POLLUTION FROM THE COMBINED ACTIVITIES, ACTIONS ...

EPA Pesticide Factsheets

ORD's four-fold objectives in its efforts have been to: (i) Identify potential (future) environmental concerns (anticipatory research and identification of emerging issues, especially to identify pivotal sources of uncertainty that might affect risk estimates), (ii) Be proactive versus reactive (allowing for pollution prevention versus remediation/restoration; identify and foster investigation of

Measuring transplant center performance: The goals are not controversial but the methods and consequences can be.

PubMed

Jay, Colleen; Schold, Jesse D

2017-03-01

Risks of regulatory scrutiny has generated widespread concern about increasingly risk averse transplant center behaviors regarding both donor and candidate acceptance patterns. To address potential unintended consequences threatening access to care, we discuss recent changes in regulatory metrics and potential improvements in quality oversight of transplant centers. Despite many recent changes to one-year patient and graft survival regulatory criteria, the capacity to accurately identify true underperforming centers and avoiding false positive flagging remains an area of great concern. Numerous studies have demonstrated restrictions in transplant volume and access following transplant center flagging. Current regulatory criteria are limited in their capacity to accurately identify poorly performing centers and potentially encourage risk-averse behavior by transplant centers. Efforts to address these concerns should focus on (1) improving risk-adjustment models with better data which captures the acuity of candidate and donor risk, (2) reconsidering primary outcomes measured to assess comprehensive transplant center performance, (3) improving education to address rational or perceived disincentives, and (4) using data more effectively to share best practices.

Fate and Transport of Select Hydraulic Fracturing Compounds of Potential Concern

EPA Pesticide Factsheets

Use of proprietary mixtures of reagents in fracing fluids injected in deep zones, has led to controversy over potential contamination of drinking water aquifers. This presentation focuses on the different classes of compounds identified in fracing fluids.

Assessing public concern for landscape quality: a potential model to identify visual thresholds

Treesearch

Arthur W. Magill

1990-01-01

Considerable public criticism and sometimes legal obstructions have been directed toward landscape management in relation to the extraction of natural resources. Many managers do not understand public concerns for visually attractive resources. Managers need to know when landscape alterations, like clearcuts, attract public attention and become visually objectionable....

Fate and Effects of Leachate Contamination on Alaska's Tribal Drinking Water Sources

EPA Science Inventory

EPA and Alaskan tribal communities identified and selected five representative Alaskan tribal landfills/dump sites and performed water quality sampling and analysis to identify chemical and microbial contaminants of concern (COCs) that could potentially impact the local drinking ...

POLLUTION FROM THE COMBINED ACTIVITIES, ACTIONS, AND BEHAVIORS OF THE PUBLIC: PHARMACEUTICALS AND PERSONAL CARE PRODUCTS

EPA Science Inventory

ORD's four-fold objectives in its efforts have been to: (i) Identify potential (future) environmental concerns (anticipatory research and identification of emerging issues, especially to identify pivotal sources of uncertainty that might affect risk estimates), (ii) Be proactive ...

Emerging data on the incidence of concussion in football practice at all levels of amateur play.

PubMed

Guthrie, Robert M

2015-11-01

There has been increasing concern, particularly in the US, about potential long-term neurological deterioration syndromes seen in the US football players. Recurrent concussions are a potential area of concern. The authors of this paper have used data bases from three levels of amateur US football to identify the rate and risk of concussion injury in both football games and practice at the youth, high school, and college levels. This information is very important initial data around concussion rates at these levels.

Challenges created by data dissemination and access restrictions when attempting to address community concerns: individual privacy versus public wellbeing.

PubMed

Colquhoun, Amy; Aplin, Laura; Geary, Janis; Goodman, Karen J; Hatcher, Juanita

2012-05-08

Population health data are vital for the identification of public health problems and the development of public health strategies. Challenges arise when attempts are made to disseminate or access anonymised data that are deemed to be potentially identifiable. In these situations, there is debate about whether the protection of an individual's privacy outweighs potentially beneficial public health initiatives developed using potentially identifiable information. While these issues have an impact at planning and policy levels, they pose a particular dilemma when attempting to examine and address community concerns about a specific health problem. Research currently underway in northern Canadian communities on the frequency of Helicobacter pylori infection and associated diseases, such as stomach cancer, is used in this article to illustrate the challenges that data controls create on the ability of researchers and health officials to address community concerns. Barriers are faced by public health professionals and researchers when endeavouring to address community concerns; specifically, provincial cancer surveillance departments and community-driven participatory research groups face challenges related to data release or access that inhibit their ability to effectively address community enquiries. The resulting consequences include a limited ability to address misinformation or to alleviate concerns when dealing with health problems in small communities. The development of communication tools and building of trusting relationships are essential components of a successful investigation into community health concerns. It may also be important to consider that public wellbeing may outweigh the value of individual privacy in these situations. As such, a re-evaluation of data disclosure policies that are applicable in these circumstances should be considered.

78 FR 77466 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... regular yearly basis. Entities that are affected by the Civil Rights Information Request Form are: health... working with health care providers because potential civil rights concerns can be identified prior to... identifier HHS-OS-21138-60D for reference. Information Collection Request Title: The Civil Rights Information...

43 CFR 11.32 - How does the authorized official develop the Assessment Plan?

Code of Federal Regulations, 2012 CFR

2012-10-01

... briefly describe, to the extent known, the site, vessel, or facility involved, the discharge of oil or... Assessment Plan available for review by any identified potentially responsible parties, other natural... until after this review period. (2) Any comments concerning the Assessment Plan received from identified...

43 CFR 11.32 - How does the authorized official develop the Assessment Plan?

Code of Federal Regulations, 2013 CFR

2013-10-01

... briefly describe, to the extent known, the site, vessel, or facility involved, the discharge of oil or... Assessment Plan available for review by any identified potentially responsible parties, other natural... until after this review period. (2) Any comments concerning the Assessment Plan received from identified...

43 CFR 11.32 - How does the authorized official develop the Assessment Plan?

Code of Federal Regulations, 2014 CFR

2014-10-01

... briefly describe, to the extent known, the site, vessel, or facility involved, the discharge of oil or... Assessment Plan available for review by any identified potentially responsible parties, other natural... until after this review period. (2) Any comments concerning the Assessment Plan received from identified...

The Value of Family Welfare Conferencing within the Child Protection and Welfare System

ERIC Educational Resources Information Center

Devaney, Carmel; Byrne, Paul

2015-01-01

The Family Welfare Conference (FWC) is a model used within the child protection and welfare services to address concerns about the needs of children and their family's ability to respond to these needs. The FWC model operates in partnership with family members, who participate in identifying both the issues of concern and potential responses to…

Sex Differences in Pre-Diagnosis Concerns for Children Later Diagnosed with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Hiller, Rachel M.; Young, Robyn L.; Weber, Nathan

2016-01-01

In the absence of intellectual impairment, girls are diagnosed with autism spectrum disorder significantly less and later than boys. This study explored potential reasons for why autism spectrum disorder may be more difficult to identify in girls, based on carer concerns during the pre-diagnosis period. Carers of 92 boys and 60 girls diagnosed…

Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.

