstring exercise are risk factors for HSIs in rugby union. Cohort study; Level of evidence, 2. This prospective study was conducted over the 2014 Super Rugby and Queensland Rugby Union seasons. In total, 178 rugby union players (mean age, 22.6 ± 3.8 years; mean height, 185.0 ± 6.8 cm; mean weight, 96.5 ± 13.1 kg) had their eccentric knee flexor strength assessed using a custom-made device during the preseason. Reports of previous hamstring, quadriceps, groin, calf, and anterior cruciate ligament injuries were also obtained. The main outcome measure was the prospective occurrence of HSIs. Twenty players suffered at least 1 HSI during the study period. Players with a history of HSIs had a 4.1-fold (95% CI, 1.9-8.9; P = .001) greater risk of subsequent HSIs than players without such a history. Between-limb imbalance in eccentric knee flexor strength of ≥15% and ≥20% increased the risk of HSIs by 2.4-fold (95% CI, 1.1-5.5; P = .033) and 3.4-fold (95% CI, 1.5-7.6; P = .003), respectively. Lower eccentric knee flexor strength and other prior injuries were not associated with an increased risk of future HSIs. Multivariate logistic regression revealed that the risk of reinjuries was augmented in players with strength imbalances. Previous HSIs and between-limb imbalance in eccentric knee flexor strength were associated with an increased risk of future HSIs in rugby union. These results support the rationale for reducing imbalance, particularly in players who have suffered a prior HSI, to mitigate the risk of future injuries. © 2015 The Author(s).

Projected Risk of Flooding Disaster over China in 21st Century Based on CMIP5 Models

NASA Astrophysics Data System (ADS)

Li, Rouke; Xu, Ying

2016-04-01

Based on the simulations from CMIP5 models, using climate indices which have high correlation with historical disaster data, and in combination with terrain elevation data and the socio-economic data, to project the flooding disaster risk, the vulnerability of flooding hazard affected body and the risk of flooding hazard respectively during the near term(2015-2039), medium term(2045-2069) and long term(2075-2099) under RCP8.5. According to the IPCC AR5 WGII, we used risk evaluation model of disaster: R=E*H*V. R on behalf of disaster risk index. H, E and V express risk, exposure and vulnerability respectively. The results show that the extreme flooding disaster risk will gradually increase during different terms in the future, and regions with high risk level of flooding hazard are might mainly located in southeastern and eastern China. Under the RCP8.5 greenhouse gas emissions scenario, the high risk of flooding disaster in future might mainly appear in eastern part of Sichuan, most of North China, and major of East China. Compared with the baseline period,21st century forward, although the occurrence of floods area changes little, the regional strong risk will increase during the end of the 21st century. Due to the coarse resolution of climate models and the methodology for determining weight coefficients, large uncertainty still exists in the projection of the flooding disaster risk.

Factors related to alcohol and drug consumption in Swedish widows.

PubMed

Grimby, Agneta; Johansson, Asa K

2009-01-01

The use of alcohol and medications among Swedish widows was analyzed in relation to various background variables. In Total, 1053 widows (640 widows younger than 65 years and 413 widows older than 65 years) answered the questionnaire. Many reported increased fatigue and sleeping problems. Around one-third of the widows reported drinking alcohol for relief of grief and inadequate support. Association existed between grief and increased intake of sedatives and sleeping pills, and between grief and drinking for relief of grief, as well as increase in intake of sedatives. In widows older than 65 years, perception of bad health, negative outlook for the future, and insufficient support seemed to increase the risk of more sedatives and sleeping pills. Negative outlook for the future also tended to lead to a heightened risk for increased intake of alcohol. There seems to be remaining health problems a long time after bereavement, and counseling may be needed especially when drugs and alcohol are extensively used.

Recent victimization increases risk for violence in justice-involved persons with mental illness.

PubMed

Sadeh, Naomi; Binder, Renée L; McNiel, Dale E

2014-04-01

A large body of research has examined relationships between distal experiences of victimization and the likelihood of engaging in violence later in life. Less is known about the influence of recent violent victimization on risk for violence perpetration. To our knowledge, this is the first study to examine prospectively whether recent victimization in adulthood increases the risk of future violence. Specifically, the present study assessed the incremental validity of recent violent victimization in the prediction of future violence in a sample of justice-involved adults with serious mental illness. The study examined (a) whether recent experiences of violent victimization (i.e., within 6 months of the baseline assessment) predicted a greater likelihood of perpetrating violence in the next year, and (b) whether inclusion of recent victimization enhanced the predictive validity of a model of violence risk in a sample of justice-involved adults with severe mental illness (N = 167). Hierarchical logistic regression analyses indicated that exposure to recent violent victimization at the baseline assessment predicted a greater likelihood of engaging in violent behavior during the year follow-up period. Additionally, recent exposure to violence at the baseline assessment continued to explain a significant amount of variance in a model of future violence perpetration above the variance accounted for by well-established violence risk factors. Taken together, the findings suggest that recent victimization is important to consider in understanding and evaluating risk of violence by persons with mental disorders who are involved in the criminal justice system. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The Shape of Ecosystem Management to Come: Anticipating Risks and Fostering Resilience

PubMed Central

Seidl, Rupert

2014-01-01

Global change is increasingly challenging the sustainable provisioning of ecosystem services to society. Addressing future uncertainty and risk has therefore become a central problem of ecosystem management. With risk management and resilience-based stewardship, two contrasting approaches have been proposed to address this issue. Whereas one is concentrated on anticipating and mitigating risks, the other is focused on fostering the ability to absorb perturbations and maintain desired properties. While they have hitherto been discussed largely separately in the literature, I here propose a unifying framework of anticipating risks and fostering resilience in ecosystem management. Anticipatory action is advocated when the predictability of risk is high and sufficient knowledge to address it is available. Conversely, in situations in which predictability and knowledge are limited, resilience-based measures are paramount. I conclude that, by adopting a purposeful combination of insights from risk and resilience research, we can make ecosystem services provisioning more robust to future uncertainty and change. PMID:25729079

Assessing surface water flood risk and management strategies under future climate change: Insights from an Agent-Based Model.

PubMed

Jenkins, K; Surminski, S; Hall, J; Crick, F

2017-10-01

Climate change and increasing urbanization are projected to result in an increase in surface water flooding and consequential damages in the future. In this paper, we present insights from a novel Agent Based Model (ABM), applied to a London case study of surface water flood risk, designed to assess the interplay between different adaptation options; how risk reduction could be achieved by homeowners and government; and the role of flood insurance and the new flood insurance pool, Flood Re, in the context of climate change. The analysis highlights that while combined investment in property-level flood protection and sustainable urban drainage systems reduce surface water flood risk, the benefits can be outweighed by continued development in high risk areas and the effects of climate change. In our simulations, Flood Re is beneficial in its function to provide affordable insurance, even under climate change. However, the scheme does face increasing financial pressure due to rising surface water flood damages. If the intended transition to risk-based pricing is to take place then a determined and coordinated strategy will be needed to manage flood risk, which utilises insurance incentives, limits new development, and supports resilience measures. Our modelling approach and findings are highly relevant for the ongoing regulatory and political approval process for Flood Re as well as for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and internationally. Copyright © 2017 Elsevier B.V. All rights reserved.

Erectile dysfunction in the cardiovascular patient.

PubMed

Vlachopoulos, Charalambos; Jackson, Graham; Stefanadis, Christodoulos; Montorsi, Piero

2013-07-01

Erectile dysfunction is common in the patient with cardiovascular disease. It is an important component of the quality of life and it also confers an independent risk for future cardiovascular events. The usual 3-year time period between the onset of erectile dysfunction symptoms and a cardiovascular event offers an opportunity for risk mitigation. Thus, sexual function should be incorporated into cardiovascular disease risk assessment for all men. A comprehensive approach to cardiovascular risk reduction (comprising of both lifestyle changes and pharmacological treatment) improves overall vascular health, including sexual function. Proper sexual counselling improves the quality of life and increases adherence to medication. This review explores the critical connection between erectile dysfunction and cardiovascular disease and evaluates how this relationship may influence clinical practice. Algorithms for the management of patient with erectile dysfunction according to the risk for sexual activity and future cardiovascular events are proposed.

Expected changes in future agro-climatological conditions in Northeast Thailand and their differences between general circulation models

NASA Astrophysics Data System (ADS)

Masaki, Yoshimitsu; Ishigooka, Yasushi; Kuwagata, Tsuneo; Goto, Shinkichi; Sawano, Shinji; Hasegawa, Toshihiro

2011-12-01

We have studied future changes in the atmospheric and hydrological environments in Northeast Thailand from the viewpoint of risk assessment of future cultural environments in crop fields. To obtain robust and reliable estimation for future climate, ten general circulation models under three warming scenarios, B1, A1B, and A2, were used in this study. The obtained change trends show that daily maximum air temperature and precipitation will increase by 2.6°C and 4.0%, respectively, whereas soil moisture will decrease by c.a. 1% point in volumetric water content at the end of this century under the A1B scenario. Seasonal contrasts in precipitation will intensify: precipitation increases in the rainy season and precipitation decreases in the dry season. Soil moisture will slightly decrease almost throughout the year. Despite a homogeneous increase in the air temperature over Northeast Thailand, a future decrease in soil water content will show a geographically inhomogeneous distribution: Soil will experience a relative larger decrease in wetness at a shallow depth on the Khorat plateau than in the surrounding mountainous area, reflecting vegetation cover and soil texture. The predicted increase in air temperature is relatively consistent between general circulation models. In contrast, relatively large intermodel differences in precipitation, especially in long-term trends, produce unwanted bias errors in the estimation of other hydrological elements, such as soil moisture and evaporation, and cause uncertainties in projection of the agro-climatological environment. Offline hydrological simulation with a wide precipitation range is one strategy to compensate for such uncertainties and to obtain reliable risk assessment of future cultural conditions in rainfed paddy fields in Northeast Thailand.

Climate change will increase the naturalization risk from garden plants in Europe.

PubMed

Dullinger, Iwona; Wessely, Johannes; Bossdorf, Oliver; Dawson, Wayne; Essl, Franz; Gattringer, Andreas; Klonner, Günther; Kreft, Holger; Kuttner, Michael; Moser, Dietmar; Pergl, Jan; Pyšek, Petr; Thuiller, Wilfried; van Kleunen, Mark; Weigelt, Patrick; Winter, Marten; Dullinger, Stefan; Beaumont, Linda

2017-01-01

Plant invasions often follow initial introduction with a considerable delay. The current non-native flora of a region may hence contain species that are not yet naturalized but may become so in the future, especially if climate change lifts limitations on species spread. In Europe, non-native garden plants represent a huge pool of potential future invaders. Here, we evaluate the naturalization risk from this species pool and how it may change under a warmer climate. Europe. We selected all species naturalized anywhere in the world but not yet in Europe from the set of non-native European garden plants. For this subset of 783 species, we used species distribution models to assess their potential European ranges under different scenarios of climate change. Moreover, we defined geographical hotspots of naturalization risk from those species by combining projections of climatic suitability with maps of the area available for ornamental plant cultivation. Under current climate, 165 species would already find suitable conditions in > 5% of Europe. Although climate change substantially increases the potential range of many species, there are also some that are predicted to lose climatically suitable area under a changing climate, particularly species native to boreal and Mediterranean biomes. Overall, hotspots of naturalization risk defined by climatic suitability alone, or by a combination of climatic suitability and appropriate land cover, are projected to increase by up to 102% or 64%, respectively. Our results suggest that the risk of naturalization of European garden plants will increase with warming climate, and thus it is very likely that the risk of negative impacts from invasion by these plants will also grow. It is therefore crucial to increase awareness of the possibility of biological invasions among horticulturalists, particularly in the face of a warming climate.

Factors that determine parents' perception of their child's risk of life-threatening food-induced anaphylaxis.

PubMed

Ogg, Jennifer; Wong, Jayne; Wan, Ming Wai; Davis, Naomi; Arkwright, Peter D

2017-01-01

Although food allergy is known to be associated with increased disease burden, factors that shape parents' perception of their child's risk of future severe or fatal anaphylaxis are poorly understood. This study aimed to evaluate factors associated with parents' perceived risk of food-induced anaphylaxis. A questionnaire-based survey of 202 parents was conducted in a single specialist center outpatient clinic that treats children with food allergies. Parents' perceived risk of their child experiencing further food-induced anaphylaxis was assessed by using a validated food allergy independent measure. Demographic data as well as parents' anxiety and depression scores were assessed by using the Hospital Anxiety and Depression score. Nineteen percent of parents believed that their child had a moderate-to-high chance of dying from food-induced anaphylaxis. A lack of a university education, higher anxiety score, and, particularly, possession of an epinephrine autoinjector (relative risk 9.9 [95% confidence interval, 3.3-30]) were key factors associated with heightened risk perception. Caring for a child with multiple food allergies was the main factor associated with parents feeling less able to manage future reactions (relative risk 9.5 [95% confidence interval, 1.7-53]). Parents' risk perception of fatal anaphylaxis correlated with anxiety and mood scores. Parents' education, affect, and possession of an epinephrine autoinjector were associated with a heightened perceived risk of future anaphylaxis. Clinicians should consider not only the child's needs but should also provide counseling for parents, particularly those who possess autoinjectors. Parents of children with multiple food allergies may need additional education and training to help them cope with future reactions.

Dietary Sodium Consumption Predicts Future Blood Pressure and Incident Hypertension in the Japanese Normotensive General Population

PubMed Central

Takase, Hiroyuki; Sugiura, Tomonori; Kimura, Genjiro; Ohte, Nobuyuki; Dohi, Yasuaki

2015-01-01

Background Although there is a close relationship between dietary sodium and hypertension, the concept that persons with relatively high dietary sodium are at increased risk of developing hypertension compared with those with relatively low dietary sodium has not been studied intensively in a cohort. Methods and Results We conducted an observational study to investigate whether dietary sodium intake predicts future blood pressure and the onset of hypertension in the general population. Individual sodium intake was estimated by calculating 24-hour urinary sodium excretion from spot urine in 4523 normotensive participants who visited our hospital for a health checkup. After a baseline examination, they were followed for a median of 1143 days, with the end point being development of hypertension. During the follow-up period, hypertension developed in 1027 participants (22.7%). The risk of developing hypertension was higher in those with higher rather than lower sodium intake (hazard ratio 1.25, 95% CI 1.04 to 1.50). In multivariate Cox proportional hazards regression analysis, baseline sodium intake and the yearly change in sodium intake during the follow-up period (as continuous variables) correlated with the incidence of hypertension. Furthermore, both the yearly increase in sodium intake and baseline sodium intake showed significant correlations with the yearly increase in systolic blood pressure in multivariate regression analysis after adjustment for possible risk factors. Conclusions Both relatively high levels of dietary sodium intake and gradual increases in dietary sodium are associated with future increases in blood pressure and the incidence of hypertension in the Japanese general population. PMID:26224048

Costs and benefits of adapting to river floods at the global scale

NASA Astrophysics Data System (ADS)

Ward, Philip; Aerts, Jeroen; Botzen, Wouter; Hallegatte, Stephane; Jongman, Brenden; Kind, Jarl; Scussolini, Paolo; Winsemius, Hessel

2015-04-01

It is well known that the economic losses associated with flooding are huge; for example in 2012 alone the economic losses from flooding exceeded 19 billion. As a result, different models have been developed to assess global scale flood risk. Recently, these have been used in several studies to assess current flood risk at the global scale, and to project how risk may increase as a result of climate change and/or socioeconomic development. In most regions, these studies show rapid increases in risk into the future, and therefore call for urgent adaptation. However, to date no studies have attempted to assess the costs of carrying out such adaptation, nor the benefits. In this paper, we therefore present the first global scale estimate of the costs and benefits of adapting to increased river flood risk caused by factors such as climate change and socioeconomic development. For this study, we concentrate on structural adaptation measures, such as dikes, designed to prevent flood hazard up to a certain design standard. We address two questions: 1. What would be the costs and benefits of maintaining current flood protection standards, accounting for future climate and socioeconomic change until 2100? 2. What flood protection standards would be required by 2100 to keep future flood risk constant at today's levels? And what would be the costs and benefits associated with this? In this paper, we will present our first global estimates of the costs and benefits of adaptation to increased flood risk, as well as maps of these findings per country and river basin. We present the results under 4 emission scenarios (RCPs), 5 socioeconomic scenarios (SSPs), and under several assumptions relating to total potential flood damages, discount rates, construction costs, maintenance costs, and so forth. The research was carried out using the GLOFRIS modelling cascade. This global flood risk model calculates flood risk in terms of annual expected damage, and has been developed and validated over the past few years. For this study we have extended GLOFRIS by developing a module that calculates the costs and benefits of adaptation by increasing dike flood protection standards. In brief, this is carried out by calculating, per cell, the length of dikes that would be required to provide flood protection, multiplying this with the change in dike height that would be required to offer a certain flood protection standard, and multiplying this with data on the costs of dike construction and maintenance.

Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate.

PubMed

Chai, Shauna-Lee; Zhang, Jian; Nixon, Amy; Nielsen, Scott

2016-01-01

Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta's biodiversity are giant knotweed (Fallopia sachalinensis), tamarisk (Tamarix chinensis), and alkali swainsonpea (Sphaerophysa salsula). We characterise giant knotweed as 'extremely invasive', with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is 'extremely invasive' with a 64% increase in suitable habitat, and alkali swainsonpea is 'highly invasive' with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change.

Using Risk Assessment and Habitat Suitability Models to Prioritise Invasive Species for Management in a Changing Climate

PubMed Central

Chai, Shauna-Lee; Zhang, Jian; Nixon, Amy; Nielsen, Scott

2016-01-01

Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta’s biodiversity are giant knotweed (Fallopia sachalinensis), tamarisk (Tamarix chinensis), and alkali swainsonpea (Sphaerophysa salsula). We characterise giant knotweed as ‘extremely invasive’, with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is ‘extremely invasive’ with a 64% increase in suitable habitat, and alkali swainsonpea is ‘highly invasive’ with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change. PMID:27768758

The Impact of Collective Efficacy on Risks for Adolescents' Perpetration of Dating Violence

ERIC Educational Resources Information Center

Schnurr, Melissa P.; Lohman, Brenda J.

2013-01-01

Given prevalence rates and negative consequences that adolescents' perpetration of dating violence may have on an individual's well-being and future relationships, it is imperative to explore factors that may increase or reduce its occurrence. Thus, we aimed to identify how multiple contextual risk factors (individual, family, schools, and…

Future heat-waves, droughts and floods in 571 European cities

NASA Astrophysics Data System (ADS)

Guerreiro, Selma B.; Dawson, Richard J.; Kilsby, Chris; Lewis, Elizabeth; Ford, Alistair

2018-03-01

Cities are particularly vulnerable to climate risks due to their agglomeration of people, buildings and infrastructure. Differences in methodology, hazards considered, and climate models used limit the utility and comparability of climate studies on individual cities. Here we assess, for the first time, future changes in flood, heat-waves (HW), and drought impacts for all 571 European cities in the Urban Audit database using a consistent approach. To capture the full range of uncertainties in natural variability and climate models, we use all climate model runs from the Coupled Model Inter-comparison Project Phase 5 (CMIP5) for the RCP8.5 emissions scenario to calculate Low, Medium and High Impact scenarios, which correspond to the 10th, 50th and 90th percentiles of each hazard for each city. We find that HW days increase across all cities, but especially in southern Europe, whilst the greatest HW temperature increases are expected in central European cities. For the low impact scenario, drought conditions intensify in southern European cities while river flooding worsens in northern European cities. However, the high impact scenario projects that most European cities will see increases in both drought and river flood risks. Over 100 cities are particularly vulnerable to two or more climate impacts. Moreover, the magnitude of impacts exceeds those previously reported highlighting the substantial challenge cities face to manage future climate risks.

Changes in Cross-Correlations as an Indicator for Systemic Risk

NASA Astrophysics Data System (ADS)

Zheng, Zeyu; Podobnik, Boris; Feng, Ling; Li, Baowen

2012-11-01

The 2008-2012 global financial crisis began with the global recession in December 2007 and exacerbated in September 2008, during which the U.S. stock markets lost 20% of value from its October 11 2007 peak. Various studies reported that financial crisis are associated with increase in both cross-correlations among stocks and stock indices and the level of systemic risk. In this paper, we study 10 different Dow Jones economic sector indexes, and applying principle component analysis (PCA) we demonstrate that the rate of increase in principle components with short 12-month time windows can be effectively used as an indicator of systemic risk--the larger the change of PC1, the higher the increase of systemic risk. Clearly, the higher the level of systemic risk, the more likely a financial crisis would occur in the near future.

Obesity in pregnancy: risks and management

PubMed Central

Fitzsimons, Kate J; Modder, Jo; Greer, Ian A

2009-01-01

Maternal obesity is now considered one of the most commonly occurring risk factors seen in obstetric practice. Compared with women with a healthy pre-pregnancy weight, women with obesity are at increased risk of miscarriage, gestational diabetes, preeclampsia, venous thromboembolism, induced labour, caesarean section, anaesthetic complications and wound infections, and they are less likely to initiate or maintain breastfeeding. Babies of obese mothers are at increased risk of stillbirth, congenital anomalies, prematurity, macrosomia and neonatal death. Intrauterine exposure to obesity is also associated with an increased risk of developing obesity and metabolic disorders in childhood. This article reviews the prevalence of obesity in pregnancy and the associated maternal and fetal complications. Recommendations and suggestions for pre-conception, antenatal and postnatal care of women with obesity are presented, and current research in the UK and future research priorities are considered. PMID:27582812

Risk Management of GM Crops

EPA Science Inventory

Driven by biofuel demand, a significant increase in GM corn acreage is anticipated for the 2007 growing season with future planted GM corn acreage approaching 80% of the corn crop by 2009. As demand increases, grower non-compliance with mandated planting requirements is likely to...

New methods in hydrologic modeling and decision support for culvert flood risk under climate change

NASA Astrophysics Data System (ADS)

Rosner, A.; Letcher, B. H.; Vogel, R. M.; Rees, P. S.

2015-12-01

Assessing culvert flood vulnerability under climate change poses an unusual combination of challenges. We seek a robust method of planning for an uncertain future, and therefore must consider a wide range of plausible future conditions. Culverts in our case study area, northwestern Massachusetts, USA, are predominantly found in small, ungaged basins. The need to predict flows both at numerous sites and under numerous plausible climate conditions requires a statistical model with low data and computational requirements. We present a statistical streamflow model that is driven by precipitation and temperature, allowing us to predict flows without reliance on reference gages of observed flows. The hydrological analysis is used to determine each culvert's risk of failure under current conditions. We also explore the hydrological response to a range of plausible future climate conditions. These results are used to determine the tolerance of each culvert to future increases in precipitation. In a decision support context, current flood risk as well as tolerance to potential climate changes are used to provide a robust assessment and prioritization for culvert replacements.

Quantifying the effect of autonomous adaptation to global river flood projections: application to future flood risk assessments

NASA Astrophysics Data System (ADS)

Kinoshita, Youhei; Tanoue, Masahiro; Watanabe, Satoshi; Hirabayashi, Yukiko

2018-01-01

This study represents the first attempt to quantify the effects of autonomous adaptation on the projection of global flood hazards and to assess future flood risk by including this effect. A vulnerability scenario, which varies according to the autonomous adaptation effect for conventional disaster mitigation efforts, was developed based on historical vulnerability values derived from flood damage records and a river inundation simulation. Coupled with general circulation model outputs and future socioeconomic scenarios, potential future flood fatalities and economic loss were estimated. By including the effect of autonomous adaptation, our multimodel ensemble estimates projected a 2.0% decrease in potential flood fatalities and an 821% increase in potential economic losses by 2100 under the highest emission scenario together with a large population increase. Vulnerability changes reduced potential flood consequences by 64%-72% in terms of potential fatalities and 28%-42% in terms of potential economic losses by 2100. Although socioeconomic changes made the greatest contribution to the potential increased consequences of future floods, about a half of the increase of potential economic losses was mitigated by autonomous adaptation. There is a clear and positive relationship between the global temperature increase from the pre-industrial level and the estimated mean potential flood economic loss, while there is a negative relationship with potential fatalities due to the autonomous adaptation effect. A bootstrapping analysis suggests a significant increase in potential flood fatalities (+5.7%) without any adaptation if the temperature increases by 1.5 °C-2.0 °C, whereas the increase in potential economic loss (+0.9%) was not significant. Our method enables the effects of autonomous adaptation and additional adaptation efforts on climate-induced hazards to be distinguished, which would be essential for the accurate estimation of the cost of adaptation to climate change.

Effectiveness of fuel treatments for mitigating wildfire risk and sequestering forest carbon: a case study in the Lake Tahoe Basin

Treesearch

Louise Loudermilk; Alison Stanton; Robert M. Scheller; Thomas E. Dilts; Peter J. Weisberg; Carl Skinner; Jian Yang

2014-01-01

Fuel-reduction treatments are used extensively to reduce wildfire risk and restore forest diversity and function. In the near future, increasing regulation of carbon (C) emissions may force forest managers to balance the use of fuel treatments for reducing wildfire risk against an alternative goal of C sequestration. The objective of this study was to evaluate how long...

Smoking and increased Alzheimer’s disease risk: A review of potential mechanisms

PubMed Central

Durazzo, Timothy C.; Mattsson, Niklas; Weiner, Michael W.

2014-01-01

Background Cigarette smoking has been linked with both increased and decreased risk for Alzheimer’s disease (AD). This is relevant for the US military because the prevalence of smoking in the military is approximately 11% higher than in civilians. Methods Systematic review of published studies on the association between smoking and increased risk for AD, and preclinical and human literature on the relationships between smoking, nicotine exposure and AD-related neuropathology. Original data from comparisons of smoking and never-smoking cognitively normal elders on in vivo amyloid imaging are also presented. Results Overall, the literature indicates that former/active smoking is related to a significantly increased risk for AD. Cigarette smoke/smoking is associated with AD neuropathology in preclinical models and humans. Smoking-related cerebral oxidative stress is a potential mechanism promoting AD pathophysiology and increased risk for AD. Conclusions A reduction in the incidence of smoking will likely reduce the future prevalence of AD. PMID:24924665

Estimated effects of projected climate change on the basic reproductive number of the Lyme disease vector Ixodes scapularis.

PubMed

Ogden, Nicholas H; Radojevic, Milka; Wu, Xiaotian; Duvvuri, Venkata R; Leighton, Patrick A; Wu, Jianhong

2014-06-01

The extent to which climate change may affect human health by increasing risk from vector-borne diseases has been under considerable debate. We quantified potential effects of future climate change on the basic reproduction number (R0) of the tick vector of Lyme disease, Ixodes scapularis, and explored their importance for Lyme disease risk, and for vector-borne diseases in general. We applied observed temperature data for North America and projected temperatures using regional climate models to drive an I. scapularis population model to hindcast recent, and project future, effects of climate warming on R0. Modeled R0 increases were compared with R0 ranges for pathogens and parasites associated with variations in key ecological and epidemiological factors (obtained by literature review) to assess their epidemiological importance. R0 for I. scapularis in North America increased during the years 1971-2010 in spatio-temporal patterns consistent with observations. Increased temperatures due to projected climate change increased R0 by factors (2-5 times in Canada and 1.5-2 times in the United States), comparable to observed ranges of R0 for pathogens and parasites due to variations in strains, geographic locations, epidemics, host and vector densities, and control efforts. Climate warming may have co-driven the emergence of Lyme disease in northeastern North America, and in the future may drive substantial disease spread into new geographic regions and increase tick-borne disease risk where climate is currently suitable. Our findings highlight the potential for climate change to have profound effects on vectors and vector-borne diseases, and the need to refocus efforts to understand these effects.

Transit time distributions to assess present and future contamination risk of karst aquifers over Europe and the Mediterranean

NASA Astrophysics Data System (ADS)

Hartmann, Andreas; Gleeson, Tom; Wada, Yoshihide; Wagener, Thorsten

2016-04-01

Karst develops through the dissolution of carbonate rock. Karst groundwater in Europe is a major source of fresh water contributing up to half of the total drinking water supply in some countries. Climate model projections suggest that in the next 100 years, karst regions will experience a strong increase in temperature and a serious decrease of precipitation - especially in the Mediterranean region. Previous work showed that the karstic preferential recharge processes result in enhanced recharge rates and future climate sensitivity. But as there is fast water flow form the surface to the aquifer, there is also an enhanced risk of groundwater contamination. In this study we will assess the contamination risk of karst aquifers over Europe and the Mediterranean using simulated transit time distributions. Using a new type of semi-distributed model that considers the spatial heterogeneity of the karst system by distribution functions we simulated a range of spatially variable pathways of karstic groundwater recharge. The model is driven by the bias-corrected 5 GCMs of the ISI-MIP project (RCP8.5). Transit time distributions are calculated by virtual tracer experiments. These are repeated several times in the present (1991-2010) and the future (2080-2099). We can show that regions with larger fractions of preferential recharge show higher risks of contamination and that spatial patterns of contamination risk change towards the future.

Current and Future Challenges to Resourcing U.S. Navy Public Shipyards

DTIC Science & Technology

carriers. For this reason, the public shipyards are required to maintain core capabilities that the private sector does not maintain. In addition, they are ...has been on the rise. Direct man-days of work assigned to and executed by the shipyards have increased during that time and are planned to continue to...role in future workforce management as the initiatives are broadened. Planned increases in civilian staffing levels are necessary but not sufficient to mitigate near-term execution risk at the shipyards.

New lakes in deglaciating high-mountain areas: Regional intercomparison of current and future risks from impact waves due to rock/ice avalanches in the Swiss Alps

NASA Astrophysics Data System (ADS)

Schaub, Y.; Huggel, C.; Serraino, M.; Haeberli, W.

2012-04-01

The changes in high-mountain environments are increasingly fast and complex. GIS-based models of the Swiss Alps show that numerous topographic overdeepenings are likely to appear on progressively exposed glacier beds, which are considered as potential sites of future lake formation. In many cases these newly forming lakes will be situated in an over-steepened and destabilized high-mountain environment and are, therefore, prone to impact waves from landslides. The risk of glacier lake outburst floods, endangering infrastructure, residential areas and persons further downvalley, is increasing with further lake formation and glacier recession. This risk may persist for many decades if not centuries. Future-oriented hazard assessments have to be integrative and must deal with all possible process chains. Reference studies and methodologies are still scarce, however. We present an approach to compare risks resulting from high-mountain lakes in the Swiss Alps amongst each other. Already existing lakes are thereby as much included in the analysis as future ones. The presented risk assessment approach integrates the envisaged high-mountain hazard process chain with present and future socio-economic conditions. Applying the concept of integral risk management, the hazard and damage potentials have to be analyzed. The areas that feature the topographic potential for rock/iceavalanches to reach a lake were analyzed regarding their susceptibility to slope failure including the factors slope inclination, permafrost occurrence, glacier recession and bedrock lithology. Together with the analysis of the lakes (volume and runout path of potential outburst floods), the hazard analysis of the process chain was completed. As an example, high long-term hazard potentials in the Swiss Alps have, for instance, to be expected in the area of the Great Aletsch glacier. A methodology for the assessment of the damage potential was elaborated and will be presented. In order to estimate the location of the largest damage potentials, driving forces of different spatial development scenarios for the Swiss Alps will be implemented in a land allocation model for the Swiss Alps. By bringing together hazard, exposure and vulnerability analyses, a risk assessment for the entire Swiss Alps regarding lake-outburst floods triggered by impacts of rock/ice avalanches can be conducted for today, the middle of the century and even beyond.

The past, present, and future of cancer incidence in the United States: 1975 through 2020.

PubMed

Weir, Hannah K; Thompson, Trevor D; Soman, Ashwini; Møller, Bjørn; Leadbetter, Steven

2015-06-01

The overall age-standardized cancer incidence rate continues to decline whereas the number of cases diagnosed each year increases. Predicting cancer incidence can help to anticipate future resource needs, evaluate primary prevention strategies, and inform research. Surveillance, Epidemiology, and End Results data were used to estimate the number of cancers (all sites) resulting from changes in population risk, age, and size. The authors projected to 2020 nationwide age-standardized incidence rates and cases (including the top 23 cancers). Since 1975, incident cases increased among white individuals, primarily caused by an aging white population, and among black individuals, primarily caused by an increasing black population. Between 2010 and 2020, it is expected that overall incidence rates (proxy for risk) will decrease slightly among black men and stabilize in other groups. By 2020, the authors predict annual cancer cases (all races, all sites) to increase among men by 24.1% (-3.2% risk and 27.3% age/growth) to >1 million cases, and by 20.6% among women (1.2% risk and 19.4% age/growth) to >900,000 cases. The largest increases are expected for melanoma (white individuals); cancers of the prostate, kidney, liver, and urinary bladder in males; and the lung, breast, uterus, and thyroid in females. Overall, the authors predict cancer incidence rates/risk to stabilize for the majority of the population; however, they expect the number of cancer cases to increase by >20%. A greater emphasis on primary prevention and early detection is needed to counter the effect of an aging and growing population on the burden of cancer. © 2015 American Cancer Society.

The Past, Present, and Future of Cancer Incidence in the United States: 1975 Through 2020

PubMed Central

Weir, Hannah K.; Thompson, Trevor D.; Soman, Ashwini; Møller, Bjørn; Leadbetter, Steven

2015-01-01

BACKGROUND The overall age-standardized cancer incidence rate continues to decline whereas the number of cases diagnosed each year increases. Predicting cancer incidence can help to anticipate future resource needs, evaluate primary prevention strategies, and inform research. METHODS Surveillance, Epidemiology, and End Results data were used to estimate the number of cancers (all sites) resulting from changes in population risk, age, and size. The authors projected to 2020 nationwide age-standardized incidence rates and cases (including the top 23 cancers). RESULTS Since 1975, incident cases increased among white individuals, primarily caused by an aging white population, and among black individuals, primarily caused by an increasing black population. Between 2010 and 2020, it is expected that overall incidence rates (proxy for risk) will decrease slightly among black men and stabilize in other groups. By 2020, the authors predict annual cancer cases (all races, all sites) to increase among men by 24.1% (−3.2% risk and 27.3% age/growth) to >1 million cases, and by 20.6% among women (1.2% risk and 19.4% age/growth) to >900,000 cases. The largest increases are expected for melanoma (white individuals); cancers of the prostate, kidney, liver, and urinary bladder in males; and the lung, breast, uterus, and thyroid in females. CONCLUSIONS Overall, the authors predict cancer incidence rates/risk to stabilize for the majority of the population; however, they expect the number of cancer cases to increase by >20%. A greater emphasis on primary prevention and early detection is needed to counter the effect of an aging and growing population on the burden of cancer. PMID:25649671

[Symposium The future of informal care].

PubMed

Broese van Groenou, Marjolein; de Boer, Alice; Putters, Kim; Henkens, Kène; Nies, Henk; Dykstra, Pearl A; van Solinge, Hanna; van Campen, Cretien; Kooiker, Sjoerd

2017-04-01

Due to the reform of long term care in 2015, there is growing concern about whether groups at risk receive the care they need. People in need of care have to rely more on help from their social network. The increased need for informal care requires resilience and organizational skills of families, but also of volunteers, professionals and employers. What does this mean for the provision of informal care in the next decennia? The symposium 'The future of informal care', organized on January 26 2017 by the National Institute for Social Research and the Institute for Societal Resilience of the Vrije Universiteit, addressed possible answers to this question. In her inaugural speech Alice de Boer discussed social inequality as possible determinant and outcome of informal care. Some conclusions:Until 2050 the absolute number of 75-plus doubled to about 3 million persons, but the number of informal caregivers will decrease. In addition to the importance of social and economic resources (the 'have & have-nots'), the ability to arrange care (the 'can & can-nots') gains importance.Almost half of the older employers provides informal care just before retirement. Flexibility in working hours and work location facilitates combining work and care, but about half of the employers indicates that partial retirement and working at home are no options.Informal caregivers and professionals often provide care from comparable perspectives and identities. Addressing similarities rather than differences improves their chances for collaboration.The number of adult children providing household care to older parents increased between 2002 and 2014. This suggests an increase in family solidarity, but current reform policies may increase the gender inequality in caregiving families.Spouses and children remain primary caregivers in the future, preferably supported by many different types of caregivers. Not everybody has the capabilities to organize and direct such a large care network.Providing informal care increases the risk for overburden and absence at work or education. Informal caregivers at risk remain, also in the future, women, spouses, migrants, and younger carers.

Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE

PubMed Central

Atella, Vincenzo; Brunetti, Marianna; Maestas, Nicole

2013-01-01

Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households’ probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors. PMID:23885134

Latest Developments and Future Perspectives in the Field Of Obesity.

PubMed

Pérez-Pevida, Belén; Miras, Alexander D

2017-04-01

The prevalence of obesity is increasing exponentially worldwide, becoming an international public health issue that affects quality of life, increases the risk of illness and raises healthcare costs in countries in all parts of the world. In this editorial, we analyse the latest progress in the management of obesity and associated cardiovascular risk factors, and summarise the latest randomised controlled trials that have had the biggest influence on the current changes we are experiencing in obesity management.

Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis.

PubMed

Llewellyn, A; Simmonds, M; Owen, C G; Woolacott, N

2016-01-01

Obese children are at higher risk of being obese as adults, and adult obesity is associated with an increased risk of morbidity. This systematic review and meta-analysis investigates the ability of childhood body mass index (BMI) to predict obesity-related morbidities in adulthood. Thirty-seven studies were included. High childhood BMI was associated with an increased incidence of adult diabetes (OR 1.70; 95% CI 1.30-2.22), coronary heart disease (CHD) (OR 1.20; 95% CI 1.10-1.31) and a range of cancers, but not stroke or breast cancer. The accuracy of childhood BMI when predicting any adult morbidity was low. Only 31% of future diabetes and 22% of future hypertension and CHD occurred in children aged 12 or over classified as being overweight or obese. Only 20% of all adult cancers occurred in children classified as being overweight or obese. Childhood obesity is associated with moderately increased risks of adult obesity-related morbidity, but the increase in risk is not large enough for childhood BMI to be a good predictor of the incidence of adult morbidities. This is because the majority of adult obesity-related morbidity occurs in adults who were of healthy weight in childhood. Therefore, targeting obesity reduction solely at obese or overweight children may not substantially reduce the overall burden of obesity-related disease in adulthood. © 2015 World Obesity.

Impacts of climate change on heat-related mortality risk across the Middle East and North Africa (MENA)

NASA Astrophysics Data System (ADS)

Moradkhani, H.; Ahmadalipour, A.

2017-12-01

It has been reported that even if the global mean temperature increase is limited to 2°C, warming over land will be far beyond that in many regions. Global climate change will increase the frequency and intensity of heatwaves and extreme high temperatures, which will in turn have severe impacts on human life. In this study, the mortality risk caused by excessive heat stress is investigated. Daily maximum air temperature and relative humidity are acquired from 17 CMIP5 Regional Climate Models (RCMs) developed by CORDEX at 0.44 degree spatial resolution. Then, the daily wet-bulb temperature is calculated and a recently developed health risk model is implemented to quantify the mortality risk. The study is applied over the latitudes 6.6°S-42°N and longitudes 20°W-60°E covering parts of 70 countries and accommodating over 600 million inhabitants. The analysis is performed for the historical period of 1951-2005 as well as two future scenarios of RCP4.5 (moderate) and RCP8.5 (business as usual) during 2006-2100. Results indicate about 5 to 30 times higher mortality risk in distant future compared to the historical period. The most aggravation of mortality risk over land is found at the southwestern regions of MENA, due to substantial increase in frequency and intensity of extreme temperatures. Mortality risk is found to be much higher over open waters and coastal regions due to abundant humidity, especially in the coastal regions of the Red sea and Persian Gulf.

Predictors of Suicide Ideation in a Random Digit Dial Study: Exposure to Suicide Matters.

PubMed

van de Venne, Judy; Cerel, Julie; Moore, Melinda; Maple, Myfanwy

2017-07-03

Suicide is an important public health concern requiring ongoing research to understand risk factors for suicide ideation. A dual-frame, random digit dial survey was utilized to identify demographic and suicide-related factors associated with suicide ideation in a statewide sample of 1,736 adults. The PH-Q 9 Depression scale suicide ideation question was used to assess current suicide ideation in both the full sample and suicide exposed sub-sample. Being non-married and having previous suicide exposure were separately associated with higher risks of suicide ideation in the full sample. Being male, having increased suicide exposures, and having increased perceptions of closeness to the decedent increased risks, while older age decreased risks for the suicide exposed. Implications for future screening and research are discussed.

Increased Wildfire Risk Driven by Climate and Development Interactions in the Bolivian Chiquitania, Southern Amazonia.

PubMed

Devisscher, Tahia; Anderson, Liana O; Aragão, Luiz E O C; Galván, Luis; Malhi, Yadvinder

2016-01-01

Wildfires are becoming increasingly dominant in tropical landscapes due to reinforcing feedbacks between land cover change and more severe dry conditions. This study focused on the Bolivian Chiquitania, a region located at the southern edge of Amazonia. The extensive, unique and well-conserved tropical dry forest in this region is susceptible to wildfires due to a marked seasonality. We used a novel approach to assess fire risk at the regional level driven by different development trajectories interacting with changing climatic conditions. Possible future risk scenarios were simulated using maximum entropy modelling with presence-only data, combining land cover, anthropogenic and climatic variables. We found that important determinants of fire risk in the region are distance to roads, recent deforestation and density of human settlements. Severely dry conditions alone increased the area of high fire risk by 69%, affecting all categories of land use and land cover. Interactions between extreme dry conditions and rapid frontier expansion further increased fire risk, resulting in potential biomass loss of 2.44±0.8 Tg in high risk area, about 1.8 times higher than the estimates for the 2010 drought. These interactions showed particularly high fire risk in land used for 'extensive cattle ranching', 'agro-silvopastoral use' and 'intensive cattle ranching and agriculture'. These findings have serious implications for subsistence activities and the economy in the Chiquitania, which greatly depend on the forestry, agriculture and livestock sectors. Results are particularly concerning if considering the current development policies promoting frontier expansion. Departmental protected areas inhibited wildfires when strategically established in areas of high risk, even under drought conditions. However, further research is needed to assess their effectiveness accounting for more specific contextual factors. This novel and simple modelling approach can inform fire and land management decisions in the Chiquitania and other tropical forest landscapes to better anticipate and manage large wildfires in the future.

Increased Wildfire Risk Driven by Climate and Development Interactions in the Bolivian Chiquitania, Southern Amazonia

PubMed Central

Devisscher, Tahia; Anderson, Liana O.; Aragão, Luiz E. O. C.; Galván, Luis; Malhi, Yadvinder

2016-01-01

Wildfires are becoming increasingly dominant in tropical landscapes due to reinforcing feedbacks between land cover change and more severe dry conditions. This study focused on the Bolivian Chiquitania, a region located at the southern edge of Amazonia. The extensive, unique and well-conserved tropical dry forest in this region is susceptible to wildfires due to a marked seasonality. We used a novel approach to assess fire risk at the regional level driven by different development trajectories interacting with changing climatic conditions. Possible future risk scenarios were simulated using maximum entropy modelling with presence-only data, combining land cover, anthropogenic and climatic variables. We found that important determinants of fire risk in the region are distance to roads, recent deforestation and density of human settlements. Severely dry conditions alone increased the area of high fire risk by 69%, affecting all categories of land use and land cover. Interactions between extreme dry conditions and rapid frontier expansion further increased fire risk, resulting in potential biomass loss of 2.44±0.8 Tg in high risk area, about 1.8 times higher than the estimates for the 2010 drought. These interactions showed particularly high fire risk in land used for ‘extensive cattle ranching’, ‘agro-silvopastoral use’ and ‘intensive cattle ranching and agriculture’. These findings have serious implications for subsistence activities and the economy in the Chiquitania, which greatly depend on the forestry, agriculture and livestock sectors. Results are particularly concerning if considering the current development policies promoting frontier expansion. Departmental protected areas inhibited wildfires when strategically established in areas of high risk, even under drought conditions. However, further research is needed to assess their effectiveness accounting for more specific contextual factors. This novel and simple modelling approach can inform fire and land management decisions in the Chiquitania and other tropical forest landscapes to better anticipate and manage large wildfires in the future. PMID:27632528

Mapping eutrophication risk from climate change: Future phosphorus concentrations in English rivers.

PubMed

Charlton, Matthew B; Bowes, Michael J; Hutchins, Michael G; Orr, Harriet G; Soley, Rob; Davison, Paul

2018-02-01

Climate change is expected to increase eutrophication risk in rivers yet few studies identify the timescale or spatial extent of such impacts. Phosphorus concentration, considered the primary driver of eutrophication risk in English rivers, may increase through reduced dilution particularly if river flows are lower in summer. Detailed models can indicate change in catchment phosphorus concentrations but targeted support for mitigation measures requires a national scale evaluation of risk. In this study, a load apportionment model is used to describe the current relationship between flow and total reactive phosphorus (TRP) at 115 river sites across England. These relationships are used to estimate TRP concentrations for the 2050s under 11 climate change driven scenarios of future river flows and under scenarios of both current and higher levels of sewage treatment. National maps of change indicate a small but inconsistent increase in annual average TRP concentrations with a greater change in summer. Reducing the TRP concentration of final sewage effluent to 0.5mg/L P for all upstream sewage treatment works was inadequate to meet existing P standards required through the EU Water Framework Directive, indicating that more needs to be done, including efforts to reduce diffuse pollution. Copyright © 2017 Elsevier B.V. All rights reserved.

Exposure Assessment at 30 000 Feet: Challenges and Future Directions

PubMed Central

Grajewski, Barbara; Pinkerton, Lynne E.

2015-01-01

Few studies of cancer mortality and incidence among flight crew have included a detailed assessment of both occupational exposures and lifestyle factors that may influence the risk of cancer. In this issue, Kojo et al. (Risk factors for skin cancer among Finnish airline cabin crew. Ann. Occup. Hyg 2013; 57: 695–704) evaluated the relative contributions of ultraviolet and cosmic radiation to the incidence of skin cancer in Finnish flight attendants. This is a useful contribution, yet the reason flight crew members have an increased risk of skin cancer compared with the general population remains unclear. Good policy decisions for flight crew will depend on continued and emerging effective collaborations to increase study power and improve exposure assessment in future flight crew health studies. Improving the assessment of occupational exposures and non-occupational factors will cost additional time and effort, which are well spent if the role of exposures can be clarified in larger studies. PMID:23818455

Storm surges - a globally distributed risk, and the case of Hamburg (Invited)

NASA Astrophysics Data System (ADS)

von Storch, H.

2010-12-01

For most coasts, storm surges represent the major geo risk. A map of these risks shows that the phenomenon is really a global phenomenon. However, when discussing dynamics, risks, adaptation, future perspectives as well as aggravating local factors, the situation is mostly perceived as a regional or even local phenomenon. In the talk first the different manifestations of storm surges, mainly at mid latitudes and in the tropics are discussed; the historical perceptions of such events are touched upon, projection for the future presented and issues of management and adaptation discussed. In a second part, a specific situation is discussed, namely the case of Hamburg since 1750. This case is particularly interesting, because specific analysis has been done for past variability, possible future developments; local perceptions of risk and un-conventional mitigation measures. For the time prior to 1850, coastal defence failure was a regular phenomenon; from about 1850-1960 coastal defence was hardly challenged, and after the 1962 storm surge heights rose to levels never recorded before. The most likely causes for this change are modifications of the Elbe estuary, related to coastal defence and improving the shipping channel. Anthropogenic climate change may lead in the future to even higher storm surges (mainly because of increased sea level). While for the foreseeable future, conventional measures will be sufficient for ensuring coastal defence, a mitigation option of local mitigation of high water levels seems to be available. This may be achieved though the "tidal Elbe project", which was designed to reduce upstream river sediment transport.

Projections of hepatitis A virus infection associated with flood events by 2020 and 2030 in Anhui Province, China

NASA Astrophysics Data System (ADS)

Gao, Lu; Zhang, Ying; Ding, Guoyong; Liu, Qiyong; Wang, Changke; Jiang, Baofa

2016-12-01

Assessing and responding to health risk of climate change is important because of its impact on the natural and societal ecosystems. More frequent and severe flood events will occur in China due to climate change. Given that population is projected to increase, more people will be vulnerable to flood events, which may lead to an increased incidence of HAV infection in the future. This population-based study is going to project the future health burden of HAV infection associated with flood events in Huai River Basin of China. The study area covered four cities of Anhui province in China, where flood events were frequent. Time-series adjusted Poisson regression model was developed to quantify the risks of flood events on HAV infection based on the number of daily cases during summer seasons from 2005 to 2010, controlling for other meteorological variables. Projections of HAV infection in 2020 and 2030 were estimated based on the scenarios of flood events and demographic data. Poisson regression model suggested that compared with the periods without flood events, the risks of severe flood events for HAV infection were significant (OR = 1.28, 95 % CI 1.05-1.55), while risks were not significant from moderate flood events (OR = 1.16, 95 % CI 0.72-1.87) and mild flood events (OR = 1.14, 95 % CI 0.87-1.48). Using the 2010 baseline data and the flood event scenarios (one severe flood event), increased incidence of HAV infection were estimated to be between 0.126/105 and 0.127/105 for 2020. Similarly, the increased HAV infection incidence for 2030 was projected to be between 0.382/105 and 0.399/105. Our study has, for the first time, quantified the increased incidence of HAV infection that will result from flood events in Anhui, China, in 2020 and 2030. The results have implications for public health preparation for developing public health responses to reduce HAV infection during future flood events.

Cardiovascular risk management after reproductive and pregnancy-related disorders: A Dutch multidisciplinary evidence-based guideline.

PubMed

Heida, Karst Y; Bots, Michiel L; de Groot, Christianne Jm; van Dunné, Frederique M; Hammoud, Nurah M; Hoek, Annemiek; Laven, Joop Se; Maas, Angela Hem; Roeters van Lennep, Jeanine E; Velthuis, Birgitta K; Franx, Arie

2016-11-01

In the past decades evidence has accumulated that women with reproductive and pregnancy-related disorders are at increased risk of developing cardiovascular disease (CVD) in the future. Up to now there is no standardised follow-up of these women becausee guidelines on cardiovascular risk management for this group are lacking. However, early identification of high-risk populations followed by prevention and treatment of CVD risk factors has the potential to reduce CVD incidence. Therefore, the Dutch Society of Obstetrics and Gynaecology initiated a multidisciplinary working group to develop a guideline for cardiovascular risk management after reproductive and pregnancy-related disorders. The guideline addresses the cardiovascular risk consequences of gestational hypertension, preeclampsia, preterm delivery, small-for-gestational-age infant, recurrent miscarriage, polycystic ovary syndrome and premature ovarian insufficiency. The best available evidence on these topics was captured by systematic review. Recommendations for clinical practice were formulated based on the evidence and consensus of expert opinion. The Dutch societies of gynaecologists, cardiologists, vascular internists, radiologists and general practitioners reviewed the guideline to ensure support for implementation in clinical practice. For all reproductive and pregnancy-related disorders a moderate increased relative risk was found for overall CVD, except for preeclampsia (relative risk 2.15, 95% confidence interval 1.76-2.61). Based on the current available evidence, follow-up is only recommended for women with a history of preeclampsia. For all reproductive and pregnancy-related disorders optimisation of modifiable cardiovascular risk factors is recommended to reduce the risk of future CVD. © The European Society of Cardiology 2016.

Assessment of winter wheat loss risk impacted by climate change from 1982 to 2011

NASA Astrophysics Data System (ADS)

Du, Xin

2017-04-01

The world's farmers will face increasing pressure to grow more food on less land in succeeding few decades, because it seems that the continuous population growth and agricultural products turning to biofuels would extend several decades into the future. Therefore, the increased demand for food supply worldwide calls for improved accuracy of crop productivity estimation and assessment of grain production loss risk. Extensive studies have been launched to evaluate the impacts of climate change on crop production based on various crop models drove with global or regional climate model (GCM/RCM) output. However, assessment of climate change impacts on agriculture productivity is plagued with uncertainties of the future climate change scenarios and complexity of crop model. Therefore, given uncertain climate conditions and a lack of model parameters, these methods are strictly limited in application. In this study, an empirical assessment approach for crop loss risk impacted by water stress has been established and used to evaluate the risk of winter wheat loss in China, United States, Germany, France and United Kingdom. The average value of winter wheat loss risk impacted by water stress for the three countries of Europe is about -931kg/ha, which is obviously higher in contrast with that in China (-570kg/ha) and in United States (-367kg/ha). Our study has important implications for further application of operational assessment of crop loss risk at a country or region scale. Future studies should focus on using higher spatial resolution remote sensing data, combining actual evapo-transpiration to estimate water stress, improving the method for downscaling of statistic crop yield data, and establishing much more rational and elaborate zoning method.

Communication about melanoma and risk reduction after melanoma diagnosis.

PubMed

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

2017-12-01

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

Becoming Criminal: The Cultural Politics of Risk

ERIC Educational Resources Information Center

Armstrong, Derrick

2006-01-01

At the same time as youth crime in the UK is falling, there has been an increase in the numbers of young people in custody together with an explosion of social policy initiatives aimed at young people deemed to be "at risk" of becoming criminal and focused upon the prevention of future offending and inclusion in mainstream society. This…

The impact of youth, family, peer and neighborhood risk factors on developmental trajectories of risk involvement from early through middle adolescence.

PubMed

Wang, Bo; Deveaux, Lynette; Li, Xiaoming; Marshall, Sharon; Chen, Xinguang; Stanton, Bonita

2014-04-01

Few studies have analyzed the development course beginning in pre-/early adolescence of overall engagement in health-risk behaviors and associated social risk factors that place individuals in different health-risk trajectories through mid-adolescence. The current longitudinal study identified 1276 adolescents in grade six and followed them for three years to investigate their developmental trajectories of risk behaviors and to examine the association of personal and social risk factors with each trajectory. Group-based trajectory modeling was applied to identify distinctive trajectory patterns of risk behaviors. Multivariate multinomial logistic regression analyses were performed to examine the effects of the personal and social risk factors on adolescents' trajectories. Three gender-specific behavioral trajectories were identified for males (55.3% low-risk, 37.6% moderate-risk, increasing, and 7.1% high-risk, increasing) and females (41.4% no-risk, 53.4% low-risk, increasing and 5.2% moderate to high-risk, increasing). Sensation-seeking, family, peer, and neighborhood factors at baseline predicted following the moderate-risk, increasing trajectory and the high-risk, increasing trajectory in males; these risk factors predicted following the moderate to high-risk, increasing trajectory in females. The presence of all three social risk factors (high-risk neighborhood, high-risk peers and low parental monitoring) had a dramatic impact on increased probability of being in a high-risk trajectory group. These findings highlight the developmental significance of early personal and social risk factors on subsequent risk behaviors in early to middle adolescence. Future adolescent health behavior promotion interventions might consider offering additional prevention resources to pre- and early adolescent youth who are exposed to multiple contextual risk factors (even in the absence of risk behaviors) or youth who are early-starters of delinquency and substance use behaviors in early adolescence. Copyright © 2014. Published by Elsevier Ltd.

Loneliness and Suicidal Risk in Young Adults: Does Believing in a Changeable Future Help Minimize Suicidal Risk Among the Lonely?

PubMed

Chang, Edward C; Wan, Liangqiu; Li, Pengzi; Guo, Yuncheng; He, Jiaying; Gu, Yu; Wang, Yingjie; Li, Xiaoqing; Zhang, Zhan; Sun, Yingrui; Batterbee, Casey N-H; Chang, Olivia D; Lucas, Abigael G; Hirsch, Jameson K

2017-07-04

This study examined loneliness and future orientation as predictors of suicidal risk, namely, depressive symptoms and suicide ideation, in a sample of 228 college students (54 males and 174 females). Results of regression analyses indicated that loneliness was a significant predictor of both indices of suicidal risk. The inclusion of future orientation was found to significantly augment the prediction model of both depressive symptoms and suicide ideation, even after accounting for loneliness. Noteworthy, beyond loneliness and future orientation, the Loneliness × Future Orientation interaction term was found to further augment both prediction models of suicidal risk. Consistent with the notion that future orientation is an important buffer of suicidal risk, among lonely students, those with high future orientation, compared to low future orientation, were found to report significantly lower levels of depressive symptoms and suicide ideation. Some implications of the present findings for studying both risk and protective factors associated with suicidal risk in young adults are discussed.

Effect of climate change on vector-borne disease risk in the UK.

PubMed

Medlock, Jolyon M; Leach, Steve A

2015-06-01

During the early part of the 21st century, an unprecedented change in the status of vector-borne disease in Europe has occurred. Invasive mosquitoes have become widely established across Europe, with subsequent transmission and outbreaks of dengue and chikungunya virus. Malaria has re-emerged in Greece, and West Nile virus has emerged throughout parts of eastern Europe. Tick-borne diseases, such as Lyme disease, continue to increase, or, in the case of tick-borne encephalitis and Crimean-Congo haemorrhagic fever viruses, have changed their geographical distribution. From a veterinary perspective, the emergence of Bluetongue and Schmallenberg viruses show that northern Europe is equally susceptible to transmission of vector-borne disease. These changes are in part due to increased globalisation, with intercontinental air travel and global shipping transport creating new opportunities for invasive vectors and pathogens. However, changes in vector distributions are being driven by climatic changes and changes in land use, infrastructure, and the environment. In this Review, we summarise the risks posed by vector-borne diseases in the present and the future from a UK perspective, and assess the likely effects of climate change and, where appropriate, climate-change adaptation strategies on vector-borne disease risk in the UK. Lessons from the outbreaks of West Nile virus in North America and chikungunya in the Caribbean emphasise the need to assess future vector-borne disease risks and prepare contingencies for future outbreaks. Ensuring that adaptation strategies for climate change do not inadvertently exacerbate risks should be a primary focus for decision makers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intention to undergo colonoscopy screening among relatives of colorectal cancer cases: a theory-based model.

PubMed

Boonyasiriwat, Watcharaporn; Hung, Man; Hon, Shirley D; Tang, Philip; Pappas, Lisa M; Burt, Randall W; Schwartz, Marc D; Stroup, Antoinette M; Kinney, Anita Y

2014-06-01

It is recommended that persons having familial risk of colorectal cancer begin regular colonoscopy screening at an earlier age than those in the general population. However, many individuals at increased risk do not adhere to these screening recommendations. The goal of this study was to examine cognitive, affective, social, and behavioral motivators of colonoscopy intention among individuals at increased risk of familial colorectal cancer. Relatives of colorectal cancer cases (N = 481) eligible for colonoscopy screening completed a survey assessing constructs from several theoretical frameworks including fear appeal theories. Structural equation modeling indicated that perceived colorectal cancer risk, past colonoscopy, fear of colorectal cancer, support from family and friends, and health-care provider recommendation were determinants of colonoscopy intention. Future interventions to promote colonoscopy in this increased risk population should target the factors we identified as motivators. (ClinicalTrials.gov number NCT01274143).

Dense breast tissue notification: impact on women's perceived risk, anxiety, and intentions for future breast cancer screening.

PubMed

Yeh, Vivian M; Schnur, Julie B; Margolies, Laurie; Montgomery, Guy H

2015-03-01

The aim of this study was to explore how women respond to the wording of dense breast tissue notifications, which are increasingly required by state law after mammography. The specific aims were to (1) determine whether perceived lifetime risk for breast cancer and intentions to undergo mammography increase after reviewing a sample notification, (2) explore individual difference variables (eg, minority status, insurance coverage) that may influence intentions for additional ultrasound screening, and (3) assess whether anxiety mediates the relationship between perceived risk and screening intentions. A total of 184 women aged >40 years in the United States were recruited from Amazon Mechanical Turk to respond to a dense breast tissue notification as if they had personally received it. After reviewing a notification, women reported greater perceived risk (d = 0.67) and intentions to undergo mammography (d = 0.25) than before. Most women intended to undergo additional ultrasound screening, although to a lesser extent when ultrasound was covered by insurance than when it was not (d = 1.03). All screening intentions were lower in women with ambiguity aversion, a tendency to avoid tests without medical consensus, and those who preferred an active decision-making role. Anxiety mediated the relationship between perceived breast cancer risk and all screening intentions. Women who receive dense breast tissue notifications may generally increase their breast cancer screening intentions; however, intention strength varies depending on internal (eg, ambiguity aversion) and external (eg, insurance for ultrasound) factors. Although perceived risk increases after notification, it is anxiety that drives women's intentions for future screening. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

National Assessment of Human Health Effects of Climate Change in Portugal: Approach and Key Findings

PubMed Central

Casimiro, Elsa; Calheiros, Jose; Santos, Filipe Duarte; Kovats, Sari

2006-01-01

In this study we investigated the potential impact of climate change in Portugal on heat-related mortality, air pollution–related health effects, and selected vectorborne diseases. The assessment used climate scenarios from two regional climate models for a range of future time periods. The annual heat-related death rates in Lisbon may increase from between 5.4 and 6 per 100,000 in 1980–1998 to between 8.5 and 12.1 by the 2020s and to a maximum of 29.5 by the 2050s, if no adaptations occur. The projected warmer and more variable weather may result in better dispersion of nitrogen dioxide levels in winter, whereas the higher temperatures may reduce air quality during the warmer months by increasing tropospheric ozone levels. We estimated the future risk of zoonoses using ecologic scenarios to describe future changes in vectors and parasites. Malaria and schistosomiasis, which are currently not endemic in Portugal, are more sensitive to the introduction of infected vectors than to temperature changes. Higher temperatures may increase the transmission risk of zoonoses that are currently endemic to Portugal, such as leishmaniasis, Lyme disease, and Mediterranean spotted fever. PMID:17185290

Potential future exposure of European land transport infrastructure to rainfall-induced landslides throughout the 21st century

NASA Astrophysics Data System (ADS)

Schlögl, Matthias; Matulla, Christoph

2018-04-01

In the face of climate change, the assessment of land transport infrastructure exposure towards adverse climate events is of major importance for Europe's economic prosperity and social wellbeing. In this study, a climate index estimating rainfall patterns which trigger landslides in central Europe is analysed until the end of this century and compared to present-day conditions. The analysis of the potential future development of landslide risk is based on an ensemble of dynamically downscaled climate projections which are driven by the SRES A1B socio-economic scenario. Resulting regional-scale climate change projections across central Europe are concatenated with Europe's road and railway network. Results indicate overall increases of landslide occurrence. While flat terrain at low altitudes exhibits an increase of about 1 more potentially landslide-inducing rainfall period per year until the end of this century, higher elevated regions are more affected and show increases of up to 14 additional periods. This general spatial distribution emerges in the near future (2021-2050) but becomes more pronounced in the remote future (2071-2100). Since largest increases are to be found in Alsace, potential impacts of an increasing amount of landslides are discussed using the example of a case study covering the Black Forest mountain range in Baden-Württemberg by further enriching the climate information with additional geodata. The findings derived are suitable to support political decision makers and European authorities in transport, freight and logistics by offering detailed information on which parts of Europe's ground transport network are at particularly high risk concerning landslide activity.

Dietary Sodium Consumption Predicts Future Blood Pressure and Incident Hypertension in the Japanese Normotensive General Population.

PubMed

Takase, Hiroyuki; Sugiura, Tomonori; Kimura, Genjiro; Ohte, Nobuyuki; Dohi, Yasuaki

2015-07-29

Although there is a close relationship between dietary sodium and hypertension, the concept that persons with relatively high dietary sodium are at increased risk of developing hypertension compared with those with relatively low dietary sodium has not been studied intensively in a cohort. We conducted an observational study to investigate whether dietary sodium intake predicts future blood pressure and the onset of hypertension in the general population. Individual sodium intake was estimated by calculating 24-hour urinary sodium excretion from spot urine in 4523 normotensive participants who visited our hospital for a health checkup. After a baseline examination, they were followed for a median of 1143 days, with the end point being development of hypertension. During the follow-up period, hypertension developed in 1027 participants (22.7%). The risk of developing hypertension was higher in those with higher rather than lower sodium intake (hazard ratio 1.25, 95% CI 1.04 to 1.50). In multivariate Cox proportional hazards regression analysis, baseline sodium intake and the yearly change in sodium intake during the follow-up period (as continuous variables) correlated with the incidence of hypertension. Furthermore, both the yearly increase in sodium intake and baseline sodium intake showed significant correlations with the yearly increase in systolic blood pressure in multivariate regression analysis after adjustment for possible risk factors. Both relatively high levels of dietary sodium intake and gradual increases in dietary sodium are associated with future increases in blood pressure and the incidence of hypertension in the Japanese general population. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Estimates of Present and Future Flood Risk in the Conterminous United States

NASA Astrophysics Data System (ADS)

Wing, O.; Bates, P. D.; Smith, A.; Sampson, C. C.; Johnson, K.; Fargione, J.; Morefield, P.

2017-12-01

Past attempts to estimate flood risk across the USA either have incomplete coverage, coarse resolution or use overly simplified models of the flooding process. In this paper, we use a new 30m resolution model of the entire conterminous US (CONUS) with realistic flood physics to produce estimates of flood hazard which match to within 90% accuracy the skill of local models built with detailed data. Socio-economic data of commensurate resolution are combined with these flood depths to estimate current and future flood risk. Future population and land-use projections from the US Environmental Protection Agency (USEPA) are employed to indicate how flood risk might change through the 21st Century, while present-day estimates utilize the Federal Emergency Management Agency (FEMA) National Structure Inventory and a USEPA map of population distribution. Our data show that the total CONUS population currently exposed to serious flooding is 2.6 to 3.1 times higher than previous estimates; with nearly 41 million Americans living within the so-called 1 in 100-year (1% annual probability) floodplain, compared to only 13 million according to FEMA flood maps. Moreover, socio-economic change alone leads to significant future increases in flood exposure and risk, even before climate change impacts are accounted for. The share of the population living on the 1 in 100-year floodplain is projected to increase from 13.3% in the present-day to 15.6 - 15.8% in 2050 and 16.4 - 16.8% in 2100. The area of developed land within this floodplain, currently at 150,000 km2, is likely to increase by 37 - 72% in 2100 based on the scenarios selected. 5.5 trillion worth of assets currently lie on the 1% floodplain; we project that by 2100 this number will exceed 10 trillion. With this detailed spatial information on present-day flood risk, federal and state agencies can take appropriate action to mitigate losses. Use of USEPA population and land-use projections mean that particular attention can be paid to floodplains where development is projected. Steps to conserve such areas or ensure adequate defenses are in place could avoid the exposure of trillions of dollars of assets, not to mention the human suffering caused by loss of property and life.

Caries Risk Assessment Item Importance

PubMed Central

Chaffee, B.W.; Featherstone, J.D.B.; Gansky, S.A.; Cheng, J.; Zhan, L.

2016-01-01

Caries risk assessment (CRA) is widely recommended for dental caries management. Little is known regarding how practitioners use individual CRA items to determine risk and which individual items independently predict clinical outcomes in children younger than 6 y. The objective of this study was to assess the relative importance of pediatric CRA items in dental providers’ decision making regarding patient risk and in association with clinically evident caries, cross-sectionally and longitudinally. CRA information was abstracted retrospectively from electronic patient records of children initially aged 6 to 72 mo at a university pediatric dentistry clinic (n = 3,810 baseline; n = 1,315 with follow-up). The 17-item CRA form included caries risk indicators, caries protective items, and clinical indicators. Conditional random forests classification trees were implemented to identify and assign variable importance to CRA items independently associated with baseline high-risk designation, baseline evident tooth decay, and follow-up evident decay. Thirteen individual CRA items, including all clinical indicators and all but 1 risk indicator, were independently and statistically significantly associated with student/resident providers’ caries risk designation. Provider-assigned baseline risk category was strongly associated with follow-up decay, which increased from low (20.4%) to moderate (30.6%) to high/extreme risk patients (68.7%). Of baseline CRA items, before adjustment, 12 were associated with baseline decay and 7 with decay at follow-up; however, in the conditional random forests models, only the clinical indicators (evident decay, dental plaque, and recent restoration placement) and 1 risk indicator (frequent snacking) were independently and statistically significantly associated with future disease, for which baseline evident decay was the strongest predictor. In this predominantly high-risk population under caries-preventive care, more individual CRA items were independently associated with providers’ risk determination than with future caries status. These university dental providers considered many items in decision making regarding patient risk, suggesting that, in turn, these comprehensive CRA forms could also aid individualized care, linking risk assessment to disease management. Knowledge Transfer Statement: Caries risk assessment (CRA) is widely recommended for patient-tailored, prevention-focused caries management. Studies show mixed predictive performance of pediatric CRA instruments, but little is known regarding how information captured in CRA forms guides clinical decision making. This study, in high-caries prevalence 6- to 72-mo-olds, demonstrates the following: 1) most items in a CRA instrument were independently associated with practitioners’ risk designations, 2) practitioners’ risk designations were significantly associated with future disease, and 3) of baseline measures associated with future caries, evident decay was the strongest independent indicator of future caries status. Although current disease (resulting from existing pathological and protective factor imbalance) may sufficiently predict future caries status in populations, other CRA items incorporated during risk categorization could aid practitioners to develop individualized intervention strategies against identified risk factors. PMID:27403458

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers.

PubMed

Kanamori, Mariano; De La Rosa, Mario; Diez, Stephanie; Weissman, Jessica; Trepka, Mary Jo; Sneij, Alicia; Schmidt, Peter; Rojas, Patria

2016-12-30

Throughout the past decade, HIV rates in Florida-particularly South Florida, where many Latina seasonal farmworkers reside and work-have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings.

Study on the water related disaster risks using the future socio-economic scenario in Asia

NASA Astrophysics Data System (ADS)

Kiguchi, M.; Hatono, M.; Ikeuchi, H.; Nakamura, S.; Hirabayashi, Y.; Kanae, S.; Oki, T.

2014-12-01

In this study, flood risks in the present and the end of the 21st century in Asia are estimated using a future socio-economic scenario. Using the runoff data of 7 GCMs (RCP 8.5) of CMIP5, the river discharge, inundation area, and inundation depth are calculated for the assessment of flood risk. Finally, the flood risk is estimated using a function of damage. The flood frequency in the end of the 21st century in Asia tends to increase. Inundation area in Japan, Taiwan, and Kyrgyz is almost unchanged. At the same time, that in Sri Lanka, Bangladesh, Laos, and Myanmar reached about 1.4-1.6 times compared to present. Damage cost is largely influenced by economic growth, however, we show that it is important that we distinguish the influence of climate change from economic development and evaluate it when we think about an adaptation.

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers

PubMed Central

Kanamori, Mariano; De La Rosa, Mario; Diez, Stephanie; Weissman, Jessica; Trepka, Mary Jo; Sneij, Alicia; Schmidt, Peter; Rojas, Patria

2016-01-01

Throughout the past decade, HIV rates in Florida—particularly South Florida, where many Latina seasonal farmworkers reside and work—have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings. PMID:28042852

Island Economic Vulnerability to Natural Disasters—the case of Changdao

NASA Astrophysics Data System (ADS)

Zhang, Z.

2016-12-01

The paper take Changdao County as sample to analyze differentiated impacts of natural disasters on island counties. The result shows that under increased population densities, small islands quickly face binding size limitations and suffer diminished per-capita resources from sustained population increases. The isolated, high-risk geography of small islands exacerbate the scale of a natural disaster shock, rendering many risk-pooling local mechanisms ineffective; disaster assistance flows were also shown to be ineffective in this study. In an environment of increasing weather hazards and resources at risk, it is imperative to understand the determinants of natural disaster vulnerability towards future loss mitigation. Importantly, disaster-thwarting polices must consider perverse implications of economic development measures, such as per-capita income, and infrastructure investments interacting with increased population densities.

Economists' perspectives on health care delivery in California as of 1995.

PubMed Central

Singer, S J

1998-01-01

The health care delivery system is made up of providers--hospitals and doctors--increasingly organized into medical groups. Medical groups interact with payors, primarily health maintenance organizations, that increasingly pass through both risk and prices from increasingly demanding purchasers. This article summarizes the present and future prospects for each of these groups. PMID:9614794

Football Players' Perceptions of Future Risk of Concussion and Concussion-Related Health Outcomes.

PubMed

Baugh, Christine M; Kroshus, Emily; Kiernan, Patrick T; Mendel, David; Meehan, William P

2017-02-15

Concussion is increasingly recognized as a risk of participation in contact and collision sports. There have been few examinations of athletes' perceptions of their susceptibility to concussion or concussion-related health consequences. We examine college football players' perceptions of their risk of sustaining a concussion and concussion-related health consequences in their future, whether these perceptions change over time, and how concussion history is related to perceived future risk of concussion and concussion-related health consequences. A survey was administered to National Collegiate Athletic Association Division I Football Championship Series athletes on 10 teams in 2013 and to nine of those teams in 2014. Athletes answered questions assessing their perceptions of concussion and potential concussion-related health consequences. Approximately 40% of athletes believed there was a strong possibility that they would sustain a concussion in the future, while approximately one-in-four thought a concussion would make them miss a few games. About one-in-10 athletes predicted dementia, Alzheimer's disease, or chronic traumatic encephalopathy would develop from concussions. These beliefs were stronger among athletes who had sustained previous concussions. Across the two years studied, athletes' perceptions of the risk of concussion and missing a few games because of concussion decreased significantly. Overall, a substantial proportion of college football players believe they will have long-term health consequences as a result of sustaining sport-related concussions. The true incidence and prevalence of many of these outcomes are unknown. Further research is needed to determine whether athletes have an accurate perception of the risks of these outcomes developing.

Football Players' Perceptions of Future Risk of Concussion and Concussion-Related Health Outcomes

PubMed Central

Kroshus, Emily; Kiernan, Patrick T.; Mendel, David; Meehan, William P.

2017-01-01

Abstract Concussion is increasingly recognized as a risk of participation in contact and collision sports. There have been few examinations of athletes' perceptions of their susceptibility to concussion or concussion-related health consequences. We examine college football players' perceptions of their risk of sustaining a concussion and concussion-related health consequences in their future, whether these perceptions change over time, and how concussion history is related to perceived future risk of concussion and concussion-related health consequences. A survey was administered to National Collegiate Athletic Association Division I Football Championship Series athletes on 10 teams in 2013 and to nine of those teams in 2014. Athletes answered questions assessing their perceptions of concussion and potential concussion-related health consequences. Approximately 40% of athletes believed there was a strong possibility that they would sustain a concussion in the future, while approximately one-in-four thought a concussion would make them miss a few games. About one-in-10 athletes predicted dementia, Alzheimer's disease, or chronic traumatic encephalopathy would develop from concussions. These beliefs were stronger among athletes who had sustained previous concussions. Across the two years studied, athletes' perceptions of the risk of concussion and missing a few games because of concussion decreased significantly. Overall, a substantial proportion of college football players believe they will have long-term health consequences as a result of sustaining sport-related concussions. The true incidence and prevalence of many of these outcomes are unknown. Further research is needed to determine whether athletes have an accurate perception of the risks of these outcomes developing. PMID:27526721

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

NASA Astrophysics Data System (ADS)

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

2014-11-01

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

Predicting the patterns of change in spring onset and false springs in China during the twenty-first century

NASA Astrophysics Data System (ADS)

Zhu, Likai; Meng, Jijun; Li, Feng; You, Nanshan

2017-10-01

Spring onset has generally shifted earlier in China over the past several decades in response to the warming climate. However, future changes in spring onset and false springs, which will have profound effects on ecosystems, are still not well understood. Here, we used the extended form of the Spring Indices model (SI-x) to project changes in the first leaf and first bloom dates, and predicted false springs for the historical (1950-2005) and future (2006-2100) periods based on the downscaled daily maximum/minimum temperatures under two emission scenarios from 21 General Circulation Models (GCMs) of the Coupled Model Intercomparison Project Phase 5 (CMIP5). On average, first leaf and first bloom in China were projected to occur 21 and 23 days earlier, respectively, by the end of the twenty-first century in the Representative Concentration Pathway (RCP) 8.5 scenario. Areas with greater earlier shifts in spring onset were in the warm temperate zone, as well as the north and middle subtropical zones of China. Early false spring risk increased rapidly in the warm temperate and north subtropical zones, while that declined in the cold temperate zone. Relative to early false spring risk, late false spring risk showed a common increase with smaller magnitude in the RCP 8.5 scenario but might cause greater damage to ecosystems because plants tend to become more vulnerable to the later occurrence of a freeze event. We conclude that future climate warming will continue to cause earlier occurrence of spring onset in general, but might counterintuitively increase plant damage risk in natural and agricultural systems of the warm temperate and subtropical China.

Predicting the patterns of change in spring onset and false springs in China during the twenty-first century.

PubMed

Zhu, Likai; Meng, Jijun; Li, Feng; You, Nanshan

2017-10-28

Spring onset has generally shifted earlier in China over the past several decades in response to the warming climate. However, future changes in spring onset and false springs, which will have profound effects on ecosystems, are still not well understood. Here, we used the extended form of the Spring Indices model (SI-x) to project changes in the first leaf and first bloom dates, and predicted false springs for the historical (1950-2005) and future (2006-2100) periods based on the downscaled daily maximum/minimum temperatures under two emission scenarios from 21 General Circulation Models (GCMs) of the Coupled Model Intercomparison Project Phase 5 (CMIP5). On average, first leaf and first bloom in China were projected to occur 21 and 23 days earlier, respectively, by the end of the twenty-first century in the Representative Concentration Pathway (RCP) 8.5 scenario. Areas with greater earlier shifts in spring onset were in the warm temperate zone, as well as the north and middle subtropical zones of China. Early false spring risk increased rapidly in the warm temperate and north subtropical zones, while that declined in the cold temperate zone. Relative to early false spring risk, late false spring risk showed a common increase with smaller magnitude in the RCP 8.5 scenario but might cause greater damage to ecosystems because plants tend to become more vulnerable to the later occurrence of a freeze event. We conclude that future climate warming will continue to cause earlier occurrence of spring onset in general, but might counterintuitively increase plant damage risk in natural and agricultural systems of the warm temperate and subtropical China.

Rib fracture as a predictor of future fractures in young and older postmenopausal women: National Osteoporosis Risk Assessment (NORA)

PubMed Central

Sajjan, S. G.; Barrett-Connor, E.; McHorney, C. A.; Miller, P. D.; Sen, S. S.; Siris, E.

2013-01-01

Summary A rib fracture history after age 45 was associated with a 5.4-fold increase in new rib fracture risk and a 2.4-fold increase in risk of any new clinical fracture in 155,031 postmenopausal women. A rib fracture history suggests osteoporosis and should be considered when evaluating patients for interventions to prevent fractures. Introduction Until recently, little attention was paid to rib fracture as an osteoporosis marker. Emerging evidence suggests rib fracture may be an osteoporotic fracture in men and women. We report the 5-year independent association between baseline rib fracture histories and self-reported future fractures by age (decade) in the NORA cohort (155,031 postmenopausal women, 50–99 years). Methods Participants reported fracture history and responded to follow-up surveys at years 1, 3, or 6. Women with a baseline rib fracture history without other fractures were compared with women with no fracture. Results At baseline, 4,758 (3.07%) women reported a rib fracture history without other fractures; 6,300 women reported 6,830 new clinical fractures, including wrist (2,271), rib (1,891), spine (1,136), hip (941), and forearm (591). Adjusted relative risk (ARR) values (95% confidence interval [CI]) for future fractures in women with rib fracture history versus women with no fracture history were 5.4 (4.8–6.1) at the rib, 2.1 (1.7–2.6) at the spine, and 1.4 (1.1–1.7) at the wrist, and not significant for forearm or hip fractures. Future fracture risk was at least doubled in women with a rib fracture history in all ages: ARR (95% CI) 3.4 (2.8–4.0) for ages 50–59, 2.5 (2.1–3.0) for ages 60–69, 2.0 (1.7–2.3) for ages 70–79, and 2.0 (1.6–2.6) for ages >80. Conclusions Rib fracture, the second most common clinical fracture in women (after wrist fracture), predicted future fractures of the rib, wrist, and spine at all ages. Women presenting with rib fractures should be evaluated for appropriate management to prevent future fractures. PMID:21904951

The Individual Health Discount Rate in Patients with Ulcerative Colitis

PubMed Central

Waljee, Akbar K.; Morris, Arden M.; Waljee, Jennifer F.; Higgins, Peter D.R.

2015-01-01

Background In cost-effectiveness analysis, discount rates are used in calculating the value of future costs and benefits. However, standard discount rates may not accurately describe the decision-making of patients with Ulcerative Colitis (UC). These patients often choose the long-term risks of immunosuppressive therapy over the short-term risks of colectomy, demonstrating very high discount rates for future health. In this study, we aimed to measure the discount rate in UC patients and identify variables associated with the discount rate. Methods We surveyed patients with UC and patients who were post-colectomy for UC to measure their valuations of UC and colectomy health states. We used Standard Gamble(SG) and Time-Trade-Off(TTO) methods to assess current and future health state valuations, and calculated the discount rate. Results Participants included 150 subjects with UC and 150 subjects who were post-colectomy for UC. Discount rates varied widely (20.6%–100%) with an overall median rate of 55.0%, which was significantly higher than the standard rate of 5%. Older age and male gender and predicted high discount rates (aversion to immediate risk in favor of distant future risk). For each additional decade of age, patients’ expected discount rate increased by 0.77%. Female gender was the only predictor of very low discount rates. Female patients’ discount rates averaged 8.1% less than age-matched males. Conclusions The accepted discount rate of 5% grossly underestimates UC patients’ preference for long-term over short-term risk. This might explain UC patients’ frequent choice of the long-term risks of immunosuppressive medical therapy over the short-term risks of colectomy. PMID:21560195

Preparing young people for future decision-making about cancer risk in families affected or at risk from hereditary breast cancer: A qualitative interview study.

PubMed

Rowland, Emma; Plumridge, Gill; Considine, Anna-Marie; Metcalfe, Alison

2016-12-01

Women carrying the mutated BRCA gene, have approximately an 80% life-time risk of developing breast cancer with 50% risk of their children inheriting the gene mutation. Many parents find it difficult to know when and how to disclose this information to their children and how such disclosure might affect their child's future decision-making. This study explored the communication of genetic risk information in families using qualitative semi-structured interviews conducted with parents, children (7-11years) and young people (12-18years) affected or at risk from a BRCA gene mutation. Thematic analysis was applied to coded transcripts producing four themes; family communication, perception of cancer risks, risk management strategies and impact of genetic risk communication in children and young people's decision making. Twenty-seven individuals from 11 families took part, recruited through purposive sampling techniques. Cancer risk caused by a BRCA gene mutation induced a sense of fear in parents about their children's future. As a result, parents with hereditary breast cancer disclosed limited information about the risks associated with prophylactic surgery and/or the psychological and emotional impacts of surgery on body image. This had implications to children and young people's perceptions of prophylactic procedures, which were already influenced by cultural understandings of the 'desirable body' and increasing acceptance and proliferation cosmetic surgery. Lack of risk management information and the acculturation of cosmetic surgery combined to limit children and young people's understanding of the impact of hereditary breast cancer; reducing their ability to actualise the physiological, psychological and emotional consequences of surgery. Copyright © 2016. Published by Elsevier Ltd.

Risk-taking and the media.

PubMed

Fischer, Peter; Vingilis, Evelyn; Greitemeyer, Tobias; Vogrincic, Claudia

2011-05-01

In recent years, media formats with risk-glorifying content, such as video games that simulate illegal street racing ("bang and crash" games), films about extreme sports, and risky stunts have emerged as top sellers of the media industry. A variety of recent studies conducted by several researchers revealed that exposure to risk-glorifying media content (e.g., video games that simulate reckless driving, smoking and drinking in movies, or depictions that glorify extreme sports) increases the likelihood that recipients will show increased levels of risk-taking inclinations and behaviors. The present article (1) reviews the latest research on the detrimental impact of risk-glorifying media on risk-taking inclinations (cognitions, emotions, behaviors), (2) puts these findings in the theoretical context of recent sociocognitive models on media effects, and (3) makes suggestions to science and policymakers on how to deal with these effects in the future. © 2010 Society for Risk Analysis.

Emotion, Affect, and Risk Communication with Older Adults: Challenges and Opportunities

PubMed Central

Finucane, Melissa L.

2008-01-01

Recent research suggests that emotion, affect, and cognition play important roles in risk perception and that their roles in judgment and decision-making processes may change over the lifespan. This paper discusses how emotion and affect might help or hinder risk communication with older adults. Currently, there are few guidelines for developing effective risk messages for the world’s aging population, despite the array of complex risk decisions that come with increasing age and the importance of maintaining good decision making in later life. Age-related declines in cognitive abilities such as memory and processing speed, increased reliance on automatic processes, and adaptive motivational shifts toward focusing more on affective (especially positive) information mean that older and younger adults may respond differently to risk messages. Implications for specific risk information formats (probabilities, frequencies, visual displays, and narratives) are discussed and directions for future research are highlighted. PMID:19169420

Exploring Psychiatric Inpatients' Beliefs About the Role of Post-discharge Follow-up Care in Suicide Prevention.

PubMed

Riblet, Natalie; Shiner, Brian; Scott, Robert; Bruce, Martha L; Wasserman, Danuta; Watts, Bradley V

2018-05-31

Patients are at increased risk for death by suicide following a psychiatric hospitalization. There has been limited study of the association between patient engagement in follow-up care after psychiatric hospitalization and suicide risk. Understanding why psychiatric inpatients choose to engage in post-discharge care is important in developing effective suicide prevention strategies. The theory of planned behavior (TPB) has been widely used to understand many health behaviors including healthcare utilization. Using the TPB, we developed an interview guide that assessed psychiatric inpatients' attitudes and beliefs about the role of post-discharge care in addressing suicide risk. We also inquired about perception of future risk for suicide after discharge. We conducted semi-structured interviews prior to discharge and administered the Columbia-Suicide Severity Rating Scale (C-SSRS). We assessed healthcare utilization at 1 and 3 mo after discharge. We coded and grouped the transcribed data according to the three domains of the TPB model: attitudes, subjective norms, and perceived behavioral control. Sixteen individuals consented to enrollment. More than half (N = 10) believed that they were at no or low future suicide risk after discharge. Participants who felt that their future risk for suicide was low or none were significantly older (mean 59.3 yr, SD: 8.3) and reported significantly less severe suicidal ideation in the past month (mean CSSR-S 2.5, SD 2.1) compared to those participants who believed that their future risk was high (mean age 47.5, SD: 8.6; mean CSSR-S 4.7, SD 0.5, p < 0.05). However, all participants had a lifetime history of severe suicidal ideation (mean CSSR-S > 4.7). Many participants felt that peers facilitated treatment engagement. However, participants expressed a tendency to avoid treatment if they experienced unwanted side effects, encountered stigma, or experienced poor-therapeutic alliance. Five participants experienced poor continuity of care after discharge. Of these participants, four reported at the time of discharge no or low perceived future risk of suicide and three were readmitted within 90 d after discharge. Individuals may not appreciate that they are at heightened risk for suicide after hospitalization and this may negatively impact treatment engagement.

Scenario-neutral Food Security Risk Assessment: A livestock Heat Stress Case Study

NASA Astrophysics Data System (ADS)

Broman, D.; Rajagopalan, B.; Hopson, T. M.

2015-12-01

Food security risk assessments can provide decision-makers with actionable information to identify critical system limitations, and alternatives to mitigate the impacts of future conditions. The majority of current risk assessments have been scenario-led and results are limited by the scenarios - selected future states of the world's climate system and socioeconomic factors. A generic scenario-neutral framework for food security risk assessments is presented here that uses plausible states of the world without initially assigning likelihoods. Measures of system vulnerabilities are identified and system risk is assessed for these states. This framework has benefited greatly by research in the water and natural resource fields to adapt their planning to provide better risk assessments. To illustrate the utility of this framework we develop a case study using livestock heat stress risk within the pastoral system of West Africa. Heat stress can have a major impact not only on livestock owners, but on the greater food production system, decreasing livestock growth, milk production, and reproduction, and in severe cases, death. A heat stress index calculated from daily weather is used as a vulnerability measure and is computed from historic daily weather data at several locations in the study region. To generate plausible states, a stochastic weather generator is developed to generate synthetic weather sequences at each location, consistent with the seasonal climate. A spatial model of monthly and seasonal heat stress provide projections of current and future livestock heat stress measures across the study region, and can incorporate in seasonal climate and other external covariates. These models, when linked with empirical thresholds of heat stress risk for specific breeds offer decision-makers with actionable information for use in near-term warning systems as well as for future planning. Future assessment can indicate under which states livestock are at greatest risk of heat stress; when coupled with assessments of additional measures (e.g. water and fodder availability) can inform on alternatives that provide satisfactory performance under a wide range of states (e.g. optimal cattle breed, supplemental feed, increased water access).

Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees.

PubMed

Lund, Thomas; Kivimäki, Mika; Labriola, Merete; Villadsen, Ebbe; Christensen, Karl Bang

2008-01-01

The aim of this study was to examine duration of sickness absence as a risk marker for future disability pension among all private sector employees in Denmark 1998-2004. All private sector employees receiving sickness absence compensation from the municipality in 1998, a total of 225 056 persons (39.2% women 61.8% men, age range 18-65, mean age 37.2), were followed in a national register to determine granted disability pension during the period 1 January 2001 through 31 December 2004. The authors excluded pensions in 1999 and 2000 to determine the status of sickness absence duration as an early risk marker. 5694 persons (2.5%) received disability pension during follow-up, more men (53.4%) than women (46.6%). There was a strong graded association between increasing length of absence and increasing risk of future disability pension. Significant differences were found between the younger and older age strata: men below 40 experiencing more than 26 weeks of sickness absence had a 16-fold risk of disability pension. The corresponding figure for men 40 years or older was approximately 7. For women, the corresponding figures were 12.6 and 6.7 respectively. The findings suggest that administratively collected data on sickness absence compensation are an important predictor of disability pension among private sector employees. The use of information on sick leave may improve the effectiveness of early interventions by policy makers, case managing authorities, employers and physicians.

Simulating the Risk of Liver Fluke Infection using a Mechanistic Hydro-epidemiological Model

NASA Astrophysics Data System (ADS)

Beltrame, Ludovica; Dunne, Toby; Rose, Hannah; Walker, Josephine; Morgan, Eric; Vickerman, Peter; Wagener, Thorsten

2016-04-01

Liver Fluke (Fasciola hepatica) is a common parasite found in livestock and responsible for considerable economic losses throughout the world. Risk of infection is strongly influenced by climatic and hydrological conditions, which characterise the host environment for parasite development and transmission. Despite on-going control efforts, increases in fluke outbreaks have been reported in recent years in the UK, and have been often attributed to climate change. Currently used fluke risk models are based on empirical relationships derived between historical climate and incidence data. However, hydro-climate conditions are becoming increasingly non-stationary due to climate change and direct anthropogenic impacts such as land use change, making empirical models unsuitable for simulating future risk. In this study we introduce a mechanistic hydro-epidemiological model for Liver Fluke, which explicitly simulates habitat suitability for disease development in space and time, representing the parasite life cycle in connection with key environmental conditions. The model is used to assess patterns of Liver Fluke risk for two catchments in the UK under current and potential future climate conditions. Comparisons are made with a widely used empirical model employing different datasets, including data from regional veterinary laboratories. Results suggest that mechanistic models can achieve adequate predictive ability and support adaptive fluke control strategies under climate change scenarios.

Modelling the effects of past and future climate on the risk of bluetongue emergence in Europe

PubMed Central

Guis, Helene; Caminade, Cyril; Calvete, Carlos; Morse, Andrew P.; Tran, Annelise; Baylis, Matthew

2012-01-01

Vector-borne diseases are among those most sensitive to climate because the ecology of vectors and the development rate of pathogens within them are highly dependent on environmental conditions. Bluetongue (BT), a recently emerged arboviral disease of ruminants in Europe, is often cited as an illustration of climate's impact on disease emergence, although no study has yet tested this association. Here, we develop a framework to quantitatively evaluate the effects of climate on BT's emergence in Europe by integrating high-resolution climate observations and model simulations within a mechanistic model of BT transmission risk. We demonstrate that a climate-driven model explains, in both space and time, many aspects of BT's recent emergence and spread, including the 2006 BT outbreak in northwest Europe which occurred in the year of highest projected risk since at least 1960. Furthermore, the model provides mechanistic insight into BT's emergence, suggesting that the drivers of emergence across Europe differ between the South and the North. Driven by simulated future climate from an ensemble of 11 regional climate models, the model projects increase in the future risk of BT emergence across most of Europe with uncertainty in rate but not in trend. The framework described here is adaptable and applicable to other diseases, where the link between climate and disease transmission risk can be quantified, permitting the evaluation of scale and uncertainty in climate change's impact on the future of such diseases. PMID:21697167

Bimodal distribution of risk for childhood obesity in urban Baja California, Mexico.

PubMed

Wojcicki, Janet M; Jimenez-Cruz, Arturo; Bacardi-Gascon, Montserrat; Schwartz, Norah; Heyman, Melvin B

2012-08-01

In Mexico, higher socioeconomic status (SES) has been found to be associated with increased risk for obesity in children. Within developed urban areas, however, there may be increased risk among lower SES children. Students in grades 4-6 from five public schools in Tijuana and Tecate, Mexico, were interviewed and weight, height and waist circumference (WC) measurements were taken. Interviews consisted of questions on food frequency, food insecurity, acculturation, physical activity and lifestyle practices. Multivariate logistic models were used to assess risk factors for obesity (having a body mass index [BMI] ≥95th percentile) and abdominal obesity (a WC >90th percentile) using Stata 11.0. Five hundred and ninety students were enrolled; 43.7% were overweight or obese, and 24.3% were obese and 20.2% had abdominal obesity. Independent risk factors for obesity included watching TV in English (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.06-2.41) and perceived child food insecurity (OR 1.57, 95% CI 1.05-2.36). Decreased risk for obesity was associated with female sex (OR 0.64, 95% CI 0.43-0.96), as was regular multivitamin use (OR 0.63, 95% CI 0.42-0.94). Risk obesity was also decreased with increased taco consumption (≥1×/week; OR 0.64, 95% CI 0.43-0.96). Independent risk factors for abdominal obesity included playing video games ≥1×/week (OR 1.18, 95% CI 1.11-2.96) and older age group (10-11 years, OR 2.47, 95% CI 1.29-4.73 and ≥12 years, OR 2.21, 95% CI 1.09-4.49). Increased consumption of tacos was also associated with decreased risk for abdominal obesity (≥1×/week; OR 0.56, 95% CI 0.40-1.00). We found a bimodal distribution for risk of obesity and abdominal obesity in school aged children on the Mexican border with the United States. Increased risk for obesity and abdominal obesity were associated with factors indicative of lower and higher SES including watching TV in English, increased video game playing and perceived food insecurity. Increased consumption of tacos (≥1×/week) was associated with decreased risk, possibly suggesting an association with children from middle income families. Regular multivitamin use was protective and future studies may focus on micronutrient supplementation as a means to prevent obesity in children or further investigate factors associated with vitamin use. Additionally, future studies need to examine the processes of acculturation on both sides of the US-Mexican border that contribute to increased risk for obesity in children in relation to SES.

A stereo-vision hazard-detection algorithm to increase planetary lander autonomy

NASA Astrophysics Data System (ADS)

Woicke, Svenja; Mooij, Erwin

2016-05-01

For future landings on any celestial body, increasing the lander autonomy as well as decreasing risk are primary objectives. Both risk reduction and an increase in autonomy can be achieved by including hazard detection and avoidance in the guidance, navigation, and control loop. One of the main challenges in hazard detection and avoidance is the reconstruction of accurate elevation models, as well as slope and roughness maps. Multiple methods for acquiring the inputs for hazard maps are available. The main distinction can be made between active and passive methods. Passive methods (cameras) have budgetary advantages compared to active sensors (radar, light detection and ranging). However, it is necessary to proof that these methods deliver sufficiently good maps. Therefore, this paper discusses hazard detection using stereo vision. To facilitate a successful landing not more than 1% wrong detections (hazards that are not identified) are allowed. Based on a sensitivity analysis it was found that using a stereo set-up at a baseline of ≤ 2 m is feasible at altitudes of ≤ 200 m defining false positives of less than 1%. It was thus shown that stereo-based hazard detection is an effective means to decrease the landing risk and increase the lander autonomy. In conclusion, the proposed algorithm is a promising candidate for future landers.

Multifactor valuation models of energy futures and options on futures

NASA Astrophysics Data System (ADS)

Bertus, Mark J.

The intent of this dissertation is to investigate continuous time pricing models for commodity derivative contracts that consider mean reversion. The motivation for pricing commodity futures and option on futures contracts leads to improved practical risk management techniques in markets where uncertainty is increasing. In the dissertation closed-form solutions to mean reverting one-factor, two-factor, three-factor Brownian motions are developed for futures contracts. These solutions are obtained through risk neutral pricing methods that yield tractable expressions for futures prices, which are linear in the state variables, hence making them attractive for estimation. These functions, however, are expressed in terms of latent variables (i.e. spot prices, convenience yield) which complicate the estimation of the futures pricing equation. To address this complication a discussion on Dynamic factor analysis is given. This procedure documents latent variables using a Kalman filter and illustrations show how this technique may be used for the analysis. In addition, to the futures contracts closed form solutions for two option models are obtained. Solutions to the one- and two-factor models are tailored solutions of the Black-Scholes pricing model. Furthermore, since these contracts are written on the futures contracts, they too are influenced by the same underlying parameters of the state variables used to price the futures contracts. To conclude, the analysis finishes with an investigation of commodity futures options that incorporate random discrete jumps.

Ozone depletion following future volcanic eruptions

NASA Astrophysics Data System (ADS)

Eric Klobas, J.; Wilmouth, David M.; Weisenstein, Debra K.; Anderson, James G.; Salawitch, Ross J.

2017-07-01

While explosive volcanic eruptions cause ozone loss in the current atmosphere due to an enhancement in the availability of reactive chlorine following the stratospheric injection of sulfur, future eruptions are expected to increase total column ozone as halogen loading approaches preindustrial levels. The timing of this shift in the impact of major volcanic eruptions on the thickness of the ozone layer is poorly known. Modeling four possible climate futures, we show that scenarios with the smallest increase in greenhouse gas concentrations lead to the greatest risk to ozone from heterogeneous chemical processing following future eruptions. We also show that the presence in the stratosphere of bromine from natural, very short-lived biogenic compounds is critically important for determining whether future eruptions will lead to ozone depletion. If volcanic eruptions inject hydrogen halides into the stratosphere, an effect not considered in current ozone assessments, potentially profound reductions in column ozone would result.

The effects of violence exposure on the development of impulse control and future orientation across adolescence and early adulthood: Time-specific and generalized effects in a sample of juvenile offenders.

PubMed

Monahan, Kathryn C; King, Kevin M; Shulman, Elizabeth P; Cauffman, Elizabeth; Chassin, Laurie

2015-11-01

Impulse control and future orientation increase across adolescence, but little is known about how contextual factors shape the development of these capacities. The present study investigates how stress exposure, operationalized as exposure to violence, alters the developmental pattern of impulse control and future orientation across adolescence and early adulthood. In a sample of 1,354 serious juvenile offenders, higher exposure to violence was associated with lower levels of future orientation at age 15 and suppressed development of future orientation from ages 15 to 25. Increases in witnessing violence or victimization were linked to declines in impulse control 1 year later, but only during adolescence. Thus, beyond previous experiences of exposure to violence, witnessing violence and victimization during adolescence conveys unique risk for suppressed development of self-regulation.

Defining the Scope of Prognosis: Primary Care Clinicians' Perspectives on Predicting the Future Health of Older Adults.

PubMed

Thomas, John M; Fried, Terri R

2018-05-01

Studies examining the attitudes of clinicians toward prognostication for older adults have focused on life expectancy prediction. Little is known about whether clinicians approach prognostication in other ways. To describe how clinicians approach prognostication for older adults, defined broadly as making projections about patients' future health. In five focus groups, 30 primary care clinicians from community-based, academic-affiliated, and Veterans Affairs primary care practices were given open-ended questions about how they make projections about their patients' future health and how this informs the approach to care. Content analysis was used to organize responses into themes. Clinicians spoke about future health in terms of a variety of health outcomes in addition to life expectancy, including independence in activities and decision making, quality of life, avoiding hospitalization, and symptom burden. They described approaches in predicting these health outcomes, including making observations about the overall trajectory of patients to predict health outcomes and recognizing increased risk for adverse health outcomes. Clinicians expressed reservations about using estimates of mortality risk and life expectancy to think about and communicate patients' future health. They discussed ways in which future research might help them in thinking about and discussing patients' future health to guide care decisions, including identifying when and whether interventions might impact future health. The perspectives of primary care clinicians in this study confirm that prognostic considerations can go beyond precise estimates of mortality risk and life expectancy to include a number of outcomes and approaches to predicting those outcomes. Published by Elsevier Inc.

Three essays on agricultural price volatility and the linkages between agricultural and energy markets

NASA Astrophysics Data System (ADS)

Wu, Feng

This dissertation contains three essays. In the first essay I use a volatility spillover model to find evidence of significant spillovers from crude oil prices to corn cash and futures prices, and that these spillover effects are time-varying. Results reveal that corn markets have become much more connected to crude oil markets after the introduction of the Energy Policy Act of 2005. Furthermore, crude oil prices transmit positive volatility spillovers into corn prices and movements in corn prices become more energy-driven as the ethanol gasoline consumption ratio increases. Based on this strong volatility link between crude oil and corn prices, a new cross hedging strategy for managing corn price risk using oil futures is examined and its performance studied. Results show that this cross hedging strategy provides only slightly better hedging performance compared to traditional hedging in corn futures markets alone. The implication is that hedging corn price risk in corn futures markets alone can still provide relatively satisfactory performance in the biofuel era. The second essay studies the spillover effect of biofuel policy on participation in the Conservation Reserve Program. Landowners' participation decisions are modeled using a real options framework. A novel aspect of the model is that it captures the structural change in agriculture caused by rising biofuel production. The resulting model is used to simulate the spillover effect under various conditions. In particular, I simulate how increased growth in agricultural returns, persistence of the biofuel production boom, and the volatility surrounding agricultural returns, affect conservation program participation decisions. Policy implications of these results are also discussed. The third essay proposes a methodology to construct a risk-adjusted implied volatility measure that removes the forecasting bias of the model-free implied volatility measure. The risk adjustment is based on a closed-form relationship between the expectation of future volatility and the model-free implied volatility assuming a jump-diffusion model. I use a GMM estimation framework to identify the key model parameters needed to apply the model. An empirical application to corn futures implied volatility is used to illustrate the methodology and demonstrate differences between my approach and the model-free implied volatility using observed corn option prices. I compare the risk-adjusted forecast with the unadjusted forecast as well as other alternatives; and results suggest that the risk-adjusted volatility is unbiased, informationally more efficient, and has superior predictive power over the alternatives considered.

An acute post-rape intervention to prevent substance use and abuse.

PubMed

Acierno, Ron; Resnick, Heidi S; Flood, Amanda; Holmes, Melisa

2003-12-01

The trauma of rape is routinely associated with extreme acute distress. Such peri-event anxiety increases risk of developing psychopathology and substance use or abuse post-rape, with the degree of initial distress positively predicting future problems. Unfortunately, the nature of post-rape forensic evidence collection procedures may exacerbate initial distress, thereby potentiating post-rape negative emotional sequelae. Consequently, substance use may increase in an effort to ameliorate this distress. To address this, a two-part video intervention was developed for use in acute post-rape time frames to (a) minimize anxiety during forensic rape examinations, thereby reducing risk of future emotional problems, and (b) prevent increased post-rape substance use and abuse. Pilot study data with 124 rape victims indicated that the low-cost, easily administered intervention was effective in reducing risk of marijuana abuse at 6 weeks. Nonstatistically significant trends also were evident for reduced marijuana use. Trends were also noted in favor of the intervention in the subgroup of women who were actively using substances pre-rape (among pre-rape alcohol users, 28% viewers vs. 43% nonviewers met criteria for post-rape alcohol abuse; among pre-rape marijuana users, the rates of post-marijuana use were 17% vs. 43%).

Barriers to human immunodeficiency virus related risk reduction among male street prostitutes.

PubMed

Simon, P M; Morse, E V; Balson, P M; Osofsky, H J; Gaumer, H R

1993-01-01

Two hundred eleven male street prostitutes between the ages of 18 and 51 years were interviewed and tested for antibodies to the human immunodeficiency virus (HIV). Economic, social, and emotional barriers to the reduction of HIV-related risk behavior were examined within the context of several concepts present in the Health Belief Model (HBM). Three lifestyle factors were found to function as barriers to engaging in risk reduction behavior. Subjects who were more economically dependent on prostitution, perceived less control over the hustling encounter, and reported increased pleasure from sexual activity with their customers were more likely to engage in risk-taking behavior. Prostitutes' perception of the severity of HIV infection was not significantly associated with their risk behavior. Unexpected findings indicated that increases in perceived susceptibility to HIV and perceived benefit of condom use for HIV prevention were significantly related to increased risk-taking behavior. Practical applications of findings in the design and implementation of future HIV-related preventive health education programs are discussed.

Stress testing hydrologic models using bottom-up climate change assessment

NASA Astrophysics Data System (ADS)

Stephens, C.; Johnson, F.; Marshall, L. A.

2017-12-01

Bottom-up climate change assessment is a promising approach for understanding the vulnerability of a system to potential future changes. The technique has been utilised successfully in risk-based assessments of future flood severity and infrastructure vulnerability. We find that it is also an ideal tool for assessing hydrologic model performance in a changing climate. In this study, we applied bottom-up climate change to compare the performance of two different hydrologic models (an event-based and a continuous model) under increasingly severe climate change scenarios. This allowed us to diagnose likely sources of future prediction error in the two models. The climate change scenarios were based on projections for southern Australia, which indicate drier average conditions with increased extreme rainfall intensities. We found that the key weakness in using the event-based model to simulate drier future scenarios was the model's inability to dynamically account for changing antecedent conditions. This led to increased variability in model performance relative to the continuous model, which automatically accounts for the wetness of a catchment through dynamic simulation of water storages. When considering more intense future rainfall events, representation of antecedent conditions became less important than assumptions around (non)linearity in catchment response. The linear continuous model we applied may underestimate flood risk in a future climate with greater extreme rainfall intensity. In contrast with the recommendations of previous studies, this indicates that continuous simulation is not necessarily the key to robust flood modelling under climate change. By applying bottom-up climate change assessment, we were able to understand systematic changes in relative model performance under changing conditions and deduce likely sources of prediction error in the two models.