PubMed

Douw, Gooske; Schoonhoven, Lisette; Holwerda, Tineke; Huisman-de Waal, Getty; van Zanten, Arthur R H; van Achterberg, Theo; van der Hoeven, Johannes G

2015-05-20

Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the 'worry or concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses' worry or concern about a patient's condition. We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: 'nurses', 'worry/concern' and 'deterioration'. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014. The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs. The signs and symptoms we found in the literature reflect the nature of nurses' worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration.

Global surveillance for chemical incidents of international public health concern.

PubMed Central

Olowokure, B.; Pooransingh, S.; Tempowski, J.; Palmer, S.; Meredith, T.

2005-01-01

OBJECTIVE: In December 2001, an expert consultation convened by WHO identified strengthening national and global chemical incident preparedness and response as a priority. WHO is working towards this objective by developing a surveillance and response system for chemical incidents. This report describes the frequency, nature and geographical location of acute chemical incidents of potential international concern from August 2002 to December 2003. METHODS: Acute chemical incidents were actively identified through several informal (e.g. Internet-based resources) and formal (e.g. various networks of organizations) sources and assessed against criteria for public health emergencies of international concern using the then proposed revised International Health Regulations (IHR). WHO regional and country offices were contacted to obtain additional information regarding identified incidents. FINDINGS: Altogether, 35 chemical incidents from 26 countries met one or more of the IHR criteria. The WHO European Region accounted for 43% (15/35) of reports. The WHO Regions for Africa, Eastern Mediterranean and Western Pacific each accounted for 14% (5/35); South-East Asia and the Americas accounted for 9% (3/35) and 6% (2/35), respectively. Twenty-three (66%) events were identified within 24 hours of their occurrence. CONCLUSION: To our knowledge this is the first global surveillance system for chemical incidents of potential international concern. Limitations such as geographical and language bias associated with the current system are being addressed. Nevertheless, the system has shown that it can provide early detection of important events, as well as information on the magnitude and geographical distribution of such incidents. It can therefore contribute to improving global public health preparedness. PMID:16462985

Myocardial infarction in intensive care units: A systematic review of diagnosis and treatment

PubMed Central

Mount, Thomas; Atkinson, Dougal

2016-01-01

Introduction Patients in the intensive care unit are vulnerable to myocardial injury from a variety of causes, both ischaemic and non-ischaemic. It is challenging for ICU clinicians to apply the conventional guidance concerning diagnosis and treatment. We conducted this review to examine the evidence concerning diagnosis and treatment of myocardial infarction in the ICU. Methods A systematic review was performed to identify relevant studies. Results 19 studies concerning use of ECG, cardiac enzymes, echocardiography and angiography were identified. 4 studies considered treatment of myocardial infarction. Conclusions Regular 12 lead ECG or 12 lead ECG monitoring is more sensitive than 2 lead monitoring, regular measurement of cardiac enzymes is more sensitive than when provoked by symptoms. Coronary angiography rarely identifies treatable lesions, without regional wall motion abnormality on echocardiography. Evidence relating to treatment was limited. A potential strategy to diagnose myocardial infarctions in the ICU is proposed. PMID:28979516

Three critical questions for future research on lesbian relationships.

PubMed

Diamond, Lisa M

2017-01-02

In this article I discuss three questions that should be priorities for future research on lesbian love and relationships. The first question concerns the very definition of "lesbian relationship," given how many women may be engaged in same-sex relationships without identifying as lesbian. The second question concerns the potential influence of childhood neglect and abuse on adult women's same-sex relationships, a topic that has important implications for both psychological well-being and relationship functioning. The third question concerns the potential downsides of legal marriage for women's same-sex relationships, a topic that is particularly important in light of the newfound legal recognition of same-sex marriage in all 50 states. Although there are many understudied questions in the domain of women's same-sex relationships, research on these three questions has particularly strong potential to advance our understanding of lesbian love and relationships in important ways.

Pharmaceutical issues during the review of European Marketing Authorisation Applications in Malta.

PubMed

Chetcuti, Michael; Serracino-Inglott, Anthony; Flores, Gavril; Borg, John J

2018-07-01

The aim of this study was to identify pharmaceutical issues encountered during regulatory review in European Procedures. A database of issues from Day 70 assessment reports of 150 EU procedures was compiled; most procedures were for generics (108). Frequencies of common deficiencies have been calculated and summarised for use of all stakeholders. Out of the 150 procedures reviewed, covering 309 products, a total of 4796 concerns were identified. Of these concerns, 167 were Potential Serious Risks to Public Health, 67 were raised on drug substance and 100 on the drug product. The distribution of total concerns was as follows: 2168 concerns on drug substance and 2584 on drug product. Most concerns raised were on control of drug substance and drug product (834 & 626 for 3.2.S.4 and 3.2.P.5, respectively), followed by concerns on the manufacturing (482 & 564 for 3.2.S.2 and 3.2.P.3, respectively) and stability 147 & 398 for 3.2.S.7 and 3.2.P.8, respectively). In conclusion, the frequencies and trends of identified deficiencies together with their impact were discussed from a regulatory point of view. The main findings indicate that applicants would benefit from following published guidelines so that delays in the registration of medicines could be avoided.

Compassion and Vigilance: Investigators' Strategies To Manage Ethical Concerns in Palliative and End-of-Life Research

PubMed Central

Cartwright, Juliana C.; Nelson, Christine A.; Knafl, Kathleen

2012-01-01

Abstract Background Ethical concerns were identified as a potential barrier to advancing palliative and end-of-life science at the 2004 National Institutes of Health State of the Science Meeting. However, data are lacking about the nature of ethical concerns and strategies for balancing the need to advance science with human subjects protections. Methods A qualitative case-study design was used to follow 43 end-of-life studies from proposal development through the review process and implementation. Investigators participated in semi-structured telephone interviews and provided document data regarding their experiences with grant and IRB reviews. Using constant comparative analysis within and across cases, the investigators identified commonly encountered and unique concerns and strategies for managing these concerns. Findings Investigator strategies fell into two broad categories: 1) Recruitment and consent strategies related to subject identification and enrollment; and 2) Protocol-related strategies related to the process of data collection. These strategies shared the overarching meta-themes of compassion, as evidenced by a heightened sensitivity to the needs of the population, coupled with vigilance, as evidenced by close attention to the possible effects of study participation on the participants' well-being, clinical care, and the needs of research staff. Conclusions Ethical concerns have led to the development of compassionate and vigilant strategies designed to balance the potential for risk of harm with the need to advance the science of palliative and end-of-life care. These strategies can be used by investigators to address ethical concerns and minimize barriers to the development of palliative and end-of-life care science. PMID:22731516

Compassion and vigilance: investigators' strategies to manage ethical concerns in palliative and end-of-life research.

PubMed

Hickman, Susan E; Cartwright, Juliana C; Nelson, Christine A; Knafl, Kathleen

2012-08-01

Ethical concerns were identified as a potential barrier to advancing palliative and end-of-life science at the 2004 National Institutes of Health State of the Science Meeting. However, data are lacking about the nature of ethical concerns and strategies for balancing the need to advance science with human subjects protections. A qualitative case-study design was used to follow 43 end-of-life studies from proposal development through the review process and implementation. Investigators participated in semi-structured telephone interviews and provided document data regarding their experiences with grant and IRB reviews. Using constant comparative analysis within and across cases, the investigators identified commonly encountered and unique concerns and strategies for managing these concerns. Investigator strategies fell into two broad categories: 1) Recruitment and consent strategies related to subject identification and enrollment; and 2) Protocol-related strategies related to the process of data collection. These strategies shared the overarching meta-themes of compassion, as evidenced by a heightened sensitivity to the needs of the population, coupled with vigilance, as evidenced by close attention to the possible effects of study participation on the participants' well-being, clinical care, and the needs of research staff. Ethical concerns have led to the development of compassionate and vigilant strategies designed to balance the potential for risk of harm with the need to advance the science of palliative and end-of-life care. These strategies can be used by investigators to address ethical concerns and minimize barriers to the development of palliative and end-of-life care science.