Radiation dose reduction in computed tomography: techniques and future perspective

PubMed Central

Yu, Lifeng; Liu, Xin; Leng, Shuai; Kofler, James M; Ramirez-Giraldo, Juan C; Qu, Mingliang; Christner, Jodie; Fletcher, Joel G; McCollough, Cynthia H

2011-01-01

Despite universal consensus that computed tomography (CT) overwhelmingly benefits patients when used for appropriate indications, concerns have been raised regarding the potential risk of cancer induction from CT due to the exponentially increased use of CT in medicine. Keeping radiation dose as low as reasonably achievable, consistent with the diagnostic task, remains the most important strategy for decreasing this potential risk. This article summarizes the general technical strategies that are commonly used for radiation dose management in CT. Dose-management strategies for pediatric CT, cardiac CT, dual-energy CT, CT perfusion and interventional CT are specifically discussed, and future perspectives on CT dose reduction are presented. PMID:22308169

Past and future weather-induced risk in crop production

NASA Astrophysics Data System (ADS)

Elliott, J. W.; Glotter, M.; Russo, T. A.; Sahoo, S.; Foster, I.; Benton, T.; Mueller, C.

2016-12-01

Drought-induced agricultural loss is one of the most costly impacts of extreme weather and may harm more people than any other consequence of climate change. Improvements in farming practices have dramatically increased crop productivity, but yields today are still tightly linked to climate variation. We report here on a number of recent studies evaluating extreme event risk and impacts under historical and near future conditions, including studies conducted as part of the Agricultural Modeling Intercomparison and Improvement Project (AgMIP), the Inter-Sectoral Impacts Model Intercomparison Project (ISI-MIP) and the UK-US Taskforce on Extreme Weather and Global Food System Resilience.

Lessons learnt from past Flash Floods and Debris Flow events to propose future strategies on risk management

NASA Astrophysics Data System (ADS)

Cabello, Angels; Velasco, Marc; Escaler, Isabel

2010-05-01

Floods, including flash floods and debris flow events, are one of the most important hazards in Europe regarding both economic and life loss. Moreover, changes in precipitation patterns and intensity are very likely to increase due to the observed and predicted global warming, rising the risk in areas that are already vulnerable to floods. Therefore, it is very important to carry out new strategies to improve flood protection, but it is also crucial to take into account historical data to identify high risk areas. The main objective of this paper is to show a comparative analysis of the flood risk management information compiled in four test-bed basins (Llobregat, Guadalhorce, Gardon d'Anduze and Linth basins) from three different European countries (Spain, France and Switzerland) and to identify which are the lessons learnt from their past experiences in order to propose future strategies on risk management. This work is part of the EU 7th FP project IMPRINTS which aims at reducing loss of life and economic damage through the improvement of the preparedness and the operational risk management of flash flood and debris flow (FF & DF) events. The methodology followed includes the following steps: o Specific survey on the effectivity of the implemented emergency plans and risk management procedures sent to the test-bed basin authorities that participate in the project o Analysis of the answers from the questionnaire and further research on their methodologies for risk evaluation o Compilation of available follow-up studies carried out after major flood events in the four test-bed basins analyzed o Collection of the lessons learnt through a comparative analysis of the previous information o Recommendations for future strategies on risk management based on lessons learnt and management gaps detected through the process As the Floods Directive (FD) already states, the flood risks associated to FF & DF events should be assessed through the elaboration of Flood Risk Management Plans (FRMP) with tailored solutions for each basin, evaluating their flood mitigation potential, promoting environmental objectives and increasing the efficiency of the already adopted measures. The FRMP should focus on prevention (and protection), preparedness and response, and these have been the three main risk management phases of a flood crisis that have been assessed when extracting the lessons learnt from past events. Lessons learnt concerning dissemination through the three previously mentioned phases and also related to education initiatives have also been included. A common response to most of the events described in this paper was to upgrade the meteorological and hydrological forecasting systems, making the forecasting lead-time as large as possible. Another common recommendation from the test-beds was the need to implement and accomplish the land use regulations. All the basins also detected that structural measures are necessary to increase the population's protection level, but replacing the traditional safety mentality by a risk culture based on a comprehensive analysis of the flood risk. The four basins studied have also highlighted the importance of collecting information when FF & DF events occur and creating historic databases that will provide extremely useful information in the future.

Identifying outdoor thermal risk areas and evaluation of future thermal comfort concerning shading orientation in a traditional settlement.

PubMed

Huang, Kuo-Tsang; Yang, Shing-Ru; Matzarakis, Andreas; Lin, Tzu-Ping

2018-06-01

The outdoor thermal environment is expected to be deteriorated under climate change. An approach of risk identification including assessment from aspects of thermal stress effect, people's exposure, and local's vulnerability were adopted to study a hot-and-humid traditional rural community located at Tainan, Taiwan. Layers of each aspect were either constructed by in-situ measurements or simulations. To evaluate the future thermal comfort changes by simulations, the prerequisite hourly climate data of three future time slices were produced. Prognostic simulation model, ENVI-met, in combination with diagnostic model, RayMan, were respectively used for identifying current spatial distribution of thermal stress and for assessing the future thermal comfort changes. High thermal risk area was identified by superimposing layers of hazard, exposure and vulnerability. It revealed that because of the tourists' vulnerability to adapt local climate and the inflexibleness of choosing visiting time, it exhibited a high thermal stress at the Main Courtyard where its thermal comfort conditions will be deteriorated due to climate change. Furthermore, the thermal comfort conditions in various shading orientation were analyzed based on the changing climate in three future time slices, i.e. 2011-2040, 2041-2070, and 2071-2100. The results show the area with shading in the East and West side is more comfort than in the North side. In hot season, shading in the West side contributes less PET increasing, especially in the afternoon period. The severest overheat problem (the physiological equivalent temperature, PET>40°C) at the Main Courtyard will increase from current 10% to 28% in 2071-2100 in terms of overheating occurrence frequency. The results of this study can be used as the guidelines for environment analysis before planning or redesign community. Copyright © 2018 Elsevier B.V. All rights reserved.

Sea-Level Rise and Land Subsidence in Deltas: Estimating Future Flood Risk Through Integrated Natural and Human System Modeling

NASA Astrophysics Data System (ADS)

Tessler, Z. D.; Vorosmarty, C. J.

2016-12-01

Deltas are highly sensitive to local human activities, land subsidence, regional water management, global sea-level rise, and climate extremes. We present a new delta flood exposure and risk framework for estimating the sensitivity of deltas to relative sea-level rise. We have applied this framework to a set of global environmental, geophysical, and social indicators over 48 major river deltas to quantify how contemporary risks vary across delta systems. The risk modeling framework incorporates upstream sediment flux and coastal land subsidence models, global empirical estimates of contemporary storm surge exposure, and population distribution and growth. Future scenarios are used to test the impacts on coastal flood risk of upstream dam construction, coastal population growth, accelerated sea-level rise, and enhanced storm surge. Results suggest a wide range of outcomes across different delta systems within each scenario. Deltas in highly engineered watersheds (Mississippi, Rhine) exhibit less sensitivity to increased dams due to saturation of sediment retention effects, though planned or under-construction dams are expected to have a substantial impact in the Yangtze, Irrawaddy, and Magdalena deltas. Population growth and sea-level rise are expected to be the dominant drivers of increased human risk in most deltas, with important exceptions in several countries, particularly China, where population are forecast to contract over the next several decades.

Risk, Resiliency and Coping in National Guard Families

DTIC Science & Technology

2015-10-01

future research and larger quantitative studies of injury trajectory. CONCLUSION This study increases our understanding of risk, resilience and coping... Solomon et al. 2008). This finding is supported by other research that found emotional numbing behaviors associated with the avoidance cluster to be...and effectively, all four symptomatic clusters of PTSD within a relational context. Research suggests that each cluster impacts veterans’ intimate

The relationship between cancer and rheumatoid arthritis: still a large research agenda.

PubMed

Love, Thorvardur; Solomon, Daniel H

2008-01-01

The association between rheumatoid arthritis (RA) and malignancies has received increased attention in recent years. Reports suggesting that tumor necrosis factor blockers might elevate the risk of malignancy in RA patients have prompted researchers to look at the incidence of malignancies in all RA patients. In a recent issue of Arthritis Research & Therapy, Smitten and colleagues suggest that previous reports of a standardized incidence ratio close to one for malignancies in RA may reflect an increased risk for some site-specific malignancies and a reduced risk for others. Here we discuss these findings and suggest what issues could be addressed in future studies.

Climate change effects on wildland fire risk in the Northeastern and Great Lakes states predicted by a downscaled multi-model ensemble

NASA Astrophysics Data System (ADS)

Kerr, Gaige Hunter; DeGaetano, Arthur T.; Stoof, Cathelijne R.; Ward, Daniel

2018-01-01

This study is among the first to investigate wildland fire risk in the Northeastern and the Great Lakes states under a changing climate. We use a multi-model ensemble (MME) of regional climate models from the Coordinated Regional Downscaling Experiment (CORDEX) together with the Canadian Forest Fire Weather Index System (CFFWIS) to understand changes in wildland fire risk through differences between historical simulations and future projections. Our results are relatively homogeneous across the focus region and indicate modest increases in the magnitude of fire weather indices (FWIs) during northern hemisphere summer. The most pronounced changes occur in the date of the initialization of CFFWIS and peak of the wildland fire season, which in the future are trending earlier in the year, and in the significant increases in the length of high-risk episodes, defined by the number of consecutive days with FWIs above the current 95th percentile. Further analyses show that these changes are most closely linked to expected changes in the focus region's temperature and precipitation. These findings relate to the current understanding of particulate matter vis-à-vis wildfires and have implications for human health and local and regional changes in radiative forcings. When considering current fire management strategies which could be challenged by increasing wildland fire risk, fire management agencies could adapt new strategies to improve awareness, prevention, and resilience to mitigate potential impacts to critical infrastructure and population.

An Integrated and Interdisciplinary Model for Predicting the Risk of Injury and Death in Future Earthquakes.

PubMed

Shapira, Stav; Novack, Lena; Bar-Dayan, Yaron; Aharonson-Daniel, Limor

2016-01-01

A comprehensive technique for earthquake-related casualty estimation remains an unmet challenge. This study aims to integrate risk factors related to characteristics of the exposed population and to the built environment in order to improve communities' preparedness and response capabilities and to mitigate future consequences. An innovative model was formulated based on a widely used loss estimation model (HAZUS) by integrating four human-related risk factors (age, gender, physical disability and socioeconomic status) that were identified through a systematic review and meta-analysis of epidemiological data. The common effect measures of these factors were calculated and entered to the existing model's algorithm using logistic regression equations. Sensitivity analysis was performed by conducting a casualty estimation simulation in a high-vulnerability risk area in Israel. the integrated model outcomes indicated an increase in the total number of casualties compared with the prediction of the traditional model; with regard to specific injury levels an increase was demonstrated in the number of expected fatalities and in the severely and moderately injured, and a decrease was noted in the lightly injured. Urban areas with higher populations at risk rates were found more vulnerable in this regard. The proposed model offers a novel approach that allows quantification of the combined impact of human-related and structural factors on the results of earthquake casualty modelling. Investing efforts in reducing human vulnerability and increasing resilience prior to an occurrence of an earthquake could lead to a possible decrease in the expected number of casualties.

Spatial vulnerability of Australian urban populations to extreme heat events

NASA Astrophysics Data System (ADS)

Loughnan, Margaret; Tapper, Nigel; Phan, Thu; Lynch, Kellie; McInnes, Judith

2013-04-01

Extreme heat events pose a risk to the health of all individuals, especially the elderly and the chronically ill, and are associated with an increased demand for healthcare services. In order to address this problem, policy makers' need information about temperatures above which mortality and morbidity of the exposed population is likely to increase, where the vulnerable groups in the community are located, and how the risks from extreme heat events are likely to change in the future. This study identified threshold temperatures for all Australian capital cities, developed a spatial index of population vulnerability, and used climate model output to predict changes in the number of days exceeding temperature thresholds in the future, as well as changes in risk related to changes in urban density and an ageing population. The study has shown that daily maximum and minimum temperatures from the Bureau of Meteorology forecasts can be used to calculate temperature thresholds for heat alert days. The key risk factors related to adverse health outcomes were found to be areas with intense urban heat islands, areas with higher proportions of older people, and areas with ethnic communities. Maps of spatial vulnerability have been developed to provide information to assist emergency managers, healthcare professionals, and ancillary services develop heatwave preparedness plans at a local scale that target vulnerable groups and address heat-related health risks. The numbers of days exceeding current heat thresholds are predicted to increase over the next 20 to 40 years in all Australian capital cities.

Falls prevention focused medication review by a pharmacist in an acute hospital: implications for future practice.

PubMed

Browne, Claire; Kingston, Claire; Keane, Claire

2014-10-01

Patients at risk of falling are regularly prescribed medicines which increase falls risk. Medication review is a widely advocated risk reduction strategy. The objectives of this descriptive study were to determine the number and types of falls risk medicines suitable for intervention, and to develop guidance to optimise the effectiveness of future medication related falls prevention initiatives. An Irish acute teaching hospital and tertiary referral centre. 50 hospital in-patients at risk of falls underwent medication review focused on falls prevention by a pharmacist. Falls risk medicines were identified, and reviewed. If scope to discontinue, dose reduce or switch to a safer alternative was identified by the pharmacist, the suggested medication changes were communicated to the patient's care team. Identification of the classes of falls risk medicines and types of prescriptions with greatest potential for intervention. Results The mean number of falls risk medicines prescribed to each patient was 4.8 (± 2.8) and the total number prescribed to the 50 patients was 238. Following medication review, the pharmacist identified 48 (20 %) as suitable for intervention. Consequently, 34 medication changes (70.8 %) were implemented. Four medication classes accounted for over 80 % of medication changes. These were anti-emetics, opioid analgesics, anti-cholinergic agents acting on the bladder and benzodiazepines/hypnotics. Intervention was statistically significantly more likely to be possible in the case of p.r.n. medicines compared to regular medicines (p < 0.001, Chi square test). Medication reviews focused on falls prevention took an average of 23.5 min per patient to complete. Medication reviews focused on falls prevention involve striking a balance between minimising medicines associated with falls and effectively treating medical conditions. We found only 20 % of falls risk medicines were suitable for change, and reviews were time consuming and resource intensive. However, targeting four medication classes, and being particularly alert to the potential to discontinue 'as required' medicines, has the potential to achieve most of the benefits of more comprehensive reviews. This information will guide the development of future falls risk medicine review initiatives in our hospital, increasing their feasibility in the acute hospital setting.

A large set of potential past, present and future hydro-meteorological time series for the UK

NASA Astrophysics Data System (ADS)

Guillod, Benoit P.; Jones, Richard G.; Dadson, Simon J.; Coxon, Gemma; Bussi, Gianbattista; Freer, James; Kay, Alison L.; Massey, Neil R.; Sparrow, Sarah N.; Wallom, David C. H.; Allen, Myles R.; Hall, Jim W.

2018-01-01

Hydro-meteorological extremes such as drought and heavy precipitation can have large impacts on society and the economy. With potentially increasing risks associated with such events due to climate change, properly assessing the associated impacts and uncertainties is critical for adequate adaptation. However, the application of risk-based approaches often requires large sets of extreme events, which are not commonly available. Here, we present such a large set of hydro-meteorological time series for recent past and future conditions for the United Kingdom based on weather@home 2, a modelling framework consisting of a global climate model (GCM) driven by observed or projected sea surface temperature (SST) and sea ice which is downscaled to 25 km over the European domain by a regional climate model (RCM). Sets of 100 time series are generated for each of (i) a historical baseline (1900-2006), (ii) five near-future scenarios (2020-2049) and (iii) five far-future scenarios (2070-2099). The five scenarios in each future time slice all follow the Representative Concentration Pathway 8.5 (RCP8.5) and sample the range of sea surface temperature and sea ice changes from CMIP5 (Coupled Model Intercomparison Project Phase 5) models. Validation of the historical baseline highlights good performance for temperature and potential evaporation, but substantial seasonal biases in mean precipitation, which are corrected using a linear approach. For extremes in low precipitation over a long accumulation period ( > 3 months) and shorter-duration high precipitation (1-30 days), the time series generally represents past statistics well. Future projections show small precipitation increases in winter but large decreases in summer on average, leading to an overall drying, consistently with the most recent UK Climate Projections (UKCP09) but larger in magnitude than the latter. Both drought and high-precipitation events are projected to increase in frequency and intensity in most regions, highlighting the need for appropriate adaptation measures. Overall, the presented dataset is a useful tool for assessing the risk associated with drought and more generally with hydro-meteorological extremes in the UK.

Risk of future trauma based on alcohol screening scores: A two-year prospective cohort study among US veterans

PubMed Central

2012-01-01

Background Severe alcohol misuse as measured by the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) is associated with increased risk of future fractures and trauma-related hospitalizations. This study examined the association between AUDIT-C scores and two-year risk of any type of trauma among US Veterans Health Administration (VHA) patients and assessed whether risk varied by age or gender. Methods Outpatients (215, 924 male and 9168 female) who returned mailed AUDIT-C questionnaires were followed for 24 months in the medical record for any International Statistical Classification of Diseases and Related Health Problems (ICD-9) code related to trauma. The two-year prevalence of trauma was examined as a function of AUDIT-C scores, with low-level drinking (AUDIT-C 1–4) as the reference group. Men and women were examined separately, and age-stratified analyses were performed. Results Having an AUDIT-C score of 9–12 (indicating severe alcohol misuse) was associated with increased risk for trauma. Mean (SD) ages for men and women were 68.2 (11.5) and 57.2 (15.8), respectively. Age-stratified analyses showed that, for men ≤50 years, those with AUDIT-C scores ≥9 had an increased risk for trauma compared with those with AUDIT-C scores in the 1–4 range (adjusted prevalence, 25.7% versus 20.8%, respectively; OR = 1.24; 95% confidence interval [CI], 1.03–1.50). For men ≥65 years with average comorbidity and education, those with AUDIT-C scores of 5–8 (adjusted prevalence, 7.9% versus 7.4%; OR = 1.16; 95% CI, 1.02–1.31) and 9–12 (adjusted prevalence 11.1% versus 7.4%; OR = 1.68; 95% CI, 1.30–2.17) were at significantly increased risk for trauma compared with men ≥65 years in the reference group. Higher AUDIT-C scores were not associated with increased risk of trauma among women. Conclusions Men with severe alcohol misuse (AUDIT-C 9–12) demonstrate an increased risk of trauma. Men ≥65 showed an increased risk for trauma at all levels of alcohol misuse (AUDIT-C 5–8 and 9–12). These findings may be used as part of an evidence-based brief intervention for alcohol use disorders. More research is needed to understand the relationship between AUDIT-C scores and risk of trauma in women. PMID:22966411

A big data analysis of the relationship between future thinking and decision-making.

PubMed

Thorstad, Robert; Wolff, Phillip

2018-02-20

We use big data methods to investigate how decision-making might depend on future sightedness (that is, on how far into the future people's thoughts about the future extend). In study 1, we establish a link between future thinking and decision-making at the population level in showing that US states with citizens having relatively far future sightedness, as reflected in their tweets, take fewer risks than citizens in states having relatively near future sightedness. In study 2, we analyze people's tweets to confirm a connection between future sightedness and decision-making at the individual level in showing that people with long future sightedness are more likely to choose larger future rewards over smaller immediate rewards. In study 3, we show that risk taking decreases with increases in future sightedness as reflected in people's tweets. The ability of future sightedness to predict decisions suggests that future sightedness is a relatively stable cognitive characteristic. This implication was supported in an analysis of tweets by over 38,000 people that showed that future sightedness has both state and trait characteristics (study 4). In study 5, we provide evidence for a potential mechanism by which future sightedness can affect decisions in showing that far future sightedness can make the future seem more connected to the present, as reflected in how people refer to the present, past, and future in their tweets over the course of several minutes. Our studies show how big data methods can be applied to naturalistic data to reveal underlying psychological properties and processes.

Predicting Health Resilience in Pediatric Type 1 Diabetes: A Test of the Resilience Model Framework

PubMed Central

Huang, Bin; Pendley, Jennifer Shroff; Delamater, Alan; Dolan, Lawrence; Reeves, Grafton; Drotar, Dennis

2015-01-01

Objectives This research examined whether individual and family-level factors during the transition from late childhood to early adolescence protected individuals from an increased risk of poor glycemic control across time, which is a predictor of future diabetes-related complications (i.e., health resilience). Methods This longitudinal, multisite study included 239 patients with type 1 diabetes and their caregivers. Glycemic control was based on hemoglobin A1c. Individual and family-level factors included: demographic variables, youth behavioral regulation, adherence (frequency of blood glucose monitoring), diabetes self-management, level of parental support for diabetes autonomy, level of youth mastery and responsibility for diabetes management, and diabetes-related family conflict. Results Longitudinal mixed-effects logistic regression indicated that testing blood glucose more frequently, better self-management, and less diabetes-related family conflict were indicators of health resilience. Conclusions Multiple individual and family-level factors predicted risk for future health complications. Future research should develop interventions targeting specific individual and family-level factors to sustain glycemic control within recommended targets, which reduces the risk of developing future health complications during the transition to adolescence and adulthood. PMID:26152400

Cervical HSV-2 infection causes cervical remodeling and increases risk for ascending infection and preterm birth.

PubMed

McGee, Devin; Smith, Arianna; Poncil, Sharra; Patterson, Amanda; Bernstein, Alison I; Racicot, Karen

2017-01-01

Preterm birth (PTB), or birth before 37 weeks gestation, is the leading cause of neonatal mortality worldwide. Cervical viral infections have been established as risk factors for PTB in women, although the mechanism leading to increased risk is unknown. Using a mouse model of pregnancy, we determined that intra-vaginal HSV2 infection caused increased rates of preterm birth following an intra-vaginal bacterial infection. HSV2 infection resulted in histological changes in the cervix mimicking cervical ripening, including significant collagen remodeling and increased hyaluronic acid synthesis. Viral infection also caused aberrant expression of estrogen and progesterone receptor in the cervical epithelium. Further analysis using human ectocervical cells demonstrated a role for Src kinase in virus-mediated changes in estrogen receptor and hyaluronic acid expression. In conclusion, HSV2 affects proteins involved in tissue hormone responsiveness, causes significant changes reminiscent of premature cervical ripening, and increases risk of preterm birth. Studies such as this improve our chances of identifying clinical interventions in the future.

Cervical HSV-2 infection causes cervical remodeling and increases risk for ascending infection and preterm birth

PubMed Central

McGee, Devin; Poncil, Sharra; Patterson, Amanda

2017-01-01

Preterm birth (PTB), or birth before 37 weeks gestation, is the leading cause of neonatal mortality worldwide. Cervical viral infections have been established as risk factors for PTB in women, although the mechanism leading to increased risk is unknown. Using a mouse model of pregnancy, we determined that intra-vaginal HSV2 infection caused increased rates of preterm birth following an intra-vaginal bacterial infection. HSV2 infection resulted in histological changes in the cervix mimicking cervical ripening, including significant collagen remodeling and increased hyaluronic acid synthesis. Viral infection also caused aberrant expression of estrogen and progesterone receptor in the cervical epithelium. Further analysis using human ectocervical cells demonstrated a role for Src kinase in virus-mediated changes in estrogen receptor and hyaluronic acid expression. In conclusion, HSV2 affects proteins involved in tissue hormone responsiveness, causes significant changes reminiscent of premature cervical ripening, and increases risk of preterm birth. Studies such as this improve our chances of identifying clinical interventions in the future. PMID:29190738

Current and future ozone risks to global terrestrial biodiversity and ecosystem processes.

PubMed

Fuhrer, Jürg; Val Martin, Maria; Mills, Gina; Heald, Colette L; Harmens, Harry; Hayes, Felicity; Sharps, Katrina; Bender, Jürgen; Ashmore, Mike R

2016-12-01

Risks associated with exposure of individual plant species to ozone (O 3 ) are well documented, but implications for terrestrial biodiversity and ecosystem processes have received insufficient attention. This is an important gap because feedbacks to the atmosphere may change as future O 3 levels increase or decrease, depending on air quality and climate policies. Global simulation of O 3 using the Community Earth System Model (CESM) revealed that in 2000, about 40% of the Global 200 terrestrial ecoregions (ER) were exposed to O 3 above thresholds for ecological risks, with highest exposures in North America and Southern Europe, where there is field evidence of adverse effects of O 3 , and in central Asia. Experimental studies show that O 3 can adversely affect the growth and flowering of plants and alter species composition and richness, although some communities can be resilient. Additional effects include changes in water flux regulation, pollination efficiency, and plant pathogen development. Recent research is unraveling a range of effects belowground, including changes in soil invertebrates, plant litter quantity and quality, decomposition, and nutrient cycling and carbon pools. Changes are likely slow and may take decades to become detectable. CESM simulations for 2050 show that O 3 exposure under emission scenario RCP8.5 increases in all major biomes and that policies represented in scenario RCP4.5 do not lead to a general reduction in O 3 risks; rather, 50% of ERs still show an increase in exposure. Although a conceptual model is lacking to extrapolate documented effects to ERs with limited or no local information, and there is uncertainty about interactions with nitrogen input and climate change, the analysis suggests that in many ERs, O 3 risks will persist for biodiversity at different trophic levels, and for a range of ecosystem processes and feedbacks, which deserves more attention when assessing ecological implications of future atmospheric pollution and climate change.

Plaque Structural Stress Estimations Improve Prediction of Future Major Adverse Cardiovascular Events After Intracoronary Imaging.

PubMed

Brown, Adam J; Teng, Zhongzhao; Calvert, Patrick A; Rajani, Nikil K; Hennessy, Orla; Nerlekar, Nitesh; Obaid, Daniel R; Costopoulos, Charis; Huang, Yuan; Hoole, Stephen P; Goddard, Martin; West, Nick E J; Gillard, Jonathan H; Bennett, Martin R

2016-06-01

Although plaque rupture is responsible for most myocardial infarctions, few high-risk plaques identified by intracoronary imaging actually result in future major adverse cardiovascular events (MACE). Nonimaging markers of individual plaque behavior are therefore required. Rupture occurs when plaque structural stress (PSS) exceeds material strength. We therefore assessed whether PSS could predict future MACE in high-risk nonculprit lesions identified on virtual-histology intravascular ultrasound. Baseline nonculprit lesion features associated with MACE during long-term follow-up (median: 1115 days) were determined in 170 patients undergoing 3-vessel virtual-histology intravascular ultrasound. MACE was associated with plaque burden ≥70% (hazard ratio: 8.6; 95% confidence interval, 2.5-30.6; P<0.001) and minimal luminal area ≤4 mm(2) (hazard ratio: 6.6; 95% confidence interval, 2.1-20.1; P=0.036), although absolute event rates for high-risk lesions remained <10%. PSS derived from virtual-histology intravascular ultrasound was subsequently estimated in nonculprit lesions responsible for MACE (n=22) versus matched control lesions (n=22). PSS showed marked heterogeneity across and between similar lesions but was significantly increased in MACE lesions at high-risk regions, including plaque burden ≥70% (13.9±11.5 versus 10.2±4.7; P<0.001) and thin-cap fibroatheroma (14.0±8.9 versus 11.6±4.5; P=0.02). Furthermore, PSS improved the ability of virtual-histology intravascular ultrasound to predict MACE in plaques with plaque burden ≥70% (adjusted log-rank, P=0.003) and minimal luminal area ≤4 mm(2) (P=0.002). Plaques responsible for MACE had larger superficial calcium inclusions, which acted to increase PSS (P<0.05). Baseline PSS is increased in plaques responsible for MACE and improves the ability of intracoronary imaging to predict events. Biomechanical modeling may complement plaque imaging for risk stratification of coronary nonculprit lesions. © 2016 American Heart Association, Inc.

Analysis of Lrrk2 R1628P as a risk factor for Parkinson's disease.

PubMed

Ross, Owen A; Wu, Yih-Ru; Lee, Mei-Ching; Funayama, Manabu; Chen, Meng-Ling; Soto, Alexandra I; Mata, Ignacio F; Lee-Chen, Guey-Jen; Chen, Chiung Mei; Tang, Michelle; Zhao, Yi; Hattori, Nobutaka; Farrer, Matthew J; Tan, Eng-King; Wu, Ruey-Meei

2008-07-01

Common genetic variants that increase the risk for Parkinson's disease may differentiate patient subgroups and influence future individualized therapeutic strategies. Herein we show evidence for leucine-rich repeat kinase 2 (LRRK2) c.4883G>C (R1628P) as a risk factor in ethnic Chinese populations. A study of 1,986 individuals from 3 independent centers in Taiwan and Singapore demonstrates that Lrrk2 R1628P increases risk for Parkinson's disease (odds ratio, 1.84; 95% confidence interval, 1.20-2.83; p = 0.006). Haplotype analysis suggests an ancestral founder for carriers approximately 2,500 years ago. These findings support the importance of LRRK2 variants in sporadic Parkinson's disease. Ann Neurol 2008.

Landscape, Environmental and Social Predictors of Hantavirus Risk in São Paulo, Brazil

PubMed Central

Uriarte, Maria; Tambosi, Leandro Reverberi; Prado, Amanda; Pardini, Renata; D´Andrea, Paulo Sérgio; Metzger, Jean Paul

2016-01-01

Hantavirus Pulmonary Syndrome (HPS) is a disease caused by Hantavirus, which are negative-sense RNA viruses in the family Bunyaviridae that are highly virulent to humans. Numerous factors modify risk of Hantavirus transmission and consequent HPS risk. Human-driven landscape change can foster transmission risk by increasing numbers of habitat generalist rodent species that serve as the principal reservoir host. Climate can also affect rodent population dynamics and Hantavirus survival, and a number of social factors can influence probability of HPS transmission to humans. Evaluating contributions of these factors to HPS risk may enable predictions of future outbreaks, and is critical to development of effective public health strategies. Here we rely on a Bayesian model to quantify associations between annual HPS incidence across the state of São Paulo, Brazil (1993–2012) and climate variables (annual precipitation, annual mean temperature), landscape structure metrics (proportion of native habitat cover, number of forest fragments, proportion of area planted with sugarcane), and social factors (number of men older than 14 years and Human Development Index). We built separate models for the main two biomes of the state (cerrado and Atlantic forest). In both biomes Hantavirus risk increased with proportion of land cultivated for sugarcane and HDI, but proportion of forest cover, annual mean temperature, and population at risk also showed positive relationships in the Atlantic forest. Our analysis provides the first evidence that social, landscape, and climate factors are associated with HPS incidence in the Neotropics. Our risk map can be used to support the adoption of preventive measures and optimize the allocation of resources to avoid disease propagation, especially in municipalities that show medium to high HPS risk (> 5% of risk), and aimed at sugarcane workers, minimizing the risk of future HPS outbreaks. PMID:27780250

ARV robotic technologies (ART): a risk reduction effort for future unmanned systems

NASA Astrophysics Data System (ADS)

Jaster, Jeffrey F.

2006-05-01

The Army's ARV (Armed Robotic Vehicle) Robotic Technologies (ART) program is working on the development of various technological thrusts for use in the robotic forces of the future. The ART program will develop, integrate and demonstrate the technology required to advance the maneuver technologies (i.e., perception, mobility, tactical behaviors) and increase the survivability of unmanned platforms for the future force while focusing on reducing the soldiers' burden by providing an increase in vehicle autonomy coinciding with a decrease in the total number user interventions required to control the unmanned assets. This program will advance the state of the art in perception technologies to provide the unmanned platform an increasingly accurate view of the terrain that surrounds it; while developing tactical/mission behavior technologies to provide the Unmanned Ground Vehicle (UGV) the capability to maneuver tactically, in conjunction with the manned systems in an autonomous mode. The ART testbed will be integrated with the advanced technology software and associated hardware developed under this effort, and incorporate appropriate mission modules (e.g. RSTA sensors, MILES, etc.) to support Warfighter experiments and evaluations (virtual and field) in a military significant environment (open/rolling and complex/urban terrain). The outcome of these experiments as well as other lessons learned through out the program life cycle will be used to reduce the current risks that are identified for the future UGV systems that will be developed under the Future Combat Systems (FCS) program, including the early integration of an FCS-like autonomous navigation system onto a tracked skid steer platform.

OS104. Are preeclampsia and adverse obstetrical outcomes predictors for longterm cardiovascular disease?

PubMed

Sia, W W; Tsuyuki, R; Pertman, S; Hui, W

2012-07-01

Epidemiologic studies suggest that pregnancy complications such as preeclampsia, gestational diabetes, preterm delivery and low birth weight independently increase maternal risk for future development of cardiovascular disease. To further investigate whether preeclampsia, gestational diabetes, and adverse obstetrical outcomes such as placental abruption, intrauterine growth restriction and preterm delivery, are independent risk factors for longterm cardiovascular disease. This was a case-control study where 252 parous women (cases) with coronary artery disease were matched with a parous woman within 5 years of age with no known coronary artery disease (controls). Participants were recruited from the Royal Alexandra Hospital in cardiac catheterization lab recovery room in Edmonton, Canada. Women with significant angiographic coronary artery stenosis were eligible as cases and those without were eligible as controls. Participants were interviewed on their pregnancy histories and traditional cardiovascular risk factors, such as hypertension, diabetes etc. Descriptive statistics, chi-square tests and conditional regression analysis were performed. We recruited 244 cases and 246 controls. The average age was 66.3 and 65.8 respectively. Cases were more likely obese, had more pregnancies as well as traditional cardiovascular risk factors than controls. Adverse pregnancy outcomes were similar between the two groups except gestational hypertension. However, it was not statistically significant in the conditional logistic regression model. Independent risk factors for future cardiovascular diseases were: dyslipidemia (OR 12.8), hypertension (3.0), and being a current (OR 7.4) or former smoker (1.8). Adverse pregnancy outcomes In this study, adverse pregnancy outcomes were not independently associated with cardiovascular disorders. Our study was limited by recall bias, and ascertainment of diagnosis.Our study supports that dyslipidemia, hypertensiion and smoking increase future cardiovascular disease. Further studies are needed to examine a postpartum intervention model to proactively manage cardiovascular risk factors, such as lipids, in these at-risk women. Copyright © 2012. Published by Elsevier B.V.

Past and future drivers of increased erosion risk in the northern Gulf of Mexico

NASA Astrophysics Data System (ADS)

Wahl, T.; Plant, N. G.

2014-12-01

We use hourly observations of water levels from two tide gauges and wave data from three buoys to assess their relative contribution to past and potential future changes in the erosion risk for Dauphin Island, a barrier island located off the coastline of Alabama. Topographic information (i.e. beach slopes and dune toe and crest heights) is obtained from the most recent lidar survey conducted in the area in July 2013. Water levels and wave parameters (i.e. significant wave height and peak period) from the two tide gauges and three wave buoys are merged into single records spanning the period from 1981 to 2013. The Stockdon et al. (2006) run-up model is used to estimate the 2% exceedance values of wave run-up maxima, which are then combined with the observed water levels at the representative tide gauge site to obtain total water levels (TWLs). With this information we assess the relative contribution of geocentric sea level rise, vertical land-movement, and long-term changes in the wave parameters to the observed increase in erosion risk. The latter is approximated using the concept of impact hours per year (IHPY; Ruggiero 2013) at dune toe and dune crest elevation thresholds derived from the lidar data. Wahl et al. (2014) recently discovered a significant increase in the amplitude of the seasonal sea level cycle in the Gulf of Mexico. Here, we explore the potential of these changes, and similar developments in the seasonal cycle of the wave data and corresponding IHPY, to affect coastal erosion. Such intra-annual signals with longer-term variations have not been included in most earlier studies in favour of analysing the effects of annually averaged long-term trends. Finally, scenarios of potential future changes of all relevant parameters are used to explore their relative contribution to further increase in the coastal erosion risk over the next few decades.

Serum TSH within the reference range as a predictor of future hypothyroidism and hyperthyroidism: 11-year follow-up of the HUNT Study in Norway.

PubMed

Åsvold, Bjørn O; Vatten, Lars J; Midthjell, Kristian; Bjøro, Trine

2012-01-01

Serum TSH in the upper part of the reference range may sometimes be a response to autoimmune thyroiditis in early stage and may therefore predict future hypothyroidism. Conversely, relatively low serum TSH could predict future hyperthyroidism. The objective of the study was to assess TSH within the reference range and subsequent risk of hypothyroidism and hyperthyroidism. This was a prospective population-based study with linkage to the Norwegian Prescription Database. A total of 10,083 women and 5,023 men without previous thyroid disease who had a baseline TSH of 0.20-4.5 mU/liter and who participated at a follow-up examination 11 yr later. Predicted probabilities of developing hypothyroidism or hyperthyroidism during follow-up, by categories of baseline TSH, were estimated. During 11 yr of follow-up, 3.5% of women and 1.3% of men developed hypothyroidism, and 1.1% of women and 0.6% of men developed hyperthyroidism. In both sexes, the baseline TSH was positively associated with the risk of subsequent hypothyroidism. The risk increased gradually from TSH of 0.50-1.4 mU/liter [women, 1.1%, 95% confidence interval (CI) 0.8-1.4; men, 0.3%, 95% CI 0.1-0.6] to a TSH of 4.0-4.5 mU/liter (women, 31.5%, 95% CI 24.6-39.3; men, 14.7%, 95% CI 7.7-26.2). The risk of hyperthyroidism was higher in women with a baseline TSH of 0.20-0.49 mU/liter (3.9%, 95% CI 1.8-8.4) than in women with a TSH of 0.50-0.99 mU/liter (1.4%, 95% CI 0.9-2.1) or higher (∼1.0%). TSH within the reference range is positively and strongly associated with the risk of future hypothyroidism. TSH at the lower limit of the reference range may be associated with an increased risk of hyperthyroidism.

Beyond dose assessment: using risk with full disclosure of uncertainty in public and scientific communication.

PubMed

Hoffman, F Owen; Kocher, David C; Apostoaei, A Iulian

2011-11-01

Evaluations of radiation exposures of workers and the public traditionally focus on assessments of radiation dose, especially annual dose, without explicitly evaluating the health risk associated with those exposures, principally the risk of radiation-induced cancer. When dose is the endpoint of an assessment, opportunities to communicate the significance of exposures are limited to comparisons with dose criteria in regulations, doses due to natural background or medical x-rays, and doses above which a statistically significant increase of disease has been observed in epidemiologic studies. Risk assessment generally addresses the chance (probability) that specific diseases might be induced by past, present, or future exposure. The risk of cancer per unit dose will vary depending on gender, age, exposure type (acute or chronic), and radiation type. It is not uncommon to find that two individuals with the same effective dose will have substantially different risks. Risk assessment has shown, for example, that: (a) medical exposures to computed tomography scans have become a leading source of future risk to the general population, and that the risk would be increased above recently published estimates if the incidence of skin cancer and the increased risk from exposure to x-rays compared with high-energy photons were taken into account; (b) indoor radon is a significant contributor to the baseline risk of lung cancer, particularly among people who have never smoked; and (c) members of the public who were exposed in childhood to I in fallout from atmospheric nuclear weapons tests and were diagnosed with thyroid cancer later in life would frequently meet criteria established for federal compensation of cancers experienced by energy workers and military participants at atmospheric weapons tests. Risk estimation also enables comparisons of impacts of exposures to radiation and chemical carcinogens and other hazards to life and health. Communication of risk with uncertainty is essential for reaching informed consent, whether communicating to a larger community debating the tradeoffs of risks and benefits of an action that involves radiation exposure or communicating at the level of a physician and patient.

Medically assisted reproduction and ethical challenges

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

Kaeaeriaeinen, Helena; Evers-Kiebooms, Gerry; Coviello, Domenico

2005-09-01

Many of the ethical challenges associated with medically assisted reproduction are societal. Should the technique be restricted to only ordinary couples or could it be used also to single females or couples of same sex? Should the future child be entitled to know the identity of the gamete donor? Should there be age limits? Can embryos or gametes be used after the death of the donor? Can surrogate mothers be part of the process? Can preimplantation diagnostics be used to select the future baby's sex? In addition, there are several clearly medical questions that lead to difficult ethical problems. Ismore » it safe to use very premature eggs or sperms? Is the risk for some rare syndromes caused by imprinting errors really increased when using these techniques? Do we transfer genetic infertility to the offspring? Is the risk for multiple pregnancies too high when several embryos are implanted? Does preimplantation diagnosis cause some extra risks for the future child? Should the counselling of these couples include information of all these potential but unlikely risks? The legislation and practices differ in different countries and ethical discussion and professional guidelines are still needed.« less

The value of a registry negative urine pregnancy test for the prediction of a future unintended pregnancy among young women.

PubMed

Rottenstreich, Misgav; Grisaru-Granovsky, Sorina; Rottenstreich, Amihai

2018-06-01

Performance of urine pregnancy test in general adolescents' clinic reflects caregiver or woman's concern that there might be a pregnancy. We aimed to assess whether young-unmarried women in whom a negative urine pregnancy test was registered would be at increased risk of a future unintended pregnancy. The study cohort included consecutive women drafted by the Israeli military between 2013 and 2015. The risk of unintended pregnancy was compared between women with a negative urine pregnancy test (n = 2774), the study group, and those in whom urine pregnancy test was not carried out (n = 126,659), the control group. During the study period, 2147 (1.7%) women experienced an unintended pregnancy. The risk of unintended pregnancy was significantly higher in patients in whom a past pregnancy test was negative 4.3% (n = 118), as compared with the control group 1.6% (n = 2028) (odds ratio [OR], 2.7; 95% confidence interval [CI], 2.23-3.26). In multivariate analysis history of a negative pregnancy test results was an independent predictor for a future unintended pregnancy (adjusted OR, 2.0; 95% CI, 1.63-2.52). A history of a negative pregnancy test among young conscripted women is a significant risk indicator for a future unintended pregnancy. Directed efforts should be made in this particular vulnerable group of patients.

Climate change will increase the naturalization risk from garden plants in Europe

PubMed Central

Wessely, Johannes; Bossdorf, Oliver; Dawson, Wayne; Essl, Franz; Gattringer, Andreas; Klonner, Günther; Kreft, Holger; Kuttner, Michael; Moser, Dietmar; Pergl, Jan; Pyšek, Petr; Thuiller, Wilfried; van Kleunen, Mark; Weigelt, Patrick; Winter, Marten; Dullinger, Stefan; Beaumont, Linda

2016-01-01

Abstract Aim Plant invasions often follow initial introduction with a considerable delay. The current non‐native flora of a region may hence contain species that are not yet naturalized but may become so in the future, especially if climate change lifts limitations on species spread. In Europe, non‐native garden plants represent a huge pool of potential future invaders. Here, we evaluate the naturalization risk from this species pool and how it may change under a warmer climate. Location Europe. Methods We selected all species naturalized anywhere in the world but not yet in Europe from the set of non‐native European garden plants. For this subset of 783 species, we used species distribution models to assess their potential European ranges under different scenarios of climate change. Moreover, we defined geographical hotspots of naturalization risk from those species by combining projections of climatic suitability with maps of the area available for ornamental plant cultivation. Results Under current climate, 165 species would already find suitable conditions in > 5% of Europe. Although climate change substantially increases the potential range of many species, there are also some that are predicted to lose climatically suitable area under a changing climate, particularly species native to boreal and Mediterranean biomes. Overall, hotspots of naturalization risk defined by climatic suitability alone, or by a combination of climatic suitability and appropriate land cover, are projected to increase by up to 102% or 64%, respectively. Main conclusions Our results suggest that the risk of naturalization of European garden plants will increase with warming climate, and thus it is very likely that the risk of negative impacts from invasion by these plants will also grow. It is therefore crucial to increase awareness of the possibility of biological invasions among horticulturalists, particularly in the face of a warming climate. PMID:28111525

Contribution of future urbanisation expansion to flood risk changes

NASA Astrophysics Data System (ADS)

Bruwier, Martin; Mustafa, Ahmed; Archambeau, Pierre; Erpicum, Sébastien; Pirotton, Michel; Teller, Jacques; Dewals, Benjamin

2016-04-01

The flood risk is expected to increase in the future due to climate change and urban development. Climate change modifies flood hazard and urban development influences exposure and vulnerability to floods. While the influence of climate change on flood risk has been studied widely, the impact of urban development also needs to be considered in a sustainable flood risk management approach. The main goal of this study is the determination of the sensitivity of future flood risk to different urban development scenarios at a relatively short-time horizon in the River Meuse basin in Wallonia (Belgium). From the different scenarios, the expected impact of urban development on flood risk is assessed. Three urban expansion scenarios are developed up to 2030 based on a coupled cellular automata (CA) and agent-based (AB) urban expansion model: (i) business-as-usual, (ii) restrictive and (iii) extreme expansion scenarios. The main factor controlling these scenarios is the future urban land demand. Each urban expansion scenario is developed by considering or not high and/or medium flood hazard zones as a constraint for urban development. To assess the model's performance, it is calibrated for the Meuse River valley (Belgium) to simulate urban expansion between 1990 and 2000. Calibration results are then assessed by comparing the 2000 simulated land-use map and the actual 2000 land-use map. The flood damage estimation for each urban expansion scenario is determined for five flood discharges by overlaying the inundation map resulting from a hydraulic computation and the urban expansion map and by using damage curves and specific prices. The hydraulic model Wolf2D has been extensively validated by comparisons between observations and computational results during flood event .This study focuses only on mobile and immobile prices for urban lands, which are associated to the most severe damages caused by floods along the River Meuse. These findings of this study offers tools to drive urban expansion based on numerous policies visions to mitigate future flood risk along the Meuse River. In particular, we assess the impacts on future flood risk of the prohibition of urban development in high and/or medium flood hazard zones. Acknowledgements The research was funded through the ARC grant for Concerted Research Actions, financed by the Wallonia-Brussels Federation.

Increasing weather-related impacts on European population under climate and demographic change

NASA Astrophysics Data System (ADS)

Forzieri, Giovanni; Cescatti, Alessandro; Batista e Silva, Filipe; Kovats, Sari R.; Feyen, Luc

2017-04-01

Over the last three decades the overwhelming majority of disasters have been caused by weather-related events. The observed rise in weather-related disaster losses has been largely attributed to increased exposure and to a lesser degree to global warming. Recent studies suggest an intensification in the climatology of multiple weather extremes in Europe over the coming decades in view of climate change, while urbanization continues. In view of these pressures, understanding and quantifying the potential impacts of extreme weather events on future societies is imperative in order to identify where and to what extent their livelihoods will be at risk in the future, and develop timely and effective adaptation and disaster risk reduction strategies. Here we show a comprehensive assessment of single- and multi-hazard impacts on the European population until the year 2100. For this purpose, we developed a novel methodology that quantifies the human impacts as a multiplicative function of hazard, exposure and population vulnerability. We focus on seven of the most impacting weather-related hazards - including heat and cold waves, wildfires, droughts, river and coastal floods and windstorms - and evaluated their spatial and temporal variations in intensity and frequency under a business-as-usual climate scenario. Long-term demographic dynamics were modelled to assess exposure developments under a corresponding middle-of-the-road scenario. Vulnerability of humans to weather extremes was appraised based on more than 2300 records of weather-related disasters. The integration of these elements provides a range of plausible estimates of extreme weather-related risks for future European generations. Expected impacts on population are quantified in terms of fatalities and number of people exposed. We find a staggering rise in fatalities from extreme weather events, with the projected death toll by the end of the century amounting to more than 50 times the present number of people killed. Approximately two-thirds of European citizens could then be exposed to a weather-related disaster each year, which will bring about huge rises in health costs to society. Future impacts show a prominent spatial gradient towards southern regions, where weather extremes could become the greatest environmental risk factor for people. The projected changes are dominated by global warming, mainly through a rise in heatwaves, but ongoing urbanization, development in hazard-prone areas and ageing population will likely further increase human risk. The results call for immediate action to achieve the Paris goals on climate mitigation and adaptation in order to protect future European generations.

Belgium: risk adjustment and financial responsibility in a centralised system.

PubMed

Schokkaert, Erik; Van de Voorde, Carine

2003-07-01

Since 1995 Belgian sickness funds are partially financed through a risk adjustment system and are held partially financially responsible for the difference between their actual and their risk-adjusted expenditures. However, they did not get the necessary instruments for exerting a real influence on expenditures and the health insurance market has not been opened for new entrants. At the same time the sickness funds have powerful tools for risk selection, because they also dominate the market for supplementary health insurance. The present risk-adjustment system is based on the results of a regression analysis with aggregate data. The main proclaimed purpose of this system is to guarantee a fair treatment to all the sickness funds. Until now the danger of risk selection has not been taken seriously. Consumer mobility has remained rather low. However, since the degree of financial responsibility is programmed to increase in the near future, the potential profits from cream skimming will increase.

Are Eating Disorders Risk Factors for Type 2 Diabetes? A Systematic Review and Meta-analysis.

PubMed

Nieto-Martínez, Ramfis; González-Rivas, Juan P; Medina-Inojosa, José R; Florez, Hermes

2017-11-22

Eating disorders (ED) affect energy intake modifying body fat depots. Prior evidence suggests that binge eating disorder (BED) and bulimia nervosa (BN) could increase the risk for type 2 diabetes (T2D), while anorexia nervosa (AN) could reduce it. A systematic review and meta-analysis were conducted to evaluate if ED are risk factors for T2D. Ten studies were selected out of 1057 screened. Meta-analysis of six studies with T2D as outcome is reported. Among cross-sectional studies, both BED (OR 3.69, 95% CI [1.12-12.12]) and BN (OR 3.45 [1.92-6.1]) increased the risk of T2D, while AN was not associated with lower risk (OR 0.87 [0.40-1.88]). Cohort studies showed increased risk of T2D with BN (RR 1.7 [1.2-2.5]), and decreased risk with AN (RR 0.71 [0.52-0.98]), but for BED the association was less clear (OR 3.34 [0.85-13.12]). Limitations of studies and recommendations for future research are presented.

Exercise-related injuries among women: strategies for prevention from civilian and military studies.

PubMed

Gilchrist, J; Jones, B H; Sleet, D A; Kimsey, C D

2000-03-31

The numerous health benefits of physical activity have been well documented, resulting in public health support of regular physical activity and exercise. Although beneficial, exercise also has corresponding risks, including musculoskeletal injuries. The incidence and risk factors for exercise-related injury have been poorly assessed in women. Many civilian exercise activities (e.g., jogging, walking, and erobics) have corollaries in military physical training; injury incidence and risk factors associated with military physical training have been more thoroughly studied. Injury risks increase as the amount of training increases (increased xposure). The same exercise parameters that can be modified to enhance physical fitness (i.e., frequency, duration, and intensity) also influence the risk for injury in a dose-response manner. Higher levels of current physical fitness (aerobic fitness) protect the participant against future injury. A history of previous injury is a risk factor for future injury. Smoking cigarettes has been associated with increased risk for exercise-related injury. Studies conducted in military populations suggest that the most important risk factor for injuries among persons engaged in vigorous weight-bearing aerobic physical activity might be low aerobic fitness rather than female sex. Because of the limited scientific research regarding women engaging in exercise, general recommendations are provided. Women starting exercise programs should be realistic about their goals and start slowly at frequency, duration, and intensity levels commensurate with their current physical fitness condition. Women should be informed about the early indicators of potential injury. Women who have sustained an injury should take precautions to prevent reinjury (e.g., ensuring appropriate recovery and rehabilitation). In general, a combination of factors affects the risk for exercise-related injury in women. How these factors act singly and in combination to influence injury risk is not well understood. Additional research regarding exercise-related injury in women is needed to answer many of the remaining epidemiologic questions and to help develop exercise programs that improve health while reducing the risk for injury. Exercise is an important component in improving and maintaining health; however, injury is also an accompanying risk. A review of key military and civilian research studies regarding exercise-related injuries provides some clues to reducing these injuries in women. Greater adherence to exercise guidelines can help decrease these risks.

Modeled changes in 100 year Flood Risk and Asset Damages within Mapped Floodplains of the Contiguous United States

EPA Science Inventory

A growing body of recent work suggests that the extreme weather events that drive inland flooding are likely to increase in frequency and magnitude with a warming climate. These changes are likely to increase flooding damages in the future. We use hydrologic projections from 2...

Tryptase increase on the first day of hymenoptera venom immunotherapy might be a predictor of future systemic reactions during treatment.

PubMed

Vega-Castro, A; Alonso-Llamazares, A; Cárdenas, R; Beitia, J M; Mateo, B; Alvarez-Twose, I; Blanco, C

2018-03-28

Serum tryptase (ST) decreases in long-term venom immunotherapy (VIT). A circadian tryptase variation with a small decrease has been found after sting challenge. Both findings have been related to successful VIT. Objective: To assess whether variation (increase or decrease) in ST on the first day of VIT is associated with the likehood of future systemic adverse reactions (SAR) during treatment. We prospectively studied patients who underwent cluster VIT and continued it for at least 6 months. ST was measured on the first day of VIT, before the first dose (pre-IT tryptase) and after the last dose (post-IT tryptase). Differences between patients' groups (with and without SAR) were analysed. One hundred and sixty VIT were administered to 150 patients. The median baseline ST value was 4.3 μg/L. A total of 25 VIT (15.6%) were associated with SAR. In 64% of the 25 patients with SAR, post-IT tryptase value was higher than pre-IT tryptase level; the median increment was 19% in these patients. We found a significant relation between this increase in tryptase level on the first day of VIT and future SAR (risk ratio 7.6). This elevation was independent of the VIT scheduled day and severity of the SAR, as well as of the basal ST value. A slight increase in tryptase on the first day of VIT is an independent variable strongly related to a high risk of future SAR. This simple biomarker could be helpful to improve patients´ safety.

Abbreviated MRI Protocols: Wave of the Future for Breast Cancer Screening.

PubMed

Chhor, Chloe M; Mercado, Cecilia L

2017-02-01

The purpose of this article is to describe the use of abbreviated breast MRI protocols for improving access to screening for women at intermediate risk. Breast MRI is not a cost-effective modality for screening women at intermediate risk, including those with dense breast tissue as the only risk. Abbreviated breast MRI protocols have been proposed as a way of achieving efficiency and rapid throughput. Use of these abbreviated protocols may increase availability and provide women with greater access to breast MRI.

[Clinical risk factors for progressive myopia].

PubMed

Schaeffel, F

2012-08-01

The average worldwide frequency of myopia is approximately 30 % and is traditionally subdivided into school myopia and pathological myopia. A further distinction is made between progressive myopia and stationary myopia. There is a high correlation between the frequency of myopia and urbanization and training. Risk factors for development of myopia are close-up work, lack of outdoor activity, biometrical variables of the eye and genetic risk factors. Development of myopia can be positively influenced by peripheral focusing, increased exposure to light and in the future possibly pharmacologically.

Grade-Level Differences in Future-Oriented Self-Concept During Early Adolescence: Potential Relevance to School Nursing

PubMed Central

2016-01-01

The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents’ future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and building effective health-promotion and risk reduction interventions. Therefore, this study explored grade-level differences in hoped for and feared possible selves in a sample of 6th – 9th grade students (n = 2,498; Mage = 12.72, SD = 1.15; 51.3% female). Findings suggest that adolescents list a variety of possible selves, and the content differs according to grade-level. These findings offer helpful insight for intervention work aimed at improving student outcomes and preventing risk behavior. Understanding what adolescents hope and fear for themselves in the future may be particularly beneficial for school nurses in identifying the unique challenges students experience and tailoring health-promotion efforts. PMID:27222444

Grade-Level Differences in Future-Oriented Self-Concept During Early Adolescence: Potential Relevance to School Nursing.

PubMed

Stoddard, Sarah A; Pierce, Jennifer; Schmidt, Carissa J

2016-12-01

The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents' future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and building effective health promotion and risk reduction interventions. Therefore, this study explored grade-level differences in hoped for and feared possible selves in a sample of sixth- to ninth-grade students (n = 2,498; M age = 12.72, SD = 1.15; 51.3% female). Findings suggest that adolescents list a variety of possible selves, and the content differs according to grade level. These findings offer helpful insight for intervention work aimed at improving student outcomes and preventing risk behavior. Understanding what adolescents hope and fear for themselves in the future may be particularly beneficial for school nurses in identifying the unique challenges students experience and tailoring health promotion efforts. © The Author(s) 2016.

Prognostic value of choline and betaine depends on intestinal microbiota-generated metabolite trimethylamine-N-oxide.

PubMed

Wang, Zeneng; Tang, W H Wilson; Buffa, Jennifer A; Fu, Xiaoming; Britt, Earl B; Koeth, Robert A; Levison, Bruce S; Fan, Yiying; Wu, Yuping; Hazen, Stanley L

2014-04-01

Recent metabolomics and animal model studies show trimethylamine-N-oxide (TMAO), an intestinal microbiota-dependent metabolite formed from dietary trimethylamine-containing nutrients such as phosphatidylcholine (PC), choline, and carnitine, is linked to coronary artery disease pathogenesis. Our aim was to examine the prognostic value of systemic choline and betaine levels in stable cardiac patients. We examined the relationship between fasting plasma choline and betaine levels and risk of major adverse cardiac events (MACE = death, myocardial infraction, stroke) in relation to TMAO over 3 years of follow-up in 3903 sequential stable subjects undergoing elective diagnostic coronary angiography. In our study cohort, median (IQR) TMAO, choline, and betaine levels were 3.7 (2.4-6.2)μM, 9.8 (7.9-12.2)μM, and 41.1 (32.5-52.1)μM, respectively. Modest but statistically significant correlations were noted between TMAO and choline (r = 0.33, P < 0.001) and less between TMAO and betaine (r = 0.09, P < 0.001). Higher plasma choline and betaine levels were associated with a 1.9-fold and 1.4-fold increased risk of MACE, respectively (Quartiles 4 vs. 1; P < 0.01, each). Following adjustments for traditional cardiovascular risk factors and high-sensitivity C-reactive protein, elevated choline [1.34 (1.03-1.74), P < 0.05], and betaine levels [1.33 (1.03-1.73), P < 0.05] each predicted increased MACE risk. Neither choline nor betaine predicted MACE risk when TMAO was added to the adjustment model, and choline and betaine predicted future risk for MACE only when TMAO was elevated. Elevated plasma levels of choline and betaine are each associated with incident MACE risk independent of traditional risk factors. However, high choline and betaine levels are only associated with higher risk of future MACE with concomitant increase in TMAO.

Prognostic value of choline and betaine depends on intestinal microbiota-generated metabolite trimethylamine-N-oxide

PubMed Central

Wang, Zeneng; Tang, W. H. Wilson; Buffa, Jennifer A.; Fu, Xiaoming; Britt, Earl B.; Koeth, Robert A.; Levison, Bruce S.; Fan, Yiying; Wu, Yuping; Hazen, Stanley L.

2014-01-01

Aims Recent metabolomics and animal model studies show trimethylamine-N-oxide (TMAO), an intestinal microbiota-dependent metabolite formed from dietary trimethylamine-containing nutrients such as phosphatidylcholine (PC), choline, and carnitine, is linked to coronary artery disease pathogenesis. Our aim was to examine the prognostic value of systemic choline and betaine levels in stable cardiac patients. Methods and results We examined the relationship between fasting plasma choline and betaine levels and risk of major adverse cardiac events (MACE = death, myocardial infraction, stroke) in relation to TMAO over 3 years of follow-up in 3903 sequential stable subjects undergoing elective diagnostic coronary angiography. In our study cohort, median (IQR) TMAO, choline, and betaine levels were 3.7 (2.4–6.2)μM, 9.8 (7.9–12.2)μM, and 41.1 (32.5–52.1)μM, respectively. Modest but statistically significant correlations were noted between TMAO and choline (r = 0.33, P < 0.001) and less between TMAO and betaine (r = 0.09, P < 0.001). Higher plasma choline and betaine levels were associated with a 1.9-fold and 1.4-fold increased risk of MACE, respectively (Quartiles 4 vs. 1; P < 0.01, each). Following adjustments for traditional cardiovascular risk factors and high-sensitivity C-reactive protein, elevated choline [1.34 (1.03–1.74), P < 0.05], and betaine levels [1.33 (1.03–1.73), P < 0.05] each predicted increased MACE risk. Neither choline nor betaine predicted MACE risk when TMAO was added to the adjustment model, and choline and betaine predicted future risk for MACE only when TMAO was elevated. Conclusion Elevated plasma levels of choline and betaine are each associated with incident MACE risk independent of traditional risk factors. However, high choline and betaine levels are only associated with higher risk of future MACE with concomitant increase in TMAO. PMID:24497336

Development of a prototype Typhoon Risk Model over the Korean Peninsula

NASA Astrophysics Data System (ADS)

Kim, K. Y.; Cocke, S.; Shin, D. W.; CHOI, M.; Kwon, J.

2016-12-01

Risk can be defined as probability of a given hazard of a given level causing a particular level of loss of damage (Alexander, 2000). Risk management is important for mitigation and developing plans for emergencies. More effective risk management strategies can help reduce potential losses from natural disasters like typhoon, floods, earthquakes, and so on. We are developing a prototype typhoon risk model to assess the current and potentially future hazard due to typhoons in the Western Pacific. To develop the typhoon risk model, a variety of sources of data over Korea are used such as population, damage to buildings, agriculture, ships, etc. The model is based on proven concepts used in catastrophe models that have been used in the U.S. and other regions of the world. Recently, the sea surface temperatures where typhoons have occurred have tended to increase. According to recent studies of global warming, the intensity of typhoons could increase, and the frequency of typhoons may decrease in the future climate. The prototype risk model can help us determine the change in risk as a consequence of the change in typhoon activity. We focus on Korea and other regions of interest to Korean insurers, re-insurers, and related industries. The model can potentially be coupled to various damage models or emergency management systems for planning and mitigation. In addition, the assessment would be useful for emergency planners, coastal community planners, and private and governmental insurance programs. This work was funded by the Korea Meteorological Administration Research and Development Program under Grant KMIPA2016-8030.

Dual-task testing to predict falls in community-dwelling older adults: a systematic review.

PubMed

Muir-Hunter, S W; Wittwer, J E

2016-03-01

Cognitive impairment increases fall risk in older adults. Dual-task testing is an accepted way to assess the interaction between cognition and mobility; however, there is a lack of evidence-based recommendations for dual-task testing to evaluate fall risk in clinical practice. To evaluate the association between dual-task testing protocols and future fall risk, and to identify the specific dual-task test protocols associated with elevated risk. MEDLINE, Pubmed and EMBASE electronic databases were searched from January 1988 to September 2013. Two independent raters identified prospective cohort studies (duration of at least 1 year) of dual-task assessment in community-dwelling participants aged ≥60 years, with 'falls' as the primary outcome. Methodological quality was scored independently by two raters using a published checklist of criteria for evaluating threats to the validity of observational studies. Deterioration in gait during dual-task testing compared with single-task performance was associated with increased fall risk. Shortcomings within the literature significantly limit knowledge translation of dual-task gait protocols into clinical practice. There is a paucity of prospective studies on the association of dual-task gait assessment with fall risk. Changes in gait under dual-task testing are associated with future fall risk, and this association is stronger than that for single-task conditions. Limitations in the available literature preclude development of detailed recommendations for dual-task gait testing procedures in clinical practice to identify and stratify fall risk in older adults. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?

PubMed Central

Attenhofer Jost, Christine H.; Schmidt, Dörthe; Huebler, Michael; Balmer, Christian; Noll, Georg; Caduff, Rosmarie; Greutmann, Matthias

2013-01-01

Due to impressive improvements in surgical repair options, even patients with complex congenital heart disease (CHD) may survive into adulthood and have a high risk of end-stage heart failure. Thus, the number of patients with CHD needing heart transplantation (HTx) has been increasing in the last decades. This paper summarizes the changing etiology of causes of death in heart failure in CHD. The main reasons, contraindications, and risks of heart transplantation in CHD are discussed and underlined with three case vignettes. Compared to HTx in acquired heart disease, HTx in CHD has an increased risk of perioperative death and rejection. However, outcome of HTx for complex CHD has improved over the past 20 years. Additionally, mechanical support options might decrease the waiting list mortality in the future. The number of patients needing heart-lung transplantation (especially for Eisenmenger's syndrome) has decreased in the last years. Lung transplantation with intracardiac repair of a cardiac defect is another possibility especially for patients with interatrial shunts. Overall, HTx will remain an important treatment option for CHD in the near future. PMID:23577237

Trends in ischemic heart disease mortality in Korea, 1985-2009: an age-period-cohort analysis.

PubMed

Lee, Hye Ah; Park, Hyesook

2012-09-01

Economic growth and development of medical technology help to improve the average life expectancy, but the western diet and rapid conversions to poor lifestyles lead an increasing risk of major chronic diseases. Coronary heart disease mortality in Korea has been on the increase, while showing a steady decline in the other industrialized countries. An age-period-cohort analysis can help understand the trends in mortality and predict the near future. We analyzed the time trends of ischemic heart disease mortality, which is on the increase, from 1985 to 2009 using an age-period-cohort model to characterize the effects of ischemic heart disease on changes in the mortality rate over time. All three effects on total ischemic heart disease mortality were statistically significant. Regarding the period effect, the mortality rate was decreased slightly in 2000 to 2004, after it had continuously increased since the late 1980s that trend was similar in both sexes. The expected age effect was noticeable, starting from the mid-60's. In addition, the age effect in women was more remarkable than that in men. Women born from the early 1900s to 1925 observed an increase in ischemic heart mortality. That cohort effect showed significance only in women. The future cohort effect might have a lasting impact on the risk of ischemic heart disease in women with the increasing elderly population, and a national prevention policy is need to establish management of high risk by considering the age-period-cohort effect.

Risk and Protective Processes Predicting Rural African American Young Men's Substance Abuse.

PubMed

Cho, Junhan; Kogan, Steven M

2016-12-01

Informed by a life course perspective, this study tested a cascade model linking harsh, unresponsive parenting during childhood to young African American men's substance abuse via precocious transitions, economic instability, and future orientation. The moderating influence of community disadvantage and romantic partner support on the hypothesized pathways was also examined. At the baseline, the sample included 505 African American men between ages 19 and 22 years from high-poverty rural communities. Follow-up data were collected 18 months after baseline. Using structural equation modeling, we identified harsh, unresponsive parenting influenced precocious transitions in adolescence, which in turn increased economic instability during young adulthood. Economic instability was associated with a reduction in future orientation, a proximal influence on increases in substance abuse. Also, residence in a disadvantaged community amplified the influence of precocious transitions on economic instability and the influence of economic instability on future orientation. Involvement with supportive romantic partnership evinced a protective effect, attenuating the influence of precocious transitions on economic instability and the influence of economic instability on a future orientation. This study expands understanding of young adults' substance abuse by demonstrating the risk and protective processes linking substance abuse to developmental factors across childhood, adolescence, and young adulthood. © Society for Community Research and Action 2016.

Characterizing Fractures Across the Astronaut Corps: Preliminary Findings from Population-Level Analysis

NASA Technical Reports Server (NTRS)

Rossi, Meredith M.; Charvat, Jacqueline M.; Sibonga, Jean D.; Sieker, Jeremy

2017-01-01

Despite evidence of bone loss during spaceflight and the implementation of countermeasures to mitigate this loss, the subsequent risk of fracture among astronauts is not known. Multiple factors such as age, sex, fracture history, and others may combine to increase fracture risk. The purpose of this study was to describe fractures among the astronaut population and generate questions for future occupational surveillance studies.

Changes in Cross-Correlations as an Indicator for Systemic Risk

PubMed Central

Zheng, Zeyu; Podobnik, Boris; Feng, Ling; Li, Baowen

2012-01-01

The 2008–2012 global financial crisis began with the global recession in December 2007 and exacerbated in September 2008, during which the U.S. stock markets lost 20% of value from its October 11 2007 peak. Various studies reported that financial crisis are associated with increase in both cross-correlations among stocks and stock indices and the level of systemic risk. In this paper, we study 10 different Dow Jones economic sector indexes, and applying principle component analysis (PCA) we demonstrate that the rate of increase in principle components with short 12-month time windows can be effectively used as an indicator of systemic risk—the larger the change of PC1, the higher the increase of systemic risk. Clearly, the higher the level of systemic risk, the more likely a financial crisis would occur in the near future. PMID:23185692

Defining the Relationship Between Biomarkers of Oxidative and Inflammatory Stress and the Risk for Atherosclerosis in Astronauts During and After Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Lee, S. M. C.; Martin, D. S.; Smith, S. M.; Zwart, S. R.; Laurie, S. S; Ribeiro, L. C.; Stenger, M. B.

2017-01-01

Current human space travel consists primarily of long-duration missions onboard the International Space Station (ISS), but in the future may include exploration-class missions to nearby asteroids, Mars, or its moons. These missions will expose astronauts to increased risk of oxidative and inflammatory damage from a variety of sources, including radiation, psychological stress, reduced physical activity, diminished nutritional status, and hyperoxic exposure during extravehicular activity. Evidence exists that increased oxidative stress and inflammation can accelerate the development of atherosclerosis.

Defining the Relationship Between Biomarkers of Oxidation and Inflammatory Stress and the Risk for Atherosclerosis in Astronauts During and After Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Lee, Stuart M. C.; Stenger, Michael B.; Smith, Scott M.; Zwart, Sara R.

2016-01-01

Future human space travel will consist primarily of long-duration missions onboard the International Space Station (ISS) or exploration-class missions to Mars, its moons, or nearby asteroids. These missions will expose astronauts to increased risk of oxidative and inflammatory damage from a variety of sources, including radiation, psychological stress, reduced physical activity, diminished nutritional status, and hyperoxic exposure during extravehicular activity. Evidence exists that increased oxidative damage and inflammation can accelerate the development of atherosclerosis.

Future probabilities of coastal floods in Finland

NASA Astrophysics Data System (ADS)

Pellikka, Havu; Leijala, Ulpu; Johansson, Milla M.; Leinonen, Katri; Kahma, Kimmo K.

2018-04-01

Coastal planning requires detailed knowledge of future flooding risks, and effective planning must consider both short-term sea level variations and the long-term trend. We calculate distributions that combine short- and long-term effects to provide estimates of flood probabilities in 2050 and 2100 on the Finnish coast in the Baltic Sea. Our distributions of short-term sea level variations are based on 46 years (1971-2016) of observations from the 13 Finnish tide gauges. The long-term scenarios of mean sea level combine postglacial land uplift, regionally adjusted scenarios of global sea level rise, and the effect of changes in the wind climate. The results predict that flooding risks will clearly increase by 2100 in the Gulf of Finland and the Bothnian Sea, while only a small increase or no change compared to present-day conditions is expected in the Bothnian Bay, where the land uplift is stronger.

Mesocosms Reveal Ecological Surprises from Climate Change.

PubMed

Fordham, Damien A

2015-12-01

Understanding, predicting, and mitigating the impacts of climate change on biodiversity poses one of the most crucial challenges this century. Currently, we know more about how future climates are likely to shift across the globe than about how species will respond to these changes. Two recent studies show how mesocosm experiments can hasten understanding of the ecological consequences of climate change on species' extinction risk, community structure, and ecosystem functions. Using a large-scale terrestrial warming experiment, Bestion et al. provide the first direct evidence that future global warming can increase extinction risk for temperate ectotherms. Using aquatic mesocosms, Yvon-Durocher et al. show that human-induced climate change could, in some cases, actually enhance the diversity of local communities, increasing productivity. Blending these theoretical and empirical results with computational models will improve forecasts of biodiversity loss and altered ecosystem processes due to climate change.

Gene-by-Environment Interactions in Pancreatic Cancer: Implications for Prevention

PubMed Central

Jansen, Rick J.; Tan, Xiang-Lin; Petersen, Gloria M.

2015-01-01

Pancreatic cancer (PC) has been estimated to have higher incidence and correspondingly higher mortality rates in more developed regions worldwide. Overall, the age-adjusted incidence rate is 4.9/105 and age-adjusted mortality rate is at 4.8/105. We review here our current knowledge of modifiable risk factors (cigarette smoking, obesity, diet, and alcohol) for PC, genetic variants implicated by genome-wide association studies, possible genetic interactions with risk factors, and prevention strategies to provide future research directions that may further our understanding of this complex disease. Cigarette smoking is consistently associated with a two-fold increased PC risk. PC associations with dietary intake have been largely inconsistent, with the potential exception of certain unsaturated fatty acids decreasing risk and well-done red meat or meat mutagens increasing risk. There is strong evidence to support that obesity (and related measures) increase risk of PC. Only the heaviest alcohol drinkers seem to be at an increased risk of PC. Currently, key prevention strategies include avoiding tobacco and excessive alcohol consumption and adopting a healthy lifestyle. Screening technologies and PC chemoprevention are likely to become more sophisticated, but may only apply to those at high risk. Risk stratification may be improved by taking into account gene environment interactions. Research on these modifiable risk factors is key to reducing the incidence of PC and understanding who in the population can be considered high risk. PMID:26029010

Foresight Infectious Diseases China Project--a novel approach to anticipating future trends in risk of infectious diseases in China: methodology and results from an initial application.

PubMed

Nicoll, A; Huang, J; Xie, Z

2009-07-09

The project devised a simple but novel methodology for identifying possible future trends in infectious diseases in animals and humans in China, of priority concern to the Chinese authorities. It used a model of disease drivers (social, economic, biological or environmental factors that affect disease outcomes, by changing the behaviour of diseases, sources or pathways) devised for the Foresight Programme in the United Kingdom. Nine families of drivers were adapted to Chinese circumstances and matrices were constructed to identify the likely relationship of single infectious diseases or families of diseases to the drivers. The likely future trends in those drivers in China were determined by interviews with 36 independent Chinese experts. These trends included not only potentially adverse animal and human movements but also opportunities for innovative surveillance methods, more use of hospitals, antimicrobials and vaccines. Some human behaviours and social trends were expected to increase the risk of infections (in particular sexually transmitted and healthcare-associated infections) while at the same time the experts thought the awareness of risk in the Chinese population would increase. The results suggested a number of areas where the Chinese authorities may experience difficulties in the future, such as rising numbers of healthcare-associated infections, zoonoses and other emerging diseases and sexually transmitted infections (including HIV). Not making firm predictions, this work identifies priority disease groups requiring surveillance and consideration of countermeasures as well as recommending strengthening basic surveillance and response mechanisms for unanticipatable zoonoses and other emerging disease threats.

Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

NASA Technical Reports Server (NTRS)

Johnson, A. Steve; Badhwar, Gautam D.; Golightly, Michael J.; Hardy, Alva C.; Konradi, Andrei; Yang, Tracy Chui-Hsu

1993-01-01

The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk.

Fibrinogen concentration and its role in CVD risk in black South Africans--effect of urbanisation.

PubMed

Pieters, Marlien; de Maat, Moniek P M; Jerling, Johann C; Hoekstra, Tiny; Kruger, Annamarie

2011-09-01

The aim of this study was to investigate correlates of fibrinogen concentration in black South Africans, as well as its association with cardiovascular disease (CVD) risk and whether urbanisation influences this association. A total of 1,006 rural and 1,004 urban black South Africans from the PURE study were cross-sectionally analysed. The association of fibrinogen with CVD risk was determined by investigating the association of fibrinogen with other CVD risk markers as well as with predicted CVD risk using the Reynolds Risk score. The rural group had a significantly higher fibrinogen concentration than the urban group, despite higher levels of risk factors and increased predicted CVD risk in the urban group. Increased levels of CVD risk factors were, however, still associated with increased fibrinogen concentration. Fibrinogen correlated significantly, but weakly, with overall predicted CVD risk. This correlation was stronger in the urban than in the rural group. Multiple regression analysis showed that a smaller percentage of the variance in fibrinogen is explained by the traditional CVD risk factors in the rural than in the urban group. In conclusion, fibrinogen is weakly associated with CVD risk (predicted overall risk as well with individual risk factors) in black South Africans, and is related to the degree of urbanisation. Increased fibrinogen concentration, in black South Africans, especially in rural areas, is largely unexplained, and likely not strongly correlated with traditional CVD-related lifestyle and pathophysiological processes. This does, however, not exclude the possibility that once increased, the fibrinogen concentration contributes to future development of CVD.

Sex of the baby and future maternal risk of Type 2 diabetes in women who had gestational diabetes.

PubMed

Retnakaran, R; Shah, B R

2016-07-01

Women who develop gestational diabetes mellitus have a chronic defect in the secretion of insulin by the pancreatic β cells that underlies both their diagnostic hyperglycaemia in pregnancy and their elevated lifetime risk of developing Type 2 diabetes in the future. It has recently emerged that carrying a male fetus is associated with poorer maternal β-cell function and an increased risk of gestational diabetes, whereas the development of gestational diabetes when carrying a girl (as compared with a boy) predicts a comparatively higher risk of early progression to Type 2 diabetes before any subsequent pregnancy. In this context, we sought to determine the impact of fetal sex on the long-term risk of Type 2 diabetes in women with gestational diabetes. Using population-based administrative databases, we identified all women in Ontario, Canada, with a singleton live-birth first pregnancy complicated by gestational diabetes between April 2000 and March 2010 (n = 23 363). We compared the risk of subsequent Type 2 diabetes after pregnancy in those who carried a girl (n = 11 229) vs. those who carried a boy (n = 12 134). Over median 5.5 years follow-up, 5483 women (23.5%) were diagnosed with diabetes. Compared with those who carried a boy, women who had a girl had an elevated risk of subsequently developing diabetes (adjusted hazard ratio = 1.06, 95% CI 1.01-1.12). Among women with gestational diabetes, those who are carrying a girl have a slightly higher overall future risk of Type 2 diabetes. © 2015 Diabetes UK.

Self-disgust as a potential mechanism underlying the association between PTSD and suicide risk.

PubMed

Brake, C Alex; Rojas, Sasha M; Badour, Christal L; Dutton, Courtney E; Feldner, Matthew T

2017-04-01

Suicide risk is highly prevalent among individuals with posttraumatic stress disorder (PTSD). Self-disgust, defined as disgust directed internally and comprised of disgust with oneself (disgusting self) and with one's behaviors (disgusting ways), may impact this increased risk. The present study examined self-disgust as a putative mechanism linking PTSD symptoms with suicide risk. A sample of 347 trauma-exposed undergraduates completed measures of PTSD symptoms, suicide risk, self-disgust, and depressive symptoms. Controlling for depressive symptoms, a process model indicated PTSD symptoms were positively linked to suicide risk via increased disgusting self but not disgusting ways. Process models examining individual PTSD symptom clusters revealed positive, indirect links between all PTSD symptom clusters except alterations in arousal and reactivity and suicide risk via disgusting self. These findings expand on growing literature documenting the importance of self-disgust in trauma-related pathology by identifying connections with suicide risk. Future directions and clinical considerations are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

The influence of religion on sexual HIV risk.

PubMed

Shaw, Stacey A; El-Bassel, Nabila

2014-08-01

This systematic review examines the relationship between religion and sexual HIV risk behavior. It focuses primarily on how studies have conceptualized and defined religion, methodologies, and sexual risk outcomes. We also describe regions where studies were conducted and mechanisms by which religion may be associated with sexual risk. We included 137 studies in this review, classifying them as measuring: (1) only religious affiliation (n = 57), (2) only religiosity (n = 48), and (3) both religious affiliation and religiosity (n = 32). A number of studies identified lower levels of sexual HIV risk among Muslims, although many of these examined HIV prevalence rather than specific behavioral risk outcomes. Most studies identified increased religiosity to be associated with lower levels of sexual HIV risk. This finding persists but is weaker when the outcome considered is condom use. The paper reviews ways in which religion may contribute to increase and reduction in sexual HIV risk, gaps in research, and implications for future research on religion and HIV.

Resiliency of the Nation's Power Grid: Assessing Risks of Premature Failure of Large Power Transformers Under Climate Warming and Increased Heat Waves

NASA Astrophysics Data System (ADS)

Schlosser, C. A.; Gao, X.; Morgan, E.

2017-12-01

The aging pieces of our nation's power grid - the largest machine ever built - are at a critical time. Key assets in the transmission system, including large power transformers (LPTs), are approaching their originally designed lifetimes. Moreover, extreme weather and climate events upon which these design lifetimes are partially based are expected to change. In particular, more frequent and intense heat waves can accelerate the degradation of LPTs' insulation/cooling system. Thus, there are likely thousands of LPTs across the United States under increasing risk of premature failure - yet this risk has not been assessed. In this study, we investigate the impact of climate warming and corresponding shifts in heat waves for critical LPTs located in the Northeast corridor of the United States to assess: To what extent do changes in heat waves/events present a rising threat to the transformer network over the Northeast U.S. and to what extent can climate mitigation reduce this risk? This study focuses on a collection of LPTs with a high degree of "betweenness" - while recognizing other factors such as: connectivity, voltage rating, MVA rating, approximate price, weight, location/proximity to major transportation routes, and age. To assess the risk of future change in heat wave occurrence we use an analogue method, which detects the occurrence of heat waves based on associated large-scale atmospheric conditions. This method is compared to the more conventional approach that uses model-simulated daily maximum temperature. Under future climate warming scenarios, multi-model medians of both methods indicate strong increases in heat wave frequency during the latter half of this century. Under weak climate mitigation - the risks imposed from heat wave occurrence could quadruple, but a modest mitigation scenario cuts the increasing threat in half. As important, the analogue method substantially improves the model consensus through reduction of the interquartile range by a factor of three. The improved inter-model consensus is viewed as a promising step toward providing more actionable climate information. Ultimately - this technique could be applied to the entirety of the U.S. power grid as well as other weather extrema (e.g. precipitation, ice, and wind) as well as assess current and future topologies of any electricity system.

Climate change and rising heat: population health implications for working people in Australia.

PubMed

Hanna, Elizabeth G; Kjellstrom, Tord; Bennett, Charmian; Dear, Keith

2011-03-01

The rapid rise in extreme heat events in Australia recently is already taking a health toll. Climate change scenarios predict increases in the frequency and intensity of extreme heat events in the future, and population health may be significantly compromised for people who cannot reduce their heat exposure. Exposure to extreme heat presents a health hazard to all who are physically active, particularly outdoor workers and indoor workers with minimal access to cooling systems while working. At air temperatures close to (or beyond) the core body temperature of 37°C, body cooling via sweating is essential, and this mechanism is hampered by high air humidity. Heat exposure among elite athletes and the military has been investigated, whereas the impacts on workers remain largely unexplored, particularly in relation to future climate change. Workers span all age groups and diverse levels of fitness and health status, including people with higher than "normal" sensitivity to heat. In a hotter world, workers are likely to experience more heat stress and find it increasingly difficult to maintain productivity. Modeling of future climate change in Australia shows a substantial increase in the number of very hot days (>35°C) across the country. In this article, the authors characterize the health risks associated with heat exposure on working people and discuss future exposure risks as temperatures rise. Progress toward developing occupational health and safety guidelines for heat in Australia are summarized.

Cost-effective and robust mitigation of space debris in low earth orbit

NASA Astrophysics Data System (ADS)

Walker, R.; Martin, C.

It is predicted that the space debris population in low Earth orbit (LEO) will continue to grow and in an exponential manner in the long-term due to an increasing rate of collisions between large objects, unless internationally-accepted space debris mitigation measures are adopted soon. Such measures are aimed at avoiding the future generation of space debris objects and primarily need to be effective in preventing significant long-term growth in the debris population, even in the potential scenario of an increase in future space activity. It is also important that mitigation measures can limit future debris population levels, and therefore the underlying collision risk to space missions, to the lowest extent possible. However, for their wide acceptance, the cost of implementation associated with mitigation measures needs to be minimised as far as possible. Generally, a lower collision risk will cost more to achieve and vice versa, so it is necessary to strike a balance between cost and risk in order to find a cost-effective set of mitigation measures. In this paper, clear criteria are established in order to assess the cost-effectiveness of space debris mitigation measures. A full cost-risk-benefit trade-off analysis of numerous mitigation scenarios is presented. These scenarios consider explosion prevention and post-mission disposal of space systems, including de-orbiting to limited lifetime orbits and re-orbiting above the LEO region. The ESA DELTA model is used to provide long-term debris environment projections for these scenarios as input to the benefit and risk parts of the trade-off analysis. Manoeuvre requirements for the different post-mission disposal scenarios were also calculated in order to define the cost-related element. A 25-year post-mission lifetime de-orbit policy, combined with explosion prevention and mission-related object limitation, was found to be the most cost-effective solution to the space debris problem in LEO. This package would also remain effective after a significant increase in future launch traffic. It was found that the re-orbiting of space systems above the LEO region would not lead to significant collision activity there over the next century. However, above-LEO disposal should be used sparingly because the disposal region could become unstable after a limited number of explosions or collisions due to a lack of air drag to remove the resulting fragments.

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

PubMed Central

Arabin, Birgit; Baschat, Ahmet A.

2017-01-01

Physiologic adaptations during pregnancy unmask a woman’s predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent’s risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms “fetal programming” and “pregnancy complications combined with maternal disease” until January 2017. Studies linking pregnancy complications to future cardiovascular, metabolic, and thrombotic risks for mother and offspring were reviewed. Women with a history of miscarriage, fetal growth restriction, preeclampsia, preterm delivery, obesity, excessive gestational weight gain, gestational diabetes, subfertility, and thrombophilia more frequently demonstrate with echocardiographic abnormalities, higher fasting insulin, deviating lipids or clotting factors and show defective endothelial function. Thrombophilia hints to thrombotic risks in later life. Pregnancy abnormalities correlate with future cardiovascular and metabolic complications and earlier mortality. Conversely, women with a normal pregnancy have lower rates of subsequent diseases than the general female population creating the term: “Pregnancy as a window for future health.” Although the placenta works as a gatekeeper, many pregnancy complications may lead to sickness and earlier death in later life when the child becomes an adult. The epigenetic mechanisms and the mismatch between pre- and postnatal life have created the term “fetal origin of adult disease.” Up to now, the impact of cardiovascular, metabolic, or thrombotic risk profiles has been investigated separately for mother and child. In this manuscript, we strive to illustrate the consequences for both, fetus and mother within a cohesive perspective and thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal–fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources. PMID:28451583

At, with and beyond risk: expectations of living with the possibility of future dementia.

PubMed

Milne, Richard; Diaz, Ana; Badger, Shirlene; Bunnik, Eline; Fauria, Karine; Wells, Katie

2018-04-16

Biomedical research aimed at the development of therapies for chronic and late-onset conditions increasingly concentrates on the early treatment of symptom-less disease. This broad trend is evidenced in prominent shifts in contemporary dementia research. Revised diagnostic criteria and new approaches to clinical trials propose a focus on earlier stages of disease and prompt concerns about the implications of communicating test results associated with the risk of developing dementia when no effective treatments are available. This article examines expectations of the implications of learning test results related to dementia risk, based on focus group research conducted in the UK and Spain. It points to the extended social and temporal aspects of the dementia risk experience. Three key dimensions of this risk experience are elaborated: living 'at risk', represented in efforts to reduce risk and plan for the future; 'with risk', through vigilance towards cognitive health and earlier or prolonged contact with healthcare services; and finally, 'beyond risk' through a cessation of the self in its current social, legal and financial form. A virtual abstract of this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA. © 2018 Foundation for the Sociology of Health & Illness.

Young people's beliefs about the risk of bowel cancer and its link with physical activity.

PubMed

Newby, Katie V; Cook, Chloe; Meisel, Susanne F; Webb, Thomas L; Fisher, Bernadette; Fisher, Abi

2017-09-01

The primary objective was to explore young people's risk appraisals of bowel cancer, including whether they had a coherent understanding of the protective effects of physical activity (PA). A secondary objective was to examine whether the illness risk representations (IRRs) framework could be used to understand beliefs underlying bowel cancer risk appraisals. Qualitative. Framework analysis of semi-structured interviews with 19 people aged 14-17 years. Participants judged their risk of getting bowel cancer as low. This was based on a lack of family history of cancer and their current lifestyle behaviours, which were viewed as having a protective effect, or because they planned on making change to their lifestyle in the future when disease risk became more relevant. Participants were not aware of, and struggled to understand, the link between PA and bowel cancer. They also lacked knowledge of the effects of, or treatments for, bowel cancer. Beliefs underlying judgements about the risk of bowel cancer fitted the IRR framework reasonably well. The present research suggests that interventions designed to increase PA with a view to reducing the risk of bowel cancer should aim to make the future risk of bowel cancer feel more tangible, help young people to understand the full range of consequences, explain how and why preventative behaviours such as PA are effective in reducing risk, and emphasize that the typical late presentation of symptoms, and therefore investigation by health care services, reduces treatability. Statement of contribution What is already known on this subject? Physical activity (PA) performed throughout the lifespan can have a protective effect on bowel cancer, but levels of PA are low among young people. Changing beliefs about the risk of getting bowel cancer may be a useful strategy in motivating PA. What does this study add? Increased understanding of how young people think about bowel cancer and the relationship between PA and cancer. Identification of strategies for increasing young adults' appraisals of the likelihood and severity of bowel cancer. Evidence to support the validity of illness risk representations framework. © 2017 The British Psychological Society.

Early warning of climate tipping points

NASA Astrophysics Data System (ADS)

Lenton, Timothy M.

2011-07-01

A climate 'tipping point' occurs when a small change in forcing triggers a strongly nonlinear response in the internal dynamics of part of the climate system, qualitatively changing its future state. Human-induced climate change could push several large-scale 'tipping elements' past a tipping point. Candidates include irreversible melt of the Greenland ice sheet, dieback of the Amazon rainforest and shift of the West African monsoon. Recent assessments give an increased probability of future tipping events, and the corresponding impacts are estimated to be large, making them significant risks. Recent work shows that early warning of an approaching climate tipping point is possible in principle, and could have considerable value in reducing the risk that they pose.

Physiological Reactivity to Psychological Stress in Human Pregnancy: Current Knowledge and Future Directions

PubMed Central

Christian, Lisa M.

2012-01-01

Cardiovascular and neuroendocrine reactivity to acute stress are important predictors of health outcomes in non-pregnant populations. Greater magnitude and duration of physiological responses have been associated with increased risk of hypertensive disorders and diabetes, greater susceptibility to infectious illnesses, suppression of cell-mediated immunity as well as risk for depression and anxiety disorders. Stress reactivity during pregnancy has unique implications for maternal health, birth outcomes, and fetal development. However, as compared to the larger literature, our understanding of the predictors and consequences of exaggerated stress reactivity in pregnancy is limited. This paper reviews the current state of this literature with an emphasis on gaps in knowledge and future directions. PMID:22800930

A test of the vulnerability model: temperament and temperament change as predictors of future mental disorders - the TRAILS study.

PubMed

Laceulle, Odilia M; Ormel, Johan; Vollebergh, Wilma A M; van Aken, Marcel A G; Nederhof, Esther

2014-03-01

This study aimed to test the vulnerability model of the relationship between temperament and mental disorders using a large sample of adolescents from the TRacking Adolescents Individual Lives' Survey (TRAILS). The vulnerability model argues that particular temperaments can place individuals at risk for the development of mental health problems. Importantly, the model may imply that not only baseline temperament predicts mental health problems prospectively, but additionally, that changes in temperament predict corresponding changes in risk for mental health problems. Data were used from 1195 TRAILS participants. Adolescent temperament was assessed both at age 11 and at age 16. Onset of mental disorders between age 16 and 19 was assessed at age 19, by means of the World Health Organization Composite International Diagnostic Interview (WHO CIDI). Results showed that temperament at age 11 predicted future mental disorders, thereby providing support for the vulnerability model. Moreover, temperament change predicted future mental disorders above and beyond the effect of basal temperament. For example, an increase in frustration increased the risk of mental disorders proportionally. This study confirms, and extends, the vulnerability model. Consequences of both temperament and temperament change were general (e.g., changes in frustration predicted both internalizing and externalizing disorders) as well as dimension specific (e.g., changes in fear predicted internalizing but not externalizing disorders). These findings confirm previous studies, which showed that mental disorders have both unique and shared underlying temperamental risk factors. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

Effective Mitigation and Adaptation Strategies for Public Health Impacts of Heatwaves for Brookline, MA

NASA Astrophysics Data System (ADS)

Jalalzadeh Fard, B.; Hassanzadeh, H.; Bhatia, U.; Ganguly, A. R.

2016-12-01

Studies on urban areas show a significant increase in frequency and intensity of heatwaves over the past decades, and predict the same trend for future. Since heatwaves have been responsible for a large number of life losses, urgent adaptation and mitigation strategies are required in the policy and decision making level for a sustainable urban planning. The Sustainability and Data Sciences Laboratory at Northeastern University, under the aegis of Thriving Earth Exchange of AGU, is working with the town of Brookline to understand the potential public health impacts of anticipated heatwaves. We consider the most important social and physical factors to obtain vulnerability and exposure parameters for each census block group of the town. Utilizing remote sensing data, we locate Urban Heat Islands (UHIs) during a recent heatwave event, as the hazard parameter. We then create priority risk map using the risk framework. Our analyses show spatial correlations between the UHIs and social factors such as poverty, and physical factors such as land cover variations. Furthermore, we investigate the future heatwave frequency and intensity increases by analyzing the climate models predictions. For future changes of UHIs, land cover changes are investigated using available predictive data. Also, socioeconomic predictions are carried out to complete the futuristic models of heatwave risks. Considering plausible scenarios for Brookline, we develop different risk maps based on the vulnerability, exposure and hazard parameters. Eventually, we suggest guidelines for Heatwave Action Plans for prioritizing effective mitigation and adaptation strategies in urban planning for the town of Brookline.

Exploring Alternate Processes Contributing to the Association Between Maternal Smoking and the Smoking Behavior Among Young Adult Offspring

PubMed Central

2013-01-01

Introduction: Maternal smoking during pregnancy (MSP) is a known risk factor for regular smoking in young adulthood and may pose a risk independently of mother’s lifetime smoking. The processes through which MSP exerts this influence are unknown but may occur through greater smoking quantity and frequency following initiation early in adolescence or increased sensitivity to nicotine dependence (ND) at low levels of smoking. Methods: This study used path analysis to investigate adolescent smoking quantity, smoking frequency, and ND as potential simultaneous mediating pathways through which MSP and mother’s lifetime smoking (whether she has ever smoked) increase the risk of smoking in young adulthood among experimenters (at baseline, <100 cigarettes/lifetime) and current smokers (>100 cigarettes/lifetime). Results: For experimenters, MSP was directly associated with more frequent young adult smoking and was not mediated by adolescent smoking behavior or ND. Independently of MSP, the effect of mother’s lifetime smoking was fully mediated through frequent smoking and was heightened ND during adolescence. Controlling for MSP eliminated a previously observed direct association between mother’s lifetime smoking and future smoking among experimenters. For current smokers, only prior smoking behavior was associated with future smoking frequency. Conclusions: These results seem to rule out sensitivity to ND and increased smoking behavior as contributing pathways of MSP. Further, the impact of MSP on young adult smoking extends beyond that of having an ever-smoking mother. Future work should test other possible mediators; for example, MSP-related epigenetic changes or gene variants influencing the brain’s nicotine response. PMID:23766342

Unprecedented 21st century drought risk in the American Southwest and Central Plains

PubMed Central

Cook, Benjamin I.; Ault, Toby R.; Smerdon, Jason E.

2015-01-01

In the Southwest and Central Plains of Western North America, climate change is expected to increase drought severity in the coming decades. These regions nevertheless experienced extended Medieval-era droughts that were more persistent than any historical event, providing crucial targets in the paleoclimate record for benchmarking the severity of future drought risks. We use an empirical drought reconstruction and three soil moisture metrics from 17 state-of-the-art general circulation models to show that these models project significantly drier conditions in the later half of the 21st century compared to the 20th century and earlier paleoclimatic intervals. This desiccation is consistent across most of the models and moisture balance variables, indicating a coherent and robust drying response to warming despite the diversity of models and metrics analyzed. Notably, future drought risk will likely exceed even the driest centuries of the Medieval Climate Anomaly (1100–1300 CE) in both moderate (RCP 4.5) and high (RCP 8.5) future emissions scenarios, leading to unprecedented drought conditions during the last millennium. PMID:26601131

Unprecedented 21st century drought risk in the American Southwest and Central Plains.

PubMed

Cook, Benjamin I; Ault, Toby R; Smerdon, Jason E

2015-02-01

In the Southwest and Central Plains of Western North America, climate change is expected to increase drought severity in the coming decades. These regions nevertheless experienced extended Medieval-era droughts that were more persistent than any historical event, providing crucial targets in the paleoclimate record for benchmarking the severity of future drought risks. We use an empirical drought reconstruction and three soil moisture metrics from 17 state-of-the-art general circulation models to show that these models project significantly drier conditions in the later half of the 21st century compared to the 20th century and earlier paleoclimatic intervals. This desiccation is consistent across most of the models and moisture balance variables, indicating a coherent and robust drying response to warming despite the diversity of models and metrics analyzed. Notably, future drought risk will likely exceed even the driest centuries of the Medieval Climate Anomaly (1100-1300 CE) in both moderate (RCP 4.5) and high (RCP 8.5) future emissions scenarios, leading to unprecedented drought conditions during the last millennium.

The Science-Policy Link: Stakeholder Reactions to the Uncertainties of Future Sea Level Rise

NASA Astrophysics Data System (ADS)

Plag, H.; Bye, B.

2011-12-01

Policy makers and stakeholders in the coastal zone are equally challenged by the risk of an anticipated rise of coastal Local Sea Level (LSL) as a consequence of future global warming. Many low-lying and often densely populated coastal areas are under risk of increased inundation. More than 40% of the global population is living in or near the coastal zone and this fraction is steadily increasing. A rise in LSL will increase the vulnerability of coastal infrastructure and population dramatically, with potentially devastating consequences for the global economy, society, and environment. Policy makers are faced with a trade-off between imposing today the often very high costs of coastal protection and adaptation upon national economies and leaving the costs of potential major disasters to future generations. They are in need of actionable information that provides guidance for the development of coastal zones resilient to future sea level changes. Part of this actionable information comes from risk and vulnerability assessments, which require information on future LSL changes as input. In most cases, a deterministic approach has been applied based on predictions of the plausible range of future LSL trajectories as input. However, there is little consensus in the scientific community on how these trajectories should be determined, and what the boundaries of the plausible range are. Over the last few years, many publications in Science, Nature and other peer-reviewed scientific journals have revealed a broad range of possible futures and significant epistemic uncertainties and gaps concerning LSL changes. Based on the somewhat diffuse science input, policy and decision makers have made rather different choices for mitigation and adaptation in cases such as Venice, The Netherlands, New York City, and the San Francisco Bay area. Replacing the deterministic, prediction-based approach with a statistical one that fully accounts for the uncertainties and epistemic gaps would provide a different kind of science input to policy makers and stakeholders. Like in many other insurance problems (for example, earthquakes), where deterministic predictions are not possible and decisions have to be made on the basis of statistics and probabilities, the statistical approach to coastal resilience would require stakeholders to make decisions on the basis of probabilities instead of predictions. The science input for informed decisions on adaptation would consist of general probabilities of decadal to century scale sea level changes derived from paleo records, including the probabilities for large and rapid rises. Similar to other problems where the appearance of a hazard is associated with a high risk (like a fire in a house), this approach would also require a monitoring and warning system (a "smoke detector") capable of detecting any onset of a rapid sea level rise.

Projections of hepatitis A virus infection associated with flood events by 2020 and 2030 in Anhui Province, China.

PubMed

Gao, Lu; Zhang, Ying; Ding, Guoyong; Liu, Qiyong; Wang, Changke; Jiang, Baofa

2016-12-01

Assessing and responding to health risk of climate change is important because of its impact on the natural and societal ecosystems. More frequent and severe flood events will occur in China due to climate change. Given that population is projected to increase, more people will be vulnerable to flood events, which may lead to an increased incidence of HAV infection in the future. This population-based study is going to project the future health burden of HAV infection associated with flood events in Huai River Basin of China. The study area covered four cities of Anhui province in China, where flood events were frequent. Time-series adjusted Poisson regression model was developed to quantify the risks of flood events on HAV infection based on the number of daily cases during summer seasons from 2005 to 2010, controlling for other meteorological variables. Projections of HAV infection in 2020 and 2030 were estimated based on the scenarios of flood events and demographic data. Poisson regression model suggested that compared with the periods without flood events, the risks of severe flood events for HAV infection were significant (OR = 1.28, 95 % CI 1.05-1.55), while risks were not significant from moderate flood events (OR = 1.16, 95 % CI 0.72-1.87) and mild flood events (OR = 1.14, 95 % CI 0.87-1.48). Using the 2010 baseline data and the flood event scenarios (one severe flood event), increased incidence of HAV infection were estimated to be between 0.126/10 5 and 0.127/10 5 for 2020. Similarly, the increased HAV infection incidence for 2030 was projected to be between 0.382/10 5 and 0.399/10 5 . Our study has, for the first time, quantified the increased incidence of HAV infection that will result from flood events in Anhui, China, in 2020 and 2030. The results have implications for public health preparation for developing public health responses to reduce HAV infection during future flood events.

Occurrence, impact variables and potential risk of PPCPs and pesticides in a drinking water reservoir and related drinking water treatment plants in the Yangtze Estuary.

PubMed

Xu, Cong; Chen, Lei; You, Luhua; Xu, Zheng; Ren, Long-Fei; Yew-Hoong Gin, Karina; He, Yiliang; Kai, Weizhi

2018-06-14

PPCPs and pesticides have been documented throughout the world over the years, yet relatively little is known about the factors affecting their spatial distribution and temporal change in order to know their potential risk to the ecosystem or human health in the future. In our study, 5 PPCPs and 9 pesticides were selected to study their occurrence, impact variables and potential risk in a drinking water reservoir in Yangtze Estuary and related drinking water treatment plants (DWTPs) in China. The detection results showed the presence of PPCPs and pesticides reflected in a large part of croplands and urban and built-up land in the adjacent basin. The discrepancy of concentration among the different PPCPs and pesticides was mainly decided by their application amount or daily usage. Then, the major factors regulating the occurrence of these contaminants in the surface water were found as the living expenditure attributed to food and medicine based on a correlation analysis. Also, the PPCPs were found to negatively correlate to the effectiveness of sewage management. The detection of the PPCPs and pesticides in DWTPs indicated that, except for atrazine and simazine, the removal percentages were increased significantly in advanced DWTPs. Moreover, risk assessment estimated by a Risk Quotient and Hazard Quotient showed that while caffeine, bisphenol A, estrone and simazine were at a high-risk level in the reservoir water, all of the contaminants detected posed no risk to human health through drinking water. It's possible that atrazine could pose a high risk to the ecosystem while simazine could pose a risk to human health in the future considering the increasing expenditure attributed to food.

Targets to treat metabolic syndrome in polycystic ovary syndrome

PubMed Central

Mahalingaiah, Shruthi; Diamanti-Kandarakis, Evanthia

2016-01-01

Introduction Metabolic syndrome is comprised of a combination of the following states: increased insulin resistance, dyslipidemia, cardiovascular disease, and increased abdominal obesity. Women with polycystic ovary syndrome (PCOS) have an increased risk of developing metabolic syndrome over the course of their lives. Metabolic syndrome increases risk of major cardiovascular events, morbidity, quality of life, and overall health care costs. Though metabolic syndrome in women with PCOS is an area of great concern, there is no effective individual medical therapeutic to adequately treat this issue. Areas Covered This article will review key aspects of metabolic syndrome in PCOS. We will discuss classic and novel therapeutics to address metabolic syndrome in women with PCOS. We will conclude with the importance of developing strategic interventions to increase the compliance to lifestyle and dietary modification, in addition to appreciation of the emerging pharmaceutical therapeutics available. Expert Opinion Innovation in lifestyle modification, including diet, exercise, with and without dedicated stress reduction techniques is the future in treatment of metabolic syndrome in PCOS. Application of novel interventions, such as group medical care, may improve future adherence to lifestyle modification recommendations, in addition to or in combination with pharmaceutical therapeutics. PMID:26488852

Future treatment and research directions in distal radius fracture.

PubMed

Jupiter, Jesse

2012-05-01

Whether or not they will have their lives dramatically extended in the next few decades, it is clear that people are living longer, healthier, and more active lives. The two peak incidences of distal radius fractures will remain within the pediatric and geriatric age groups, with the latter experiencing a substantial increase in the coming years. This article attempts to project future developments with regard to epidemiology, risk and prevention, fracture assessment, and treatment of distal radius fractures, and the ever increasing concern for the economic impact of this prevalent injury. Copyright © 2012. Published by Elsevier Inc.

Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk.

PubMed

Grimm, Lars J; Saha, Ashirbani; Ghate, Sujata V; Kim, Connie; Soo, Mary Scott; Yoon, Sora C; Mazurowski, Maciej A

2018-03-27

To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer. All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts. Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3-4.8, P = .005). There was fair interreader agreement (κ = 0.39). High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Update On Vapor Intrusion At The U.S. EPA

EPA Science Inventory

Increasing attention has been given to understanding the impacts of subsurface vapor contaminant migration into overlying buildings. Many of these impacted structures are residences and manufacturing facilities where current and future occupants face undesirable health risks. T...

An Integrated and Interdisciplinary Model for Predicting the Risk of Injury and Death in Future Earthquakes

PubMed Central

Shapira, Stav; Novack, Lena; Bar-Dayan, Yaron; Aharonson-Daniel, Limor

2016-01-01

Background A comprehensive technique for earthquake-related casualty estimation remains an unmet challenge. This study aims to integrate risk factors related to characteristics of the exposed population and to the built environment in order to improve communities’ preparedness and response capabilities and to mitigate future consequences. Methods An innovative model was formulated based on a widely used loss estimation model (HAZUS) by integrating four human-related risk factors (age, gender, physical disability and socioeconomic status) that were identified through a systematic review and meta-analysis of epidemiological data. The common effect measures of these factors were calculated and entered to the existing model’s algorithm using logistic regression equations. Sensitivity analysis was performed by conducting a casualty estimation simulation in a high-vulnerability risk area in Israel. Results the integrated model outcomes indicated an increase in the total number of casualties compared with the prediction of the traditional model; with regard to specific injury levels an increase was demonstrated in the number of expected fatalities and in the severely and moderately injured, and a decrease was noted in the lightly injured. Urban areas with higher populations at risk rates were found more vulnerable in this regard. Conclusion The proposed model offers a novel approach that allows quantification of the combined impact of human-related and structural factors on the results of earthquake casualty modelling. Investing efforts in reducing human vulnerability and increasing resilience prior to an occurrence of an earthquake could lead to a possible decrease in the expected number of casualties. PMID:26959647

Marketing a hard-to-swallow message: recommendations for the design of media campaigns to increase awareness about the risks of binge drinking.

PubMed

Jack, Susan M; Bouck, L Michelle Sangster; Beynon, Charlene E; Ciliska, Donna K; Mitchell, Martha J Lewis

2005-01-01

Binge drinking, commonly defined as having more than five drinks on a single occasion, is a public health issue affecting two thirds of Canadian young adults between the ages of 19-24 years. To educate young adults about alcohol poisoning, a network of 16 Ontario Health Units developed and implemented a mass-media campaign. The focus of this article is to report on post-secondary students' perceptions about key media campaign strategies, elements and messages for future campaigns designed to increase awareness about the risks of binge drinking. As part of a multi-method process evaluation, nine focus groups were facilitated to explore the young adults' knowledge, attitudes and beliefs about binge drinking and the campaign messages. Participants were also asked to identify specific marketing messages and techniques that would increase their level of awareness about the risks of binge drinking. Participants recommended that campaigns be targeted towards parents and high school and post-secondary school students. Participants provided recommendations for the types of messages, images, and language they perceived would capture the attention of young adults. Television, posters and the internet were identified as key media channels for disseminating health information about the risks associated with excessive alcohol consumption. The problem of binge drinking is pervasive across Canadian campuses and students are largely unaware of the risks associated with excessive alcohol consumption. To reach this target population, it is important for future media campaign developers to utilize language, definitions, graphics and channels of communication to which this group relates.