Research Suggestions in the Design of a Global Graduate Business Program Delivered by Online Learning

ERIC Educational Resources Information Center

Puderbaugh, Amy

2015-01-01

The purpose of this paper was to examine the unique areas of concern when establishing an eLearning program in the field of global business. A survey of eLearning and a global management subject matter appears. This paper identifies potential challenges in program design and raises practical concerns for future research. [For the full proceedings,…

Perspectives of Foster Parents and Social Workers on Foster Placement Disruption

ERIC Educational Resources Information Center

Taylor, Brian J.; McQuillan, Karen

2014-01-01

The potential human and financial costs of foster placement disruption for the children, families, professionals and agencies involved are widely accepted. This service evaluation identified and described perspectives of foster parents and social workers regarding placement disruptions in order to identify the main issues of concern and to derive…

Contrasting the ethical perspectives of biospecimen research among individuals with familial risk for hereditary cancer and biomedical researchers: implications for researcher training.

PubMed

Quinn, Gwendolyn P; Koskan, Alexis; Sehovic, Ivana; Pal, Tuya; Meade, Cathy; Gwede, Clement K

2014-07-01

While ethical concerns about participating in biospecimen research have been previously identified, few studies have reported the concerns among individuals with familial risk for hereditary cancer (IFRs). At the same time, biomedical researchers often lack training in discussing such concerns to potential donors. This study explores IFRs' and biomedical researchers' perceptions of ethical concerns about participating in biobanking research. In separate focus groups, IFRs and biomedical researchers participated in 90-min telephone focus groups. Focus group questions centered on knowledge about laws that protect the confidentiality of biospecimen donors, understanding of informed consent and study procedures, and preferences for being recontacted about potential incidental discovery and also study results. A total of 40 IFRs and 32 biomedical researchers participated in the focus groups. Results demonstrated discrepancies between the perceptions of IFRs and researchers. IFRs' concerns centered on health information protection; potential discrimination by insurers and employers; and preferences for being recontacted upon discovery of gene mutations or to communicate study results. Researchers perceived that participants understood laws protecting donors' privacy and (detailed study information outlined in the informed consent process), study outcomes were used to create a training tool kit to increase researchers' understanding of IFRs' concerns about biobanking.

Contrasting the Ethical Perspectives of Biospecimen Research Among Individuals with Familial Risk for Hereditary Cancer and Biomedical Researchers: Implications for Researcher Training

PubMed Central

Koskan, Alexis; Sehovic, Ivana; Pal, Tuya; Meade, Cathy; Gwede, Clement K.

2014-01-01

While ethical concerns about participating in biospecimen research have been previously identified, few studies have reported the concerns among individuals with familial risk for hereditary cancer (IFRs). At the same time, biomedical researchers often lack training in discussing such concerns to potential donors. This study explores IFRs' and biomedical researchers' perceptions of ethical concerns about participating in biobanking research. In separate focus groups, IFRs and biomedical researchers participated in 90-min telephone focus groups. Focus group questions centered on knowledge about laws that protect the confidentiality of biospecimen donors, understanding of informed consent and study procedures, and preferences for being recontacted about potential incidental discovery and also study results. A total of 40 IFRs and 32 biomedical researchers participated in the focus groups. Results demonstrated discrepancies between the perceptions of IFRs and researchers. IFRs' concerns centered on health information protection; potential discrimination by insurers and employers; and preferences for being recontacted upon discovery of gene mutations or to communicate study results. Researchers perceived that participants understood laws protecting donors' privacy and (detailed study information outlined in the informed consent process), study outcomes were used to create a training tool kit to increase researchers' understanding of IFRs' concerns about biobanking. PMID:24786355

Key issues concerning environmental enrichment for laboratory-held fish species.

PubMed

Williams, T D; Readman, G D; Owen, S F

2009-04-01

An improved knowledge and understanding of the fundamental biological requirements is needed for many of the species of fish held in captivity and, without this knowledge it is difficult to determine the optimal conditions for laboratory culture. The aim of this paper is to review the key issues concerning environmental enrichment for laboratory-held fish species and identify where improvements are required. It provides background information on environmental enrichment, describes enrichment techniques currently used in aquatic ecotoxicology studies, identifies potential restrictions in their use and discusses why more detailed and species-specific guidance is needed.

Cooperative Development of the Digital Library: Identifying and Working with Potential Partners.

ERIC Educational Resources Information Center

Poland, Jean

In a university environment, the library can benefit from interest in the digital future on the part of other concerned groups. Computer science departments are natural partners in the development of digital libraries. Professional societies, for-profit companies, and foundations are also potential sources of support. Cornell University Library…

Postcessation weight gain concern as a barrier to smoking cessation: Assessment considerations and future directions.

PubMed

Germeroth, Lisa J; Levine, Michele D

2018-01-01

Concern about postcessation weight gain may be one potential barrier to quitting smoking. In this 'mini-review' of recent literature, we summarize findings on the relationship between postcessation weight gain concern and smoking cessation, and evaluate varied use of postcessation weight gain concern assessments and potential moderators of the postcessation weight gain concern-cessation association. We conducted a search using the terms "smoking" OR "smoking cessation" AND "weight concern" for articles published between January 1, 2011 and December 31, 2016. We identified 17 studies assessing postcessation weight gain concern, seven of which evaluated the postcessation weight gain concern-cessation association. The relationship between postcessation weight gain concern and smoking cessation was mixed. Recent studies varied in their assessments of postcessation weight gain concern, many of which were not validated and assessed correlates of this construct. Studies varied in their adjustment of demographic (e.g., sex), smoking-specific (e.g., smoking level), and weight-specific (e.g., body mass index) variables. The use of non-validated assessments and variability in testing covariates/moderators may contribute to conflicting results regarding the postcessation weight gain concern-cessation relationship. We recommend validating an assessment of postcessation weight gain concern, maintaining vigilance in testing and reporting covariates/moderators, and investigating trajectories of this construct over time and by smoking status to inform future assessment and intervention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preferences and concerns of potential users in the selection of solar thermal systems for industrial and small utility applications

NASA Astrophysics Data System (ADS)

Gresham, J. B.; Kriz, T. A.

1981-03-01

To achieve widespread application in the industrial and utility sectors, solar systems must be economically competitive. Economic viability is, in turn, determined by a number of supporting criteria, ranging from system reliability to dispatch characteristics to how the system supports the main product line. In addition, solar systems possess some inherent attributes that may render some of the traditional supporting criteria inappropriate or require their redefinition. Those criteria and their relation to the solar investments are discussed in three steps. First, the main concerns and preferences of the potential users, as identified in recent SERI studies, are identified. Second, the equitability of the resulting decision criteria for solar investments are examined. Finally, the implications of these criteria for solar energy's penetration into these markets are discussed.

Effect of refining variables on the properties and composition of JP-5

NASA Technical Reports Server (NTRS)

Lieberman, M.; Taylor, W. F.