Potential drivers of virulence evolution in aquaculture

USGS Publications Warehouse

Kennedy, David A.; Kurath, Gael; Brito, Ilana L.; Purcell, Maureen K.; Read, Andrew F.; Winton, James R.; Wargo, Andrew R.

2016-01-01

Infectious diseases are economically detrimental to aquaculture, and with continued expansion and intensification of aquaculture, the importance of managing infectious diseases will likely increase in the future. Here, we use evolution of virulence theory, along with examples, to identify aquaculture practices that might lead to the evolution of increased pathogen virulence. We identify eight practices common in aquaculture that theory predicts may favor evolution toward higher pathogen virulence. Four are related to intensive aquaculture operations, and four others are related specifically to infectious disease control. Our intention is to make aquaculture managers aware of these risks, such that with increased vigilance, they might be able to detect and prevent the emergence and spread of increasingly troublesome pathogen strains in the future.

Declining vulnerability to river floods and the global benefits of adaptation

PubMed Central

Jongman, Brenden; Winsemius, Hessel C.; Aerts, Jeroen C. J. H.; Coughlan de Perez, Erin; van Aalst, Maarten K.; Kron, Wolfgang; Ward, Philip J.

2015-01-01

The global impacts of river floods are substantial and rising. Effective adaptation to the increasing risks requires an in-depth understanding of the physical and socioeconomic drivers of risk. Whereas the modeling of flood hazard and exposure has improved greatly, compelling evidence on spatiotemporal patterns in vulnerability of societies around the world is still lacking. Due to this knowledge gap, the effects of vulnerability on global flood risk are not fully understood, and future projections of fatalities and losses available today are based on simplistic assumptions or do not include vulnerability. We show for the first time (to our knowledge) that trends and fluctuations in vulnerability to river floods around the world can be estimated by dynamic high-resolution modeling of flood hazard and exposure. We find that rising per-capita income coincided with a global decline in vulnerability between 1980 and 2010, which is reflected in decreasing mortality and losses as a share of the people and gross domestic product exposed to inundation. The results also demonstrate that vulnerability levels in low- and high-income countries have been converging, due to a relatively strong trend of vulnerability reduction in developing countries. Finally, we present projections of flood losses and fatalities under 100 individual scenario and model combinations, and three possible global vulnerability scenarios. The projections emphasize that materialized flood risk largely results from human behavior and that future risk increases can be largely contained using effective disaster risk reduction strategies. PMID:25902499

Declining vulnerability to river floods and the global benefits of adaptation.

PubMed

Jongman, Brenden; Winsemius, Hessel C; Aerts, Jeroen C J H; Coughlan de Perez, Erin; van Aalst, Maarten K; Kron, Wolfgang; Ward, Philip J

2015-05-05

The global impacts of river floods are substantial and rising. Effective adaptation to the increasing risks requires an in-depth understanding of the physical and socioeconomic drivers of risk. Whereas the modeling of flood hazard and exposure has improved greatly, compelling evidence on spatiotemporal patterns in vulnerability of societies around the world is still lacking. Due to this knowledge gap, the effects of vulnerability on global flood risk are not fully understood, and future projections of fatalities and losses available today are based on simplistic assumptions or do not include vulnerability. We show for the first time (to our knowledge) that trends and fluctuations in vulnerability to river floods around the world can be estimated by dynamic high-resolution modeling of flood hazard and exposure. We find that rising per-capita income coincided with a global decline in vulnerability between 1980 and 2010, which is reflected in decreasing mortality and losses as a share of the people and gross domestic product exposed to inundation. The results also demonstrate that vulnerability levels in low- and high-income countries have been converging, due to a relatively strong trend of vulnerability reduction in developing countries. Finally, we present projections of flood losses and fatalities under 100 individual scenario and model combinations, and three possible global vulnerability scenarios. The projections emphasize that materialized flood risk largely results from human behavior and that future risk increases can be largely contained using effective disaster risk reduction strategies.

Cardiovascular fitness in late adolescent males and later risk of serious non-affective mental disorders: a prospective, population-based study.

PubMed

Nyberg, J; Henriksson, M; Åberg, M A I; Rosengren, A; Söderberg, M; Åberg, N D; Kuhn, H G; Waern, M

2018-02-01

Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship. Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3-42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life. Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29-1.61], other psychotic disorders (HR 1.41, 95% CI 1.27-1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37-1.54). Relationships persisted in models that included illness in brothers. Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.

Explanatory Models of Genetics and Genetic Risk among a Selected Group of Students.

PubMed

Goltz, Heather Honoré; Bergman, Margo; Goodson, Patricia

2016-01-01

This exploratory qualitative study focuses on how college students conceptualize genetics and genetic risk, concepts essential for genetic literacy (GL) and genetic numeracy (GN), components of overall health literacy (HL). HL is dependent on both the background knowledge and culture of a patient, and lower HL is linked to increased morbidity and mortality for a number of chronic health conditions (e.g., diabetes and cancer). A purposive sample of 86 students from three Southwestern universities participated in eight focus groups. The sample ranged in age from 18 to 54 years, and comprised primarily of female (67.4%), single (74.4%), and non-White (57%) participants, none of whom were genetics/biology majors. A holistic-content approach revealed broad categories concerning participants' explanatory models (EMs) of genetics and genetic risk. Participants' EMs were grounded in highly contextualized narratives that only partially overlapped with biomedical models. While higher education levels should be associated with predominately knowledge-based EM of genetic risk, this study shows that even in well-educated populations cultural factors can dominate. Study findings reveal gaps in how this sample of young adults obtains, processes, and understands genetic/genomic concepts. Future studies should assess how individuals with low GL and GN obtain and process genetics and genetic risk information and incorporate this information into health decision making. Future work should also address the interaction of communication between health educators, providers, and genetic counselors, to increase patient understanding of genetic risk.

Do levels of immunoglobulin G antibodies to foods predict the development of immunoglobulin E antibodies to cat, dog and/or mite?

PubMed

Eysink, P E D; Bindels, P J E; Stapel, S O; Bottema, B J A M; Van Der Zee, J S; Aalberse, R C

2002-04-01

In children at high risk of inhalation allergy, food sensitization is associated with an increased risk for sensitization to inhalant allergens. Furthermore, this association was also found in a cross-sectional study. To examine in a prospective study, whether levels of IgG to foods (i.e. mixture of wheat and rice, mixture of soy bean and peanut, egg white, cow's milk, meat, orange and potato) indicate an increased risk for the future development of IgE antibodies to inhalant allergens in a low-risk population and whether they can be used as predictors of the subsequent development of IgE antibodies in young, initially IgE-negative children. Coughing children, aged 1-5, visiting their GPs, were tested for IgE antibodies to mite, dog and cat (RAST) and IgG (ELISA) to foods. All IgE-negative children were retested for IgE antibodies after two years. The IgG results (66 percentiles) of the first blood sample were compared to the RAST-scores of the second blood sample. After two years, 51 out of 397 (12.8%) originally IgE-negative children, had become IgE-positive for cat, dog and/or mite. An increased IgG antibody level to wheat-rice (OR = 2.2) and to orange (OR = 2.0) indicated an increased risk of developing IgE to cat, dog or mite allergens. In addition to IgG to a mixture of wheat-rice and orange; total IgE, breastfeeding, eczema as a baby and age were the most important predictors for the subsequent development of IgE to inhalant allergens. An increased IgG antibody level to a mixture of wheat-rice or orange, indicates an increased risk of developing IgE to cat, dog or mite allergens. This indicates that excessive activity of the mucosal immune system is present before IgE antibodies to airborne allergens can be demonstrated. Nevertheless, IgG to foods is not very helpful (with a positive predictive value of 16.5%, and negative predictive value of 90.6%) in identifying individual children at risk in clinical practice. However, besides other risk factors, IgG to wheat-rice and to orange could be useful as a screening test for studies in the early identification, i.e. before IgE antibodies can be detected, of children with an increased risk of developing IgE antibodies in the future.

Cardiovascular and metabolic risks in psoriasis and psoriatic arthritis: pragmatic clinical management based on available evidence.

PubMed

Johnsson, Hanna; McInnes, Iain B; Sattar, Naveed

2012-04-01

Several studies suggest that patients with psoriasis and, in particular, psoriatic arthritis (PsA) are at increased risk of cardiovascular disease. These patients are also more likely to be obese and to have diabetes and fatty liver disease. This article discusses the association between psoriasis and PsA and cardiometabolic disorders, emphasising the need for better consideration of simple lifestyle interventions. It also highlights areas for future research and proposes a simple and pragmatic test portfolio to screen for cardiovascular risk and metabolic disorders in patients at higher risk.

Assessing the impacts induced by global climate change through a multi-risk approach: lessons learned from the North Adriatic coast (Italy)

NASA Astrophysics Data System (ADS)

Gallina, Valentina; Torressan, Silvia; Zabeo, Alex; Critto, Andrea; Glade, Thomas; Marcomini, Antonio

2015-04-01

Climate change is expected to pose a wide range of impacts on natural and human systems worldwide, increasing risks from long-term climate trends and disasters triggered by weather extremes. Accordingly, in the future, one region could be potentially affected by interactions, synergies and trade-offs of multiple hazards and impacts. A multi-risk risk approach is needed to effectively address multiple threats posed by climate change across regions and targets supporting decision-makers toward a new paradigm of multi-hazard and risk management. Relevant initiatives have been already developed for the assessment of multiple hazards and risks affecting the same area in a defined timeframe by means of quantitative and semi-quantitative approaches. Most of them are addressing the relations of different natural hazards, however, the effect of future climate change is usually not considered. In order to fill this gap, an advanced multi-risk methodology was developed at the Euro-Mediterranean Centre on Climate Change (CMCC) for estimating cumulative impacts related to climate change at the regional (i.e. sub-national) scale. This methodology was implemented into an assessment tool which allows to scan and classify quickly natural systems and human assets at risk resulting from different interacting hazards. A multi-hazard index is proposed to evaluate the relationships of different climate-related hazards (e.g. sea-level rise, coastal erosion, storm surge) occurring in the same spatial and temporal area, by means of an influence matrix and the disjoint probability function. Future hazard scenarios provided by regional climate models are used as input for this step in order to consider possible effects of future climate change scenarios. Then, the multi-vulnerability of different exposed receptors (e.g. natural systems, beaches, agricultural and urban areas) is estimated through a variety of vulnerability indicators (e.g. vegetation cover, sediment budget, % of urbanization), tailored case by case to different sets of natural hazards and elements at risk. Finally, the multi-risk assessment integrates the multi-hazard with the multi-vulnerability index of exposed receptors, providing a relative ranking of areas and targets potentially affected by multiple risks in the considered region. The methodology was applied to the North Adriatic coast (Italy) producing a range of GIS-based multi-hazard, exposure, multi-vulnerability and multi-risk maps that can be used by policy-makers to define risk management and adaptation strategies. Results show that areas affected by higher multi-hazard scores are located close to the coastline where all the investigated hazards are present. Multi-vulnerability assumes relatively high scores in the whole case study, showing that beaches, wetlands, protected areas and river mouths are the more sensible targets. The final estimate of multi-risk for coastal municipalities provides useful information for local public authorities to set future priorities for adaptation and define future plans for shoreline and coastal management in view of climate change.

Impact of Vitamin D Replacement on Markers of Glucose Metabolism and Cardio-Metabolic Risk in Women with Former Gestational Diabetes--A Double-Blind, Randomized Controlled Trial.

PubMed

Yeow, Toh Peng; Lim, Shueh Lin; Hor, Chee Peng; Khir, Amir S; Wan Mohamud, Wan Nazaimoon; Pacini, Giovanni

2015-01-01

Gestational Diabetes Mellitus (GDM) and vitamin D deficiency are related to insulin resistance and impaired beta cell function, with heightened risk for future development of diabetes. We evaluated the impact of vitamin D supplementation on markers of glucose metabolism and cardio metabolic risk in Asian women with former GDM and hypovitaminosis D. In this double blind, randomized controlled trial, 26 participants were randomized to receive either daily 4000 IU vitamin D3 or placebo capsules. 75 g Oral Glucose Tolerance Test (OGTT) and biochemistry profiles were performed at baseline and 6 month visits. Mathematical models, using serial glucose, insulin and C peptide measurements from OGTT, were employed to calculate insulin sensitivity and beta cell function. Thirty three (76%) women with former GDM screened had vitamin D level of <50 nmol/L at baseline. Supplementation, when compared with placebo, resulted in increased vitamin D level (+51.1 nmol/L vs 0.2 nmol/L, p<0.001) and increased fasting insulin (+20% vs 18%, p = 0.034). The vitamin D group also demonstrated a 30% improvement in disposition index and an absolute 0.2% (2 mmol/mol) reduction in HbA1c. There was no clear change in insulin sensitivity or markers of cardio metabolic risk. This study highlighted high prevalence of vitamin D deficiency among Asian women with former GDM. Six months supplementation with 4000 IU of vitamin D3 safely restored the vitamin D level, improved basal pancreatic beta-cell function and ameliorated the metabolic state. There was no effect on markers of cardio metabolic risk. Further mechanistic studies exploring the role of vitamin D supplementation on glucose homeostasis among different ethnicities may be needed to better inform future recommendations for these women with former GDM at high risk of both hypovitaminosis D and future diabetes.

Maternal outcomes and follow-up after gestational diabetes mellitus.

PubMed

Kim, C

2014-03-01

Gestational diabetes mellitus reflects impaired maternal insulin secretion relative to demand prior to pregnancy, as well as temporary metabolic stressors imposed by the placenta and fetus. Thus, after delivery, women with gestational diabetes have increased risk of diabetes and recurrent gestational diabetes because of their underlying impairment, which may be further exacerbated by fat accretion during pregnancy and post-partum deterioration in lifestyle behaviours. This hypothetical model is discussed in greater detail, particularly the uncertainty regarding pregnancy as an accelerator of β-cell decline and the role of gestational weight gain. This report also presents risk estimates for future glucose intolerance and diabetes and reviews modifiable risk factors, particularly body mass and lifestyle alterations, including weight loss and breastfeeding. Non-modifiable risk factors such as race/ethnicity and insulin use during pregnancy are also discussed. The review concludes with current literature on lifestyle modification, recommendations for post-partum glucose screening, and future directions for research to prevent maternal disease. © 2013 The Author. Diabetic Medicine © 2013 Diabetes UK.

Maternal outcomes and follow-up after gestational diabetes mellitus

PubMed Central

Kim, C.

2014-01-01

Gestational diabetes mellitus reflects impaired maternal insulin secretion relative to demand prior to pregnancy, as well as temporary metabolic stressors imposed by the placenta and fetus. Thus, after delivery, women with gestational diabetes have increased risk of diabetes and recurrent gestational diabetes because of their underlying impairment, which may be further exacerbated by fat accretion during pregnancy and post-partum deterioration in lifestyle behaviours. This hypothetical model is discussed in greater detail, particularly the uncertainty regarding pregnancy as an accelerator of β-cell decline and the role of gestational weight gain. This report also presents risk estimates for future glucose intolerance and diabetes and reviews modifiable risk factors, particularly body mass and lifestyle alterations, including weight loss and breastfeeding. Non-modifiable risk factors such as race/ethnicity and insulin use during pregnancy are also discussed. The review concludes with current literature on lifestyle modification, recommendations for post-partum glucose screening, and future directions for research to prevent maternal disease. PMID:24341443

The future of pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) infection.

PubMed

Özdener, Ayşe Elif; Park, Tae Eun; Kalabalik, Julie; Gupta, Rachna

2017-05-01

People at high risk for HIV acquisition should be offered pre-exposure prophylaxis (PrEP). Tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) is currently the only medication recommended for pre-exposure prophylaxis (PrEP) by the Centers for Disease Control and Prevention (CDC) in people at high risk for HIV acquisition. This article will review medications currently under investigation and the future landscape of PrEP therapy. Areas covered: This article will review clinical trials that have investigated nontraditional regimens of TDF/FTC, antiretroviral agents from different drug classes such as integrase strand transfer inhibitors (INSTI), nucleoside reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) as potential PrEP therapies. Expert commentary: Currently, there are several investigational drugs in the pipeline for PrEP against HIV infection. Increased utilization of PrEP therapy depends on provider identification of people at high risk for HIV transmission. Advances in PrEP development will expand options and access for people and reduce the risk of HIV acquisition.

Enhancing Human Responses to Climate Change Risks through Simulated Flooding Experiences

NASA Astrophysics Data System (ADS)

Zaalberg, Ruud; Midden, Cees

Delta areas are threatened by global climate change. The general aims of our research were (1) to increase our understanding of climate and flood risk perceptions and the factors that influence these judgments, and (2) to seek for interventions that can contribute to a realistic assessment by laypersons of long-term flooding risks. We argue that awareness of one's own vulnerability to future flooding and insights into the effectiveness of coping strategies is driven by direct flooding experiences. In the current research multimodal sensory stimulation by means of interactive 3D technology is used to simulate direct flooding experiences at the experiential or sensory level, thereby going beyond traditional persuasion attempts using fear-evoking images. Our results suggest that future communication efforts should not only use these new technologies to transfer knowledge about effective coping strategies and flooding risks, but should especially be directed towards residents living in flood prone areas, but who lack direct flooding experiences as their guiding principle.

The consumption of two or more fall risk-increasing drugs rather than polypharmacy is associated with falls.

PubMed

Zia, Anam; Kamaruzzaman, Shahrul B; Tan, Maw P

2017-03-01

The presemt study aimed to determine the association between the risk of recurrent and injurious falls with polypharmacy, fall risk-increasing drugs (FRID) and FRID count among community-dwelling older adults. Participants (n = 202) were aged ≥65 years with two or more falls or one injurious fall in the past year, whereas controls (n = 156) included volunteers aged ≥65 years with no falls in the past year. A detailed medication history was obtained alongside demographic data. Polypharmacy was defined as "regular use of five or more prescription drugs." FRID were identified as cardiovascular agents, central nervous system drugs, analgesics and endocrine drugs; multiple FRID were defined as two or more FRID. Multiple logistic regression analyses were used to adjust for confounders. The use of non-steroidal anti-inflammatory drugs was independently associated with an increased risk of falls. Univariate analyses showed both polypharmacy (OR 2.23, 95% CI 1.39-3.56; P = 0.001) and the use of two or more FRID (OR 2.9, 95% CI 1.9-4.5; P = 0.0001) were significantly more likely amongst fallers. After adjustment for age, sex and comorbidities, blood pressure, and physical performance scores, polypharmacy was no longer associated with falls (OR 1.6, 95% CI 0.9-2.9; P = 0.102), whereas the consumption of two or more FRID remained a significant predictor for falls (OR 2.8, 95% CI 1.4-5.3; P = 0.001). Among high risk fallers, the use of two or more FRID was an independent risk factor for falls instead of polypharmacy. Our findings will inform clinical practice in terms of medication reviews among older adults at higher risk of falls. Future intervention studies will seek to confirm whether avoidance or withdrawal of multiple FRID reduces the risk of future falls. Geriatr Gerontol Int 2017; 17: 463-470. © 2016 Japan Geriatrics Society.

Recent evolution of surge-related events and assessment of coastal flooding risk on the eastern coasts of the English Channel

NASA Astrophysics Data System (ADS)

Pirazzoli, Paolo Antonio; Costa, Stéphane; Dornbusch, Uwe; Tomasin, Alberto

2006-12-01

This paper is based on statistical analysis of hourly tide measurements for some 285 equivalent full years from the stations of Weymouth, Bournemouth, Portsmouth, Newhaven, Dover and Sheerness in the UK, and of Cherbourg, Le Havre, Dieppe, Boulogne, Calais and Dunkirk in France. For each tidal value, surge heights have been determined and correlated with hourly or three-hourly wind and air pressure data from nearby meteorological stations. Major surges in the area are generally produced by storms associated with wind from north-west or south-west that tend to push oceanic water into the Channel. Recent medium-term climate evolution does not seem to increase the flooding risk at French stations, where surge-related winds tend to decrease in frequency and speed (Cherbourg, Dieppe and Boulogne) or show little change (Le Havre). However, the long-term risk of flooding will increase through the loss in land elevation due to a continuation of the local relative sea-level rise, especially if this effect will be enhanced by an acceleration in the global sea-level rise predicted by climatic models. The northern side of the Channel (Weymouth, Bournemouth and Portsmouth) is mainly exposed to southerly winds that show variable trends. It is also apparently affected by strong subsidence trends during the last two decades. If lasting, such trends can only increase long-term flooding risk. The flooding risk has not increased near the eastern end of the Channel. The duration of significant cyclonic events tends to decrease near Cherbourg but tends to increase near Weymouth, with no conclusive trends in other stations (Portsmouth, Calais and Dunkirk), where extreme surges may occur also in relatively high-air-pressure situations. In conclusion, medium-term coastal flooding risk seems to increase especially at Weymouth, Bournemouth and Portsmouth, and also, but less so, at Le Havre and Sheerness. In addition, few extreme surges occurred during the last decades at the time of spring high tide, which would seem to be a fortunate coincidence or, in some cases, an effect of tide-surge interaction. The risk of occurrence of less favourable random events in the near future is therefore of concern, and flood potential would greatly increase if the global sea-level rise expected in the near future is also considered.

Human Factors in Training

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin

2010-01-01

Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 09 (FY09) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: 1) Risk associated with poor task design; 2) Risk of error due to inadequate information; and 3) Risk associated with reduced safety and efficiency due to poor human factors design.

Human Factors in Training

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin; Sandor, Aniko

2009-01-01

Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 08 (FY08) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: (1) Risk associated with poor task design (2) Risk of error due to inadequate information (3) Risk associated with reduced safety and efficiency due to poor human factors design

Overwintering of herbaceous plants in a changing climate. Still more questions than answers.

PubMed

Rapacz, Marcin; Ergon, Ashild; Höglind, Mats; Jørgensen, Marit; Jurczyk, Barbara; Ostrem, Liv; Rognli, Odd Arne; Tronsmo, Anne Marte

2014-08-01

The increase in surface temperature of the Earth indicates a lower risk of exposure for temperate grassland and crop to extremely low temperatures. However, the risk of low winter survival rate, especially in higher latitudes may not be smaller, due to complex interactions among different environmental factors. For example, the frequency, degree and length of extreme winter warming events, leading to snowmelt during winter increased, affecting the risks of anoxia, ice encasement and freezing of plants not covered with snow. Future climate projections suggest that cold acclimation will occur later in autumn, under shorter photoperiod and lower light intensity, which may affect the energy partitioning between the elongation growth, accumulation of organic reserves and cold acclimation. Rising CO2 levels may also disturb the cold acclimation process. Predicting problems with winter pathogens is also very complex, because climate change may greatly influence the pathogen population and because the plant resistance to these pathogens is increased by cold acclimation. All these factors, often with contradictory effects on winter survival, make plant overwintering viability under future climates an open question. Close cooperation between climatologists, ecologists, plant physiologists, geneticists and plant breeders is strongly required to predict and prevent possible problems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prospective study of risk factors for suicidal behavior in individuals with anxiety disorders.

PubMed

Uebelacker, L A; Weisberg, R; Millman, M; Yen, S; Keller, M

2013-07-01

Anxiety disorders are very common and increase risk for suicide attempts. Little is known about predictors of increased risk specifically among individuals with anxiety disorders. The purpose of this study was to investigate whether specific anxiety disorders and other co-morbid psychiatric disorders, physical health, or work or social functioning increased the future likelihood of a suicide attempts among individuals with anxiety disorders. Method In this prospective study, 676 individuals with an anxiety disorder were followed for an average of 12 years. As hypothesized, we found that post-traumatic stress disorder, major depressive disorder (MDD), intermittent depressive disorder (IDD), epilepsy, pain, and poor work and social functioning all predicted a shorter time to a suicide attempt in univariate analyses. In multivariate analyses, baseline MDD and IDD were independent predictors of time to suicide attempt, even when controlling for a past history of suicide attempt. No specific anxiety disorder was an independent predictor of time to attempt in this anxiety-disordered sample. Adding baseline physical health variables and social functioning did not improve the ability of the model to predict time to suicide attempt. Mood disorders and past history of suicide attempts are the most powerful predictors of a future suicide attempt in this sample of individuals, all of whom have an anxiety disorder.

Likelihood of a marine vessel accident from wind energy development in the Atlantic: Likelihood of shipping accident from wind energy in the Atlantic

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

Copping, Andrea; Breithaupt, Stephen; Whiting, Jonathan

2015-11-02

Offshore wind energy development is planned for areas off the Atlantic coast. Many of the planned wind development areas fall within traditional commercial vessel routes. In order to mitigate possible hazards to ships and to wind turbines, it is important to understand the potential for increased risk to commercial shipping from the presence of wind farms. Using Automatic Identification System (AIS) data, historical shipping routes between ports in the Atlantic were identified, from Maine to the Florida Straits. The AIS data were also used as inputs to a numerical model that can simulate cargo, tanker and tug/towing vessel movement alongmore » typical routes. The model was used to recreate present day vessel movement, as well as to simulate future routing that may be required to avoid wind farms. By comparing the present and future routing of vessels, a risk analysis was carried out to determine the increased marginal risk of vessel collisions, groundings, and allisions with stationary objects, due to the presence of wind farms. The outcome of the analysis showed little increase in vessel collisions or allisions, and a decrease in groundings as more vessels were forced seaward by the wind farms.« less

Hypertension complicating diabetic pregnancies: pathophysiology, management, and controversies.

PubMed

Sullivan, Shannon D; Umans, Jason G; Ratner, Robert

2011-04-01

Hypertensive disorders of pregnancy (HDP), including pre-existing hypertension, gestational hypertension, and preeclampsia, further complicate already high-risk pregnancies in women with diabetes mellitus (DM). Women with both pre-existing and gestational diabetes are at increased risk for HDP, leading to higher maternal and fetal morbidity. Further, particularly in diabetic women and women with a history of gestational diabetes, HDP significantly increases the risk for future cardiovascular events. For clinicians, women with hypertension and diabetes during pregnancy pose a management challenge. Specifically, preconception management should stress strict control of glycemia, blood pressure, and prevention of diabetic complications, specifically nephropathy, which specifically increases the risk for preeclampsia. During gestation, clinicians must be aware of potential maternal and fetal complications associated with various anti-hypertensive therapies, including known fetotoxicity of ACE inhibitors and ARBs when given in the 2nd or 3rd trimester, and the risks and benefits of expectant management versus delivery in cases of severe gestational hypertension or preeclampsia. Indeed, diabetic women must be followed closely prior to conception and throughout gestation to minimize the risk of HDP and its associated complications. © 2011 Wiley Periodicals, Inc.

Climate change risk perception and communication: addressing a critical moment?

PubMed

Pidgeon, Nick

2012-06-01

Climate change is an increasingly salient issue for societies and policy-makers worldwide. It now raises fundamental interdisciplinary issues of risk and uncertainty analysis and communication. The growing scientific consensus over the anthropogenic causes of climate change appears to sit at odds with the increasing use of risk discourses in policy: for example, to aid in climate adaptation decision making. All of this points to a need for a fundamental revision of our conceptualization of what it is to do climate risk communication. This Special Collection comprises seven papers stimulated by a workshop on "Climate Risk Perceptions and Communication" held at Cumberland Lodge Windsor in 2010. Topics addressed include climate uncertainties, images and the media, communication and public engagement, uncertainty transfer in climate communication, the role of emotions, localization of hazard impacts, and longitudinal analyses of climate perceptions. Climate change risk perceptions and communication work is critical for future climate policy and decisions. © 2012 Society for Risk Analysis.

Achieving Higher-Fidelity Conjunction Analyses Using Cryptography to Improve Information Sharing

DTIC Science & Technology

2014-01-01

debris—the man-made orbital junk that represents a collision risk to operational satellites—is a growing threat that will increasingly affect future space ...Plans, Hq USAF. Library of Congress Cataloging-in-Publication Data is available for this publication. ISBN: 978-0-8330-8166-7 iii Preface Space ...reducing future debris populations using political and technical means. The 2010 U.S. Space Policy makes several policy recommendations for addressing

Shuttle Risk Progression: Use of the Shuttle Probabilistic Risk Assessment (PRA) to Show Reliability Growth

NASA Technical Reports Server (NTRS)

Hamlin, Teri L.

2011-01-01

It is important to the Space Shuttle Program (SSP), as well as future manned spaceflight programs, to understand the early mission risk and progression of risk as the program gains insights into the integrated vehicle through flight. The risk progression is important to the SSP as part of the documentation of lessons learned. The risk progression is important to future programs to understand reliability growth and the first flight risk. This analysis uses the knowledge gained from 30 years of operational flights and the current Shuttle PRA to calculate the risk of Loss of Crew and Vehicle (LOCV) at significant milestones beginning with the first flight. Key flights were evaluated based upon historical events and significant re-designs. The results indicated that the Shuttle risk tends to follow a step function as opposed to following a traditional reliability growth pattern where risk exponentially improves with each flight. In addition, it shows that risk can increase due to trading safety margin for increased performance or due to external events. Due to the risk drivers not being addressed, the risk did not improve appreciably during the first 25 flights. It was only after significant events occurred such as Challenger and Columbia, where the risk drivers were apparent, that risk was significantly improved. In addition, this paper will show that the SSP has reduced the risk of LOCV by almost an order of magnitude. It is easy to look back afte r 30 years and point to risks that are now obvious, however; the key is to use this knowledge to benefit other programs which are in their infancy stages. One lesson learned from the SSP is understanding risk drivers are essential in order to considerably reduce risk. This will enable the new program to focus time and resources on identifying and reducing the significant risks. A comprehensive PRA, similar to that of the Shuttle PRA, is an effective tool quantifying risk drivers if support from all of the stakeholders is given.

Flood risk (d)evolution: Disentangling key drivers of flood risk change with a retro-model experiment.

PubMed

Zischg, Andreas Paul; Hofer, Patrick; Mosimann, Markus; Röthlisberger, Veronika; Ramirez, Jorge A; Keiler, Margreth; Weingartner, Rolf

2018-05-19

Flood risks are dynamically changing over time. Over decades and centuries, the main drivers for flood risk change are influenced either by perturbations or slow alterations in the natural environment or, more importantly, by socio-economic development and human interventions. However, changes in the natural and human environment are intertwined. Thus, the analysis of the main drivers for flood risk changes requires a disentangling of the individual risk components. Here, we present a method for isolating the individual effects of selected drivers of change and selected flood risk management options based on a model experiment. In contrast to purely synthetic model experiments, we built our analyses upon a retro-model consisting of several spatio-temporal stages of river morphology and settlement structure. The main advantage of this approach is that the overall long-term dynamics are known and do not have to be assumed. We used this model setup to analyse the temporal evolution of the flood risk, for an ex-post evaluation of the key drivers of change, and for analysing possible alternative pathways for flood risk evolution under different governance settings. We showed that in the study region the construction of lateral levees and the consecutive river incision are the main drivers for decreasing flood risks over the last century. A rebound effect in flood risk can be observed following an increase in settlements since the 1960s. This effect is not as relevant as the river engineering measures, but it will become increasingly relevant in the future with continued socio-economic growth. The presented approach could provide a methodological framework for studying pathways for future flood risk evolvement and for the formulation of narratives for adapting governmental flood risk strategies to the spatio-temporal dynamics in the built environment. Copyright © 2018 Elsevier B.V. All rights reserved.

Predicting Health Resilience in Pediatric Type 1 Diabetes: A Test of the Resilience Model Framework.

PubMed

Rohan, Jennifer M; Huang, Bin; Pendley, Jennifer Shroff; Delamater, Alan; Dolan, Lawrence; Reeves, Grafton; Drotar, Dennis

2015-10-01

This research examined whether individual and family-level factors during the transition from late childhood to early adolescence protected individuals from an increased risk of poor glycemic control across time, which is a predictor of future diabetes-related complications (i.e., health resilience). This longitudinal, multisite study included 239 patients with type 1 diabetes and their caregivers. Glycemic control was based on hemoglobin A1c. Individual and family-level factors included: demographic variables, youth behavioral regulation, adherence (frequency of blood glucose monitoring), diabetes self-management, level of parental support for diabetes autonomy, level of youth mastery and responsibility for diabetes management, and diabetes-related family conflict. Longitudinal mixed-effects logistic regression indicated that testing blood glucose more frequently, better self-management, and less diabetes-related family conflict were indicators of health resilience. Multiple individual and family-level factors predicted risk for future health complications. Future research should develop interventions targeting specific individual and family-level factors to sustain glycemic control within recommended targets, which reduces the risk of developing future health complications during the transition to adolescence and adulthood. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessing Climate Change Perceptions, Management Strategies, and Information Needs for Indiana Agricultural and Forestry Sectors

NASA Astrophysics Data System (ADS)

Cherkauer, K. A.; Chin, N.

2016-12-01

The agricultural and forestry sectors in the state of Indiana are highly dependent on climate and, subsequently, highly vulnerable to the impacts of climate change. Higher temperatures, shifts in precipitation patterns, more widespread prevalence of pests and pathogens, and increased frequency and severity of extreme weather events could all have negative effects on these two sectors in the future. Agricultural and forest producers are already modifying their management strategies in response to perceptions of changes in climate risk, but such responses have been primarily reactive in nature and, in many cases, demonstrate a disconnect between scientific findings and stakeholder perceptions of the greatest climate risks. This research has been conducted to help improve understanding of climate change risks to agriculture and forestry in Indiana; stakeholder perceptions of climate risks and their current management strategies; and the effectiveness of these management strategies for dealing with current and future climate risk. Sector-specific focus groups, expert panel assessments and surveys have all been utilized in this work, which will also contribute to the new Indiana Climate Change Impacts Assessment report.

Vulnerability of species to climate change in the Southwest: threatened, endangered, and at-risk species at the Barry M. Goldwater Range, Arizona

Treesearch

Karen E. Bagne; Deborah M. Finch

2012-01-01

Future climate change is anticipated to result in ecosystem changes, and consequently, many species are expected to become increasingly vulnerable to extinction. This scenario is of particular concern for threatened, endangered, and at-risk species (TER-S) or other rare species. The response of species to climate change is uncertain and will be the outcome of complex...

Vulnerability of species to climate change in the Southwest: threatened, endangered, and at-risk species at Fort Huachuca, Arizona

Treesearch

Karen E. Bagne; Deborah M. Finch

2013-01-01

Future climate change is anticipated to result in ecosystem changes, and consequently, many species are expected to become increasingly vulnerable to extinction. This scenario is of particular concern for threatened, endangered, and at-risk species (TER-S) or other rare species. The response of species to climate change is uncertain and will be the outcome of complex...

Bringing Back the Social History

PubMed Central

Pierce, Mary Clyde; Kaczor, Kim; Thompson, Richard

2014-01-01

The social environment of the child is a key determinant of the child’s current and future health. Factors in the child’s family environment, both protective and harmful, have profound impact on the child’s long-term health, brain development, and mortality. Adverse childhood experiences, and specifically, child maltreatment, are directly linked to increased risk for harm, poor outcomes, ill-health as adults, and even death during childhood or early adulthood. Therefore, it is important to obtain a detailed social history from the first medical visit with the dual goals of identifying strengths to reinforce and weaknesses to address. Screening is paramount in order to foster healthy parenting and help identify areas needing intervention. Occasionally, serious problems are uncovered indicating the child is at significant risk for maltreatment. By addressing these risks openly and directly before serious or permanent harm occurs, child maltreatment and its potentially life-altering consequences (for all) may be prevented. The social history may very well be the best all-around tool available for promoting the child’s future health and well-being. It is a key first step in identifying social needs of the child and family so that they may benefit from intervention. This article focuses on key social history elements known to increase a child’s risk of maltreatment and provides case examples. PMID:25242704

Risk of HIV/AIDS in China: subpopulations of special importance

PubMed Central

Qian, Z; Vermund, S; Wang, N

2005-01-01

Objective: To describe the HIV/AIDS epidemic in mainland China. Methods: We review the magnitude of the HIV/AIDS epidemic and the social characteristics and geographic distribution of at-risk groups in China based on published literature and unpublished official data. Results: Injection drug use has been the dominant route for HIV infection in China, and will continue to be a major risk factor with increasing numbers of new drug users and needle sharing. Commercial plasma donation with unhygienic re-infusion of red blood cells was common in rural communities in the early 1990s. While this is unlikely to constitute a major factor for future HIV spread, those already infected represent a formidable treatment challenge. Huge seasonal work migration facilitates disease spread across regions. Many homosexual men have unprotected sex with men, women, or both, and may contract or spread HIV. Though commercial sex workers have contributed to a small proportion of the reported epidemic thus far, flourishing commercial sex is of growing concern and may have a bridging role in transmitting HIV from core groups to the general population. Conclusion: Increasing numbers of sex workers and drug users, internal migration, high risk behaviours, and low condom use suggest a future upward trend for HIV/AIDS and underscore the urgency of scaling up interventions in China. PMID:16326842

Systematic testing of flood adaptation options in urban areas through simulations

NASA Astrophysics Data System (ADS)

Löwe, Roland; Urich, Christian; Sto. Domingo, Nina; Mark, Ole; Deletic, Ana; Arnbjerg-Nielsen, Karsten

2016-04-01

While models can quantify flood risk in great detail, the results are subject to a number of deep uncertainties. Climate dependent drivers such as sea level and rainfall intensities, population growth and economic development all have a strong influence on future flood risk, but future developments can only be estimated coarsely. In such a situation, robust decision making frameworks call for the systematic evaluation of mitigation measures against ensembles of potential futures. We have coupled the urban development software DAnCE4Water and the 1D-2D hydraulic simulation package MIKE FLOOD to create a framework that allows for such systematic evaluations, considering mitigation measures under a variety of climate futures and urban development scenarios. A wide spectrum of mitigation measures can be considered in this setup, ranging from structural measures such as modifications of the sewer network over local retention of rainwater and the modification of surface flow paths to policy measures such as restrictions on urban development in flood prone areas or master plans that encourage compact development. The setup was tested in a 300 ha residential catchment in Melbourne, Australia. The results clearly demonstrate the importance of considering a range of potential futures in the planning process. For example, local rainwater retention measures strongly reduce flood risk a scenario with moderate increase of rain intensities and moderate urban growth, but their performance strongly varies, yielding very little improvement in situations with pronounced climate change. The systematic testing of adaptation measures further allows for the identification of so-called adaptation tipping points, i.e. levels for the drivers of flood risk where the desired level of flood risk is exceeded despite the implementation of (a combination of) mitigation measures. Assuming a range of development rates for the drivers of flood risk, such tipping points can be translated into anticipated time spans over which a measure will be effective. While the new simulation setup is limited to situations where the planner is able to define realistic ranges for the development of drivers of flood risk, it certainly contributes to an improved consideration of deep uncertainties in the planning process. Future work will particularly focus on the application of the framework in a variety of urban development contexts.

The Future of the Deep Space Network: Technology Development for K2-Band Deep Space Communications

NASA Technical Reports Server (NTRS)

Bhanji, Alaudin M.

1999-01-01

Projections indicate that in the future the number of NASA's robotic deep space missions is likely to increase significantly. A launch rate of up to 4-6 launches per year is projected with up to 25 simultaneous missions active [I]. Future high resolution mapping missions to other planetary bodies as well as other experiments are likely to require increased downlink capacity. These future deep space communications requirements will, according to baseline loading analysis, exceed the capacity of NASA's Deep Space Network in its present form. There are essentially two approaches for increasing the channel capacity of the Deep Space Network. Given the near-optimum performance of the network at the two deep space communications bands, S-Band (uplink 2.025-2.120 GHz, downlink 2.2-2.3 GHz), and X-Band (uplink 7.145-7.19 GHz, downlink 8.48.5 GHz), additional improvements bring only marginal return for the investment. Thus the only way to increase channel capacity is simply to construct more antennas, receivers, transmitters and other hardware. This approach is relatively low-risk but involves increasing both the number of assets in the network and operational costs.

Plasma concentrations of ascorbic acid and C-reactive protein, and risk of future coronary artery disease, in apparently healthy men and women: the EPIC-Norfolk prospective population study.

PubMed

Boekholdt, S Matthijs; Meuwese, Marijn C; Day, Nicholas E; Luben, Robert; Welch, Ailsa; Wareham, Nicholas J; Khaw, Kay-Tee

2006-09-01

High plasma concentrations of ascorbic acid, a marker of fruit and vegetable intake, are associated with low risk of coronary artery disease. Whether this relationship is explained by a reduction in systemic inflammation is unclear. We investigated the relationship between ascorbic acid plasma concentration and coronary artery disease risk, and in addition whether this relationship depended on classical risk factors and C-reactive protein (CRP) concentration. We used a prospective nested case-control design. The study consisted of 979 cases and 1794 controls (1767 men and 1006 women). Increasing ascorbic acid quartiles were associated with lower age, BMI, systolic and diastolic blood pressure, and CRP concentration, but with higher HDL-cholesterol concentration. No associations existed between ascorbic acid concentration and total cholesterol concentration or LDL-cholesterol concentration. When data from men and women were pooled, the risk estimates decreased with increasing ascorbic acid quartiles such that people in the highest ascorbic acid quartile had an odds ratio for future coronary artery disease of 0.67 (95 % CI 0.52, 0.87) compared with those in the lowest quartile (P for linearity=0.001). This relationship was independent of sex, age, diabetes, smoking, BMI, LDL-cholesterol, HDL-cholesterol, systolic blood pressure and CRP level. These data suggest that the risk reduction associated with higher ascorbic acid plasma concentrations, a marker of fruit and vegetable intake, is independent of classical risk factors and also independent of CRP concentration.

Effectiveness of Neuromuscular Training Based on the Neuromuscular Risk Profile.

PubMed

Hewett, Timothy E; Ford, Kevin R; Xu, Yingying Y; Khoury, Jane; Myer, Gregory D

2017-07-01

The effects of targeted neuromuscular training (TNMT) on movement biomechanics associated with the risk of anterior cruciate ligament (ACL) injuries are currently unknown. Purpose/Hypotheses: To determine the effectiveness of TNMT specifically designed to increase trunk control and hip strength. The hypotheses were that (1) TNMT would decrease biomechanical and neuromuscular factors related to an increased ACL injury risk and (2) TNMT would decrease these biomechanical and neuromuscular factors to a greater extent in athletes identified as being at a high risk for future ACL injuries. Controlled laboratory study. Female athletes who participated in jumping, cutting, and pivoting sports underwent 3-dimensional biomechanical testing before the season and after completing TNMT. During testing, athletes performed 3 different types of tasks: (1) drop vertical jump, (2) single-leg drop, and (3) single-leg cross drop. Analysis of covariance was used to examine the treatment effects of TNMT designed to enhance core and hip strength on biomechanical and neuromuscular characteristics. Differences were also evaluated by risk profile. Differences were considered statistically significant at P < .05. TNMT significantly increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. Athletes with a high risk before the intervention (risk profile III) had a more significant treatment effect of TNMT than low-risk groups (risk profiles I and II). TNMT significantly improved proximal biomechanics, including increased hip external rotation moments and moment impulses, increased peak trunk flexion, and decreased peak trunk extension. TNMT that focuses exclusively on proximal leg and trunk risk factors is not, however, adequate to induce significant changes in frontal-plane knee loading. Biomechanical changes varied across the risk profile groups, with higher risk groups exhibiting greater improvements in their biomechanics.

Metabolic Basis of Ethnic Differences in Diabetes Risk in Overweight and Obese Youth

PubMed Central

Alderete, TL; Toledo-Corral, CM; Goran, MI

2015-01-01

The global pandemic of childhood obesity has led to increased risk for prediabetes and type 2 diabetes mellitus (T2DM). Studies have shown decreased insulin sensitivity and/or secretion with increasing adiposity and consistently observed greater risk for T2DM in obese, non-Caucasian youth. In the current review we describe recent advances in understanding how obesity and metabolic status in children and adolescents confers various risk profiles for T2DM among Latinos, African-Americans, Caucasians, Asians and Native Americans. These possible determinants include ectopic fat distribution, adipose tissue inflammation and fibrosis, and elevated plasma levels of non-esterified free fatty acids. Future work should aim to elucidate the ethnic-specific pathophysiology of T2DM in order to develop and implement appropriate prevention and treatment strategies based on different ethnic profiles of diabetes risk. PMID:24445905

Risk factors for mortality during the 2002 landslides in Chuuk, Federated States of Micronesia.

PubMed

Sanchez, Carlos; Lee, Tze-San; Young, Stacy; Batts, Dahna; Benjamin, Jefferson; Malilay, Josephine

2009-10-01

This study examines health effects resulting from landslides in Chuuk during Tropical Storm Chata'an in July 2002, and suggests strategies to prevent future mortality. In August 2002, we conducted a cross-sectional survey to identify risk factors for mortality during landslides, which included 52 survivors and 40 surrogates for 43 decedents to identify risk factors for death. Findings suggest that 1) females had a higher mortality rate from this event than males, and 2) children aged 5-14 years had a 10-fold increase in mortality when compared with annual mortality rates from all causes. Awareness of landslides occurring elsewhere and knowledge of natural warning signs were significantly associated with lower risks of death; being outside during landslides was not associated with reduced mortality. In Chuuk, improving communication systems during tropical storms and increasing knowledge of natural warnings can reduce the risk for mortality during landslides.

Impulsivity and history of behavioral addictions are associated with drug use in adolescents.

PubMed

Chuang, Cheng-Wei I; Sussman, Steve; Stone, Matthew D; Pang, Raina D; Chou, Chih-Ping; Leventhal, Adam M; Kirkpatrick, Matthew G

2017-11-01

Previous literature suggests that trait impulsivity and engagement in non-drug-related behavioral addictions (e.g., Internet addiction, food addiction) are two risk factors for drug use. Here we further investigated the potential impact of having one or both of these risk factors on drug use in Los Angeles area adolescents. High school students (N=1612; Mean age=14.1) completed self-report surveys measuring two potential risk factors (impulsivity, lifetime history of several behavioral addictions), and past 6-month use of tobacco, alcohol and marijuana. Participants who reported never using drugs completed questionnaires assessing their susceptibility for future use. In general, adolescents who endorsed either impulsivity alone or at least two behavioral addictions alone were more likely to have used tobacco, alcohol, or marijuana compared to individuals who had neither risk factor (OR=2.50-4.13), and individuals who endorsed both impulsivity and three or more behavioral addictions were the most likely to have used these drugs (OR=9.40-10.13). Similarly, among those who had never tried a drug, individuals with this combined set of risk factors were the most likely to be susceptible to future drug use (OR=3.37-5.04). These results indicate that the combination of trait impulsivity and a history of behavioral addictions increases the risk for current and future drug use in adolescents, to a greater extent than either risk factor alone. It may be useful for drug prevention efforts to target impulsive adolescents who also actively engage in other non-drug-related addictive behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Framework for Drought Risk Management

NASA Astrophysics Data System (ADS)

Apurv, T.; Cai, X.

2016-12-01

Drought is one of the most expensive natural disasters as it affects many sectors of the economy. The threat posed by droughts is expected to further increase due to increasing water demands fuelled by increasing population and also due to climate change in many regions. Management of the increasing drought risk requires shift from traditional crisis management approaches to long term strategic planning for reduction of drought risk. This study proposes a framework for management of long term drought risk. The framework uses the system based approach proposed by Tsakiris et al. (2013), in which a watershed is considered as a system and different water sources in the watershed (like groundwater, reservoirs, streams etc.) are considered as subsystems associated with certain water requirements of different sectors. Droughts are defined separately for each subsystem considering water availability and requirement. The percentile based drought indicator framework proposed by Steinemann et al. (2015) is used for defining drought for each subsystem, allowing the selection of thresholds, variables of interest, and time scale which are most relevant for stakeholders dependent on a particular subsystem. Future drought risk under different drought management strategies are assessed using hydrologic models that model both hydrologic and human components of a watershed. The robustness of a management strategy is assessed by simulating system response across a wide range of stochastically generated future climate scenarios. The framework is useful for operational drought management as it allows direct management of drought risks with consideration of different water sources and water users. Steinemann, A., Iacobellis, S.F., Cayan, D.R., (2015) "Developing and evaluating drought indicators for decision-making" J. Hydrometeor. 16 (4), 1793-1803 Tsakiris, G, Nalbantis, I, Vangelis, H, Verbeiren, B, Huysmans, M, Tychon, B, Jacquemin, I, Canters, F, Vanderhaegen, S, Engelen, G, Poelmans, L, De Becker, P, Batelaan, O, (2013) "A system-based paradigm of drought analysis for operational management" Water Resour Manag 27(15):5281-5297

Analysis of present and future potential compound flooding risk along the European coast

NASA Astrophysics Data System (ADS)

Bevacqua, Emanuele; Maraun, Douglas; Voukouvalas, Evangelos; Vousdoukas, Michalis I.; Widmann, Martin; Manning, Colin; Vrac, Mathieu

2017-04-01

The coastal zone is the natural border between the sea and the mainland, and it is constantly under the influence of marine and land-based natural and human-induced pressure. Compound floods are extreme events occurring in coastal areas where the interaction of joint high sea level and large amount of precipitation causes extreme floodings. Typically the risk of flooding in coastal areas is defined analysing either sea level or precipitation driven floodings, however compound floods should be considered to avoid an underestimation of the risk. In the future, the human pressure at the coastal zone is expected to increase, urging for a comprehensive analysis of the compound flooding risk under different climate change scenarios. In this study we introduce the concept of "potential risk" as we investigate how often large amount of precipitation and high sea level may co-occur, and not the effective impact due to the interaction of these two hazards. The effective risk of compound flooding in a specific place depends also on the local orography and on the existing protections. The estimation of the potential risk of compound flooding is useful to individuate places where an effective risk of compound flooding may exist, and where further studies would be useful to get more precise information on the local risk. We estimate the potential risk of compound flooding along the European coastal zone incorporating the ERA-Interim meteorological reanalysis for the past and present state, and the future projections from two RCP scenarios (namely the RCP4.5 and RCP8.5 scenarios) as derived from 8 CMIP5 models of the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Sea level data are estimated by forcing the hydrodynamic model Delft3D-Flow with 6-hourly wind and atmospheric pressure fields. Based on sea level (storm surge and astronomical tide) and precipitation joint occurrence analysis, a map of the potential compound flooding risk along the European coast is proposed and critical places with high potential risk are identified. For these critical places, we plan to asses the potential compound flood risk driven by coinciding extreme values of sea level and river discharge. Finally, we analyse the atmospheric large scale processes that lead to compound floods and their variation under future climate change scenarios.

Quantitative assessment of current and future risks related rainfall in processing tomato in the Guadiana river basin (SW Spain)

NASA Astrophysics Data System (ADS)

Castañeda-Vera, Alba; Garrido, Alberto; Ruiz-Ramos, Margarita; Sánchez-Sánchez, Enrique; Inés Mínguez, M.

2013-04-01

An extension of risk coverages in the insurance policies for processing tomato, mainly related to rainfall events, has resulted in an important increase in claims. This suggests that damages related to extreme or ill-timed showers have been underestimated in previous years. An estimation of damages related to rainfall in the last thirty years and the impact of climate change in the risk related to rainfall in processing tomato crops in the Guadiana river basin (SW Spain) were studied through a risk index. First, the risk index was defined with temperature and relative humidity thresholds related to different damage magnitudes. Then, this index was applied to current climate and to future climate scenarios in nine weather stations representative of the studied area to determine the trends in losses related to extreme or inopportune rainfall events. Thresholds of temperature and relative humidity were obtained from cross-checking agricultural insurance records and meteorological data from local weather stations (REDAREX, http://sw-aperos.juntaex.es/redarex). To consider longer time series, the reanalysis database ERA-INTERIM (Dee et al., 2011) was used. Simulated climate was obtained from the European Project ENSEMBLES (http://www.ensembles-eu.org/). Trends in climatic risk were analysed by applying the risk index to three sets of data defining current climate (1980-2010), mid-future climate (2010-2040) and long-term future climate (2040-2070). An algorithm to choose the surrounding cell that minimizes the temperature and precipitation climatic biases and maximizes seasonal correlation when comparing ENSEMBLES regional climate model simulations and observed climate was applied before index calculation. The results show the trends in frequency and magnitude of the risk of suffering damages related to rainfall events. The methodology decreased the uncertainty on risk levels. Results contribute to detect the periods during the growing season with larger risk of damage in order to provide information to assist research on risk management practices and to support insurance policy makers to extend guaranties and to adapt the insurance conditions and costs to real crop risks. This research is being financed by MULCLIVAR project (CGL2012-38923-C02-02), MINECO, Spain Keywords: climate change, risk, rainfall, processing tomato. References Dee, D. P., with 35 co-authors, 2011: The ERA-Interim reanalysis: configuration and performance of the data assimilation system. Quart. J. R. Meteorol. Soc., 137, 553-597.

The economics and ethics of aerosol geoengineering strategies

NASA Astrophysics Data System (ADS)

Goes, Marlos; Keller, Klaus; Tuana, Nancy

2010-05-01

Anthropogenic greenhouse gas emissions are changing the Earth's climate and impose substantial risks for current and future generations. What are scientifically sound, economically viable, and ethically defendable strategies to manage these climate risks? Ratified international agreements call for a reduction of greenhouse gas emissions to avoid dangerous anthropogenic interference with the climate system. Recent proposals, however, call for a different approach: geoengineering climate by injecting aerosol precursors into the stratosphere. Published economic studies typically neglect the risks of aerosol geoengineering due to (i) a potential failure to sustain the aerosol forcing and (ii) due to potential negative impacts associated with aerosol forcings. Here we use a simple integrated assessment model of climate change to analyze potential economic impacts of aerosol geoengineering strategies over a wide range of uncertain parameters such as climate sensitivity, the economic damages due to climate change, and the economic damages due to aerosol geoengineering forcings. The simplicity of the model provides the advantages of parsimony and transparency, but it also imposes considerable caveats. For example, the analysis is based on a globally aggregated model and is hence silent on intragenerational distribution of costs and benefits. In addition, the analysis neglects the effects of future learning and is based on a simple representation of climate change impacts. We use this integrated assessment model to show three main points. First, substituting aerosol geoengineering for the reduction of greenhouse gas emissions can fail the test of economic efficiency. One key to this finding is that a failure to sustain the aerosol forcing can lead to sizeable and abrupt climatic changes. The monetary damages due to such a discontinuous aerosol geoengineering can dominate the cost-benefit analysis because the monetary damages of climate change are expected to increase with the rate of change. Second, the relative contribution of aerosol geoengineering to an economically optimal portfolio hinges critically on deeply uncertain estimates of the damages due to aerosol forcing. Even if we assume that aerosol forcing could be deployed continuously, the aerosol geoengineering does not considerably displace the reduction of greenhouse gas emissions in the simple economic optimal growth model until the damages due to the aerosol forcing are rather low. Third, deploying aerosol geoengineering may also fail an ethical test regarding issues of intergenerational justice. Substituting aerosol geoengineering for reducing greenhouse gas emissions constitutes a conscious risk transfer to future generations, for example due to the increased risk of future abrupt climate change. This risk transfer is in tension with the requirement of intergenerational justice that present generations should not create benefits for themselves in exchange for burdens on future generations.

Family history of cardiovascular disease (CVD), perceived CVD risk, and health-related behavior: A review of the literature

PubMed Central

Imes, Christopher C.; Lewis, Frances Marcus

2012-01-01

Background Over 82 million Americans have one or more forms of cardiovascular disease (CVD), accounting for 32.8% of all deaths in the United States. Although the evidence for the familial aggregation of CVD is strong, the relationship between family history (FH) of CVD, perceived risk for CVD and their relationship to health-related behavior is poorly understood. Objective The objective of this article is to review and summarize the published research on the relationship between a FH of CVD, an individual’s perceived risk, and health-related behavior in order to make recommendations for clinical practice and future research. Methods A literature search was conducted using PubMed, CINAHL Plus, and PsycINFO to identify articles that examined the relationship between a FH of CVD, perceived CVD risk, and health-promoting behaviors. A total of 263 unique articles were reviewed. Two hundred thirty-eight were excluded, resulting in a total of 25 articles included in the paper. Results There was a positive relationship between a reported FH of CVD and perceived risk. However, the relationship between a FH of CVD and health-related behavior change and perceived risk and behavior change was inconsistent. Conclusions A person’s awareness of their FH of CVD or their own risk for CVD is not a sufficient predictor of changes in their health-related behavior. Future studies are needed to better explain the processes by which perceived CVD risk or FH of CVD can be used to affect health-related behavior changes. It appears that both FH and perceived personal risk for CVD are necessary but not sufficient conditions to change health-related behavior in high-risk populations. Future studies should also test interventions that help individuals with a FH of CVD attribute increased personal risk to themselves for developing CVD, while providing lifestyle management options to minimize their risk. PMID:23321782

Emotions, decisions, and the limits of rationality: symposium introduction.

PubMed

Ubel, Peter A

2005-01-01

In this symposium, three speakers describe research that examines ways in which people's decision-making is affected by emotions. In his paper, Dr. Loewenstein describes research on the properties and effects of "projection bias," the tendency to allow one's immediate, often transient, preferences to influence decisions in the future when one's preferences will be predictable different. Over-shopping on an empty stomach or failing, when not addicted, to appreciate one's future helplessness in the face of drug craving, are examples. Dr. Schwarz focuses on how experiences that accompany the thought process can influence the ease of access to information or the fluency with which new information can be processed. These meta-cognitive experiences can affect decisions. For example, recalling many risk-increasing behaviors is more difficult than recalling only a few. Drawing on this difficulty, people who recall many risk-increasing behaviors infer that they are at lower risk than people who recall merely a few risk-increasing behaviors, in contrast to what the content of recall would suggest. Finally, Dr. Bodenhausen clarifies what is meant by stereotyping, considers how stereotypes might influence decision-making processes, and discuss why this influence often might not be very desirable. He then describes research about factors that amplify the biasing impact of stereotypes in decision making processes. The authors provide examples, discuss implications of their findings for medical decision-making, and describe strategies that we might employ to minimize or eliminate the biases that might be introduced into decision-making processes.

Exercise systolic blood pressure variability is associated with increased risk for new-onset hypertension among normotensive adults.

PubMed

Berger, Assaf; Grossman, Ehud; Katz, Moshe; Kivity, Shaye; Klempfner, Robert; Segev, Shlomo; Goldenberg, Ilan; Sidi, Yehezkel; Maor, Elad

2016-06-01

Both resting blood pressure (BP) variability and exercise BP previously showed association with incident hypertension. The aim of the present study was to examine whether visit-to-visit variability in exercise systolic blood pressure (SBP) can predict the risk for new-onset hypertension among normotensive adults. We investigated 6546 normotensive men and women who were annually screened in a tertiary medical center and completed treadmill exercise tests at each visit. Based on the initial three baseline annual visits, long-term intervisit variability of exercise SBP among the three tests was measured using standard deviation (SD) and coefficient of variation for each participant. The rate of newly diagnosed hypertension was measured in different variability levels during 6 ± 3 years of follow-up. Multivariate analysis adjusted for various clinical factors, including resting BP, showed that each 5 mm Hg rise in the SD of exercise SBP resulted in a significant 5% increase in the risk for the development of future hypertension (P = .015). Subjects in the upper exercise SBP SD variability tertile had a 28% (P = .007) increased risk for hypertension during follow-up, as compared with those in the lowest tertile. Similar results were achieved for the assessment of coefficient of variation of exercise SBP. In conclusion, visit-to-visit variability in exercise SBP can predict the development of future hypertension among normotensive individuals. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Divorce and health: current trends and future directions.

PubMed

Sbarra, David A

2015-04-01

Social relationships play a vital role in health and well-being, and it follows that loss experiences can be highly stressful for some people. This article reviews what is known about the association between marital separation, divorce, and health outcomes. Key findings in the area of divorce and health are discussed, and the review outlines a series of specific questions for future research. In particular, the article integrates research in social epidemiology with research in social psychophysiology. The former approach provides a broad-based estimate of the association between marital status and health outcomes, whereas the latter approach studies mechanisms of action and individual differences associated with increased risk for poor outcomes. The experience of separation or divorce confers risk for poor health outcomes, including a 23% higher mortality rate. However, most people cope well and are resilient after their marriage or long-term relationship ends. Despite the fact that resilience is the most common response, a small percentage of people (approximately 10%-15%) struggle quite substantially, and it seems that the overall elevated adverse health risks are driven by the poor functioning of this group. Several candidate mechanisms and novel (ambulatory) assessment techniques that may elucidate the poor outcomes among people who adapt poorly to separation are discussed. To increase knowledge on the association between divorce and health, three primary areas require more research: a) genetic and third variable explanations for divorce-related health outcomes, (b) better studies of objective social behavior after separation, and (c) increased attention to interventions targeting high-risk adults.

Quantifying the impact of current and future concentrations of air pollutants on respiratory disease risk in England.

PubMed

Pannullo, Francesca; Lee, Duncan; Neal, Lucy; Dalvi, Mohit; Agnew, Paul; O'Connor, Fiona M; Mukhopadhyay, Sabyasachi; Sahu, Sujit; Sarran, Christophe

2017-03-27

Estimating the long-term health impact of air pollution in a spatio-temporal ecological study requires representative concentrations of air pollutants to be constructed for each geographical unit and time period. Averaging concentrations in space and time is commonly carried out, but little is known about how robust the estimated health effects are to different aggregation functions. A second under researched question is what impact air pollution is likely to have in the future. We conducted a study for England between 2007 and 2011, investigating the relationship between respiratory hospital admissions and different pollutants: nitrogen dioxide (NO 2 ); ozone (O 3 ); particulate matter, the latter including particles with an aerodynamic diameter less than 2.5 micrometers (PM 2.5 ), and less than 10 micrometers (PM 10 ); and sulphur dioxide (SO 2 ). Bayesian Poisson regression models accounting for localised spatio-temporal autocorrelation were used to estimate the relative risks (RRs) of pollution on disease risk, and for each pollutant four representative concentrations were constructed using combinations of spatial and temporal averages and maximums. The estimated RRs were then used to make projections of the numbers of likely respiratory hospital admissions in the 2050s attributable to air pollution, based on emission projections from a number of Representative Concentration Pathways (RCP). NO 2 exhibited the largest association with respiratory hospital admissions out of the pollutants considered, with estimated increased risks of between 0.9 and 1.6% for a one standard deviation increase in concentrations. In the future the projected numbers of respiratory hospital admissions attributable to NO 2 in the 2050s are lower than present day rates under 3 Representative Concentration Pathways (RCPs): 2.6, 6.0, and 8.5, which is due to projected reductions in future NO 2 emissions and concentrations. NO 2 concentrations exhibit consistent substantial present-day health effects regardless of how a representative concentration is constructed in space and time. Thus as concentrations are predicted to remain above limits set by European Union Legislation until the 2030s in parts of urban England, it will remain a substantial health risk for some time.

Delivery of a very low birth weight infant and increased maternal risk of cancer and death: a population study with 16 years of follow-up.

PubMed

Grisaru-Granovsky, Sorina; Gordon, Ethel Sherry; Haklai, Ziona; Schimmel, Michael S; Drukker, Lior; Samueloff, Arnon; Keinan-Boker, Lital

2015-11-01

Pregnancy complications represent sentinel events for women's future health. We investigated whether delivery of a very low birth weight (VLBW) infant is associated with increased maternal risk for future incidence of maternal cancer and death. This is a population-based cohort study of linked Israeli Ministry of Health datasets between 1995 and 2011. Women delivering a live singleton <1,500 g infant (VLBW group) were compared with women delivering a live singleton, 3,000-3,500 g (control). The first pregnancy eligible for entry into the study, the "index pregnancy," reflected exposure status for each participant. Primary outcomes were maternal cancer and death. Cancer diagnoses were further classified by primary site. Cox regression models adjusted for follow-up period and maternal characteristics at index pregnancy: Age at delivery, ethnicity, years of education, marital status, and previous cancer afforded calculation of hazard ratios (HR) and 95% confidence intervals (CI). During the study period, 982,091 mothers with 2,243,736 live births were identified; of these, 13,773 births were VLBW eligible for inclusion in the study and 448,743 births were controls. Groups differed significantly by average follow-up and all maternal characteristics evaluated. Overall rate of cancers and death was significantly increased for VLBW women compared to controls: 18.4 versus 15.7% and 7.3 versus 3.2%, both p < 0.0001. The Cox model adjusted for maternal characteristics showed significantly increased risk of cancer (all sites) in the VLBW women: HR 1.18 (95% CI 1.02-1.37) and for death: HR 2.13 (95% CI 1.68-2.71), and an increased combined risk of both outcomes: HR 1.4 (95% CI 1.23-1.59). The delivery of a VLBW newborn is an independent lifetime risk factor for subsequent maternal cancers and death. These women may benefit from targeted cancer screening and counseling.

Geography of current and future global mammal extinction risk

PubMed Central

Shoemaker, Kevin T.; Weinstein, Ben; Costa, Gabriel C.; Brooks, Thomas M.; Ceballos, Gerardo; Radeloff, Volker C.; Rondinini, Carlo; Graham, Catherine H.

2017-01-01

Identifying which species are at greatest risk, what makes them vulnerable, and where they are distributed are central goals for conservation science. While knowledge of which factors influence extinction risk is increasingly available for some taxonomic groups, a deeper understanding of extinction correlates and the geography of risk remains lacking. Here, we develop a predictive random forest model using both geospatial and mammalian species’ trait data to uncover the statistical and geographic distributions of extinction correlates. We also explore how this geography of risk may change under a rapidly warming climate. We found distinctive macroecological relationships between species-level risk and extinction correlates, including the intrinsic biological traits of geographic range size, body size and taxonomy, and extrinsic geographic settings such as seasonality, habitat type, land use and human population density. Each extinction correlate exhibited ranges of values that were especially associated with risk, and the importance of different risk factors was not geographically uniform across the globe. We also found that about 10% of mammals not currently recognized as at-risk have biological traits and occur in environments that predispose them towards extinction. Southeast Asia had the most actually and potentially threatened species, underscoring the urgent need for conservation in this region. Additionally, nearly 40% of currently threatened species were predicted to experience rapid climate change at 0.5 km/year or more. Biological and environmental correlates of mammalian extinction risk exhibit distinct statistical and geographic distributions. These results provide insight into species-level patterns and processes underlying geographic variation in extinction risk. They also offer guidance for future conservation research focused on specific geographic regions, or evaluating the degree to which species-level patterns mirror spatial variation in the pressures faced by populations within the ranges of individual species. The added impacts from climate change may increase the susceptibility of at-risk species to extinction and expand the regions where mammals are most vulnerable globally. PMID:29145486

Geography of current and future global mammal extinction risk.

PubMed

Davidson, Ana D; Shoemaker, Kevin T; Weinstein, Ben; Costa, Gabriel C; Brooks, Thomas M; Ceballos, Gerardo; Radeloff, Volker C; Rondinini, Carlo; Graham, Catherine H

2017-01-01

Identifying which species are at greatest risk, what makes them vulnerable, and where they are distributed are central goals for conservation science. While knowledge of which factors influence extinction risk is increasingly available for some taxonomic groups, a deeper understanding of extinction correlates and the geography of risk remains lacking. Here, we develop a predictive random forest model using both geospatial and mammalian species' trait data to uncover the statistical and geographic distributions of extinction correlates. We also explore how this geography of risk may change under a rapidly warming climate. We found distinctive macroecological relationships between species-level risk and extinction correlates, including the intrinsic biological traits of geographic range size, body size and taxonomy, and extrinsic geographic settings such as seasonality, habitat type, land use and human population density. Each extinction correlate exhibited ranges of values that were especially associated with risk, and the importance of different risk factors was not geographically uniform across the globe. We also found that about 10% of mammals not currently recognized as at-risk have biological traits and occur in environments that predispose them towards extinction. Southeast Asia had the most actually and potentially threatened species, underscoring the urgent need for conservation in this region. Additionally, nearly 40% of currently threatened species were predicted to experience rapid climate change at 0.5 km/year or more. Biological and environmental correlates of mammalian extinction risk exhibit distinct statistical and geographic distributions. These results provide insight into species-level patterns and processes underlying geographic variation in extinction risk. They also offer guidance for future conservation research focused on specific geographic regions, or evaluating the degree to which species-level patterns mirror spatial variation in the pressures faced by populations within the ranges of individual species. The added impacts from climate change may increase the susceptibility of at-risk species to extinction and expand the regions where mammals are most vulnerable globally.

Country-level assessment of future risk of water scarcity in Europe

NASA Astrophysics Data System (ADS)

Garrote, Luis; Iglesias, Ana; Granados, Alfredo

2018-06-01

A methodology for regional assessment of current and future water availability in Europe is presented in this study. The methodology is based on a proposed indicator of risk of water scarcity based on the projections of runoff and water availability for European countries. The risk of water scarcity is the combined result of hydrological processes, which determine streamflow in natural conditions, and human intervention, which determines water management using the available hydraulic infrastructure and establishes water supply conditions through operating rules. Model results show that changes in runoff and availability obtained for individual GCM projections can be large and even contradictory. These heterogeneous results are summarized in the water scarcity risk index, a global value that accounts for the results obtained with the ensemble of model results and emission scenarios. The countries at larger risk are (in this order) Spain, Portugal, Macedonia, Greece, Bulgaria, Albania, France and Italy. They are mostly Mediterranean countries already exposed to significant water scarcity problems. There are countries, like Slovakia, Ireland, Belgium, Luxembourg, Croatia and Romania, with mild risk. Northern Arctic countries, like Sweden, Finland, Norway and Russia, show a robust however mild increase in water availability.

Adolescents' future orientation and nonmedical use of prescription drugs.

PubMed

Steiger, Rena M; Stoddard, Sarah A; Pierce, Jennifer

2017-02-01

How adolescents think about their future (i.e., future orientation) impacts their risk-taking behavior. The purpose of the present analysis was to explore whether future orientation (future planning, perceived risk to future goals, and positive future expectations) was associated with nonmedical use of stimulants and analgesics in a sample of high school students. Information on future orientation and nonmedical use of prescription drugs (NMUPD) were collected using a paper-and-pencil survey from a sample of 9th-12th grade students in a Midwestern school. Higher perceived risk to future goals and positive future expectations were associated with a lower likelihood of self-reported nonmedical use of stimulants (n=250; OR=0.46, 95% CI: 0.26, 0.83; OR=0.15, 95% CI: 0.05, 0.47, respectively). Only higher perceived risk to future goals was associated with a lower likelihood of self-reported nonmedical use of analgesics (n=250; OR=0.40, 95% CI: 0.24, 0.68). In a follow-up analysis limited to students who endorsed alcohol or marijuana use, perceived risk to future goals remained associated with a lower likelihood of nonmedical use of stimulants and analgesics. Results suggest that risk perception might be a salient protective factor against both nonmedical use of stimulants and analgesics. Overall, the differential impact of conceptualizations of future orientation might depend on the class of prescription drug used, demonstrating a need to consider prescription drugs individually in the development of future studies and interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sexual risk behaviors and acceptability of HIV pre-exposure prophylaxis among HIV-negative gay and bisexual men in serodiscordant relationships: a mixed methods study.

PubMed

Brooks, Ronald A; Landovitz, Raphael J; Kaplan, Rachel L; Lieber, Eli; Lee, Sung-Jae; Barkley, Thomas W

2012-02-01

The objective of this mixed methods study was to examine current sexual risk behaviors, acceptability and potential adoption of pre-exposure prophylaxis (PrEP) for HIV prevention, and sexual behavior intentions with PrEP adoption among HIV-negative gay and bisexual men (GBM) in HIV serodiscordant relationships. A multiracial/ethnic sample of 25 HIV-negative GBM in serodiscordant relationships completed a qualitative interview and a brief interviewer-administered survey. A modified grounded theory approach was used to identify key themes relating to acceptability and future adoption of PrEP. Participants reported engaging in sexual risk behaviors that place them at risk for HIV infection. Participants also reported a high level of acceptability for PrEP and willingness to adopt PrEP for HIV prevention. Qualitative themes explaining future PrEP adoption included: (1) the opportunity to engage in sex using a noncondom HIV prevention method, (2) protection from HIV infection, and (3) less anxiety when engaging in sex with an HIV-positive partner. Associated with the future adoption of PrEP, a majority (64%) of participants indicated the likelihood for an increase in sexual risk behaviors and a majority (60%) of participants also indicated the likelihood for a decrease or abandonment of condom use, both of which are in contrast to the findings from the large iPrEx study. These findings suggest that the use of PrEP by HIV-negative GBM in serodiscordant relationships carries with it the potential for risk compensation. The findings suggest that PrEP only be offered as part of a comprehensive HIV prevention strategy that includes ongoing risk reduction counseling in the delivery of PrEP to help moderate risk compensation.

Mortality attributable to excess adiposity in England and Wales in 2003 and 2015: explorations with a spreadsheet implementation of the Comparative Risk Assessment methodology.

PubMed

Kelly, Christopher; Pashayan, Nora; Munisamy, Sreetharan; Powles, John W

2009-06-30

Our aim was to estimate the burden of fatal disease attributable to excess adiposity in England and Wales in 2003 and 2015 and to explore the sensitivity of the estimates to the assumptions and methods used. A spreadsheet implementation of the World Health Organization's (WHO) Comparative Risk Assessment (CRA) methodology for continuously distributed exposures was used. For our base case, adiposity-related risks were assumed to be minimal with a mean (SD) BMI of 21 (1) Kg m-2. All cause mortality risks for 2015 were taken from the Government Actuary and alternative compositions by cause derived. Disease-specific relative risks by BMI were taken from the CRA project and varied in sensitivity analyses. Under base case methods and assumptions for 2003, approximately 41,000 deaths and a loss of 1.05 years of life expectancy were attributed to excess adiposity. Seventy-seven percent of all diabetic deaths, 23% of all ischaemic heart disease deaths and 14% of all cerebrovascular disease deaths were attributed to excess adiposity. Predictions for 2015 were found to be more sensitive to assumptions about the future course of mortality risks for diabetes than to variation in the assumed trend in BMI. On less favourable assumptions the attributable loss of life expectancy in 2015 would rise modestly to 1.28 years. Excess adiposity appears to contribute materially but modestly to mortality risks in England and Wales and this contribution is likely to increase in the future. Uncertainty centres on future trends of associated diseases, especially diabetes. The robustness of these estimates is limited by the lack of control for correlated risks by stratification and by the empirical uncertainty surrounding the effects of prolonged excess adiposity beginning in adolescence.

Thwarted belongingness, perceived burdensomeness, and depression among asian americans: A longitudinal study of interpersonal shame as a mediator and perfectionistic family discrepancy as a moderator.

PubMed

Carrera, Stephanie G; Wei, Meifen

2017-04-01

This short-term longitudinal study applied Joiner's (2005) Interpersonal-Psychological Theory of Suicide to Asian Americans' experiences with depression. Interpersonal shame (i.e., the experience of inadequacy arising from interpersonal concerns) was hypothesized to mediate the effects of (a) thwarted belongingness and (b) perceived burdensomeness on future depression. Furthermore, the positive associations between (a) thwarted belongingness and (b) perceived burdensomeness on future depression were hypothesized to vary depending on students' experiences with perfectionistic family discrepancy (PFD; their perceived gap between their actual performance and what their parents expect of them). A total of 605 Asian Americans attending predominantly White, Midwestern universities completed 3 online surveys. Conditional process modeling via Hayes's (2013) PROCESS was used to analyze the data. Results demonstrated that (a) thwarted belongingness and (b) perceived burdensomeness contributed to higher interpersonal shame, which influenced students' future depression. Furthermore, the effect of thwarted belongingness on future depression was significantly positive for those with PFD levels greater than the 12th percentile, after taking into account students' initial level of depression. The effect of perceived burdensomeness on future depression was not significant for those with PFD levels greater than the 3.5th percentile. This study identified that students with perfectionistic family discrepancy may be at higher risk for depression while experiencing thwarted belongingness. Overall, findings supported using Joiner's (2005) theory to understand Asian American students' risk for future depression. Future studies may gather data across Asian American students' years in college. Counselors can apply these findings to increase students' awareness about possible risk factors for depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

US power plant sites at risk of future sea-level rise

NASA Astrophysics Data System (ADS)

Bierkandt, R.; Auffhammer, M.; Levermann, A.

2015-12-01

Unmitigated greenhouse gas emissions may increase global mean sea-level by about 1 meter during this century. Such elevation of the mean sea-level enhances the risk of flooding of coastal areas. We compute the power capacity that is currently out-of-reach of a 100-year coastal flooding but will be exposed to such a flood by the end of the century for different US states, if no adaptation measures are taken. The additional exposed capacity varies strongly among states. For Delaware it is 80% of the mean generated power load. For New York this number is 63% and for Florida 43%. The capacity that needs additional protection compared to today increases by more than 250% for Texas, 90% for Florida and 70% for New York. Current development in power plant building points towards a reduced future exposure to sea-level rise: proposed and planned power plants are less exposed than those which are currently operating. However, power plants that have been retired or canceled were less exposed than those operating at present. If sea-level rise is properly accounted for in future planning, an adaptation to sea-level rise may be costly but possible.

Global-change vulnerability of a key plant resource, the African palms.

PubMed

Blach-Overgaard, Anne; Balslev, Henrik; Dransfield, John; Normand, Signe; Svenning, Jens-Christian

2015-07-27

Palms are keystone species in tropical ecosystems and provide essential ecosystem services to rural people worldwide. However, many palm species are threatened by habitat loss and over-exploitation. Furthermore, palms are sensitive to climate and thus vulnerable to future climate changes. Here, we provide a first quantitative assessment of the future risks to the African palm flora, finding that African palm species on average may experience a decline in climatic suitability in >70% of their current ranges by 2080. This suitability loss may, however, be almost halved if migration to nearby climatically suitable sites succeeds. Worryingly, 42% of the areas with 80-100% of species losing climate suitability are also characterized by high human population density (HPD). By 2080, >90% of all African palm species' ranges will likely occur at HPDs leading to increased risks of habitat loss and overexploitation. Additionally, up to 87% of all species are predicted to lose climatic suitability within current protected areas (PAs) by 2080. In summary, a major plant component of tropical ecosystems and provider of ecosystem services to rural populations will face strongly increased pressures from climate change and human populations in the near future.

Mapping rural community and dairy cow heat stress in Southern Ontario: A common geographic pattern from 2010 to 2012.

PubMed

Bishop-Williams, Katherine E; Berke, Olaf; Pearl, David L; Kelton, David F

2016-07-03

Climate change has increased the occurrence of heat waves, causing heat stress among humans and livestock, with potentially fatal consequences. Heat stress maps provide information about related health risks and insight for control strategies. Weather data were collected throughout Southern Ontario, and the heat stress index (HSI) was estimated for 2010-2012. Geostatistical kriging was applied to map heat stress, heat waves, and control periods. Average HSI for each period ranged from 55 to 78 during control periods, and from 65 to 84 during heat waves, surpassing levels where morbidity is known to increase substantially. Heat stress followed a temporally consistent geographic pattern. HSI maps indicate high-risk areas for heat-related illness and indicate areas where agriculture and human health may be at increased risk in future.

Abdominal aortic atherosclerosis at MR imaging is associated with cardiovascular events: the Dallas heart study.

PubMed

Maroules, Christopher D; Rosero, Eric; Ayers, Colby; Peshock, Ronald M; Khera, Amit

2013-10-01

To determine the value of two abdominal aortic atherosclerosis measurements at magnetic resonance (MR) imaging for predicting future cardiovascular events. This study was approved by the institutional review board and complied with HIPAA regulations. The study consisted of 2122 participants from the multiethnic, population-based Dallas Heart Study who underwent abdominal aortic MR imaging at 1.5 T. Aortic atherosclerosis was measured by quantifying mean aortic wall thickness (MAWT) and aortic plaque burden. Participants were monitored for cardiovascular death, nonfatal cardiac events, and nonfatal extracardiac vascular events over a mean period of 7.8 years ± 1.5 (standard deviation [SD]). Cox proportional hazards regression was used to assess independent associations of aortic atherosclerosis and cardiovascular events. Increasing MAWT was positively associated with male sex (odds ratio, 3.66; P < .0001), current smoking (odds ratio, 2.53; P < .0001), 10-year increase in age (odds ratio, 2.24; P < .0001), and hypertension (odds ratio, 1.66; P = .0001). A total of 143 participants (6.7%) experienced a cardiovascular event. MAWT conferred an increased risk for composite events (hazard ratio, 1.28 per 1 SD; P = .001). Aortic plaque was not associated with increased risk for composite events. Increasing MAWT and aortic plaque burden both conferred an increased risk for nonfatal extracardiac events (hazard ratio of 1.52 per 1 SD [P < .001] and hazard ratio of 1.46 per 1 SD [P = .03], respectively). MR imaging measures of aortic atherosclerosis are predictive of future adverse cardiovascular events. © RSNA, 2013.

A multiple-risk interaction model: effects of temperament and divorce on psychiatric disorders in children.

PubMed

Kasen, S; Cohen, P; Brook, J S; Hartmark, C

1996-04-01

Effects of family status on the trajectory of problematic temperament-adjustment at 1 and 10 years of age and associated psychiatric disturbance 8 years later were examined in an epidemiological sample of 648 children. After adjusting for predivorce temperament-adjustment and background factors, logistic regression yielded independent effects of single custodial mother (SCM) family status for increased risk of disruptive and anxiety disorders, and of stepfamily status for increased risk of disruptive disorders. Increased risk of psychiatric disorders was more pervasive for SCM family boys versus intact family boys than for SCM family girls versus intact family girls, however only significantly more so for depression. No significant sex interaction was observed for stepfamily status. When girls and boys were treated independently, patterns of family status and outcomes of internalizing disorders varied. In stepfamilies, an elevated risk of depression and anxiety disorders was observed in girls but not boys, whereas in SCM families an elevated risk of depression was observed in boys but not girls. Within each family status group there was support for an altered risk of later psychiatric disorders given specific problematic predivorce temperament-adjustment characteristics. Implications for future research and treatment are discussed.

Glacial Lake Outburst Flood Risk in Himachal Pradesh, India: An Integrative and Anticipatory Approach to Inform Adaptation Planning

NASA Astrophysics Data System (ADS)

Allen, Simon; Linsbauer, Andreas; Huggel, Christian; Singh Randhawa, Surjeet

2016-04-01

Most research concerning the hazard from glacial lake outburst floods (GLOFs) has focused on the threat from lakes that have formed over the past century, and which continue to expand rapidly in response to recent warming of the climate system. However, attention is shifting towards the anticipation of future hazard and risk associated with new lakes that will develop as glaciers continue to retreat and dramatically different landscapes are uncovered. Nowhere will this threat be more pronounced than in the Himalaya, where the majority of the world's glaciers are found, and where the dynamics of nature interact closely with livelihoods and anthropogenic resources. Using the Indian Himalayan state of Himachal Pradesh (HP) as a case study, we combine a suite of GIS-based approaches to: 1)Implement a large-scale automated GLOF risk assessment within an integrative climate risk framework that recognizes both physical and socio-economic determining factors. 2)Expand the assessment beyond the current situation, to provide early anticipation of emerging GLOF hazard as new lakes form in response to further retreat of the Himalayan glaciers. Results clearly demonstrate a significant future increase in relative GLOF hazard levels across most Thesils of HP (administrative units), as the overall potential for GLOFs being triggered from mass movement of ice and rock avalanches increases, and as new GLOF paths affect additional land areas. Across most Thesils, the simulated increase in GLOF frequency is an order of magnitude larger than the simulated increase in GLOF affected area, as paths from newly formed glacial lakes generally tend to converge downstream within existing flood channels. In the Thesil of Kullu for example, we demonstrate a 7-fold increase in the probability of GLOF occurrence, and a 3-fold increase in the area affected by potential GLOF paths. In those situations where potential GLOFs from new lakes will flow primarily along existing flood paths, any adaptation measures implemented now will offer dual benefits - reducing not only the current GLOF risk, but also responding to the emerging risk anticipated for the coming decades. Such adaptation strategies (e.g. early warning systems, community preparedness, disaster response planning and land zoning) can be considered "low-regret" measures, i.e, responses that offer immediate benefits to the communities now while also offering benefits over a range of possible future scenarios. Conversely in locations where the formation of new lakes over the coming decades will create an entirely new threat, local authorities would be encouraged to consider long time scales in their climate adaptation planning. This is particularly relevant for new infrastructural developments (residential property, road, hydropower dams etc) where new threats could clearly emerge during the intended lifetime of any constructions.

Wildfire air pollution hazard during the 21st century

NASA Astrophysics Data System (ADS)

Knorr, Wolfgang; Dentener, Frank; Lamarque, Jean-François; Jiang, Leiwen; Arneth, Almut

2017-07-01

Wildfires pose a significant risk to human livelihoods and are a substantial health hazard due to emissions of toxic smoke. Previous studies have shown that climate change, increasing atmospheric CO2, and human demographic dynamics can lead to substantially altered wildfire risk in the future, with fire activity increasing in some regions and decreasing in others. The present study re-examines these results from the perspective of air pollution risk, focussing on emissions of airborne particulate matter (PM2. 5), combining an existing ensemble of simulations using a coupled fire-dynamic vegetation model with current observation-based estimates of wildfire emissions and simulations with a chemical transport model. Currently, wildfire PM2. 5 emissions exceed those from anthropogenic sources in large parts of the world. We further analyse two extreme sets of future wildfire emissions in a socio-economic, demographic climate change context and compare them to anthropogenic emission scenarios reflecting current and ambitious air pollution legislation. In most regions of the world, ambitious reductions of anthropogenic air pollutant emissions have the potential to limit mean annual pollutant PM2. 5 levels to comply with World Health Organization (WHO) air quality guidelines for PM2. 5. Worst-case future wildfire emissions are not likely to interfere with these annual goals, largely due to fire seasonality, as well as a tendency of wildfire sources to be situated in areas of intermediate population density, as opposed to anthropogenic sources that tend to be highest at the highest population densities. However, during the high-fire season, we find many regions where future PM2. 5 pollution levels can reach dangerous levels even for a scenario of aggressive reduction of anthropogenic emissions.

Past and future water conflicts in the Upper Klamath Basin: An economic appraisal

NASA Astrophysics Data System (ADS)

Boehlert, Brent B.; Jaeger, William K.

2010-10-01

The water conflict in the Upper Klamath Basin typifies the growing competition between agricultural and environmental water uses. In 2001, drought conditions triggered Endangered Species Act-related requirements that curtailed irrigation diversions to the Klamath Reclamation Project, costing irrigators tens of millions of dollars. Although this event has significantly elevated the perceived risk of future economic catastrophe in the basin (and therefore the level of conflict among water users), several key changes related to water availability have occurred since 2001. These changes include reduced ESA requirements and increased groundwater pumping capacity, which have lowered the actual risk and severity of future water shortages. In this paper, we use a mathematical programming model to evaluate how these changes alter the likelihood and economic consequences of future shortages. We also consider the effect of more flexible transfers among irrigators via water markets. Our analysis indicates that future drought conditions like those seen in 2001 would have more modest economic impacts than in 2001 and that when combined with contingent groundwater supplementation and water transfer mechanisms such as water markets, both the likelihood and magnitude of economic losses among irrigators would be greatly reduced.

Collaboration in Action: Office of Research and Development ...

EPA Pesticide Factsheets

The "Collaboration in Action: US EPA's Office of Research and Develop - Current Wildfire Research Program" was invited by the USDA's US Forest Service's Scientific Executive Committee to provide USFS scientific leadership active and potential future opportunities for cooperation/collaboration. Health impacts of wildfire smoke merit the attention and action of the US EPA and current research is supported in the ACE and SHC Research Programs. Wildland fire smoke research has taken on greater importance because the 1) contribution of wildland fire PM emissions relative to total US PM emissions is increasing, 2) the population health impacts are measurable and costly, 3) vulnerable and sensitive populations at-risk are increasing attendant to our aging U.S. population and the increasing area of the wildland-urban interface, and 4) health impacts of smoke could be minimized by identifying at-risk individuals and reducing their exposures. Examples are provided. The "Collaboration in Action: US EPA's Office of Research and Develop - Current Wildfire Research Program" was invited by the USDA's US Forest Service's Scientific Executive Committee to provide USFS scientific leadership active and potential future opportunities for cooperation/collaboration.

Potential Lunar In-Situ Resource Utilization Experiments and Mission Scenarios

NASA Technical Reports Server (NTRS)

Sanders, Gerald B.

2010-01-01

The extraction and use of resources on the Moon, known as In-Situ Resource Utilization (ISRU), can potentially reduce the cost and risk of human lunar exploration while also increasing science achieved. By not having to bring all of the shielding and mission consumables from Earth and being able to make products on the Moon, missions may require less mass to accomplish the same objectives, carry more science equipment, go to more sites of exploration, and/or provide options to recover from failures not possible with delivery of spares and consumables from Earth alone. While lunar ISRU has significant potential for mass, cost, and risk reduction for human lunar missions, it has never been demonstrated before in space. To demonstrate that ISRU can meet mission needs and to increase confidence in incorporating ISRU capabilities into mission architectures, terrestrial laboratory and analog field testing along with robotic precursor missions are required. A stepwise approach with international collaboration is recommended. This paper will outline the role of ISRU in future lunar missions, and define the approach and possible experiments to increase confidence in ISRU applications for future human lunar exploration

How long can global ecological overshoot last?

NASA Astrophysics Data System (ADS)

McBain, Bonnie; Lenzen, Manfred; Wackernagel, Mathis; Albrecht, Glenn

2017-08-01

The ability of the Ecological Footprint to communicate complex environmental information in a clear and accessible way is well known; however, with growing environmental complexity, we will require increasingly sophisticated environmental indicators to inform our decisions. We have developed an integrated and dynamic global model to investigate future trajectories of the Ecological Footprint. Under a range of futures and without the mitigation of human resource demand, we find that the discrepancy between global demand and renewable supply of resources is likely to increase. Continued overshoot, although possible in the short term, means the global community is increasingly exposed to risks of environmental collapse due to the approach of at least two planetary boundaries relating to land use expansion and climate change. We show that, the Ecological Footprint trajectory and the time between the commencement of ecological overshoot and ecological collapse is sensitive to global technological, economic and population policy decisions. Importantly, this work presents a tool which can be used to support transdisciplinary decision-maker collaborations examining the risk associated with alternative policy options in the face of uncertainty at multiple scales.

Management of Cardiovascular Risk in Patients with Chronic Inflammatory Diseases: Current Evidence and Future Perspectives.

PubMed

Lindhardsen, Jesper; Kristensen, Søren Lund; Ahlehoff, Ole

2016-02-01

An increased risk of cardiovascular disease (CVD) has been observed in a range of chronic inflammatory diseases (CID), including rheumatoid arthritis (RA), psoriasis, inflammatory bowel diseases (IBD), and systemic lupus erythematosus (SLE). The increased risk of CVDs and reduced life expectancy in these conditions has stimulated considerable research and started an ongoing discussion on the need for a multidisciplinary approach and dedicated guidelines on CVD prevention in these patients. In addition, the possibility of inhibiting inflammation as a means to preventing CVD in these patients has gained considerable interest in recent years. We briefly summarize the current level of evidence of the association between CIDs and CVD and cardiovascular risk management recommendations. Perspectives of ongoing and planned trials are discussed in consideration of potential ways to improve primary and secondary CVD prevention in patients with CID.

Will HIV Vaccination Reshape HIV Risk Behavior Networks? A Social Network Analysis of Drug Users' Anticipated Risk Compensation

PubMed Central

Young, April M.; Halgin, Daniel S.; DiClemente, Ralph J.; Sterk, Claire E.; Havens, Jennifer R.

2014-01-01

Background An HIV vaccine could substantially impact the epidemic. However, risk compensation (RC), or post-vaccination increase in risk behavior, could present a major challenge. The methodology used in previous studies of risk compensation has been almost exclusively individual-level in focus, and has not explored how increased risk behavior could affect the connectivity of risk networks. This study examined the impact of anticipated HIV vaccine-related RC on the structure of high-risk drug users' sexual and injection risk network. Methods A sample of 433 rural drug users in the US provided data on their risk relationships (i.e., those involving recent unprotected sex and/or injection equipment sharing). Dyad-specific data were collected on likelihood of increasing/initiating risk behavior if they, their partner, or they and their partner received an HIV vaccine. Using these data and social network analysis, a "post-vaccination network" was constructed and compared to the current network on measures relevant to HIV transmission, including network size, cohesiveness (e.g., diameter, component structure, density), and centrality. Results Participants reported 488 risk relationships. Few reported an intention to decrease condom use or increase equipment sharing (4% and 1%, respectively). RC intent was reported in 30 existing risk relationships and vaccination was anticipated to elicit the formation of five new relationships. RC resulted in a 5% increase in risk network size (n = 142 to n = 149) and a significant increase in network density. The initiation of risk relationships resulted in the connection of otherwise disconnected network components, with the largest doubling in size from five to ten. Conclusions This study demonstrates a new methodological approach to studying RC and reveals that behavior change following HIV vaccination could potentially impact risk network connectivity. These data will be valuable in parameterizing future network models that can determine if network-level change precipitated by RC would appreciably impact the vaccine's population-level effectiveness. PMID:24992659

Increase in flood risk resulting from climate change in a developed urban watershed - the role of storm temporal patterns

NASA Astrophysics Data System (ADS)

Hettiarachchi, Suresh; Wasko, Conrad; Sharma, Ashish

2018-03-01

The effects of climate change are causing more frequent extreme rainfall events and an increased risk of flooding in developed areas. Quantifying this increased risk is of critical importance for the protection of life and property as well as for infrastructure planning and design. The updated National Oceanic and Atmospheric Administration (NOAA) Atlas 14 intensity-duration-frequency (IDF) relationships and temporal patterns are widely used in hydrologic and hydraulic modeling for design and planning in the United States. Current literature shows that rising temperatures as a result of climate change will result in an intensification of rainfall. These impacts are not explicitly included in the NOAA temporal patterns, which can have consequences on the design and planning of adaptation and flood mitigation measures. In addition there is a lack of detailed hydraulic modeling when assessing climate change impacts on flooding. The study presented in this paper uses a comprehensive hydrologic and hydraulic model of a fully developed urban/suburban catchment to explore two primary questions related to climate change impacts on flood risk. (1) How do climate change effects on storm temporal patterns and rainfall volumes impact flooding in a developed complex watershed? (2) Is the storm temporal pattern as critical as the total volume of rainfall when evaluating urban flood risk? We use the NOAA Atlas 14 temporal patterns, along with the expected increase in temperature for the RCP8.5 scenario for 2081-2100, to project temporal patterns and rainfall volumes to reflect future climatic change. The model results show that different rainfall patterns cause variability in flood depths during a storm event. The changes in the projected temporal patterns alone increase the risk of flood magnitude up to 35 %, with the cumulative impacts of temperature rise on temporal patterns and the storm volume increasing flood risk from 10 to 170 %. The results also show that regional storage facilities are sensitive to rainfall patterns that are loaded in the latter part of the storm duration, while extremely intense short-duration storms will cause flooding at all locations. This study shows that changes in temporal patterns will have a significant impact on urban/suburban flooding and need to be carefully considered and adjusted to account for climate change when used for the design and planning of future storm water systems.

The future of anticoagulation management in atrial fibrillation in Europe: An assessment of today's challenges with recommendations for the future.

PubMed

Lichten, Catherine A; Castle-Clarke, Sophie; Manville, Catriona; Horvath, Veronika; Robin, Enora; Krapels, Joachim; Parks, Sarah; Sim, Megan; van Zijverden, Olga; Chataway, Joanna

2015-11-30

Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, affecting approximately 1-2 per cent of the population worldwide. Those who suffer from AF have a five times higher risk of stroke. AF prevalence increases with age and it affects roughly 18 per cent of the population over 85. Consequently, as populations age, AF is becoming an increasingly significant public health issue. Over recent years there have been developments in treatment and management options, both for treating the arrhythmia directly, and assessing and reducing the risk of AF-related stroke, but there is a need to ensure that available knowledge is applied optimally to benefit patients so that opportunities to prevent AF-related stroke are not missed. The aims of this project were to assess the current landscape and explore the direction of future developments in AF management in Europe, with a focus on the use of anticoagulants in the prevention of AF-related stroke. Through rapid evidence assessment, key informant interviews, PESTLE analysis and the development and exploration of future scenarios, we have developed sets of shorter- and longer-term recommendations for improving AF-related patient outcomes. The short-term recommendations are: i) improve AF awareness among the public and policymakers; ii) support education about AF management for healthcare professionals and patients; and iii) maintain engagement in AF-related research across the health services.

Physiological reactivity to psychological stress in human pregnancy: current knowledge and future directions.

PubMed

Christian, Lisa M

2012-11-01

Cardiovascular and neuroendocrine reactivity to acute stress are important predictors of health outcomes in non-pregnant populations. Greater magnitude and duration of physiological responses have been associated with increased risk of hypertensive disorders and diabetes, greater susceptibility to infectious illnesses, suppression of cell-mediated immunity as well as risk for depression and anxiety disorders. Stress reactivity during pregnancy has unique implications for maternal health, birth outcomes, and fetal development. However, as compared to the larger literature, our understanding of the predictors and consequences of exaggerated stress reactivity in pregnancy is limited. This paper reviews the current state of this literature with an emphasis on gaps in knowledge and future directions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Early life factors in the pathogenesis of osteoporosis.

PubMed

Winsloe, Chivon; Earl, Susie; Dennison, Elaine M; Cooper, Cyrus; Harvey, Nicholas C

2009-12-01

Osteoporosis is a major public health burden through associated fragility fractures. Bone mass, a composite of bone size and volumetric density, increases through early life and childhood to a peak in early adulthood. The peak bone mass attained is a strong predictor of future risk of osteoporosis. Evidence is accruing that environmental factors in utero and in early infancy may permanently modify the postnatal pattern of skeletal growth to peak and thus influence risk of osteoporosis in later life. This article describes the latest data in this exciting area of research, including novel epigenetic and translation work, which should help to elucidate the underlying mechanisms and give rise to potential public health interventions to reduce the burden of osteoporotic fracture in future generations.

Increased consumption of fruit and vegetables and future cancer incidence in selected European countries.

PubMed

Soerjomataram, Isabelle; Oomen, Dian; Lemmens, Valery; Oenema, Anke; Benetou, Vassiliki; Trichopoulou, Antonia; Coebergh, Jan Willem; Barendregt, Jan; de Vries, Esther

2010-09-01

Cancer is one of the major causes of death in western countries. Fruit and vegetable consumption may reduce the risk of cancers of the oropharynx, oesophagus, lung, stomach and colorectum. We investigated the potential effect of interventions aimed at increasing the intake of fruits and vegetables to the recommended level (500 g/d) on future cancer incidence in Europe. Data on cancer incidence and daily intake of fruit and vegetables were compiled for France, Germany, The Netherlands, Spain and Sweden. We also performed a meta-analysis of European observational studies to arrive at a quantitative estimate on the association between fruit and vegetable intake and cancer risk. Predictions on the future cancer incidence were modelled using PREVENT 3.01. Our study predicted 212,000 fruit- and vegetable-related cancer cases in these countries in 2050, out of which 398 (0.19%) might be prevented if the 500 g/d fruit and vegetable intake were achieved in the aforementioned countries. The largest absolute impact was observed for lung cancer with 257 (out of 136,517) preventable cases if the intervention was successfully implemented. Sweden would benefit the most from intervention to increase fruit and vegetable consumption with a 2% reduction in expected cases. Increasing fruit and vegetable consumption has a small impact on reducing the burden of cancer in Europe. Health impact assessment tools such as PREVENT can provide the basis for decision making in chronic disease prevention. Copyright © 2010 Elsevier Ltd. All rights reserved.

Anticipating the perceived risk of nanotechnologies

NASA Astrophysics Data System (ADS)

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

2009-11-01

Understanding emerging trends in public perceptions of nanomaterials is critically important for those who regulate risks. A number of surveys have explored public perceptions of their risks and benefits. In this paper we meta-analyse these surveys to assess the extent to which the following four hypotheses derived from previous studies of new technologies might be said to be valid for nanotechnologies: risk aversion will prevail over benefit appreciation; an increase in knowledge will not result in reduced aversion to risks; judgements will be malleable and subject to persuasion given risk-centric information; and contextual, psychometric and attitudinal predictors of perceived risk from prior studies can help anticipate future perceptions of nanotechnologies. We find that half the public has at least some familiarity with nanotechnology, and those who perceive greater benefits outnumber those who perceive greater risks by 3 to 1. However, a large minority of those surveyed (44%) is unsure, suggesting that risk judgements are highly malleable. Nanotechnology risk perceptions also appear to contradict some long-standing findings. In particular, unfamiliarity with nanotechnology is, contrary to expectations, not strongly associated with risk aversion and reduced `knowledge deficits' are correlated with positive perceptions in this early and controversy-free period. Psychometric variables, trust and affect continue to drive risk perceptions in this new context, although the influence of both trust and affect is mediated, even reversed, by demographic and cultural variables. Given the potential malleability of perceptions, novel methods for understanding future public responses to nanotechnologies will need to be developed.

Coupling of phenological information and synthetically generated time-series for crop types as indicator for vegetation coverage information

USDA-ARS?s Scientific Manuscript database

It is widely believed that in Germany and Europe the risk of soil erosion by water increases as a result of changes in climate. Especially, an increase of the frequency of extreme precipitation events during phenological crop phases with reduced soil cover is very likely for the near future. A monit...

Perception of Lava Flow Hazards and Risk at Mauna Loa and Hualalai Volcanoes, Kona, Hawaii

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Houghton, B. F.; Johnston, D. M.; Paton, D.; Swanson, D. A.

2001-12-01

The island of Hawaii is composed of five sub-aerially exposed volcanoes, three of which have been active since 1801 (Kilauea, Mauna Loa, Hualalai). Hawaii has the fastest population growth in the state and the local economy in the Kona districts (i.e., western portion of the island) is driven by tourism. Kona is directly vulnerable to future lava flows from Mauna Loa and Hualalai volcanoes, as well as indirectly from the effects of lava flows elsewhere that may sever the few roads that connect Kona to other vital areas on the island. A number of factors such as steep slopes, high volume eruptions, and high effusion rates, combine to mean that lava flows from Hualalai and Mauna Loa can be fast-moving and hence unusually hazardous. The proximity of lifelines and structures to potential eruptive sources exacerbates societies' risk to future lava flows. Approximately \\$2.3 billion has been invested on the flanks of Mauna Loa since its last eruption in 1984 (Trusdell 1995). An equivalent figure has not yet been determined for Hualalai, but an international airport, several large resort complexes, and Kailua-Kona, the second largest town on the island, are down-slope and within 15km of potential eruptive Hualalai vents. Public and perhaps official understanding of specific lava flow hazards and the perceptions of risk from renewed volcanism at each volcano are proportional to the time lapsed since the most recent eruption that impacted Kona, rather than a quantitative assessment of risk that takes into account recent growth patterns. Lava flows from Mauna Loa and Hualalai last directly impacted upon Kona during the notorious 1950 and circa 1801 eruptions, respectively. Various non-profit organizations; local, state and federal government entities; and academic institutions have disseminated natural hazard information in Kona but despite the intuitive appeal that increased hazard understanding and risk perception results in increased hazard adjustment adoption, this assumption is not always justified (Burger and Palmer, 1992). We are nearing completion of a survey among high school students, adult residents, and tourists in Kona to evaluate hazard understanding, risk perception and adjustment adoption. The findings should serve as a foundation for the development of future lava flow hazard education and mitigation initiatives. An evaluation of demographic, infrastructure, and land-use planning issues is also being performed to assess vulnerability and societal resilience in future eruptions.

[Which hip articulation bearing for which patient? : Tribology of the future].

PubMed

Morlock, M M; Bishop, N; Kaddick, C

2011-12-01

Replacement of the hip joint has become an exceptionally successful procedure since the inauguration of the low friction principle by Charnley. Aseptic osteolysis and joint dislocation have been addressed by the development of wear-optimized materials and the introduction of larger heads. As an increase in head diameter against polyethylene causes wear increase, larger hard-on-hard bearings were introduced, which exhibit reduced wear and reduced dislocation risk with increasing head diameter. These findings were derived from standard simulator testing, not sufficiently considering the risk of fluid film breakdown under adverse conditions, which can cause a dramatic increase in wear and friction proportional to the head diameter. Such adverse conditions can occur clinically in patients due to several factors and have caused the presently observed unexpected problems with these new designs. Standardized preclinical testing has to be viewed as a minimum requirement but certainly not as a guarantee for the clinical success of new materials and designs even if the testing is adapted to the current patient requirements, which is presently not the case. The future of tribology lies in the prevention of adverse conditions in patients, the improvement and optimized use of proven existing materials and not in the use of new materials.

Computer-Aided Nodule Assessment and Risk Yield Risk Management of Adenocarcinoma: The Future of Imaging?

PubMed

Foley, Finbar; Rajagopalan, Srinivasan; Raghunath, Sushravya M; Boland, Jennifer M; Karwoski, Ronald A; Maldonado, Fabien; Bartholmai, Brian J; Peikert, Tobias

2016-01-01

Increased clinical use of chest high-resolution computed tomography results in increased identification of lung adenocarcinomas and persistent subsolid opacities. However, these lesions range from very indolent to extremely aggressive tumors. Clinically relevant diagnostic tools to noninvasively risk stratify and guide individualized management of these lesions are lacking. Research efforts investigating semiquantitative measures to decrease interrater and intrarater variability are emerging, and in some cases steps have been taken to automate this process. However, many such methods currently are still suboptimal, require validation and are not yet clinically applicable. The computer-aided nodule assessment and risk yield software application represents a validated tool for the automated, quantitative, and noninvasive tool for risk stratification of adenocarcinoma lung nodules. Computer-aided nodule assessment and risk yield correlates well with consensus histology and postsurgical patient outcomes, and therefore may help to guide individualized patient management, for example, in identification of nodules amenable to radiological surveillance, or in need of adjunctive therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

The impact of vehicle moving violations and freeway traffic flow on crash risk: An application of plugin development for microsimulation.

PubMed

Wang, Junhua; Kong, Yumeng; Fu, Ting; Stipancic, Joshua

2017-01-01

This paper presents the use of the Aimsun microsimulation program to simulate vehicle violating behaviors and observe their impact on road traffic crash risk. Plugins for violations of speeding, slow driving, and abrupt stopping were developed using Aimsun's API and SDK module. A safety analysis plugin for investigating probability of rear-end collisions was developed, and a method for analyzing collision risk is proposed. A Fuzzy C-mean Clustering algorithm was developed to identify high risk states in different road segments over time. Results of a simulation experiment based on the G15 Expressway in Shanghai showed that abrupt stopping had the greatest impact on increasing collision risk, and the impact of violations increased with traffic volume. The methodology allows for the evaluation and monitoring of risks, alerting of road hazards, and identification of hotspots, and could be applied to the operations of existing facilities or planning of future ones.