1980-01-01

Potential future problem areas that could arise from changes in the composition, properties, and potential availability of JP-5 produced in the near future are identified. Potential fuel problems concerning thermal stability, lubricity, low temperature flow, combustion, and the effect of the use of specific additives on fuel properties and performance are discussed. An assessment of available crudes and refinery capabilities is given.

Exploring the Potential Emotional and Behavioural Impact of Providing Personalised Genomic Risk Information to the Public: A Focus Group Study.

PubMed

Smit, Amelia K; Keogh, Louise A; Newson, Ainsley J; Hersch, Jolyn; Butow, Phyllis; Cust, Anne E

2015-01-01

To explore the potential emotional and behavioural impact of providing information on personalised genomic risk to the public, using melanoma as an example, to aid research translation. We conducted four focus groups in which 34 participants were presented with a hypothetical scenario of an individual's lifetime genomic risk of melanoma (using the term 'genetic risk'). We asked about understanding of genetic risk, who would choose to receive this risk information, potential emotional and behavioural impacts, and other concerns or potential benefits. Data were analysed thematically. Participants thought this risk information could potentially motivate preventive behaviours such as sun protection and related it to screening for other diseases including breast cancer. Factors identified as influencing the decision to receive genetic risk information included education level, children, age and gender. Participants identified potential negative impacts on the recipient such as anxiety and worry, and proposed that this could be mitigated by providing additional explanatory and prevention information, and contact details of a health professional for further discussion. Participants' concerns included workplace and insurance discrimination. Participants recognised the potential for both positive and negative emotional and behavioural impacts related to receiving information on the personalised genomic risk of melanoma. © 2015 S. Karger AG, Basel.

Providing general and preconception health care to low income women in family planning settings: perception of providers and clients.

PubMed

Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua

2012-02-01

This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

Interviews of living kidney donors to assess donation-related concerns and information-gathering practices.

PubMed

Ruck, Jessica M; Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Massie, Allan B; Segev, Dorry L

2018-06-08

Efforts are underway to improve living kidney donor (LKD) education, but current LKD concerns and information-gathering preferences have not been ascertained to inform evidence-based resource development. As a result, prior studies have found that donors desire information that is not included in current informed consent and/or educational materials. We conducted semi-structured interviews with 50 LKDs who donated at our center to assess (1) concerns about donation that they either had personally before or after donation or heard from family members or friends, (2) information that they had desired before donation, and (3) where they sought information about donation. We used thematic analysis of verbatim interview transcriptions to identify donation-related concerns. We compared the demographic characteristics of participants reporting specific concerns using Fisher's exact test. We identified 19 unique concerns that participants had or heard about living kidney donation. 20% of participants reported having had no pre-donation concerns; 38% reported no post-donation concerns. The most common concern pre-donation was future kidney failure (22%), post-donation was the recovery process (24%), and from family was endangering their family unit (16%). 44% of participants reported being less concerned than family. 26% of participants wished they had had additional information prior to donating, including practical advice for recovery (10%) and information about specific complications (14%). Caucasian participants were more likely to hear at least one concern from family (76% vs. 33%, p = 0.02). The most commonly consulted educational resources were health care providers (100%) and websites (79% of donors since 2000). 26% of participants had had contact with other donors; an additional 20% desired contact with other LKDs. Potential donors not only have personal donation-related concerns but frequently hear donation-related concerns from family members and friends. Current gaps in donor education include an absence of practical, peer-to-peer advice about donation from other prior donors and materials directed and potential donors' family members and friends. These findings can inform the development of new educational practices and resources targeted not only at LKDs but at their social networks.

76 FR 71595 - Outer Continental Shelf (OCS), Eastern Gulf of Mexico, Oil and Gas Lease Sales for Years 2012-2017

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

..., these comments should identify specific CMP policies of concern, the nature of the conflict foreseen... conditions or conflicts, or other information that might bear upon the potential leasing and development of this area. Comments are also sought on potential conflicts between future OCS oil and gas activities...

Mission Operations Working Group (MOWG) Report to the OMI Science Team

NASA Technical Reports Server (NTRS)

Fisher, Dominic M.

2017-01-01

This PowerPoint presentation will discuss Aura's current spacecraft and OMI insturment status, highlight any performance trends and impacts to OMI operations, identify any operational changes and express concerns or potential process improvements.

A Review of Radiolysis Concerns for Water Shielding in Fission Surface Power Applications

NASA Technical Reports Server (NTRS)

Schoenfeld, Michael P.

2008-01-01

This paper presents an overview of radiolysis concerns with regard to water shields for fission surface power. A review of the radiolysis process is presented and key parameters and trends are identified. From this understanding of the radiolytic decomposition of water, shield pressurization and corrosion are identified as the primary concerns. Existing experimental and modeling data addressing concerns are summarized. It was found that radiolysis of pure water in a closed volume results in minimal, if any net decomposition, and therefore reduces the potential for shield pressurization and corrosion. With the space program focus m emphasize more on permanent return to the Moon and eventually manned exploration of Mars, there has been a renewed look at fission power to meet the difficult technical & design challenges associated with this effort. This is due to the ability of fission power to provide a power rich environment that is insensitive to solar intensity and related aspects such as duration of night, dusty environments, and distance from the sun, etc. One critical aspect in the utilization of fission power for these applications of manned exploration is shielding. Although not typically considered for space applications, water shields have been identified as one potential option due to benefits in mass savings and reduced development cost and technical risk (Poston, 2006). However, the water shield option requires demonstration of its ability to meet key technical challenges including such things as adequate natural circulation for thermal management and capability for operational periods up to 8 years. Thermal management concerns have begun to be addressed and are not expected to be a problem (Pearson, 2007). One significant concern remaining is the ability to maintain the shield integrity through its operational lifetime. Shield integrity could be compromised through shield pressurization and corrosion resulting from the radiolytic decomposition of water.

Measuring and improving patient safety through health information technology: The Health IT Safety Framework

PubMed Central

Singh, Hardeep

2016-01-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings. PMID:26369894

A risk-based classification scheme for genetically modified foods. III: Evaluation using a panel of reference foods.

PubMed

Chao, Eunice; Krewski, Daniel

2008-12-01

This paper presents an exploratory evaluation of four functional components of a proposed risk-based classification scheme (RBCS) for crop-derived genetically modified (GM) foods in a concordance study. Two independent raters assigned concern levels to 20 reference GM foods using a rating form based on the proposed RBCS. The four components of evaluation were: (1) degree of concordance, (2) distribution across concern levels, (3) discriminating ability of the scheme, and (4) ease of use. At least one of the 20 reference foods was assigned to each of the possible concern levels, demonstrating the ability of the scheme to identify GM foods of different concern with respect to potential health risk. There was reasonably good concordance between the two raters for the three separate parts of the RBCS. The raters agreed that the criteria in the scheme were sufficiently clear in discriminating reference foods into different concern levels, and that with some experience, the scheme was reasonably easy to use. Specific issues and suggestions for improvements identified in the concordance study are discussed.

75 FR 59278 - Homeland Security Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... information among TSA and federal and local law enforcement agencies concerning transportation infrastructure... about the potential capabilities and vulnerabilities identified in a cyber exercise and discuss... Operational Improvements. Lessons Learned from the cyber exercise. Basis for Closure: In accordance with...

The influence of maternal self-objectification, materialism and parenting style on potentially sexualized 'grown up' behaviours and appearance concerns in 5-8year old girls.

PubMed

Slater, Amy; Tiggemann, Marika

2016-08-01

There is widespread concern about young girls displaying 'grown up' or sexualized behaviours, as well as experiencing body image and appearance concerns that were previously thought to only impact much older girls. The present study examined the influence of three maternal attributes, self-objectification, materialism and parenting style, on sexualized behaviours and appearance concerns in young girls. A sample of 252 Australian mothers of 5-8year old girls reported on the behaviours and appearance concerns observed in their daughters and also completed measures of their own self-objectification, materialism and parenting style. It was found that a significant proportion of young girls were engaging with 'teen' culture, using beauty products and expressing some degree of appearance concern. Maternal self-objectification was related to daughters' engagement in teen culture, use of beauty products and appearance concern. Maternal materialism was related to girls' engagement in teen culture and appearance concern, while an authoritative parenting style was negatively related to girls' use of beauty products. The findings suggest that maternal self-objectification and materialism play a role in the body image and appearance concerns of young girls, and in so doing, identify these maternal attributes as novel potential targets for intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Potential link between body dysmorphic disorder symptoms and alexithymia in an eating-disordered treatment-seeking sample.

PubMed

Fenwick, Andrea Siân; Sullivan, Karen Anne

2011-09-30

This study aimed to explore the manifestation of body dysmorphic disorder symptoms in a sample of people with eating disorders and to investigate possible associations between body dysmorphia and alexithymia. Forty patients currently seeking treatment for an eating disorder completed a battery of six measures assessing alexithymia, mood, eating behaviours, weight-related body image, body dysmorphia and non-weight related body image. Significant moderate positive correlations (Pearson's r) between selected variables were found, suggesting that participants with high levels of dysmorphic concern (imagined ugliness) have more difficulty with the affective elements of alexithymia, that is, identifying and describing feelings. When depression, eating attitudes, and weight-related body image concerns were controlled for, significant moderate positive correlations between this alexithymia factor and dysmorphic concerns remained present. An independent-samples t-test between eating-disordered participants with and without symptoms of body dysmorphic disorder (BDD) revealed significant group differences in difficulties identifying feelings. This pattern of results was replicated when the groups were identified on the basis of dysmorphic concerns, as opposed to BDD symptoms. This study highlights the associations between alexithymia and body dysmorphia that have not previously been demonstrated. Copyright © 2011 Elsevier Ltd. All rights reserved.

Frequency Analysis of Failure Scenarios from Shale Gas Development.

PubMed

Abualfaraj, Noura; Gurian, Patrick L; Olson, Mira S

2018-04-29

This study identified and prioritized potential failure scenarios for natural gas drilling operations through an elicitation of people who work in the industry. A list of twelve failure scenarios of concern was developed focusing on specific events that may occur during the shale gas extraction process involving an operational failure or a violation of regulations. Participants prioritized the twelve scenarios based on their potential impact on the health and welfare of the general public, potential impact on worker safety, how well safety guidelines protect against their occurrence, and how frequently they occur. Illegal dumping of flowback water, while rated as the least frequently occurring scenario, was considered the scenario least protected by safety controls and the one of most concern to the general public. In terms of worker safety, the highest concern came from improper or inadequate use of personal protective equipment (PPE). While safety guidelines appear to be highly protective regarding PPE usage, inadequate PPE is the most directly witnessed failure scenario. Spills of flowback water due to equipment failure are of concern both with regards to the welfare of the general public and worker safety as they occur more frequently than any other scenario examined in this study.

Frequency Analysis of Failure Scenarios from Shale Gas Development

PubMed Central

Abualfaraj, Noura; Olson, Mira S.

2018-01-01

This study identified and prioritized potential failure scenarios for natural gas drilling operations through an elicitation of people who work in the industry. A list of twelve failure scenarios of concern was developed focusing on specific events that may occur during the shale gas extraction process involving an operational failure or a violation of regulations. Participants prioritized the twelve scenarios based on their potential impact on the health and welfare of the general public, potential impact on worker safety, how well safety guidelines protect against their occurrence, and how frequently they occur. Illegal dumping of flowback water, while rated as the least frequently occurring scenario, was considered the scenario least protected by safety controls and the one of most concern to the general public. In terms of worker safety, the highest concern came from improper or inadequate use of personal protective equipment (PPE). While safety guidelines appear to be highly protective regarding PPE usage, inadequate PPE is the most directly witnessed failure scenario. Spills of flowback water due to equipment failure are of concern both with regards to the welfare of the general public and worker safety as they occur more frequently than any other scenario examined in this study. PMID:29710821

Screening and prioritisation of chemical risks from metal mining operations, identifying exposure media of concern.

PubMed

Pan, Jilang; Oates, Christopher J; Ihlenfeld, Christian; Plant, Jane A; Voulvoulis, Nikolaos

2010-04-01

Metals have been central to the development of human civilisation from the Bronze Age to modern times, although in the past, metal mining and smelting have been the cause of serious environmental pollution with the potential to harm human health. Despite problems from artisanal mining in some developing countries, modern mining to Western standards now uses the best available mining technology combined with environmental monitoring, mitigation and remediation measures to limit emissions to the environment. This paper develops risk screening and prioritisation methods previously used for contaminated land on military and civilian sites and engineering systems for the analysis and prioritisation of chemical risks from modern metal mining operations. It uses hierarchical holographic modelling and multi-criteria decision making to analyse and prioritise the risks from potentially hazardous inorganic chemical substances released by mining operations. A case study of an active platinum group metals mine in South Africa is used to demonstrate the potential of the method. This risk-based methodology for identifying, filtering and ranking mining-related environmental and human health risks can be used to identify exposure media of greatest concern to inform risk management. It also provides a practical decision-making tool for mine acquisition and helps to communicate risk to all members of mining operation teams.

Framework for Identifying Key Environmental Concerns in Marine Renewable Energy Projects- Appendices