Risk for Low Pathogenicity Avian Influenza Virus on Poultry Farms, the Netherlands, 2007-2013.

PubMed

Bouwstra, Ruth; Gonzales, Jose L; de Wit, Sjaak; Stahl, Julia; Fouchier, Ron A M; Elbers, Armin R W

2017-09-01

Using annual serologic surveillance data from all poultry farms in the Netherlands during 2007-2013, we quantified the risk for the introduction of low pathogenicity avian influenza virus (LPAIV) in different types of poultry production farms and putative spatial-environmental risk factors: distance from poultry farms to clay soil, waterways, and wild waterfowl areas. Outdoor-layer, turkey (meat and breeder), and duck (meat and breeder) farms had a significantly higher risk for LPAIV introduction than did indoor-layer farms. Except for outdoor-layer, all poultry types (i.e., broilers, chicken breeders, ducks, and turkeys) are kept indoors. For all production types, LPAIV risk decreased significantly with increasing distance to medium-sized waterways and with increasing distance to areas with defined wild waterfowl, but only for outdoor-layer and turkey farms. Future research should focus not only on production types but also on distance to waterways and wild bird areas. In addition, settlement of new poultry farms in high-risk areas should be discouraged.

The impact of vehicle moving violations and freeway traffic flow on crash risk: An application of plugin development for microsimulation

PubMed Central

Kong, Yumeng; Stipancic, Joshua

2017-01-01

This paper presents the use of the Aimsun microsimulation program to simulate vehicle violating behaviors and observe their impact on road traffic crash risk. Plugins for violations of speeding, slow driving, and abrupt stopping were developed using Aimsun’s API and SDK module. A safety analysis plugin for investigating probability of rear-end collisions was developed, and a method for analyzing collision risk is proposed. A Fuzzy C-mean Clustering algorithm was developed to identify high risk states in different road segments over time. Results of a simulation experiment based on the G15 Expressway in Shanghai showed that abrupt stopping had the greatest impact on increasing collision risk, and the impact of violations increased with traffic volume. The methodology allows for the evaluation and monitoring of risks, alerting of road hazards, and identification of hotspots, and could be applied to the operations of existing facilities or planning of future ones. PMID:28886141

Risk for Low Pathogenicity Avian Influenza Virus on Poultry Farms, the Netherlands, 2007–2013

PubMed Central

Bouwstra, Ruth; Gonzales, Jose L.; de Wit, Sjaak; Stahl, Julia; Fouchier, Ron A.M.

2017-01-01

Using annual serologic surveillance data from all poultry farms in the Netherlands during 2007–2013, we quantified the risk for the introduction of low pathogenicity avian influenza virus (LPAIV) in different types of poultry production farms and putative spatial-environmental risk factors: distance from poultry farms to clay soil, waterways, and wild waterfowl areas. Outdoor-layer, turkey (meat and breeder), and duck (meat and breeder) farms had a significantly higher risk for LPAIV introduction than did indoor-layer farms. Except for outdoor-layer, all poultry types (i.e., broilers, chicken breeders, ducks, and turkeys) are kept indoors. For all production types, LPAIV risk decreased significantly with increasing distance to medium-sized waterways and with increasing distance to areas with defined wild waterfowl, but only for outdoor-layer and turkey farms. Future research should focus not only on production types but also on distance to waterways and wild bird areas. In addition, settlement of new poultry farms in high-risk areas should be discouraged. PMID:28820139

A multi-disciplinary approach to evaluate vulnerability and risks of pluvial floods under changing climate: the case study of the municipality of Venice (Italy).

NASA Astrophysics Data System (ADS)

Sperotto, Anna; Torresan, Silvia; Gallina, Valentina; Coppola, Erika; Critto, Andrea; Marcomini, Antonio

2015-04-01

Global climate change is expected to affect the intensity and frequency of extreme events (e.g. heat waves, drought, heavy precipitations events) leading to increasing natural disasters and damaging events (e.g. storms, pluvial floods and coastal flooding) worldwide. Especially in urban areas, disasters risks can be exacerbated by changes in exposure and vulnerability patterns (i.e. urbanization, population growth) and should be addressed by adopting a multi-disciplinary approach. A Regional Risk Assessment (RRA) methodology integrating climate and environmental sciences with bottom-up participative processes was developed and applied to the urban territory of the municipality of Venice in order to evaluate the potential consequences of climate change on pluvial flood risk in urban areas. Based on the consecutive analysis of hazard, exposure, vulnerability and risks, the RRA methodology is a screening risk tool to identify and prioritize major elements at risk (e.g. residential, commercial areas and infrastructures) and to localize sub-areas that are more likely to be affected by flood risk due to heavy precipitation events, in the future scenario (2041-2050). From the early stages of its development and application, the RRA followed a bottom-up approach to select and score site-specific vulnerability factors (e.g. slope, permeability of the soil, past flooded areas) and to consider the requests and perspectives of local stakeholders of the North Adriatic region, by means of interactive workshops, surveys and discussions. The main outputs of the assessment are risk and vulnerability maps and statistics aimed at increasing awareness about the potential effect of climate change on pluvial flood risks and at identifying hot-spot areas where future adaptation actions should be required to decrease physical-environmental vulnerabilities or building resilience and coping capacity of human society to climate change. The overall risk assessment methodology and the results of its application to the territory of the municipality of Venice will be here presented and discussed.

Impacts of rising sea temperature on krill increase risks for predators in the Scotia Sea.

PubMed

Klein, Emily S; Hill, Simeon L; Hinke, Jefferson T; Phillips, Tony; Watters, George M

2018-01-01

Climate change is a threat to marine ecosystems and the services they provide, and reducing fishing pressure is one option for mitigating the overall consequences for marine biota. We used a minimally realistic ecosystem model to examine how projected effects of ocean warming on the growth of Antarctic krill, Euphausia superba, might affect populations of krill and dependent predators (whales, penguins, seals, and fish) in the Scotia Sea. We also investigated the potential to mitigate depletion risk for predators by curtailing krill fishing at different points in the 21st century. The projected effects of ocean warming on krill biomass were strongest in the northern Scotia Sea, with a ≥40% decline in the mass of individual krill. Projections also suggest a 25% chance that krill biomass will fall below an established depletion threshold (75% of its unimpacted level), with consequent risks for some predator populations, especially penguins. Average penguin abundance declined by up to 30% of its unimpacted level, with up to a 50% chance of falling below the depletion threshold. Simulated krill fishing at currently permitted harvest rates further increased risks for depletion, and stopping fishing offset the increased risks associated with ocean warming in our model to some extent. These results varied by location and species group. Risk reductions at smaller spatial scales also differed from those at the regional level, which suggests that some predator populations may be more vulnerable than others to future changes in krill biomass. However, impacts on predators did not always map directly to those for krill. Our findings indicate the importance of identifying vulnerable marine populations and targeting protection measures at appropriate spatial scales, and the potential for spatially-structured management to avoid aggravating risks associated with rising ocean temperatures. This may help balance tradeoffs among marine ecosystem services in an uncertain future.

Impacts of rising sea temperature on krill increase risks for predators in the Scotia Sea

PubMed Central

Hill, Simeon L.; Hinke, Jefferson T.; Phillips, Tony; Watters, George M.

2018-01-01

Climate change is a threat to marine ecosystems and the services they provide, and reducing fishing pressure is one option for mitigating the overall consequences for marine biota. We used a minimally realistic ecosystem model to examine how projected effects of ocean warming on the growth of Antarctic krill, Euphausia superba, might affect populations of krill and dependent predators (whales, penguins, seals, and fish) in the Scotia Sea. We also investigated the potential to mitigate depletion risk for predators by curtailing krill fishing at different points in the 21st century. The projected effects of ocean warming on krill biomass were strongest in the northern Scotia Sea, with a ≥40% decline in the mass of individual krill. Projections also suggest a 25% chance that krill biomass will fall below an established depletion threshold (75% of its unimpacted level), with consequent risks for some predator populations, especially penguins. Average penguin abundance declined by up to 30% of its unimpacted level, with up to a 50% chance of falling below the depletion threshold. Simulated krill fishing at currently permitted harvest rates further increased risks for depletion, and stopping fishing offset the increased risks associated with ocean warming in our model to some extent. These results varied by location and species group. Risk reductions at smaller spatial scales also differed from those at the regional level, which suggests that some predator populations may be more vulnerable than others to future changes in krill biomass. However, impacts on predators did not always map directly to those for krill. Our findings indicate the importance of identifying vulnerable marine populations and targeting protection measures at appropriate spatial scales, and the potential for spatially-structured management to avoid aggravating risks associated with rising ocean temperatures. This may help balance tradeoffs among marine ecosystem services in an uncertain future. PMID:29385153

Adverse life events increase risk for postpartum psychiatric episodes: A population-based epidemiologic study.

PubMed

Meltzer-Brody, S; Larsen, J T; Petersen, L; Guintivano, J; Florio, A Di; Miller, W C; Sullivan, P F; Munk-Olsen, T

2018-02-01

Trauma histories may increase risk of perinatal psychiatric episodes. We designed an epidemiological population-based cohort study to explore if adverse childhood experiences (ACE) in girls increases risk of later postpartum psychiatric episodes. Using Danish registers, we identified women born in Denmark between January 1980 and December 1998 (129,439 childbirths). Exposure variables were ACE between ages 0 and 15 including: (1) family disruption, (2) parental somatic illness, (3) parental labor market exclusion, (4) parental criminality, (5) parental death, (6) placement in out-of-home care, (7) parental psychopathology excluding substance use, and (8) parental substance use disorder. Primary outcome was first occurrence of in- or outpatient contact 0-6 months postpartum at a psychiatric treatment facility with any psychiatric diagnoses, ICD-10, F00-F99 (N = 651). We conducted survival analyses using Cox proportional hazard regressions of postpartum psychiatric episodes. Approximately 52% of the sample experienced ACE, significantly increasing risk of any postpartum psychiatric diagnosis. Highest risks were observed among women who experienced out-of-home placement, hazard ratio (HR) 2.57 (95% CI: 1.90-3.48). Women experiencing two adverse life events had higher risks of postpartum psychiatric diagnosis HR: 1.88 (95% CI: 1.51-2.36), compared to those with one ACE, HR: 1.24 (95% CI: 1.03-49) and no ACE, HR: 1.00 (reference group). ACE primarily due to parental psychopathology and disability contributes to increased risk of postpartum psychiatric episodes; and greater numbers of ACE increases risk for postpartum psychiatric illness with an observed dose-response effect. Future work should explore genetic and environmental factors that increase risk and/or confer resilience. © 2017 Wiley Periodicals, Inc.

Generalized optimal risk allocation: foraging and antipredator behavior in a fluctuating environment.

PubMed

Higginson, Andrew D; Fawcett, Tim W; Trimmer, Pete C; McNamara, John M; Houston, Alasdair I

2012-11-01

Animals live in complex environments in which predation risk and food availability change over time. To deal with this variability and maximize their survival, animals should take into account how long current conditions may persist and the possible future conditions they may encounter. This should affect their foraging activity, and with it their vulnerability to predation across periods of good and bad conditions. Here we develop a comprehensive theory of optimal risk allocation that allows for environmental persistence and for fluctuations in food availability as well as predation risk. We show that it is the duration of good and bad periods, independent of each other, rather than the overall proportion of time exposed to each that is the most important factor affecting behavior. Risk allocation is most pronounced when conditions change frequently, and optimal foraging activity can either increase or decrease with increasing exposure to bad conditions. When food availability fluctuates rapidly, animals should forage more when food is abundant, whereas when food availability fluctuates slowly, they should forage more when food is scarce. We also show that survival can increase as variability in predation risk increases. Our work reveals that environmental persistence should profoundly influence behavior. Empirical studies of risk allocation should therefore carefully control the duration of both good and bad periods and consider manipulating food availability as well as predation risk.

Suitability of European climate for the Asian tiger mosquito Aedes albopictus: recent trends and future scenarios

PubMed Central

Caminade, Cyril; Medlock, Jolyon M.; Ducheyne, Els; McIntyre, K. Marie; Leach, Steve; Baylis, Matthew; Morse, Andrew P.

2012-01-01

The Asian tiger mosquito (Aedes albopictus) is an invasive species that has the potential to transmit infectious diseases such as dengue and chikungunya fever. Using high-resolution observations and regional climate model scenarios for the future, we investigated the suitability of Europe for A. albopictus using both recent climate and future climate conditions. The results show that southern France, northern Italy, the northern coast of Spain, the eastern coast of the Adriatic Sea and western Turkey were climatically suitable areas for the establishment of the mosquito during the 1960–1980s. Over the last two decades, climate conditions have become more suitable for the mosquito over central northwestern Europe (Benelux, western Germany) and the Balkans, while they have become less suitable over southern Spain. Similar trends are likely in the future, with an increased risk simulated over northern Europe and slightly decreased risk over southern Europe. These distribution shifts are related to wetter and warmer conditions favouring the overwintering of A. albopictus in the north, and drier and warmer summers that might limit its southward expansion. PMID:22535696

17 CFR 23.609 - Clearing member risk management.

Code of Federal Regulations, 2014 CFR

2014-04-01

... management. 23.609 Section 23.609 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION... Clearing member risk management. (a) With respect to clearing activities in futures, security futures...) Monitor for adherence to the risk-based limits intra-day and overnight; (4) Conduct stress tests under...

17 CFR 23.609 - Clearing member risk management.

Code of Federal Regulations, 2013 CFR

2013-04-01

... management. 23.609 Section 23.609 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION... Clearing member risk management. (a) With respect to clearing activities in futures, security futures...) Monitor for adherence to the risk-based limits intra-day and overnight; (4) Conduct stress tests under...

A Guide to the Application of Probability Risk Assessment Methodology and Hazard Risk Frequency Criteria as a Hazard Control for the Use of the Mobile Servicing System on the International Space Station

NASA Astrophysics Data System (ADS)

D'silva, Oneil; Kerrison, Roger

2013-09-01

A key feature for the increased utilization of space robotics is to automate Extra-Vehicular manned space activities and thus significantly reduce the potential for catastrophic hazards while simultaneously minimizing the overall costs associated with manned space. The principal scope of the paper is to evaluate the use of industry standard accepted Probability risk/safety assessment (PRA/PSA) methodologies and Hazard Risk frequency Criteria as a hazard control. This paper illustrates the applicability of combining the selected Probability risk assessment methodology and hazard risk frequency criteria, in order to apply the necessary safety controls that allow for the increased use of the Mobile Servicing system (MSS) robotic system on the International Space Station. This document will consider factors such as component failure rate reliability, software reliability, and periods of operation and dormancy, fault tree analyses and their effects on the probability risk assessments. The paper concludes with suggestions for the incorporation of existing industry Risk/Safety plans to create an applicable safety process for future activities/programs

Increasing stress on disaster-risk finance due to large floods

NASA Astrophysics Data System (ADS)

Jongman, Brenden; Hochrainer-Stigler, Stefan; Feyen, Luc; Aerts, Jeroen C. J. H.; Mechler, Reinhard; Botzen, W. J. Wouter; Bouwer, Laurens M.; Pflug, Georg; Rojas, Rodrigo; Ward, Philip J.

2014-04-01

Recent major flood disasters have shown that single extreme events can affect multiple countries simultaneously, which puts high pressure on trans-national risk reduction and risk transfer mechanisms. So far, little is known about such flood hazard interdependencies across regions and the corresponding joint risks at regional to continental scales. Reliable information on correlated loss probabilities is crucial for developing robust insurance schemes and public adaptation funds, and for enhancing our understanding of climate change impacts. Here we show that extreme discharges are strongly correlated across European river basins. We present probabilistic trends in continental flood risk, and demonstrate that observed extreme flood losses could more than double in frequency by 2050 under future climate change and socio-economic development. We suggest that risk management for these increasing losses is largely feasible, and we demonstrate that risk can be shared by expanding risk transfer financing, reduced by investing in flood protection, or absorbed by enhanced solidarity between countries. We conclude that these measures have vastly different efficiency, equity and acceptability implications, which need to be taken into account in broader consultation, for which our analysis provides a basis.

Drug use Discrimination Predicts Formation of High-Risk Social Networks: Examining Social Pathways of Discrimination.

PubMed

Crawford, Natalie D; Ford, Chandra; Rudolph, Abby; Kim, BoRin; Lewis, Crystal M

2017-09-01

Experiences of discrimination, or social marginalization and ostracism, may lead to the formation of social networks characterized by inequality. For example, those who experience discrimination may be more likely to develop drug use and sexual partnerships with others who are at increased risk for HIV compared to those without experiences of discrimination. This is critical as engaging in risk behaviors with others who are more likely to be HIV positive can increase one's risk of HIV. We used log-binomial regression models to examine the relationship between drug use, racial and incarceration discrimination with changes in the composition of one's risk network among 502 persons who use drugs. We examined both absolute and proportional changes with respect to sex partners, drug use partners, and injecting partners, after accounting for individual risk behaviors. At baseline, participants were predominately male (70%), black or Latino (91%), un-married (85%), and used crack (64%). Among those followed-up (67%), having experienced discrimination due to drug use was significantly related to increases in the absolute number of sex networks and drug networks over time. No types of discrimination were related to changes in the proportion of high-risk network members. Discrimination may increase one's risk of HIV acquisition by leading them to preferentially form risk relationships with higher-risk individuals, thereby perpetuating racial and ethnic inequities in HIV. Future social network studies and behavioral interventions should consider whether social discrimination plays a role in HIV transmission.

Risk-sharing agreements, present and future

PubMed Central

Gonçalves, Francisco R; Santos, Susana; Silva, Catarina; Sousa, Gabriela

2018-01-01

Risk-sharing agreements between pharmaceutical companies and payers stand out as a recent practice, the use of which has been increasing in the case of innovative medicines, particularly in the field of oncology, which aims to ensure better budgetary control and a lower risk of spending on medicinal products without full evidence of clinical benefit. In this article, the authors discuss the types of existing agreements, as well as those used in Portugal, their advantages, disadvantages and future challenges of implementation, as well as their potential role in access to therapeutic innovation, namely medicines for cancer treatment. For this purpose, a nonsystematic review of indexed and nonconventional literature was carried out. There is a tendency for the risk-sharing agreements established between payers and pharmaceutical companies to include a component of monitoring the use of medicines and outcomes measurement, involving real life data collection. Portugal is no exception and, although most agreements are still financial in nature, there is already a strong desire for other agreements, in particular clinical outcomes based. It is concluded that there is not yet a gold standard methodology in relation to the type of agreements to be practiced. Moreover, its opportunity cost, including the cost of implementation, remains to be scrutinised. However, regardless of the type of agreement, the advantages of adopting these agreements are well known, inevitably related with challenges of implementation. The need for an infrastructure to support information sharing is undisputed and urgent. The future of therapeutic innovation and increased pressure on health budgets will require alternative, more flexible models, personalized reimbursement models that allow alignment of medicines prices with the value they deliver in treating the several diseases. PMID:29743943

Sustaining a Mature Risk Management Process: Ensuring the International Space Station for a Vibrant Future

NASA Technical Reports Server (NTRS)

Raftery, Michael; Carter-Journet, Katrina

2013-01-01

The International Space Station (ISS) risk management methodology is an example of a mature and sustainable process. Risk management is a systematic approach used to proactively identify, analyze, plan, track, control, communicate, and document risks to help management make risk-informed decisions that increase the likelihood of achieving program objectives. The ISS has been operating in space for over 14 years and permanently crewed for over 12 years. It is the longest surviving habitable vehicle in low Earth orbit history. Without a mature and proven risk management plan, it would be increasingly difficult to achieve mission success throughout the life of the ISS Program. A successful risk management process must be able to adapt to a dynamic program. As ISS program-level decision processes have evolved, so too has the ISS risk management process continued to innovate, improve, and adapt. Constant adaptation of risk management tools and an ever-improving process is essential to the continued success of the ISS Program. Above all, sustained support from program management is vital to risk management continued effectiveness. Risk management is valued and stressed as an important process by the ISS Program.

Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease.

PubMed

Holmlund, A; Lampa, E; Lind, L

2017-07-01

Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P < 0.001). When adjusting for calendar time, age, sex, educational level, smoking, and baseline values for bleeding on probing, probing pocket depth >4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

Testicular cancer incidence to rise by 25% by 2025 in Europe? Model-based predictions in 40 countries using population-based registry data.

PubMed

Le Cornet, Charlotte; Lortet-Tieulent, Joannie; Forman, David; Béranger, Rémi; Flechon, Aude; Fervers, Béatrice; Schüz, Joachim; Bray, Freddie

2014-03-01

Testicular cancer mainly affects White Caucasian populations, accounts for 1% of all male cancers, and is frequently the most common malignancy among young adult men. In light of the escalating rates of testicular cancer incidence in Europe, and in support of future planning to ensure optimal care of patients with what can be a curable disease, we predict the future burden in 40 European countries around 2025. Current observed trends were extrapolated with the NORDPRED model to estimate the future burden of testicular cancer in the context of changes in risk versus changes in demographics. Despite substantial heterogeneity in the rates, the vast majority of European countries will see an increasing burden over the next two decades. We estimate there will be 23,000 new cases of testicular cancer annually in Europe by 2025, a rise of 24% from 2005. Some of the most rapid increases in testicular cancer are observed in Croatia, Slovenia, Italy and Spain, and a transition is underway, whereby recent attenuations and declines in rates in certain high-risk countries in Northern Europe contrast with the increasing trends and escalating burden in Southern Europe. According to our estimates for 2025, around one in 100 men will be diagnosed with the disease annually in the highest risk countries of Europe (Croatia, Slovenia and Norway). Elucidating the key determinants of testicular cancer and the equitable provision of optimal care for patients across Europe are priorities given the steady rise in the number of patients by 2025, and an absence of primary prevention opportunities. None. Copyright © 2013 Elsevier Ltd. All rights reserved.

Limiting the financial risks of electricity generation capital investments under carbon constraints: Applications and opportunities for public policies and private investments

NASA Astrophysics Data System (ADS)

Newcomer, Adam

Increasing demand for electricity and an aging fleet of generators are the principal drivers behind an increasing need for a large amount of capital investments in the US electric power sector in the near term. The decisions (or lack thereof) by firms, regulators and policy makers in response to this challenge have long lasting consequences, incur large economic and environmental risks, and must be made despite large uncertainties about the future operating and business environment. Capital investment decisions are complex: rates of return are not guaranteed; significant uncertainties about future environmental legislation and regulations exist at both the state and national levels---particularly about carbon dioxide emissions; there is an increasing number of shareholder mandates requiring public utilities to reduce their exposure to potentially large losses from stricter environmental regulations; and there are significant concerns about electricity and fuel price levels, supplies, and security. Large scale, low carbon electricity generation facilities using coal, such as integrated gasification combined cycle (IGCC) facilities coupled with carbon capture and sequestration (CCS) technologies, have been technically proven but are unprofitable in the current regulatory and business environment where there is no explicit or implicit price on carbon dioxide emissions. The paper examines two separate scenarios that are actively discussed by policy and decision makers at corporate, state and national levels: a future US electricity system where coal plays a role; and one where the role of coal is limited or nonexistent. The thesis intends to provide guidance for firms and policy makers and outline applications and opportunities for public policies and for private investment decisions to limit financial risks of electricity generation capital investments under carbon constraints.

Future-directed thinking in first-episode psychosis.

PubMed

Goodby, Emmeline; MacLeod, Andrew K

2016-06-01

This study employed the Future Thinking Task (MacLeod et al., 2005, Br. J. Clin. Psychol., 44, 495) to investigate whether future-directed thinking in first-episode psychosis is significantly different from that of matched controls, and to identify its correlates in this patient group. Cross-sectional, mixed-model, case-control design. Participants were 30 patients with first-episode psychosis and 27 matched controls. The Future Thinking Task was used to assess future-directed thinking in both groups. Anxiety and depression were also measured as well as self-report measures of hopelessness, suicide ideation and a measure of negative symptoms. Individuals with psychosis were impaired in future-directed thinking in both positive and negative domains, particularly with respect to the coming year. Increased self-reported hopelessness was associated with reduced positive future thinking and increased negative future thinking. Increased positive future thinking was also associated with reduced severity of negative symptoms, whilst negative future thinking was associated with suicide ideation. Individuals with first-episode psychosis show a reduction in positive future thinking in line with that seen in other clinical groups, but this is accompanied by an unexpected reduction in negative future thinking. The findings suggest a general disengagement with the future in this group that may affect recovery and functioning. Individuals with first-episode psychosis may benefit from interventions to help them engage with their future, in particular in the mid-range, up to 1 year. The Future Thinking Task may be a helpful addition to the assessment of suicide risk in those with first-episode psychosis. Decreased positive future thinking was associated with increased severity of negative symptoms, indicating a potential new treatment angle for this resistant aspect of psychosis. The cross-sectional design of this study does not allow for conclusions about the causal relationship between psychosis and future-directed thinking. This study investigated future-directed thinking in individuals with a range of psychotic illnesses employing a trans-diagnostic approach; therefore, conclusions cannot be drawn about the nature of future-directed thinking in individual psychotic disorders. © 2015 The British Psychological Society.

Evaluation of Probable Maximum Precipitation and Flood under Climate Change in the 21st Century

NASA Astrophysics Data System (ADS)

Gangrade, S.; Kao, S. C.; Rastogi, D.; Ashfaq, M.; Naz, B. S.; Kabela, E.; Anantharaj, V. G.; Singh, N.; Preston, B. L.; Mei, R.

2016-12-01

Critical infrastructures are potentially vulnerable to extreme hydro-climatic events. Under a warming environment, the magnitude and frequency of extreme precipitation and flood are likely to increase enhancing the needs to more accurately quantify the risks due to climate change. In this study, we utilized an integrated modeling framework that includes the Weather Research Forecasting (WRF) model and a high resolution distributed hydrology soil vegetation model (DHSVM) to simulate probable maximum precipitation (PMP) and flood (PMF) events over Alabama-Coosa-Tallapoosa River Basin. A total of 120 storms were selected to simulate moisture maximized PMP under different meteorological forcings, including historical storms driven by Climate Forecast System Reanalysis (CFSR) and baseline (1981-2010), near term future (2021-2050) and long term future (2071-2100) storms driven by Community Climate System Model version 4 (CCSM4) under Representative Concentrations Pathway 8.5 emission scenario. We also analyzed the sensitivity of PMF to various antecedent hydrologic conditions such as initial soil moisture conditions and tested different compulsive approaches. Overall, a statistical significant increase is projected for future PMP and PMF, mainly attributed to the increase of background air temperature. The ensemble of simulated PMP and PMF along with their sensitivity allows us to better quantify the potential risks associated with hydro-climatic extreme events on critical energy-water infrastructures such as major hydropower dams and nuclear power plants.

Scarring, Disfigurement, and Quality of Life in Long-Term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

PubMed Central

Kinahan, Karen E.; Sharp, Lisa K.; Seidel, Kristy; Leisenring, Wendy; Didwania, Aarati; Lacouture, Mario E.; Stovall, Marilyn; Haryani, Anand; Robison, Leslie L.; Krull, Kevin R.

2012-01-01

Purpose Childhood cancer survivors are at increased risk for adverse outcomes and chronic medical conditions. Treatment-related scarring, disfigurement, and persistent hair loss, in addition to their long-term impact on psychological distress or health-related quality of life (HRQOL), have received little attention. Patients and Methods Self-reported scarring/disfigurement and persistent hair loss were examined in 14,358 survivors and 4,023 siblings from the Childhood Cancer Survivor Study. Multivariable models were used to examine associations with demographic and cancer treatment. The impact of disfigurement and hair loss on HRQOL (ie, Medical Outcomes Short Form–36) and emotional distress (ie, Brief Symptom Inventory–18) was examined. Results Survivors reported a significantly higher rate of scarring/disfigurement compared with siblings for head/neck (25.1% v 8.4%), arms/legs (18.2% v 10.2%), and chest/abdomen (38.1% v 9.1%), as well as hair loss (14.0% v 6.3%). In age-, sex-, and race-adjusted models, cranial radiation exposure ≥ 36 Gy increased risk for head/neck disfigurement (relative risk [RR], 2.42; 95% CI, 2.22 to 2.65) and hair loss (RR, 4.24; 95% CI, 3.63 to 4.95). Adjusting for cranial radiation, age, sex, race, education, and marital status, survivor hair loss increased risk of anxiety (RR, 1.60; 95% CI, 1.23 to 2.07), whereas head/neck disfigurement increased risk of depression (RR, 1.19; 95% CI, 1.01 to 1.41). Limitations due to emotional symptoms were associated with head/neck disfigurement (RR, 1.24; 95% CI, 1.10 to 1.41), arm/leg disfigurement (RR, 1.19; 95% CI, 1.05 to 1.35), and hair loss (RR, 1.26; 95% CI, 1.09 to 1.47). Conclusion Survivors of childhood cancer are at increased risk for disfigurement and persistent hair loss, which is associated with future emotional distress and reduced quality of life. Future studies are needed to better identify and manage functional outcomes in these patients. PMID:22614987

What causes EBRI retirement readiness ratings to vary: results from the 2014 Retirement Security Projection Model.

PubMed

VanDerhei, Jack

2014-02-01

RETIREMENT INCOME ADEQUACY IMPROVED SLIGHTLY IN 2013: Due to the increase in financial market and housing values during 2013, the probability that Baby Boomers and Generation Xers would NOT run short of money in retirement increases between 0.5 and 1.6 percentage points, based on the Employee Benefit Research Institute (EBRI) Retirement Readiness Ratings (RRRs). ELIGIBILITY FOR PARTICIPATION IN AN EMPLOYER-SPONSORED DEFINED CONTRIBUTION PLAN REMAINS ONE OF THE MOST IMPORTANT FACTORS FOR RETIREMENT INCOME ADEQUACY: RRR values double for Gen Xers in the lowest-income quartile when comparing those with 20 or more years of future eligibility with those with no years of future eligibility, while those in the middle income quartiles experience increases in RRR values by 27.1-30.3 percentage points. FUTURE SOCIAL SECURITY BENEFITS MAKE A HUGE DIFFERENCE FOR THE RETIREMENT INCOME ADEQUACY OF SOME HOUSEHOLDS, ESPECIALLY GEN XERS IN THE LOWEST-INCOME QUARTILE: If Social Security benefits are subject to proportionate decreases beginning in 2033 (according to the values in Figure 8), the RRR values for those households will drop by more than 50 percent: from 20.9 percent to 10.3 percent. LONGEVITY RISK AND STOCHASTIC HEALTH CARE RISK ARE ASSOCIATED WITH HUGE VARIATIONS IN RETIREMENT INCOME ADEQUACY: For both of these factors, a comparison between the most "risky" quartile with the least risky quartile shows a spread of approximately 30 percentage points for the lowest income range, approximately 25 to 40 percentage points for the highest income range, and even larger spreads for those in the middle income ranges. A GREAT DEAL OF THE VARIABILITY IN RETIREMENT INCOME ADEQUACY COULD BE MITIGATED BY APPROPRIATE RISK-MANAGEMENT TECHNIQUES AT OR NEAR RETIREMENT AGE: For example, the annuitization of a portion of the defined contribution and IRA balances may substantially increase the probability of not running short of money in retirement. Moreover, a well-functioning market in long-term care insurance would appear to provide an extremely useful technique to help control the volatility from the stochastic, long-term health care risk, especially for those in the middle income quartiles.

Discrimination, drugs, and alcohol among Latina/os in Brooklyn, New York: Differences by gender

PubMed Central

Gee, Gilbert C.; Iguchi, Martin Y.; Ford, Chandra L.; Friedman, Samuel R.

2013-01-01

BACKGROUND Based on a stress-coping framework, the present study investigates the relationship between discrimination and substance use, and the moderating effects of gender. METHODS This cross-sectional study analyzes data from Latina/o young adults aged 18 to 25 (n=401) from Brooklyn, New York. Multinomial logistic regression was used to test the association between discrimination and substance use. RESULTS Discrimination was significantly associated with increased odds of substance use adjusting for covariates (e.g. age, education). Gender was a moderator. Discrimination was associated with increased risk of alcohol/marijuana and hard drug use among young Latina women. However, discrimination was associated with decreased risk of alcohol/marijuana use and increased risk of hard drug use among young Latino men. CONCLUSION These findings suggest that discrimination is generally associated with risk for substance use, but further that the outcomes vary by gender. Future research should explore gender-specific dimensions of discrimination and their associations with other outcomes. PMID:23481289

Discrimination, drugs, and alcohol among Latina/os in Brooklyn, New York: differences by gender.

PubMed

Otiniano Verissimo, Angie Denisse; Gee, Gilbert C; Iguchi, Martin Y; Ford, Chandra L; Friedman, Samuel R

2013-07-01

Based on a stress-coping framework, the present study investigates the relationship between discrimination and substance use, and the moderating effects of gender. This cross-sectional study analyzes data from Latina/o young adults aged 18-25 (N = 401) from Brooklyn, New York. Multinomial logistic regression was used to test the association between discrimination and substance use. Discrimination was significantly associated with increased odds of substance use adjusting for covariates (e.g. age, education). Gender was a moderator. Discrimination was associated with increased risk of alcohol/cannabis and hard drug use among young Latina women. However, discrimination was associated with decreased risk of alcohol/cannabis use and increased risk of hard drug use among young Latino men. These findings suggest that discrimination is generally associated with risk for substance use, but further that the outcomes vary by gender. Future research should explore gender-specific dimensions of discrimination and their associations with other outcomes. Copyright © 2013 Elsevier B.V. All rights reserved.

Direct-to-consumer television advertising exposure, diagnosis with high cholesterol, and statin use.

PubMed

Niederdeppe, Jeff; Byrne, Sahara; Avery, Rosemary J; Cantor, Jonathan

2013-07-01

While statin drugs are recommended for secondary prevention of coronary heart disease (CHD), there is no medical consensus on whether or not a statin should be added to lifestyle change efforts for primary prevention of CHD. Previous research suggests that exposure to direct-to-consumer advertising (DTCA) increases drug demand among those at comparatively low risk. Research has yet to examine whether individual-level DTCA exposure may influence statin use among men and women at high, moderate, or low risk for future cardiac events. To determine the relationship between estimated exposure to DTCA for statin drugs and two clinical variables: diagnosis with high cholesterol and statin use. We used logistic regression to analyze repeated cross-sectional surveys of the United States population, merged with data on the frequency of DTCA appearances on national, cable, and local television, between 2001 and 2007. American adults (n=106,685) aged 18 and older. Levels of exposure to statin DTCA, based on ad appearances and TV viewing patterns; self-reports of whether or not a respondent has been diagnosed with high cholesterol, and whether or not a respondent took a statin in the past year. Adjusting for potential confounders, we estimate that exposure to statin ads increased the odds of being diagnosed with high cholesterol by 16 to 20 %, and increased statin use by 16 to 22 %, among both men and women (p<0.05). These associations were driven almost exclusively by men and women at low risk for future cardiac events. There was also evidence of a negative association between DTCA exposure and statin use among high-risk women (p<0.05) CONCLUSIONS: This study provides new evidence that DTCA may promote over-diagnosis of high cholesterol and over-treatment for populations where risks of statin use may outweigh potential benefits.

Warming increases the risk of civil war in Africa.

PubMed

Burke, Marshall B; Miguel, Edward; Satyanath, Shanker; Dykema, John A; Lobell, David B

2009-12-08

Armed conflict within nations has had disastrous humanitarian consequences throughout much of the world. Here we undertake the first comprehensive examination of the potential impact of global climate change on armed conflict in sub-Saharan Africa. We find strong historical linkages between civil war and temperature in Africa, with warmer years leading to significant increases in the likelihood of war. When combined with climate model projections of future temperature trends, this historical response to temperature suggests a roughly 54% increase in armed conflict incidence by 2030, or an additional 393,000 battle deaths if future wars are as deadly as recent wars. Our results suggest an urgent need to reform African governments' and foreign aid donors' policies to deal with rising temperatures.

[Analysis of 14 individuals who requested predictive genetic testing for hereditary neuromuscular diseases].

PubMed

Yoshida, Kunihiro; Tamai, Mariko; Kubota, Takeo; Kawame, Hiroshi; Amano, Naoji; Ikeda, Shu-ichi; Fukushima, Yoshimitsu

2002-02-01

Predictive genetic testing for hereditary neuromuscular diseases is a delicate issue for individuals at risk and their families, as well as for medical staff because these diseases are often late-onset and intractable. Therefore careful pre- and post-test genetic counseling and psychosocial support should be provided along with such genetic testing. The Division of Clinical and Molecular Genetics was established at our hospital in May 1996 to provide skilled professional genetic counseling. Since its establishment, 14 individuals have visited our clinic to request predictive genetic testing for hereditary neuromuscular diseases (4 for myotonic dystrophy, 6 for spinocerebellar ataxia, 3 for Huntington's disease, and 1 for Alzheimer's disease). The main reasons for considering testing were to remove uncertainty about the genetic status and to plan for the future. Nine of 14 individuals requested testing for making decisions about a forthcoming marriage or pregnancy (family planning). Other reasons raised by the individuals included career or financial planning, planning for their own health care, and knowing the risk for their children. At the first genetic counseling session, all of the individuals expressed hopes of not being a gene carrier and of escaping from fear of disease, and seemed not to be mentally well prepared for an increased-risk result. To date, 7 of the 14 individuals have received genetic testing and only one, who underwent predictive genetic testing for spinocerebellar ataxia, was given an increased-risk result. The seven individuals including the one with an increased-risk result, have coped well with their new knowledge about their genetic status after the testing results were disclosed. None of them has expressed regret. In pre-test genetic counseling sessions, we consider it quite important not only to determine the psychological status of the individual, but also to make the individual try to anticipate the changes in his/her life upon receiving an increased-risk or a decreased-risk result. Sufficient time should be taken to build a good relationship between the individual and his/her family and the medical staff during pre-test counseling sessions. This will help the individuals feel satisfied with their own decisions for the future, whether they receive genetic testing or not.

2D.01: EXERCISE SYSTOLIC BLOOD PRESSURE >/=190 MMHG AT MODERATE WORKLOAD PREDICTS CORONARY HEART DISEASE IN HEALTHY, MIDDLE-AGED MEN.

PubMed

Mariampillai, J Eek; Engeseth, K; Kjeldsen, S E; Grundvold, I; Liestøl, K; Erikssen, G; Erikssen, J E; Bodegård, J; Skretteberg, P T

2015-06-01

A hypertensive response to exercise at moderate workload is associated with future risk of coronary heart disease (CHD) and mortality. Yet there is still no consensus regarding the cut-off value for an inappropriate increase in exercise systolic blood pressure. We have previously shown that exercise blood pressure at 100W workload (SBP100W) > 200 mmHg is associated with increased risk of CHD and mortality. We now aimed to investigate the possible association between SBP100W >/= 190mmHg and risk of CHD over up to 28 years follow-up. Of the 1999 apparently healthy, middle-aged men who underwent thorough medical examination and laboratory testing, including a symptom-limited bicycle ergometer test, during 1972-1975, 1392 men were still healthy at survey 2 seven years later and completed a workload of 100 W at both surveys. Systolic blood pressure was measured near completion of the 100W stage (SBP100W). By comparing subjects having SBP100W >/=190 mmHg at baseline, follow-up or both(n=365) with subjects having SBP100W < 190 mmHg at both surveys (n = 1027), we estimated the risk of CHD (angina pectoris, non-fatal myocardial infarction and death from coronary heart disease). The combined endpoint of CHD occurred in 452 of the 1392 men; 243 events among the 365 men with SBP100W >/= 190 mmHg. When adjusting for survey 1 smoking status, age, systolic blood pressure at rest, total cholesterol and family history of coronary heart disease, there was a 1.38-fold (CI 1.11-1.71, p < 0.005) increased risk of CHD. When further adjusting for physical fitness, SBP100W >/=190mmHg was associated with a 1.35-fold (1.08-1.65) increased risk of CHD. Our findings indicate that a systolic blood pressure of 190 mmHg or more at moderate workload is associated with future risk of CHD among apparently healthy middle-aged men.(Figure is included in full-text article.).

Mammographic density, breast cancer risk and risk prediction

PubMed Central

Vachon, Celine M; van Gils, Carla H; Sellers, Thomas A; Ghosh, Karthik; Pruthi, Sandhya; Brandt, Kathleen R; Pankratz, V Shane

2007-01-01

In this review, we examine the evidence for mammographic density as an independent risk factor for breast cancer, describe the risk prediction models that have incorporated density, and discuss the current and future implications of using mammographic density in clinical practice. Mammographic density is a consistent and strong risk factor for breast cancer in several populations and across age at mammogram. Recently, this risk factor has been added to existing breast cancer risk prediction models, increasing the discriminatory accuracy with its inclusion, albeit slightly. With validation, these models may replace the existing Gail model for clinical risk assessment. However, absolute risk estimates resulting from these improved models are still limited in their ability to characterize an individual's probability of developing cancer. Promising new measures of mammographic density, including volumetric density, which can be standardized using full-field digital mammography, will likely result in a stronger risk factor and improve accuracy of risk prediction models. PMID:18190724

Climate change. Accelerating extinction risk from climate change.

PubMed

Urban, Mark C

2015-05-01

Current predictions of extinction risks from climate change vary widely depending on the specific assumptions and geographic and taxonomic focus of each study. I synthesized published studies in order to estimate a global mean extinction rate and determine which factors contribute the greatest uncertainty to climate change-induced extinction risks. Results suggest that extinction risks will accelerate with future global temperatures, threatening up to one in six species under current policies. Extinction risks were highest in South America, Australia, and New Zealand, and risks did not vary by taxonomic group. Realistic assumptions about extinction debt and dispersal capacity substantially increased extinction risks. We urgently need to adopt strategies that limit further climate change if we are to avoid an acceleration of global extinctions. Copyright © 2015, American Association for the Advancement of Science.

Oestrogen and anti-androgen therapy for transgender women

PubMed Central

Tangpricha, Vin; den Heijer, Martin

2016-01-01

Transgender women experience lifelong gender dysphoria due to a gender assignment at birth that is incongruent with their gender identity. They often seek hormone therapy, with or without surgery, to improve their gender dysphoria and to better align their physical and psychological features with a more feminine gender role. Some of the desired physical changes from oestrogen and anti-androgen therapy include decreased body and facial hair, decreased muscle mass, breast growth, and redistribution of fat. Overall the risks of treatment are low, but include thromboembolism, the risk of which depends on the dose and route of oestrogen administration. Other associated conditions commonly seen in transgender women include increased risks of depression and osteoporosis. The risk of hormone-sensitive cancer seems to be low in transgender women, with no increased risk of breast cancer compared with women and no increase in prostate cancer when compared with men. The evidence base for the care of transgender women is limited by the paucity of high-quality research, and long-term longitudinal studies are needed to inform future guidelines. PMID:27916515

Does exposure to hyperglycaemia in utero increase the risk of obesity and diabetes in the offspring? A critical reappraisal.

PubMed

Donovan, L E; Cundy, T

2015-03-01

The idea that exposure to hyperglycaemia in utero is an important factor in the development of obesity and diabetes in the offspring has become entrenched as popular belief. To appraise the literature supporting this hypothesis in the light of recent studies that have clarified the main drivers of obesity in children and adolescents. A review of published evidence from animal studies, human observational studies, systematic reviews and experimental trials that address the impact of diabetes (Types 1 and 2, genetic or gestational) on the future risk of obesity and/or glucose intolerance in the offspring. Some animal studies support a relationship between exposure to hyperglycaemia in utero and future development of obesity and diabetes, but the results are inconsistent. Most of the human studies claiming to show a relationship have not taken into account important known confounders, such as maternal and paternal BMI. Evidence supporting a dose-response relationship between maternal hyperglycaemia exposure and obesity and diabetes in the offspring is weak, and there is no convincing evidence that treating gestational diabetes reduces the later risk of offspring obesity or glucose intolerance. Exposure to hyperglycaemia in utero has minimal direct effect on the later risk of obesity and Type 2 diabetes. The increased risk of obesity in the offspring of women with Type 2 or gestational diabetes can be explained by confounding factors, such as parental obesity. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Museum specimen data reveal emergence of a plant disease may be linked to increases in the insect vector population.

PubMed

Zeilinger, Adam R; Rapacciuolo, Giovanni; Turek, Daniel; Oboyski, Peter T; Almeida, Rodrigo P P; Roderick, George K

2017-09-01

The emergence rate of new plant diseases is increasing due to novel introductions, climate change, and changes in vector populations, posing risks to agricultural sustainability. Assessing and managing future disease risks depends on understanding the causes of contemporary and historical emergence events. Since the mid-1990s, potato growers in the western United States, Mexico, and Central America have experienced severe yield loss from Zebra Chip disease and have responded by increasing insecticide use to suppress populations of the insect vector, the potato psyllid, Bactericera cockerelli (Hemiptera: Triozidae). Despite the severe nature of Zebra Chip outbreaks, the causes of emergence remain unknown. We tested the hypotheses that (1) B. cockerelli occupancy has increased over the last century in California and (2) such increases are related to climate change, specifically warmer winters. We compiled a data set of 87,000 museum specimen occurrence records across the order Hemiptera collected between 1900 and 2014. We then analyzed changes in B. cockerelli distribution using a hierarchical occupancy model using changes in background species lists to correct for collecting effort. We found evidence that B. cockerelli occupancy has increased over the last century. However, these changes appear to be unrelated to climate changes, at least at the scale of our analysis. To the extent that species occupancy is related to abundance, our analysis provides the first quantitative support for the hypothesis that B. cockerelli population abundance has increased, but further work is needed to link B. cockerelli population dynamics to Zebra Chip epidemics. Finally, we demonstrate how this historical macro-ecological approach provides a general framework for comparative risk assessment of future pest and insect vector outbreaks. © 2017 by the Ecological Society of America.

Geomagnetic storms can trigger stroke: evidence from 6 large population-based studies in Europe and Australasia.

PubMed

Feigin, Valery L; Parmar, Priya G; Barker-Collo, Suzanne; Bennett, Derrick A; Anderson, Craig S; Thrift, Amanda G; Stegmayr, Birgitta; Rothwell, Peter M; Giroud, Maurice; Bejot, Yannick; Carvil, Phillip; Krishnamurthi, Rita; Kasabov, Nikola

2014-06-01

Although the research linking cardiovascular disorders to geomagnetic activity is accumulating, robust evidence for the impact of geomagnetic activity on stroke occurrence is limited and controversial. We used a time-stratified case-crossover study design to analyze individual participant and daily geomagnetic activity (as measured by Ap Index) data from several large population-based stroke incidence studies (with information on 11 453 patients with stroke collected during 16 031 764 person-years of observation) in New Zealand, Australia, United Kingdom, France, and Sweden conducted between 1981 and 2004. Hazard ratios and corresponding 95% confidence intervals (CIs) were calculated. Overall, geomagnetic storms (Ap Index 60+) were associated with 19% increase in the risk of stroke occurrence (95% CI, 11%-27%). The triggering effect of geomagnetic storms was most evident across the combined group of all strokes in those aged <65 years, increasing stroke risk by >50%: moderate geomagnetic storms (60-99 Ap Index) were associated with a 27% (95% CI, 8%-48%) increased risk of stroke occurrence, strong geomagnetic storms (100-149 Ap Index) with a 52% (95% CI, 19%-92%) increased risk, and severe/extreme geomagnetic storms (Ap Index 150+) with a 52% (95% CI, 19%-94%) increased risk (test for trend, P<2×10(-16)). Geomagnetic storms are associated with increased risk of stroke and should be considered along with other established risk factors. Our findings provide a framework to advance stroke prevention through future investigation of the contribution of geomagnetic factors to the risk of stroke occurrence and pathogenesis. © 2014 American Heart Association, Inc.

Association between pain and the frailty phenotype in older men: longitudinal results from the Concord Health and Ageing in Men Project (CHAMP).

PubMed

Megale, Rodrigo Z; Ferreira, Manuela L; Ferreira, Paulo H; Naganathan, Vasi; Cumming, Robert; Hirani, Vasant; Waite, Louise M; Seibel, Markus J; Le Couteur, David G; Handelsman, David J; Blyth, Fiona M

2018-05-01

to determine whether pain increases the risk of developing the frailty phenotype and whether frailty increases the risk of developing chronic or intrusive pain, using longitudinal data. longitudinal data from the Concord Health and Ageing in Men Project (CHAMP), a prospective population based cohort study. a total of 1,705 men aged 70 years or older, living in an urban area of New South Wales, Australia. data on the presence of chronic pain (daily pain for at least 3 months), intrusive pain (pain causing moderate to severe interference with activities) and the criteria for the Cardiovascular Health Study (CHS) frailty phenotype were collected in three waves, from January 2005 to October 2013. Data on age, living arrangements, education, smoking status, alcohol consumption, body mass index, comorbidities, cognitive function, depressive symptoms and history of vertebral or hip fracture were also collected and included as covariates in the analyses. a total of 1,705 participants were included at baseline, of whom 1,332 provided data at the 2-year follow-up and 940 at the 5-year follow-up. Non-frail (robust and pre-frail) men who reported chronic pain were 1.60 (95% confidence interval (CI): 1.02-2.51, P = 0.039) times more likely to develop frailty at follow-up, compared to those with no pain. Intrusive pain did not significantly increase the risk of future frailty. Likewise, the frailty status was not associated with future chronic or intrusive pain in the adjusted analysis. the presence of chronic pain increases the risk of developing the frailty phenotype in community-dwelling older men.

Increased rainfall volume from future convective storms in the US

NASA Astrophysics Data System (ADS)

Prein, Andreas F.; Liu, Changhai; Ikeda, Kyoko; Trier, Stanley B.; Rasmussen, Roy M.; Holland, Greg J.; Clark, Martyn P.

2017-12-01

Mesoscale convective system (MCS)-organized convective storms with a size of 100 km have increased in frequency and intensity in the USA over the past 35 years1, causing fatalities and economic losses2. However, their poor representation in traditional climate models hampers the understanding of their change in the future3. Here, a North American-scale convection-permitting model which is able to realistically simulate MSCs4 is used to investigate their change by the end-of-century under RCP8.5 (ref. 5). A storm-tracking algorithm6 indicates that intense summertime MCS frequency will more than triple in North America. Furthermore, the combined effect of a 15-40% increase in maximum precipitation rates and a significant spreading of regions impacted by heavy precipitation results in up to 80% increases in the total MCS precipitation volume, focussed in a 40 km radius around the storm centre. These typically neglected increases substantially raise future flood risk. Current investments in long-lived infrastructures, such as flood protection and water management systems, need to take these changes into account to improve climate-adaptation practices.

Landscape, Climate and Hantavirus Cardiopulmonary Syndrome Outbreaks.

PubMed

Prist, Paula Ribeiro; D Andrea, Paulo Sérgio; Metzger, Jean Paul

2017-09-01

We performed a literature review in order to improve our understanding of how landscape and climate drivers affect HCPS outbreaks. Anthropogenic landscape changes such as forest loss, fragmentation and agricultural land uses are related with a boost in hantavirus reservoir species abundance and hantavirus prevalence in tropical areas, increasing HCPS risk. Additionally, higher precipitation, especially in arid regions, favors an increase in vegetational biomass, which augments the resources for reservoir rodents, also increasing HCPS risk. Although these relationships were observed, few studies described it so far, and the ones that did it are concentrated in few places. To guide future research on this issue, we build a conceptual model relating landscape and climate variables with HCPS outbreaks and identified research opportunities. We point out the need for studies addressing the effects of landscape configuration, temperature and the interaction between climate and landscape variables. Critical landscape thresholds are also highly relevant, once HCPS risk transmission can increase rapidly above a certain degree of landscape degradation. These studies could be relevant to implement preventive measures, creating landscapes that can mitigate disease spread risk.

[COMPLICATED URINARY TRACT INFECTIONS IN THE ELDERLY].

PubMed

Ćosić, I; Ćosić, V

2016-12-01

Urinary tract infections (UTI) are the most common bacterial infections involving lower (cystitis, prostatitis) or upper (pyelonephritis, renal abscess, perinephric abscess) urinary tract. Differentiation of complicated and uncomplicated UTI is usually based on the presence of structural or functional urinary tract abnormalities, which can increase the risk of treatment failure and development of serious complications. Factors that increase the risk are foreign bodies, stones, obstruction, neurogenic bladder, kidney transplantation, immunosuppression, and pregnancy. Complicated UTI includes a spectrum of conditions that increase the risk of treatment failure, as well as of serious complications such as bacteremia and sepsis, perinephric abscess, renal impairment and emphysematous pyelonephritis. To avoid the potentially devastating outcomes, appropriate diagnostic procedures, antibiotic and surgical treatment, and appropriate follow-up are required. The incidence of complicated UTI will grow in the future due to general aging of the population, increasing incidence of diabetes, and ever growing number of immunocompromised and immunosuppressed patients. It is of key importance to recognize complicated UTI on time, and treat it wisely and aggressively to reduce duration of the disease and the risk of antibiotic resistance.

Future orientation and suicide risk in Hungarian college students: Burdensomeness and belongingness as mediators.

PubMed

Chang, Edward C; Chang, Olivia D; Martos, Tamás; Sallay, Viola

2017-01-01

We tested a model consistent with the notion that perceived burdensomeness and thwarted belongingness mediate the association between future orientation and suicide risk (viz., depressive symptoms and suicide ideation) in college students. The sample was comprised of 195 Hungarian college students. Results indicated that the negative associations found between future orientation and suicide risk outcomes were accounted for by both perceived burdensomeness and thwarted belongingness. The present findings highlight the importance of studying positive future cognitions in suicide risk and provide support for perceived burdensomeness and thwarted belongingness as potential proximal mechanisms associated with heighted suicide risk in adults.