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

Kramer, Sharon; Previsic, Mirko; Nelson, Peter

2010-06-17

Marine wave and tidal energy technology could interact with marine resources in ways that are not well understood. As wave and tidal energy conversion projects are planned, tested, and deployed, a wide range of stakeholders will be engaged; these include developers, state and federal regulatory agencies, environmental groups, tribal governments, recreational and commercial fishermen, and local communities. Identifying stakeholders’ environmental concerns in the early stages of the industry’s development will help developers address and minimize potential environmental effects. Identifying important concerns will also assist with streamlining siting and associated permitting processes, which are considered key hurdles by the industry inmore » the U.S. today. In September 2008, RE Vision consulting, LLC was selected by the Department of Energy (DoE) to conduct a scenario-based evaluation of emerging hydrokinetic technologies. The purpose of this evaluation is to identify and characterize environmental impacts that are likely to occur, demonstrate a process for analyzing these impacts, identify the “key” environmental concerns for each scenario, identify areas of uncertainty, and describe studies that could address that uncertainty. This process is intended to provide an objective and transparent tool to assist in decision-making for siting and selection of technology for wave and tidal energy development. RE Vision worked with H. T. Harvey & Associates, to develop a framework for identifying key environmental concerns with marine renewable technology. This report describes the results of this study. This framework was applied to varying wave and tidal power conversion technologies, scales, and locations. The following wave and tidal energy scenarios were considered: 4 wave energy generation technologies 3 tidal energy generation technologies 3 sites: Humboldt coast, California (wave); Makapu’u Point, Oahu, Hawaii (wave); and the Tacoma Narrows, Washington (tidal) 3 project sizes: pilot, small commercial, and large commercial The possible combinations total 24 wave technology scenarios and 9 tidal technology scenarios. We evaluated 3 of the 33 scenarios in detail: 1. A small commercial OPT Power Buoy project off the Humboldt County, California coast 2. A small commercial Pelamis Wave Power P-2 project off Makapu’u Point, Oahu, Hawaii 3. A pilot MCT SeaGen tidal project, sited in the Tacoma Narrows, Washington. This framework document used information available from permitting documents that were written to support actual wave or tidal energy projects, but the results obtained here should not be confused with those of the permitting documents1. The main difference between this framework document and permitting documents of currently proposed pilot projects is that this framework identifies key environmental concerns and describes the next steps in addressing those concerns; permitting documents must identify effects, find or declare thresholds of significance, evaluate the effects against the thresholds, and find mitigation measures that will minimize or avoid the effects so they can be considered less-than-significant. Two methodologies, 1) an environmental effects analysis and 2) Raptools, were developed and tested to identify potential environmental effects associated with wave or tidal energy conversion projects. For the environmental effects analysis, we developed a framework based on standard risk assessment techniques. The framework was applied to the three scenarios listed above. The environmental effects analysis addressed questions such as: What is the temporal and spatial exposure of a species at a site? What are the specific potential project effects on that species? What measures could minimize, mitigate, or eliminate negative effects? Are there potential effects of the project, or species’ response to the effect, that are highly uncertain and warrant additional study? The second methodology, Raptools, is a collaborative approach useful for evaluating multiple characteristics of numerous siting or technology alternatives, and it allows us to graphically compare alternatives. We used Raptools to answer these questions: How do the scenarios compare, in terms of exposure, risks, and effects to the ecological and human environments? Are there sites that seem to present the fewest effects regardless of technology and scale? Which attributes account for many or much of the effects associated with wave or tidal energy development?« less

Comparison of estrogen mixtures in vitro vs. in vivo

EPA Science Inventory

Numerous sources contribute to widespread contamination of drinking water sources with both natural and synthetic estrogens, which isa concern for potential ecological and human health effects. In vitro screening assays are valuable tools for identifying mechanisms of toxicity bu...

Health concerns and hazardous waste

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

Yassi, A.; Weeks, J.; Kraut, A.

1990-01-01

This report discusses health effects of hazardous waste and emphasizes human health concerns related to establishing a hazardous waste management facility. The study reviewed world epidemiological and public health literature to identify cases of suspected or substantiated claims of public health impacts associated with hazardous waste management facilities and potential products or emissions from such facilities, and placed them into perspective, including possible routes and consequences of exposure, risk assessment, and the toxicity of selected organic and inorganic compounds.

Ambivalence about supervised injection facilities among community stakeholders.

PubMed

Strike, Carol; Watson, Tara Marie; Kolla, Gillian; Penn, Rebecca; Bayoumi, Ahmed M

2015-08-21

Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities. We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes. Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.

Air toxics evaluation of ABB Combustion Engineering Low-Emission Boiler Systems

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

Wesnor, J.D.

1993-10-26

The specific goals of the program are to identify air toxic compounds that might be emmitted from the new boiler with its various Air Pollution Control device for APCD alternatives in levels of regulatory concern. For the compounds thought to be of concern, potential air toxic control methodologies will be suggested and a Test Protocol will be written to be used in the Proof of Concept and full scale tests. The following task was defined: Define Replations and Standards; Identify Air Toxic Pollutants of Interest to Interest to Utility Boilers; Assesment of Air Toxic By-Products; State of the Art Assessmentmore » of Toxic By-Product Control Technologies; and Test Protocol Definition.« less

Potential structural material problems in a hydrogen energy system

NASA Technical Reports Server (NTRS)

Gray, H. R.; Nelson, H. G.; Johnson, R. E.; Mcpherson, B.; Howard, F. S.; Swisher, J. H.

1975-01-01

Potential structural material problems that may be encountered in the three components of a hydrogen energy system - production, transmission/storage, and utilization - were identified. Hydrogen embrittlement, corrosion, oxidation, and erosion may occur during the production of hydrogen. Hydrogen embrittlement is of major concern during both transmission and utilization of hydrogen. Specific materials research and development programs necessary to support a hydrogen energy system are described.

Identifying Careless Responses in Survey Data

ERIC Educational Resources Information Center

Meade, Adam W.; Craig, S. Bartholomew

2012-01-01

When data are collected via anonymous Internet surveys, particularly under conditions of obligatory participation (such as with student samples), data quality can be a concern. However, little guidance exists in the published literature regarding techniques for detecting careless responses. Previously several potential approaches have been…

TECHNIQUES FOR ANALYZING COMPLEX MIXTURES OF DRINKING WATER DBPS

EPA Science Inventory

Although chlorine has been used to disinfect drinking water for approximately 100 years, there have been concerns raised over its use, due to the formation of potentially hazardous by-products. Trihalomethanes (THMs) were the first disinfection by-products (DBPs) identified and ...

SCRI acrylamide project update

USDA-ARS?s Scientific Manuscript database

The US potato industry, with $3.5 billion in raw product value, identified acrylamide as its number one research funding priority in 2010 because of potential health concerns related to the presence of acrylamide in potato products. Acrylamide is present in much carbohydrate rich foods processed at ...

Preparing for rectal microbicides: sociocultural factors affecting product uptake among potential South American users.

PubMed

Galea, Jerome T; Kinsler, Janni J; Imrie, John; Nureña, César R; Ruiz, Lucía; Galarza, Luis Fernando; Sánchez, Jorge; Cunningham, William E

2014-06-01

We examined views on rectal microbicides (RMs), a potential HIV prevention option, among men who have sex with men and transgender women in 3 South American cities. During September 2009 to September 2010, we conducted 10 focus groups and 36 in-depth interviews (n = 140) in Lima and Iquitos, Peru, and Guayaquil, Ecuador, to examine 5 RM domains: knowledge, thoughts and opinions about RM as an HIV prevention tool, use, condoms, and social concerns. We coded emergent themes in recorded and transcribed data sets and extracted representative quotes. We collected sociodemographic information with a self-administered questionnaire. RM issues identified included limited knowledge; concerns regarding plausibility, side effects, and efficacy; impact on condom use; target users (insertive vs receptive partners); and access concerns. Understanding the sociocultural issues affecting RMs is critical to their uptake and should be addressed prior to product launch.

Preparing for Rectal Microbicides: Sociocultural Factors Affecting Product Uptake Among Potential South American Users

PubMed Central

Kinsler, Janni J.; Imrie, John; Nureña, César R.; Ruiz, Lucía; Galarza, Luis Fernando; Sánchez, Jorge; Cunningham, William E.

2014-01-01

Objectives. We examined views on rectal microbicides (RMs), a potential HIV prevention option, among men who have sex with men and transgender women in 3 South American cities. Methods. During September 2009 to September 2010, we conducted 10 focus groups and 36 in-depth interviews (n = 140) in Lima and Iquitos, Peru, and Guayaquil, Ecuador, to examine 5 RM domains: knowledge, thoughts and opinions about RM as an HIV prevention tool, use, condoms, and social concerns. We coded emergent themes in recorded and transcribed data sets and extracted representative quotes. We collected sociodemographic information with a self-administered questionnaire. Results. RM issues identified included limited knowledge; concerns regarding plausibility, side effects, and efficacy; impact on condom use; target users (insertive vs receptive partners); and access concerns. Conclusions. Understanding the sociocultural issues affecting RMs is critical to their uptake and should be addressed prior to product launch. PMID:24825222

Substance use disorder genetic research: investigators and participants grapple with the ethical issues.

PubMed

Coors, Marilyn E; Raymond, Kristen M

2009-04-01

This qualitative research examined the ethical concerns regarding the psychosocial issues, research design and implementation, and application of psychiatric genetic research on substance use disorders (SUD) from multiple perspectives. A literature review of the bioethics literature related to psychiatric genetics and focus groups explored the ethical implications of SUD genetic research. Twenty-six National Institute on Drug Abuse funded principal investigators in the field of psychiatric genetic research, nine adolescent patients in residential SUD treatment, and 10 relatives of patients participated in focus groups (held separately). The focus groups were recorded, transcribed, and the content was analyzed. The themes that emerged from the literature and the focus group transcripts were organized by using NVIVO7, a software package designed to manage, analyze, and compare narrative data. Investigators and the literature expressed similar concerns regarding the ethical concerns associated with psychiatric genetic research including violation of privacy, misunderstanding about psychiatric genetics, stigmatization, commercialization, discrimination, eugenics, consequences of research on illegal behavior, unforeseen consequences, altered notion of individual responsibility, and others. Patients and their relatives showed little familiarity with the ethical issues as identified by professionals and little concern regarding most of the potential risks. The exception was apprehension associated with potential criminal justice uses of stored genetic information, in particular enforced therapy and stigmatization, which elicited some concern from all perspectives. The challenge for further research is to identify risks and benefits of SUD research that are germane in a behaviorally disinhibited population and devise effective tools to communicate information to participants through an improved informed consent process.

Substance Use Disorder Genetic Research: Investigators and Participants Grapple with the Ethical Issues

PubMed Central

Raymond, Kristen M.

2009-01-01

Objective This qualitative research examined the ethical concerns regarding the psychosocial issues, research design and implementation, and application of psychiatric genetic research on substance use disorders (SUD) from multiple perspectives. Method A literature review of the bioethics literature related to psychiatric genetics and focus groups explored the ethical implications of SUD genetic research. Twenty-six National Institute on Drug Abuse (NIDA) funded principal investigators in the field of psychiatric genetic research, 9 adolescent patients in residential SUD treatment, and 10 relatives of patients participated in focus groups (held separately). The focus groups were recorded, transcribed, and the content was analyzed. The themes that emerged from the literature and the focus group transcripts were organized using NVIVO7, a software package designed to manage, analyze and compare narrative data. Results Investigators and the literature expressed similar concerns regarding the ethical concerns associated with psychiatric genetic research including violation of privacy, misunderstanding about psychiatric genetics, stigmatization, commercialization, discrimination, eugenics, consequences of research on illegal behavior, unforeseen consequences, altered notion of individual responsibility, and others. Patients and their relatives demonstrated little familiarity with the ethical issues as identified by professionals and little concern regarding most of the potential risks. The exception was apprehension associated with potential criminal justice uses of stored genetic information and enforced therapy, which elicited some concern from all perspectives. Conclusions The challenge for further research is to identify risks and benefits of SUD research that are germane in a behaviorally disinhibited population and devise effective tools to communicate information to participants through an improved informed consent process. PMID:19668113

Identifying chemicals of concern in hydraulic fracturing fluids used for oil production.

PubMed

Stringfellow, William T; Camarillo, Mary Kay; Domen, Jeremy K; Sandelin, Whitney L; Varadharajan, Charuleka; Jordan, Preston D; Reagan, Matthew T; Cooley, Heather; Heberger, Matthew G; Birkholzer, Jens T

2017-01-01

Chemical additives used for hydraulic fracturing and matrix acidizing of oil reservoirs were reviewed and priority chemicals of concern needing further environmental risk assessment, treatment demonstration, or evaluation of occupational hazards were identified. We evaluated chemical additives used for well stimulation in California, the third largest oil producing state in the USA, by the mass and frequency of use, as well as toxicity. The most frequently used chemical additives in oil development were gelling agents, cross-linkers, breakers, clay control agents, iron and scale control agents, corrosion inhibitors, biocides, and various impurities and product stabilizers used as part of commercial mixtures. Hydrochloric and hydrofluoric acids, used for matrix acidizing and other purposes, were reported infrequently. A large number and mass of solvents and surface active agents were used, including quaternary ammonia compounds (QACs) and nonionic surfactants. Acute toxicity was evaluated and many chemicals with low hazard to mammals were identified as potentially hazardous to aquatic environments. Based on an analysis of quantities used, toxicity, and lack of adequate hazard evaluation, QACs, biocides, and corrosion inhibitors were identified as priority chemicals of concern that deserve further investigation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Advanced Test Reactor Safety Basis Upgrade Lessons Learned Relative to Design Basis Verification and Safety Basis Management

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

G. L. Sharp; R. T. McCracken

The Advanced Test Reactor (ATR) is a pressurized light-water reactor with a design thermal power of 250 MW. The principal function of the ATR is to provide a high neutron flux for testing reactor fuels and other materials. The reactor also provides other irradiation services such as radioisotope production. The ATR and its support facilities are located at the Test Reactor Area of the Idaho National Engineering and Environmental Laboratory (INEEL). An audit conducted by the Department of Energy's Office of Independent Oversight and Performance Assurance (DOE OA) raised concerns that design conditions at the ATR were not adequately analyzedmore » in the safety analysis and that legacy design basis management practices had the potential to further impact safe operation of the facility.1 The concerns identified by the audit team, and issues raised during additional reviews performed by ATR safety analysts, were evaluated through the unreviewed safety question process resulting in shutdown of the ATR for more than three months while these concerns were resolved. Past management of the ATR safety basis, relative to facility design basis management and change control, led to concerns that discrepancies in the safety basis may have developed. Although not required by DOE orders or regulations, not performing design basis verification in conjunction with development of the 10 CFR 830 Subpart B upgraded safety basis allowed these potential weaknesses to be carried forward. Configuration management and a clear definition of the existing facility design basis have a direct relation to developing and maintaining a high quality safety basis which properly identifies and mitigates all hazards and postulated accident conditions. These relations and the impact of past safety basis management practices have been reviewed in order to identify lessons learned from the safety basis upgrade process and appropriate actions to resolve possible concerns with respect to the current ATR safety basis. The need for a design basis reconstitution program for the ATR has been identified along with the use of sound configuration management principles in order to support safe and efficient facility operation.« less

Adaptation, postpartum concerns, and learning needs in the first two weeks after caesarean birth.