Understanding hydro-climatic drivers of infectious diarrheal diseases in South Asia and their projected risks from regional climate models

NASA Astrophysics Data System (ADS)

Hasan, M. A.; Akanda, A. S.; Jutla, A.; Huq, A.; Colwell, R. R.

2017-12-01

Diarrheal diseases remain a major threat to global public health and are the second largest cause of death for children under the age of five. Cholera and Rotavirus diarrhea together comprise more than two-thirds of the diarrheal morbidity in South Asia. Recent studies have shown strong influences of hydrologic processes and climatic variabilities on the onset, intensity, and seasonality of the outbreaks of these diseases. However, our understanding of the propagation and manifestation of these diseases in a changing climate in vulnerable regions of the world are still limited. In this study, we build on our understanding of the role of the hydro-climatic drivers of diarrheal diseases in South Asia in recent decades to project the probable risks of the diseases in this century using the climate projection scenarios from dynamically downscaled climate models. To build the current model, we conducted a multivariate logistic regression assessment using 34 climate indices to examine the role of temperature and rainfall extremes over the seasonality of rotavirus and cholera over a South Asian country, Bangladesh. We utilize the availability of long and reliable time-series of cholera and rotavirus from Bangladesh and conducted a temporal and spatial analysis derived from both ground and satellite observations. For projecting the future risks of the diseases, we used five bias-corrected Regional Climate Model (RCM) results of the CMIP5 series under the RCP 4.5 scenario. Cholera risk shows a significantly higher rate of increase compared to Rotavirus in Bangladesh in the 21st century. As the disease is significantly influenced by extreme rainfall, majority projections showed a significant increase in flood-driven cholera risk. Most RCMs suggest a warmer winter in future years, suggesting reduced risk for Rotavirus. However, as the dryness of the climate is also highly correlated with rotavirus epidemics, the incremental risk of the disease due to drier winters would likely undermine the reduced risk due to temperature increase. Probabilistic risk assessments of these diarrheal diseases with respect to hydro-climatic variability will, not only improve the local policymaking processes, but also allow us to pinpoint the climate-health hotspots around the globe.

Motivation for and use of social networking sites: Comparisons among college students with and without histories of non-suicidal self-injury.

PubMed

Jarvi, Stephanie M; Swenson, Lance P; Batejan, Kristen L

2017-07-01

This research examines potential differences in social network use and motivation for social network use by non-suicidal self-injury (NSSI) status. 367 (73% women; M age = 20.60) college students were recruited in November-December 2011. A random sample of 2,500 students was accessed through a university registrar to recruit students interested in an online survey assessing NSSI and various health-related behaviors. Social network use and motivations for social networks did not differ by NSSI status. Results suggest that it is not patterns of use or motivation to use social networks that could lead to concern about online behavior (i.e., behavior increasing risk of future NSSI) among those with NSSI history. Rather, future preventive and intervention efforts should address the NSSI-related content that is available online, since this is unregulated, often explicit, and commonly includes "pro-NSSI" content that may be problematic and increase risk among vulnerable individuals.

Volcanic risk perception of young people in the urban areas of Vesuvius: Comparisons with other volcanic areas and implications for emergency management

USGS Publications Warehouse

Carlino, S.; Somma, R.; Mayberry, G.C.

2008-01-01

More than 600 000 people are exposed to volcanic risk in the urban areas near the volcano, Vesuvius, and may need to be evacuated if there is renewed volcanic activity. The success of a future evacuation will strongly depend on the level of risk perception and preparedness of the at-risk communities during the current period of quiescence. The volcanic risk perception and preparedness of young people is of particular importance because hazard education programs in schools have been shown to increase the clarity of risk perception and students often share their knowledge with their parents. In order to evaluate young people's risk perception and preparedness for a volcanic crisis, a multiple choice questionnaire was distributed to 400 high-school students in three municipalities located close to the volcano. The overall results suggest that despite a 60-year period of quiescence at Vesuvius, the interviewed students have an accurate perception of the level of volcanic risk. On the other hand, the respondents demonstrate a clear lack of understanding of volcanic processes and their related hazards. Also, the interviewed students show high levels of fear, poor perceived ability to protect themselves from the effects of a future eruption, and insufficient knowledge of the National Emergency Plan for Vesuvian Area (NEPVA). The latter result suggests that in comparison with volcanic crises in other regions, during a future eruption of Vesuvius, there may not be enough time to educate the large number of people living near the volcano about how to appropriately respond. The inadequate risk education and preparedness of respondents implies that a strong effort is needed to improve communication strategies in order to facilitate successful evacuations. Therefore, it is important to take advantage of the present period of quiescence at Vesuvius to improve the accuracy of risk perception of youth in local communities. ?? 2008.

IQ, the Urban Environment, and Their Impact on Future Schizophrenia Risk in Men.

PubMed

Toulopoulou, Timothea; Picchioni, Marco; Mortensen, Preben Bo; Petersen, Liselotte

2017-09-01

Exposure to an urban environment during early life and low IQ are 2 well-established risk factors for schizophrenia. It is not known, however, how these factors might relate to one another. Data were pooled from the North Jutland regional draft board IQ assessments and the Danish Conscription Registry for men born between 1955 and 1993. Excluding those who were followed up for less than 1 year after the assessment yielded a final cohort of 153170 men of whom 578 later developed a schizophrenia spectrum disorder. We found significant effects of having an urban birth, and also experiencing an increase in urbanicity before the age of 10 years, on adult schizophrenia risk. The effect of urban birth was independent of IQ. However, there was a significant interaction between childhood changes in urbanization in the first 10 years and IQ level on the future adult schizophrenia risk. In short, those subjects who moved to more or less urban areas before their 10th birthday lost the protective effect of IQ. When thinking about adult schizophrenia risk, the critical time window of childhood sensitivity to changes in urbanization seems to be linked to IQ. Given the prediction that by 2050, over 80% of the developed world's population will live in an urban environment, this represents a major future public health issue. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Crop connectivity under climate change: future environmental and geographic risks of potato late blight in Scotland.

PubMed

Skelsey, Peter; Cooke, David E L; Lynott, James S; Lees, Alison K

2016-11-01

The impact of climate change on dispersal processes is largely ignored in risk assessments for crop diseases, as inoculum is generally assumed to be ubiquitous and nonlimiting. We suggest that consideration of the impact of climate change on the connectivity of crops for inoculum transmission may provide additional explanatory and predictive power in disease risk assessments, leading to improved recommendations for agricultural adaptation to climate change. In this study, a crop-growth model was combined with aerobiological models and a newly developed infection risk model to provide a framework for quantifying the impact of future climates on the risk of disease occurrence and spread. The integrated model uses standard meteorological variables and can be easily adapted to various crop pathosystems characterized by airborne inoculum. In a case study, the framework was used with data defining the spatial distribution of potato crops in Scotland and spatially coherent, probabilistic climate change data to project the future connectivity of crop distributions for Phytophthora infestans (causal agent of potato late blight) inoculum and the subsequent risk of infection. Projections and control recommendations are provided for multiple combinations of potato cultivar and CO 2 emissions scenario, and temporal and spatial averaging schemes. Overall, we found that relative to current climatic conditions, the risk of late blight will increase in Scotland during the first half of the potato growing season and decrease during the second half. To guide adaptation strategies, we also investigated the potential impact of climate change-driven shifts in the cropping season. Advancing the start of the potato growing season by 1 month proved to be an effective strategy from both an agronomic and late blight management perspective. © 2016 John Wiley & Sons Ltd.

Augmentation index is a better marker for cardiovascular risk in young Malaysian males. A comparison of involvement of pulse wave velocity, augmentation index, and C-reactive protein.

PubMed

Aminuddin, Amilia; Chellappan, Kalaivani; Maskon, Oteh; Zakaria, Zaiton; Karim, Aminuddin A; Ngah, Wan Z; Nordin, Nor Anita M

2014-02-01

To determine the association between carotid femoral pulse wave velocity (PWVCF) and augmentation index (AI) with future cardiovascular disease (CVD) risk, and to assess whether high sensitivity C-reactive protein (hs-CRP) is an important mediator towards these vascular changes, among young men. This cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia from July 2011 to December 2012. Two hundred and eleven young men were recruited. The PWVCF and AI were measured using Vicorder. High sensitivity C-reactive protein was measured by using immunological methods. The future CVD risk was assessed by Framingham risk score (FRS) and age adjusted FRS (A-FRS). Data for analysis was conducted using the Statistical Package for Social Sciences Version 15 (SPSS Inc., Chicago, IL, USA). The mean age of the subjects was 27.09 (95% confidence intervals [CI] 26.39-27.79) years old. Those with ≥2 risk factors had significantly higher AI [10.09 (95% CI: 9.06-11.12) versus 6.56 (95% CI: 5.54-7.57) (p=0.001), but not PWVCF 7.45 (95% CI: 7.29-7.61) m/s versus 7.29 (95% CI: 7.06-7.51) m/s, (p=0.90) when compared to the healthy subjects. High sensitivity C-reactive protein was not an independent determinant for PWVCF and AI. Only AI was significantly associated with FRS and A-FRS (p=0.0001). To assess the impact of risk factors on vascular damage and for future assessment of CVD risk among the young men, AI may be a better marker than PWVCF. The increase in AI among these subjects was not related to hs-CRP.

A framework for global river flood risk assessments

NASA Astrophysics Data System (ADS)

Winsemius, H. C.; Van Beek, L. P. H.; Jongman, B.; Ward, P. J.; Bouwman, A.

2012-08-01

There is an increasing need for strategic global assessments of flood risks in current and future conditions. In this paper, we propose a framework for global flood risk assessment for river floods, which can be applied in current conditions, as well as in future conditions due to climate and socio-economic changes. The framework's goal is to establish flood hazard and impact estimates at a high enough resolution to allow for their combination into a risk estimate. The framework estimates hazard at high resolution (~1 km2) using global forcing datasets of the current (or in scenario mode, future) climate, a global hydrological model, a global flood routing model, and importantly, a flood extent downscaling routine. The second component of the framework combines hazard with flood impact models at the same resolution (e.g. damage, affected GDP, and affected population) to establish indicators for flood risk (e.g. annual expected damage, affected GDP, and affected population). The framework has been applied using the global hydrological model PCR-GLOBWB, which includes an optional global flood routing model DynRout, combined with scenarios from the Integrated Model to Assess the Global Environment (IMAGE). We performed downscaling of the hazard probability distributions to 1 km2 resolution with a new downscaling algorithm, applied on Bangladesh as a first case-study application area. We demonstrate the risk assessment approach in Bangladesh based on GDP per capita data, population, and land use maps for 2010 and 2050. Validation of the hazard and damage estimates has been performed using the Dartmouth Flood Observatory database and damage estimates from the EM-DAT database and World Bank sources. We discuss and show sensitivities of the estimated risks with regard to the use of different climate input sets, decisions made in the downscaling algorithm, and different approaches to establish impact models.

Burden of Type 2 Diabetes in Mexico: Past, Current and Future Prevalence and Incidence Rates

PubMed Central

Meza, Rafael; Barrientos-Gutierrez, Tonatiuh; Rojas-Martinez, Rosalba; Reynoso-Noverón, Nancy; Palacio-Mejia, Lina Sofia; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

2015-01-01

Introduction Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends. Methods We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960–2012), and birth-cohort (1920–1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010–2050 and a Multi-cohort Diabetes Markov Model. Results Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65–68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57–59. We estimate that diagnosed diabetes incidence increased exponentially during 1960–2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7–22.5% by 2050, affecting 15–25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2. Conclusions Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico. PMID:26546108

Burden of type 2 diabetes in Mexico: past, current and future prevalence and incidence rates.

PubMed

Meza, Rafael; Barrientos-Gutierrez, Tonatiuh; Rojas-Martinez, Rosalba; Reynoso-Noverón, Nancy; Palacio-Mejia, Lina Sofia; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

2015-12-01

Mexico diabetes prevalence has increased dramatically in recent years. However, no national incidence estimates exist, hampering the assessment of diabetes trends and precluding the development of burden of disease analyses to inform public health policy decision-making. Here we provide evidence regarding current magnitude of diabetes in Mexico and its future trends. We used data from the Mexico National Health and Nutrition Survey, and age-period-cohort models to estimate prevalence and incidence of self-reported diagnosed diabetes by age, sex, calendar-year (1960-2012), and birth-cohort (1920-1980). We project future rates under three alternative incidence scenarios using demographic projections of the Mexican population from 2010-2050 and a Multi-cohort Diabetes Markov Model. Adult (ages 20+) diagnosed diabetes prevalence in Mexico increased from 7% to 8.9% from 2006 to 2012. Diabetes prevalence increases with age, peaking around ages 65-68 to then decrease. Age-specific incidence follows similar patterns, but peaks around ages 57-59. We estimate that diagnosed diabetes incidence increased exponentially during 1960-2012, roughly doubling every 10 years. Projected rates under three age-specific incidence scenarios suggest diabetes prevalence among adults (ages 20+) may reach 13.7-22.5% by 2050, affecting 15-25 million individuals, with a lifetime risk of 1 in 3 to 1 in 2. Diabetes prevalence in Mexico will continue to increase even if current incidence rates remain unchanged. Continued implementation of policies to reduce obesity rates, increase physical activity, and improve population diet, in tandem with diabetes surveillance and other risk control measures is paramount to substantially reduce the burden of diabetes in Mexico. Copyright © 2015 Elsevier Inc. All rights reserved.

Prenatal and Perinatal Risk Factors in a Twin Study of Autism Spectrum Disorders

PubMed Central

Froehlich-Santino, Wendy; Tobon, Amalia Londono; Cleveland, Sue; Torres, Andrea; Phillips, Jennifer; Cohen, Brianne; Torigoe, Tiffany; Miller, Janet; Fedele, Angie; Collins, Jack; Smith, Karen; Lotspeich, Linda; Croen, Lisa A.; Ozonoff, Sally; Lajonchere, Clara; Grether, Judith K.; O’Hara, Ruth; Hallmayer, Joachim

2014-01-01

Introduction Multiple studies associate prenatal and perinatal complications with increased risks for autism spectrum disorders (ASDs). The objectives of this study were to utilize a twin study design to 1) Investigate whether shared gestational and perinatal factors increase concordance for ASDs in twins, 2) Determine whether individual neonatal factors are associated with the presence of ASDs in twins, and 3) Explore whether associated factors may influence males and females differently. Methods Data from medical records and parent response questionnaires from 194 twin pairs, in which at least one twin had an ASD, were analyzed. Results Shared factors including parental age, prenatal use of medications, uterine bleeding, and prematurity did not increase concordance risks for ASDs in twins. Among the individual factors, respiratory distress demonstrated the strongest association with increased risk for ASDs in the group as a whole (OR 2.11, 95% CI 1.27–3.51). Furthermore, respiratory distress (OR 2.29, 95% CI 1.12–4.67) and other markers of hypoxia (OR 1.99, 95% CI 1.04–3.80) were associated with increased risks for ASDs in males, while jaundice was associated with an increased risk for ASDs in females (OR 2.94, 95% CI 1.28–6.74). Conclusions Perinatal factors associated with respiratory distress and other markers of hypoxia appear to increase risk for autism in a subgroup of twins. Future studies examining potential gender differences and additional prenatal, perinatal and postnatal environmental factors are required for elucidating the etiology of ASDs and suggesting new methods for treatment and prevention. PMID:24726638

Evidence for a link between changes to gaze behaviour and risk of falling in older adults during adaptive locomotion.

PubMed

Chapman, G J; Hollands, M A

2006-11-01

There is increasing evidence that gaze stabilization with respect to footfall targets plays a crucial role in the control of visually guided stepping and that there are significant changes to gaze behaviour as we age. However, past research has not measured if age-related changes in gaze behaviour are associated with changes to stepping performance. This paper aims to identify differences in gaze behaviour between young (n=8) adults, older adults determined to be at a low-risk of falling (low-risk, n=4) and older adults prone to falling (high-risk, n=4) performing an adaptive locomotor task and attempts to relate observed differences in gaze behaviour to decline in stepping performance. Participants walked at a self-selected pace along a 9m pathway stepping into two footfall target locations en route. Gaze behaviour and lower limb kinematics were recorded using an ASL 500 gaze tracker interfaced with a Vicon motion analysis system. Results showed that older adults looked significantly sooner to targets, and fixated the targets for longer, than younger adults. There were also significant differences in these measures between high and low-risk older adults. On average, high-risk older adults looked away from targets significantly sooner and demonstrated less accurate and more variable foot placements than younger adults and low-risk older adults. These findings suggest that, as we age, we need more time to plan precise stepping movements and clearly demonstrate that there are differences between low-risk and high-risk older adults in both where and when they look at future stepping targets and the precision with which they subsequently step. We propose that high-risk older adults may prioritize the planning of future actions over the accurate execution of ongoing movements and that adoption of this strategy may contribute to an increased likelihood of falls. Copyright 2005 Elsevier B.V.

Relationships Between Future Orientation, Impulsive Sensation Seeking, and Risk Behavior Among Adjudicated Adolescents

PubMed Central

Robbins, Reuben N.; Bryan, Angela

2005-01-01

Because of high levels of risk behavior, adjudicated adolescents are at high risk for negative health outcomes such as nicotine and drug addiction and sexually transmitted diseases. The goal of this article is to examine relationships between future orientation and impulsive-sensation-seeking personality constructs to risk behaviors among 300 adjudicated adolescents. Significant relationships between impulsive sensation seeking and future orientation were found for several risk behaviors. Individuals with more positive future orientation were less likely to use marijuana, hard drugs, alcohol during sex, had fewer alcohol problems, had lower levels of alcohol frequency and quantity of use, and perceived greater risks associated with such behaviors. Higher impulsivity reliably predicted alcohol problems, alcohol use, condom use, and cigarette smoking. PMID:16429605

Correlation of Paraoxonase Status with Disease Activity Score and Systemic Inflammation in Rheumatoid Arthritic Patients.

PubMed

Bindal, Usha Dudeja; Saxena, Rahul; Siddiqui, Merajul Haque; Sharma, Dilutpal

2016-03-01

Despite, various preventive efforts on conventional cardiovascular disease (CVD) risk factors, the incidence of CVD in rheumatoid arthritis (RA) patients increases continuously. To solve this conundrum one needs more investigations. The present study was conducted to evaluate the plasma paraoxonase (PON) activity along with the markers of systemic inflammation, oxidative stress and disease activity score-28 (DAS28) in RA patients and clarify their role in determining the probability of RA patients to develop future CVD risk. Plasma PON, total antioxidant activity (TAA), C-reactive protein (CRP), synovial interleukin-6 (IL-6) and erythrocyte malondialdehyde (MDA) levels were estimated in 40 RA patients aged 40-55 years aged and 40 age-matched healthy controls. The data obtained were compared statistically by using Student's t-test and Pearson correlation test. Besides dyslipidaemia, marked reduction in plasma PON and TAA (p< 0.05) were observed in RA patients as compared with that of healthy controls. Erythrocyte MDA, plasma CRP and synovial IL-6 levels were increased significantly (p<0.05) in RA patients. PON was negatively correlated with MDA (r = - 0.672; p < 0.001), CRP (r = -0.458; p<0.05), IL-6 (r = -0.426; p<0.05) and DAS28 (r = -0.598; p < 0.001), and positively correlated with HDL cholesterol (r = 0.648; p<0.001) and TAA (r = 0.608; p< 0.001) levels in RA patients. Alteration in PON activity might contribute to the progression of future CVD risk in RA patients, which may result from interplay of several confounding factors, such as inflammation, oxidative stress and dyslipidaemia. Furthermore, plasma PON activity, CRP and TAA levels could be considered as non-traditional factors to predict CVD risk. Thus, it is suggested that future drugs could be developed to target the non-traditional risk factors in RA patients.

The Children's Hepatic tumors International Collaboration (CHIC): Novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model

PubMed Central

Czauderna, Piotr; Haeberle, Beate; Hiyama, Eiso; Rangaswami, Arun; Krailo, Mark; Maibach, Rudolf; Rinaldi, Eugenia; Feng, Yurong; Aronson, Daniel; Malogolowkin, Marcio; Yoshimura, Kenichi; Leuschner, Ivo; Lopez-Terrada, Dolores; Hishiki, Tomoro; Perilongo, Giorgio; von Schweinitz, Dietrich; Schmid, Irene; Watanabe, Kenichiro; Derosa, Marisa; Meyers, Rebecka

2016-01-01

Introduction Contemporary state-of-the-art management of cancer is increasingly defined by individualized treatment strategies. For very rare tumors, like hepatoblastoma, the development of biologic markers, and the identification of reliable prognostic risk factors for tailoring treatment, remains very challenging. The Children's Hepatic tumors International Collaboration (CHIC) is a novel international response to this challenge. Methods Four multicenter trial groups in the world, who have performed prospective controlled studies of hepatoblastoma over the past two decades (COG; SIOPEL; GPOH; and JPLT), joined forces to form the CHIC consortium. With the support of the data management group CINECA, CHIC developed a centralized online platform where data from eight completed hepatoblastoma trials were merged to form a database of 1605 hepatoblastoma cases treated between 1988 and 2008. The resulting dataset is described and the relationships between selected patient and tumor characteristics, and risk for adverse disease outcome (event-free survival; EFS) are examined. Results Significantly increased risk for EFS-event was noted for advanced PRETEXT group, macrovascular venous or portal involvement, contiguous extrahepatic disease, primary tumor multifocality and tumor rupture at enrollment. Higher age (≥8 years), low AFP (<100 ng/ml) and metastatic disease were associated with the worst outcome. Conclusion We have identified novel prognostic factors for hepatoblastoma, as well as confirmed established factors, that will be used to develop a future common global risk stratification system. The mechanics of developing the globally accessible web-based portal, building and refining the database, and performing this first statistical analysis has laid the foundation for future collaborative efforts. This is an important step for refining of the risk based grouping and approach to future treatment stratification, thus we think our collaboration offers a template for others to follow in the study of rare tumors and diseases. PMID:26655560

The Children's Hepatic tumors International Collaboration (CHIC): Novel global rare tumor database yields new prognostic factors in hepatoblastoma and becomes a research model.

PubMed

Czauderna, Piotr; Haeberle, Beate; Hiyama, Eiso; Rangaswami, Arun; Krailo, Mark; Maibach, Rudolf; Rinaldi, Eugenia; Feng, Yurong; Aronson, Daniel; Malogolowkin, Marcio; Yoshimura, Kenichi; Leuschner, Ivo; Lopez-Terrada, Dolores; Hishiki, Tomoro; Perilongo, Giorgio; von Schweinitz, Dietrich; Schmid, Irene; Watanabe, Kenichiro; Derosa, Marisa; Meyers, Rebecka

2016-01-01

Contemporary state-of-the-art management of cancer is increasingly defined by individualized treatment strategies. For very rare tumors, like hepatoblastoma, the development of biologic markers, and the identification of reliable prognostic risk factors for tailoring treatment, remains very challenging. The Children's Hepatic tumors International Collaboration (CHIC) is a novel international response to this challenge. Four multicenter trial groups in the world, who have performed prospective controlled studies of hepatoblastoma over the past two decades (COG; SIOPEL; GPOH; and JPLT), joined forces to form the CHIC consortium. With the support of the data management group CINECA, CHIC developed a centralized online platform where data from eight completed hepatoblastoma trials were merged to form a database of 1605 hepatoblastoma cases treated between 1988 and 2008. The resulting dataset is described and the relationships between selected patient and tumor characteristics, and risk for adverse disease outcome (event-free survival; EFS) are examined. Significantly increased risk for EFS-event was noted for advanced PRETEXT group, macrovascular venous or portal involvement, contiguous extrahepatic disease, primary tumor multifocality and tumor rupture at enrollment. Higher age (≥ 8 years), low AFP (<100 ng/ml) and metastatic disease were associated with the worst outcome. We have identified novel prognostic factors for hepatoblastoma, as well as confirmed established factors, that will be used to develop a future common global risk stratification system. The mechanics of developing the globally accessible web-based portal, building and refining the database, and performing this first statistical analysis has laid the foundation for future collaborative efforts. This is an important step for refining of the risk based grouping and approach to future treatment stratification, thus we think our collaboration offers a template for others to follow in the study of rare tumors and diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

The contribution to future flood risk in the Severn Estuary from extreme sea level rise due to ice sheet mass loss

NASA Astrophysics Data System (ADS)

Quinn, N.; Bates, P. D.; Siddall, M.

2013-12-01

The rate at which sea levels will rise in the coming century is of great interest to decision makers tasked with developing mitigation policies to cope with the risk of coastal inundation. Accurate estimates of future sea levels are vital in the provision of effective policy. Recent reports from UK Climate Impacts Programme (UKCIP) suggest that mean sea levels in the UK may rise by as much as 80 cm by 2100; however, a great deal of uncertainty surrounds model predictions, particularly the contribution from ice sheets responding to climatic warming. For this reason, the application of semi-empirical modelling approaches for sea level rise predictions has increased of late, the results from which suggest that the rate of sea level rise may be greater than previously thought, exceeding 1 m by 2100. Furthermore, studies in the Red Sea indicate that rapid sea level rise beyond 1m per century has occurred in the past. In light of such research, the latest UKCIP assessment has included a H++ scenario for sea level rise in the UK of up to 1.9 m which is defined as improbable but, crucially, physically plausible. The significance of such low-probability sea level rise scenarios upon the estimation of future flood risk is assessed using the Somerset levels (UK) as a case study. A simple asymmetric probability distribution is constructed to include sea level rise scenarios of up to 1.9 m by 2100 which are added to a current 1:200 year event water level to force a two-dimensional hydrodynamic model of coastal inundation. From the resulting ensemble predictions an estimation of risk by 2100 is established. The results indicate that although the likelihood of extreme sea level rise due to rapid ice sheet mass loss is low, the resulting hazard can be large, resulting in a significant (27%) increase to the projected annual risk. Furthermore, current defence construction guidelines for the coming century in the UK are expected to account for 95% of the sea level rise distribution presented in this research, while the larger, low probability scenarios beyond this level are estimated to contribute a residual annual risk of approximately £0.45 million. These findings clearly demonstrate that uncertainty in future sea level rise is a vital component of coastal flood risk, and therefore, needs to be accounted for by decision makers when considering mitigation policies related to coastal flooding.

Surplus men, sex work, and the spread of HIV in China.

PubMed

Tucker, Joseph D; Henderson, Gail E; Wang, Tian F; Huang, Ying Y; Parish, William; Pan, Sui M; Chen, Xiang S; Cohen, Myron S

2005-03-24

While 70% of HIV positive individuals live in sub-Saharan Africa, it is widely believed that the future of the epidemic depends on the magnitude of HIV spread in India and China, the world's most populous countries. China's 1.3 billion people are in the midst of significant social transformation, which will impact future sexual disease transmission. Soon approximately 8.5 million 'surplus men', unmarried and disproportionately poor and migrant, will come of age in China's cities and rural areas. Meanwhile, many millions of Chinese sex workers appear to represent a broad range of prices, places, and related HIV risk behaviors. Using demographic and behavioral data, this paper describes the combined effect of sexual practices, sex work, and a true male surplus on HIV transmission. Alongside a rapid increase in sexually transmitted disease incidence across developed parts of urban China, surplus men could become a significant new HIV risk group. The anticipated high sexual risk among many surplus men and injecting drug use use among a subgroup of surplus men may create bridging populations from high to low risk individuals. Prevention strategies that emphasize traditional measures--condom promotion, sex education, medical training--must be reinforced by strategies which acknowledge surplus men and sex workers. Reform within female sex worker mandatory re-education centers and site specific interventions at construction sites, military areas, or unemployment centers may hold promise in curbing HIV/sexually transmitted infections. From a sociological perspective, we believe that surplus men and sex workers will have a profound effect on the future of HIV spread in China and on the success or failure of future interventions.

Motives for smoking in movies affect future smoking risk in middle school students: an experimental investigation.

PubMed

Shadel, William G; Martino, Steven C; Setodji, Claude; Haviland, Amelia; Primack, Brain A; Scharf, Deborah

2012-06-01

Exposure to smoking in movies has been linked to adolescent smoking uptake. However, beyond linking amount of exposure to smoking in movies with adolescent smoking, whether the way that smoking is portrayed in movies matters for influencing adolescent smoking has not been investigated. This study experimentally examined how motivation for smoking depicted in movies affects self-reported future smoking risk (a composite measure with items that assess smoking refusal self-efficacy and smoking intentions) among early adolescents. A randomized laboratory experiment was used. Adolescents were exposed to movie scenes depicting one of three movie smoking motives: social smoking motive (characters smoked to facilitate social interaction); relaxation smoking motive (characters smoked to relax); or no smoking motive (characters smoked with no apparent motive, i.e., in neutral contexts and/or with neutral affect). Responses to these movie scenes were contrasted (within subjects) to participants' responses to control movie scenes in which no smoking was present; these control scenes matched to the smoking scenes with the same characters in similar situations but where no smoking was present. A total of 358 adolescents, aged 11-14 years, participated. Compared with participants exposed to movie scenes depicting characters smoking with no clear motive, adolescents exposed to movie scenes depicting characters smoking for social motives and adolescents exposed to movie scenes depicting characters smoking for relaxation motives had significantly greater chances of having increases in their future smoking risk. Exposure to movies that portray smoking motives places adolescents at particular risk for future smoking. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Motives for Smoking in Movies Affect Future Smoking Risk in Middle School Students: An Experimental Investigation

PubMed Central

Shadel, William G.; Martino, Steven; Setodji, Claude; Haviland, Amelia; Primack, Brian; Scharf, Deborah

2011-01-01

Background Exposure to smoking in movies has been linked to adolescent smoking uptake. However, beyond linking amount of exposure to smoking in movies with adolescent smoking, whether the way that smoking is portrayed in movies matters for influencing adolescent smoking has not been investigated. This study experimentally examined how motivation for smoking depicted in movies affects self-reported future smoking risk (a composite measure with items that assess smoking refusal self-efficacy and smoking intentions) among early adolescents. Methods A randomized laboratory experiment was used. Adolescents were exposed to movie scenes depicting one of three movie smoking motives: social smoking motive (characters smoked to facilitate social interaction); relaxation smoking motive (characters smoked to relax); or no smoking motive (characters smoked with no apparent motive, i.e., in neutral contexts and/or with neutral affect). Responses to these movie scenes were contrasted (within subjects) to participants’ responses to control movie scenes in which no smoking was present; these control scenes matched to the smoking scenes with the same characters in similar situations but where no smoking was present. A total of 358 adolescents, aged 11–14 years, participated. Results Compared with participants exposed to movie scenes depicting characters smoking with no clear motive, adolescents exposed to movie scenes depicting characters smoking for social motives and adolescents exposed to movie scenes depicting characters smoking for relaxation motives had significantly greater chances of having increases in their future smoking risk. Conclusions Exposure to movies that portray smoking motives places adolescents at particular risk for future smoking. PMID:22074766

Current and Future Science Plans for Restoring a Resilient Coast: Chapter 8A in Science and the storms-the USGS response to the hurricanes of 2005

USGS Publications Warehouse

2007-01-01

The overarching goal of U.S. Geological Survey (USGS) Gulf Coast science in the aftermath of the 2005 hurricane season will be to provide the scientific information, knowledge, and tools required to ensure that decisions about coastal land resource use, management practices, and future development in the coastal zone and adjacent watersheds promote restoration, increase coastal resilience, and mitigate risks associated with both human-created and natural hazards.

Impacts of climate change on indirect human exposure to pathogens and chemicals from agriculture.

PubMed

Boxall, Alistair B A; Hardy, Anthony; Beulke, Sabine; Boucard, Tatiana; Burgin, Laura; Falloon, Peter D; Haygarth, Philip M; Hutchinson, Thomas; Kovats, R Sari; Leonardi, Giovanni; Levy, Leonard S; Nichols, Gordon; Parsons, Simon A; Potts, Laura; Stone, David; Topp, Edward; Turley, David B; Walsh, Kerry; Wellington, Elizabeth M H; Williams, Richard J

2009-04-01

Climate change is likely to affect the nature of pathogens and chemicals in the environment and their fate and transport. Future risks of pathogens and chemicals could therefore be very different from those of today. In this review, we assess the implications of climate change for changes in human exposures to pathogens and chemicals in agricultural systems in the United Kingdom and discuss the subsequent effects on health impacts. In this review, we used expert input and considered literature on climate change; health effects resulting from exposure to pathogens and chemicals arising from agriculture; inputs of chemicals and pathogens to agricultural systems; and human exposure pathways for pathogens and chemicals in agricultural systems. We established the current evidence base for health effects of chemicals and pathogens in the agricultural environment; determined the potential implications of climate change on chemical and pathogen inputs in agricultural systems; and explored the effects of climate change on environmental transport and fate of different contaminant types. We combined these data to assess the implications of climate change in terms of indirect human exposure to pathogens and chemicals in agricultural systems. We then developed recommendations on future research and policy changes to manage any adverse increases in risks. Overall, climate change is likely to increase human exposures to agricultural contaminants. The magnitude of the increases will be highly dependent on the contaminant type. Risks from many pathogens and particulate and particle-associated contaminants could increase significantly. These increases in exposure can, however, be managed for the most part through targeted research and policy changes.

Projected changes to rain-on-snow events over North America

NASA Astrophysics Data System (ADS)

Jeong, Dae Il; Sushama, Laxmi

2016-04-01

Rain-on-snow (ROS) events have significant impacts on cold region ecosystems and water-related natural hazards, and therefore it is very important to assess how this hydro-meteorological phenomenon will evolve in a changing climate. This study evaluates the changes in ROS characteristics (i.e., frequency, amounts, and runoff) for the future 2041-2070 period with respect to the current 1976-2005 period over North America using six simulations, based on two Canadian RCMs, driven by two driving GCMs for RCP4.5 and 8.5 emission pathways. Projected changes to extreme runoff caused by the changes of the ROS characteristics are also evaluated. All simulations suggest general increases in ROS days in late autumn, winter, and early spring periods for most Canadian regions and northwestern USA for the future period, due to an increase in rain days in a warmer climate. Increases in the future ROS amounts are projected mainly due to an increase in ROS days, although increases in precipitation intensity also contributes to the future increases. Future ROS runoff is expected to increase more than future ROS amounts during snowmelt months as ROS events usually enhance runoff, given the land state and asociated reduced soil infiltration rate and also due to the faster snowmelt rate occuring during these events. The simulations also show that ROS events usually lead to extreme runoff over most of Canada and north-western and -central USA in the January-May snowmelt months for the current period and these show no significant changes in the future climate. However, the future ROS to total runoff ratio will significantly decrease for western and eastern Canada as well as north-western USA for these months, due to an overall increase of the fraction of direct snowmelt and rainfall generated runoff in a warmer climate. These results indicate the difficulties of flood risk and water resource managements in the future, particularly in Canada and north-western and -central USA, requiring more in depth studies for these regions to facilitate appropriate adaptation measures.

Delivery by Cesarean Section and Early Childhood Respiratory Symptoms and Disorders

PubMed Central

Magnus, Maria C.; Håberg, Siri E.; Stigum, Hein; Nafstad, Per; London, Stephanie J.; Vangen, Siri; Nystad, Wenche

2011-01-01

Studies have indicated that children delivered by cesarean section are at an increased risk of developing wheezing and asthma. This could be the result of an altered immune system development due to delayed gut colonization or of increased neonatal respiratory morbidity. The authors examined the associations between delivery by cesarean section and the development of wheezing, asthma, and recurrent lower respiratory tract infections in children up to 36 months of age among 37,171 children in the Norwegian Mother and Child Cohort Study. Generalized linear models were used in the multivariable analysis. Children delivered by cesarean section had an increased likelihood of current asthma at 36 months of age (relative risk = 1.17, 95% confidence interval: 1.03, 1.32), and the association was stronger among children of nonatopic mothers (relative risk = 1.33, 95% confidence interval: 1.12, 1.58). No increased risk of wheezing or recurrent lower respiratory tract infections was seen among children delivered by cesarean section. Findings were similar among children delivered by acute and elective cesarean section. In conclusion, children delivered by cesarean section may have an increased risk of current asthma at 36 months, but residual confounding cannot be excluded. In future prospective studies, investigators should reexamine this association in different age groups. PMID:22038100

High volume hydraulic fracturing operations: potential impacts on surface water and human health.

PubMed

Mrdjen, Igor; Lee, Jiyoung

2016-08-01

High volume, hydraulic fracturing (HVHF) processes, used to extract natural gas and oil from underground shale deposits, pose many potential hazards to the environment and human health. HVHF can negatively affect the environment by contaminating soil, water, and air matrices with potential pollutants. Due to the relatively novel nature of the process, hazards to surface waters and human health are not well known. The purpose of this article is to link the impacts of HVHF operations on surface water integrity, with human health consequences. Surface water contamination risks include: increased structural failure rates of unconventional wells, issues with wastewater treatment, and accidental discharge of contaminated fluids. Human health risks associated with exposure to surface water contaminated with HVHF chemicals include increased cancer risk and turbidity of water, leading to increased pathogen survival time. Future research should focus on modeling contamination spread throughout the environment, and minimizing occupational exposure to harmful chemicals.

Contraception for the older woman.

PubMed

Glasier, A; Gebbie, A

1996-04-01

Contraception presents particular problems for women over the age of 40. Although fertility is declining and the risk of pregnancy may be small, the consequences of an unplanned pregnancy may be socially devastating and medically ill-advised. Menstrual dysfunction and psychosexual difficulties increase with age and may exacerbate the side-effects of some methods of contraception. The long-term risks of combined hormonal contraception, particularly cardiovascular disease, become more pertinent to women whose natural risk of disease increases with age. Patterns of sexual activity and contraceptive use change with age. The advantages and disadvantages of currently available methods of contraception are difficult to quantify, and the choice of method is very much a matter for individual concern. The increasing prevalence of HRT may complicate matters for some women who are unsure for how long to continue using contraception. Contraceptives of the future may be designed to improve the reproductive health of all women, particularly those approaching the menopause.

Projection of future temperature-related mortality due to climate and demographic changes.

PubMed

Lee, Jae Young; Kim, Ho

2016-09-01

Understanding the effects of global climate change from both environmental and human health perspectives has gained great importance. Particularly, studies on the direct effect of temperature increase on future mortality have been conducted. However, few of those studies considered population changes, and although the world population is rapidly aging, no previous study considered the effect of society aging. Here we present a projection of future temperature-related mortality due to both climate and demographic changes in seven major cities of South Korea, a fast aging country, until 2100; we used the HadGEM3-RA model under four Representative Concentration Pathway (RCP) scenarios (RCP 2.6, 4.5, 6.0, and 8.5) and the United Nations world population prospects under three fertility scenarios (high, medium, and low). The results showed markedly increased mortality in the elderly group, significantly increasing the overall future mortality. In 2090s, South Korea could experience a four- to six-time increase in temperature-related mortality compared to that during 1992-2010 under four different RCP scenarios and three different fertility variants, while the mortality is estimated to increase only by 0.5 to 1.5 times assuming no population aging. Therefore, not considering population aging may significantly underestimate temperature risks. Copyright © 2016 Elsevier Ltd. All rights reserved.

TFOS DEWS II Epidemiology Report.

PubMed

Stapleton, Fiona; Alves, Monica; Bunya, Vatinee Y; Jalbert, Isabelle; Lekhanont, Kaevalin; Malet, Florence; Na, Kyung-Sun; Schaumberg, Debra; Uchino, Miki; Vehof, Jelle; Viso, Eloy; Vitale, Susan; Jones, Lyndon

2017-07-01

The subcommittee reviewed the prevalence, incidence, risk factors, natural history, morbidity and questionnaires reported in epidemiological studies of dry eye disease (DED). A meta-analysis of published prevalence data estimated the impact of age and sex. Global mapping of prevalence was undertaken. The prevalence of DED ranged from 5 to 50%. The prevalence of signs was higher and more variable than symptoms. There were limited prevalence studies in youth and in populations south of the equator. The meta-analysis confirmed that prevalence increases with age, however signs showed a greater increase per decade than symptoms. Women have a higher prevalence of DED than men, although differences become significant only with age. Risk factors were categorized as modifiable/non-modifiable, and as consistent, probable or inconclusive. Asian ethnicity was a mostly consistent risk factor. The economic burden and impact of DED on vision, quality of life, work productivity, psychological and physical impact of pain, are considerable, particularly costs due to reduced work productivity. Questionnaires used to evaluate DED vary in their utility. Future research should establish the prevalence of disease of varying severity, the incidence in different populations and potential risk factors such as youth and digital device usage. Geospatial mapping might elucidate the impact of climate, environment and socioeconomic factors. Given the limited study of the natural history of treated and untreated DED, this remains an important area for future research. Copyright © 2017 Elsevier Inc. All rights reserved.

Pregnancy loss history at first parity and selected adverse pregnancy outcomes.

PubMed

Ahrens, Katherine A; Rossen, Lauren M; Branum, Amy M

2016-07-01

To evaluate the association between pregnancy loss history and adverse pregnancy outcomes. Pregnancy history was captured during a computer-assisted personal interview for 21,277 women surveyed in the National Survey of Family Growth (1995-2013). History of pregnancy loss (<20 weeks) at first parity was categorized in three ways: number of losses, maximum gestational age of loss(es), and recency of last pregnancy loss. We estimated risk ratios for a composite measure of selected adverse pregnancy outcomes (preterm, stillbirth, or low birthweight) at first parity and in any future pregnancy, separately, using predicted margins from adjusted logistic regression models. At first parity, compared with having no loss, having 3+ previous pregnancy losses (adjusted risk ratio (aRR) = 1.66 [95% CI = 1.13, 2.43]), a maximum gestational age of loss(es) at ≥10 weeks (aRR = 1.28 [1.04, 1.56]) or having experienced a loss 24+ months ago (aRR = 1.36 [1.10, 1.68]) were associated with increased risks of adverse pregnancy outcomes. For future pregnancies, only having a history of 3+ previous pregnancy losses at first parity was associated with increased risks (aRR = 1.97 [1.08, 3.60]). Number, gestational age, and recency of pregnancy loss at first parity were associated with adverse pregnancy outcomes in U.S. women. Published by Elsevier Inc.

A Distal Forearm Fracture in Childhood Is Associated With an Increased Risk for Future Fragility Fractures in Adult Men, but Not Women

PubMed Central

Amin, Shreyasee; Melton, L Joseph; Achenbach, Sara J; Atkinson, Elizabeth J; Dekutoski, Mark B; Kirmani, Salman; Fischer, Philip R; Khosla, Sundeep

2014-01-01

Distal forearm fractures are among the most common fractures during childhood, but it remains unclear whether they predict an increased fracture risk later in life. We studied a population-based cohort of 1776 children ≤18 years of age, from Olmsted County, MN, USA, who had a distal forearm fracture in 1935–1992. Incident fractures occurring at age ≥35 years were identified through review of complete medical records using the linkage system of the Rochester Epidemiology Project. Observed nonpathologic fractures resulting from no more than moderate trauma (fragility fractures) were compared with expected numbers estimated from fracture site–specific incidence rates, based on age, sex, and calendar year, for Olmsted County (standardized incidence ratios [SIR]). In 1086 boys (mean ± SD age; 11 ± 4 years) and 690 girls (10 ± 4 years) followed for 27,292 person-years after the age of 35 years, subsequent fragility fractures were observed in 144 (13%) men and 74 (11%) women. There was an increased risk for future fragility fractures in boys who had a distal forearm fracture (SIR, 1.9; 95% CI, 1.6–2.3) but not girls (SIR, 1.0; 95% CI, 0.8–1.2). Fragility fractures at both major osteoporotic (hip, spine, wrist, and shoulder) sites (SIR, 2.6; 95% CI, 2.1–3.3) and remaining sites (SIR, 1.7; 95% CI, 1.3–2.0) were increased in men, irrespective of age at distal forearm fracture as boys. A distal forearm fracture in boys, but not girls, is associated with an increased risk for fragility fractures as older adults. It is necessary to determine whether the increased fractures observed in men is due to persistent deficits of bone strength, continued high fracture risk activity, or both. Until then, men should be asked about a childhood distal forearm fracture and, if so, warrant further screening and counseling on measures to optimize bone health and prevent fractures. PMID:23456800

Assessing the impact of climate change on vector-borne viruses in the EU through the elicitation of expert opinion.

PubMed

Gale, P; Brouwer, A; Ramnial, V; Kelly, L; Kosmider, R; Fooks, A R; Snary, E L

2010-02-01

Expert opinion was elicited to undertake a qualitative risk assessment to estimate the current and future risks to the European Union (EU) from five vector-borne viruses listed by the World Organization for Animal Health. It was predicted that climate change will increase the risk of incursions of African horse sickness virus (AHSV), Crimean-Congo haemorrhagic fever virus (CCHFV) and Rift Valley fever virus (RVFV) into the EU from other parts of the world, with African swine fever virus (ASFV) and West Nile virus (WNV) being less affected. Currently the predicted risks of incursion were lowest for RVFV and highest for ASFV. Risks of incursion were considered for six routes of entry (namely vectors, livestock, meat products, wildlife, pets and people). Climate change was predicted to increase the risk of incursion from entry of vectors for all five viruses to some degree, the strongest effects being predicted for AHSV, CCHFV and WNV. This work will facilitate identification of appropriate risk management options in relation to adaptations to climate change.

Sexual Behaviors of US Women at Risk of HIV Acquisition: A Longitudinal Analysis of Findings from HPTN 064.

PubMed

Justman, J; Befus, M; Hughes, J; Wang, J; Golin, C E; Adimora, A A; Kuo, I; Haley, D F; Del Rio, C; El-Sadr, W M; Rompalo, A; Mannheimer, S; Soto-Torres, L; Hodder, S

2015-07-01

We describe the sexual behaviors of women at elevated risk of HIV acquisition who reside in areas of high HIV prevalence and poverty in the US. Participants in HPTN 064, a prospective HIV incidence study, provided information about individual sexual behaviors and male sexual partners in the past 6 months at baseline, 6- and 12-months. Independent predictors of consistent or increased temporal patterns for three high-risk sexual behaviors were assessed separately: exchange sex, unprotected anal intercourse (UAI) and concurrent partnerships. The baseline prevalence of each behavior was >30 % among the 2,099 participants, 88 % reported partner(s) with >1 HIV risk characteristic and both individual and partner risk characteristics decreased over time. Less than high school education and food insecurity predicted consistent/increased engagement in exchange sex and UAI, and partner's concurrency predicted participant concurrency. Our results demonstrate how interpersonal and social factors may influence sustained high-risk behavior by individuals and suggest that further study of the economic issues related to HIV risk could inform future prevention interventions.

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

Siegel, S.

An increased level of mathematical sophistication will be needed in the future to be able to handle the spectrum of information as it comes from a broad array of biological systems and other sources. Classification will be an increasingly complex and difficult issue. Several projects that are discussed are being developed by the US Department of Health and Human Services (DHHS), including a directory of risk assessment projects and a directory of exposure information resources.

Disease Risk in a Dynamic Environment: The Spread of Tick-Borne Pathogens in Minnesota, USA

PubMed Central

Robinson, Stacie J.; Neitzel, David F.; Moen, Ronald A.; Craft, Meggan E.; Hamilton, Karin E.; Johnson, Lucinda B.; Mulla, David J.; Munderloh, Ulrike G.; Redig, Patrick T.; Smith, Kirk E.; Turner, Clarence L.; Umber, Jamie K.; Pelican, Katharine M.

2015-01-01

As humans and climate change alter the landscape, novel disease risk scenarios emerge. Understanding the complexities of pathogen emergence and subsequent spread as shaped by landscape heterogeneity is crucial to understanding disease emergence, pinpointing high-risk areas, and mitigating emerging disease threats in a dynamic environment. Tick-borne diseases present an important public health concern and incidence of many of these diseases are increasing in the United States. The complex epidemiology of tick-borne diseases includes strong ties with environmental factors that influence host availability, vector abundance, and pathogen transmission. Here, we used 16 years of case data from the Minnesota Department of Health to report spatial and temporal trends in Lyme disease (LD), human anaplasmosis, and babesiosis. We then used a spatial regression framework to evaluate the impact of landscape and climate factors on the spread of LD. Finally, we use the fitted model, and landscape and climate datasets projected under varying climate change scenarios, to predict future changes in tick-borne pathogen risk. Both forested habitat and temperature were important drivers of LD spread in Minnesota. Dramatic changes in future temperature regimes and forest communities predict rising risk of tick-borne disease. PMID:25281302

Systems engineering approach to environmental risk management: A case study of depleted uranium at test area C-64, Eglin Air Force Base, Florida. Master`s thesis

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

Carter, C.M.; Fortmann, K.M.; Hill, S.W.

1994-12-01

Environmental restoration is an area of concern in an environmentally conscious world. Much effort is required to clean up the environment and promote environmentally sound methods for managing current land use. In light of the public consciousness with the latter topic, the United States Air Force must also take an active role in addressing these environmental issues with respect to current and future USAF base land use. This thesis uses the systems engineering technique to assess human health risks and to evaluate risk management options with respect to depleted uranium contamination in the sampled region of Test Area (TA) C-64more » at Eglin Air Force Base (AFB). The research combines the disciplines of environmental data collection, DU soil concentration distribution modeling, ground water modeling, particle resuspension modeling, exposure assessment, health hazard assessment, and uncertainty analysis to characterize the test area. These disciplines are required to quantify current and future health risks, as well as to recommend cost effective ways to increase confidence in health risk assessment and remediation options.« less

Disease risk in a dynamic environment: the spread of tick-borne pathogens in Minnesota, USA.

PubMed

Robinson, Stacie J; Neitzel, David F; Moen, Ronald A; Craft, Meggan E; Hamilton, Karin E; Johnson, Lucinda B; Mulla, David J; Munderloh, Ulrike G; Redig, Patrick T; Smith, Kirk E; Turner, Clarence L; Umber, Jamie K; Pelican, Katharine M

2015-03-01

As humans and climate change alter the landscape, novel disease risk scenarios emerge. Understanding the complexities of pathogen emergence and subsequent spread as shaped by landscape heterogeneity is crucial to understanding disease emergence, pinpointing high-risk areas, and mitigating emerging disease threats in a dynamic environment. Tick-borne diseases present an important public health concern and incidence of many of these diseases are increasing in the United States. The complex epidemiology of tick-borne diseases includes strong ties with environmental factors that influence host availability, vector abundance, and pathogen transmission. Here, we used 16 years of case data from the Minnesota Department of Health to report spatial and temporal trends in Lyme disease (LD), human anaplasmosis, and babesiosis. We then used a spatial regression framework to evaluate the impact of landscape and climate factors on the spread of LD. Finally, we use the fitted model, and landscape and climate datasets projected under varying climate change scenarios, to predict future changes in tick-borne pathogen risk. Both forested habitat and temperature were important drivers of LD spread in Minnesota. Dramatic changes in future temperature regimes and forest communities predict rising risk of tick-borne disease.

Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives.

PubMed

Bartels, Christie M; Roberts, Tonya J; Hansen, Karen E; Jacobs, Elizabeth A; Gilmore, Andrea; Maxcy, Courtney; Bowers, Barbara J

2016-04-01

Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP visits could improve CVD risk management, and all participants viewed comanagement positively. Findings from this study illustrate important gaps and opportunities to support identifying and acting on CVD risk factors in RA patients from the provider, system, visit, and patient levels. Future work should investigate professional role support through improved guidelines, patient activation, and system-based RA-CVD preventive care strategies. © 2016, American College of Rheumatology.

Treatment options for hypertriglyceridemia: from risk reduction to pancreatitis

PubMed Central

Berglund, Lars; Brunzell, John D.; Goldberg, Anne C.; Goldberg, Ira J.; Stalenhoef, Anton

2013-01-01

While there has been considerable focus on the role and treatment of LDL cholesterol levels, a definitive role of triglycerides in the management of cardiovascular disease has been uncertain. Notably, with increasing triglyceride levels, there is a parallel increase in cholesterol levels carried by triglyceride-rich lipoproteins, which has prompted interest in the use of non-HDL cholesterol levels as a tool guiding interventions. Recent studies have provided evidence for an independent role of triglyceride levels as a cardiovascular risk factor, and recently, an Endocrine Society guideline was published for treatment of hypertriglyceridemia. In contrast to the relative uncertainty regarding triglycerides and cardiovascular disease, a role of very high triglyceride levels as a risk factor for pancreatitis has been well known. The present paper summarizes the underlying evidence for a risk role for triglyceride levels in cardiovascular disease and pancreatitis, current treatment recommendations and areas of future research. PMID:24840268

Risk assessment of integrated electronic health records.

PubMed

Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

2010-01-01

The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

Impacts of variability in cellulosic biomass yields on energy security.

PubMed

Mullins, Kimberley A; Matthews, H Scott; Griffin, W Michael; Anex, Robert

2014-07-01

The practice of modeling biomass yields on the basis of deterministic point values aggregated over space and time obscures important risks associated with large-scale biofuel use, particularly risks related to drought-induced yield reductions that may become increasingly frequent under a changing climate. Using switchgrass as a case study, this work quantifies the variability in expected yields over time and space through switchgrass growth modeling under historical and simulated future weather. The predicted switchgrass yields across the United States range from about 12 to 19 Mg/ha, and the 80% confidence intervals range from 20 to 60% of the mean. Average yields are predicted to decrease with increased temperatures and weather variability induced by climate change. Feedstock yield variability needs to be a central part of modeling to ensure that policy makers acknowledge risks to energy supplies and develop strategies or contingency plans that mitigate those risks.