PubMed

Weiss, Marianne; Fawcett, Jacqueline; Aber, Cynthia

2009-11-01

The purpose of this Roy Adaptation Model-based study was to describe women's physical, emotional, functional and social adaptation; postpartum concerns; and learning needs during the first two weeks following caesarean birth and identify relevant nursing interventions. Studies of caesarean-delivered women indicated a trend toward normalisation of the caesarean birth experience. Escalating caesarean birth rates mandate continued study of contemporary caesarean-delivered women. Mixed methods (qualitative and quantitative) descriptive research design. Nursing students collected data from 233 culturally diverse caesarean-delivered women in urban areas of the Midwestern and Northeastern USA between 2002-2004. The focal stimulus was the planned or unplanned caesarean birth; contextual stimuli were cultural identity and parity. Adaptation was measured by open-ended interview questions, fixed choice questionnaires about postpartum concerns and learning needs and nurse assessment of post-discharge problems. Potential interventions were identified using the Omaha System Intervention Scheme. More positive than negative responses were reported for functional and social adaptation than for physical and emotional adaptation. Women with unplanned caesarean births and primiparous women reported less favourable adaptation than planned caesarean mothers and multiparas. Black women reported lower social adaptation, Hispanic women had more role function concerns and Black and Hispanic women had more learning needs than White women. Post-discharge nursing assessments revealed that actual problems accounted for 40% of identified actual or potential problems or needs. Health teaching was the most commonly recommended postpartum intervention strategy followed by case management, treatment and surveillance interventions. Caesarean-delivered women continue to experience some problems with adapting to childbirth. Recommended intervention strategies reflect the importance of health teaching following hospital discharge. Women who experience caesarean birth require comprehensive assessment during the early postpartum period. Nurses should devise strategies to continue care services for these women following hospital discharge.

Why has Not There been More Research of Concern?

PubMed

Rappert, Brian

2014-01-01

Amid the renewed concern in the last several years about the potential for life science research to facilitate the spread of disease, a central plank of the policy response has been to enact processes for assessing the risks and benefits of "research of concern." The recent controversy regarding a proposed redaction of work on the modification of a H5N1 avian influenza virus is perhaps the most prominent such instance. And yet, a noteworthy feature of this case is its exceptionalness. In the last 10 years, life science publishers, funders, and labs have rarely identified any research as "of concern," let alone proposed censors. This article takes this experience with risk assessment as an invitation for reflection. Reasons for the low number of instances of concern are related to how the biosecurity dimensions of the life sciences are identified, how they are described, how the assessments of benefits and risks are undertaken, how value considerations do and do not enter into assessments, as well as the lack of information on the outcomes of reviews. This argument builds on such considerations to examine the limitations and implications of the risk-benefit experiment of concern framing, the politics of expertise as well as the prospects for alternative responses.

Why has Not There been More Research of Concern?

PubMed Central

Rappert, Brian

2014-01-01

Amid the renewed concern in the last several years about the potential for life science research to facilitate the spread of disease, a central plank of the policy response has been to enact processes for assessing the risks and benefits of “research of concern.” The recent controversy regarding a proposed redaction of work on the modification of a H5N1 avian influenza virus is perhaps the most prominent such instance. And yet, a noteworthy feature of this case is its exceptionalness. In the last 10 years, life science publishers, funders, and labs have rarely identified any research as “of concern,” let alone proposed censors. This article takes this experience with risk assessment as an invitation for reflection. Reasons for the low number of instances of concern are related to how the biosecurity dimensions of the life sciences are identified, how they are described, how the assessments of benefits and risks are undertaken, how value considerations do and do not enter into assessments, as well as the lack of information on the outcomes of reviews. This argument builds on such considerations to examine the limitations and implications of the risk–benefit experiment of concern framing, the politics of expertise as well as the prospects for alternative responses. PMID:25101254

Developing a national computerised absence monitoring and management system to reduce nursing student attrition: evaluation of staff and student perspectives.

PubMed

Currie, Kay; McCallum, Jacqueline; Murray, John; Scott, Janine; Strachan, Evelyn; Yates, Lynda; Wright, Marty

2014-05-01

Reducing avoidable nursing student attrition is an international challenge. A pattern of falling attendance is recognised as a frequent precursor to withdrawal from nursing programmes. To address concerns regarding nursing student attrition, the Scottish Government implemented a pilot project for a centralised Computerised Absence Management and Monitoring System (CAMMS). The CAMMS adopted an 'assertive outreach' approach, contacting students every two weeks via colour coded letters to tell them whether their attendance was 'excellent', 'good, but potentially causing concern'; or 'warning; attendance concerns/contact academic staff for support'. This article reports key findings from an evaluation of CAMMS. To explore the perceived impact of CAMMS on student support and attrition, from the perspectives of academic and administrative staff and students. Mixed methods evaluation design. Three large geographically dispersed Schools of Nursing in Scotland. 83 students; 20 academic staff; and 3 lead administrators. On-line cohort survey of academic staff and students; structured interviews with lead administrators. Findings reflected a spectrum of negative and positive views of CAMMS. Students who are attending regularly seem pleased that their commitment is recognised. Lecturers who teach larger groups report greater difficulty getting to know students individually and acknowledge the benefit of identifying potential attendance concerns at an early stage. Conversely, some students who received a 'warning' letter were frequently annoyed or irritated, rather than feeling supported. Increased staff workload resulted in negative perceptions and a consequent reluctance to use CAMMS. However, students who were causing concern reported subsequent improvement in attendance. CAMMS has the potential to identify 'at-risk' students at an early stage; however, the system should have flexibility to tailor automatically generated letters in response to individual circumstances, to avoid student frustration. Further research on the longer term impact of CAMMS on attrition rates is warranted. © 2013.

75 FR 71666 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... technological collection techniques or other forms of information technology should be addressed to: Desk...) Identify potential concerns limiting the success of the operation and develop a loan assessment outlining.... The agency is mandated to provide supervised credit; therefore, failure to collect the information, or...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

6 CFR 27.215 - Security vulnerability assessments.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of potential critical assets; identification of hazards and consequences of concern for the facility, its surroundings, its identified critical asset(s), and its supporting infrastructure; and... determination of the relative degree of risk to the facility in terms of the expected effect on each critical...

Measurement and Modeling of Near Road & Near-Port Air Quality

EPA Science Inventory

Air pollution from mobile sources has been identified by numerous organizations as a potential public health concern. Based upon multiple near-road and near-source monitoring studies, both busy roadways and large emission sources at ports can significantly impact local air qualit...

Creating Space for Learner Autonomy: An Interactional Perspective

ERIC Educational Resources Information Center

Szczepek Reed, Beatrice

2017-01-01

This paper is concerned with teachers' and learners' collaborative pursuit of learner autonomy in a highly asymmetrical education setting, the music masterclass. Evaluations are identified as a potential opportunity for the mutual construction of learner autonomy. The analysis shows that, while teaching professionals mitigate interactional…

Analysis of health economics assessment reports for pharmaceuticals in France – understanding the underlying philosophy of CEESP assessment

PubMed Central

Toumi, Mondher; Motrunich, Anastasiia; Millier, Aurélie; Rémuzat, Cécile; Chouaid, Christos; Falissard, Bruno; Aballéa, Samuel

2017-01-01

ABSTRACT Background: Despite the guidelines for Economic and Public Health Assessment Committee (CEESP) submission having been available for nearly six years, the dossiers submitted continue to deviate from them, potentially impacting product prices. Objective: to review the reports published by CEESP, analyse deviations from the guidelines, and discuss their implications for the pricing and reimbursement process. Study design: CEESP reports published until January 2017 were reviewed, and deviations from the guidelines were extracted. The frequency of deviations was described by type of methodological concern (minor, important or major). Results: In 19 reports, we identified 243 methodological concerns, most often concerning modelling, measurement and valuation of health states and results presentation and sensitivity analyses; nearly 63% were minor, 33% were important and 4.5% were major. All reports included minor methodological concerns, and 17 (89%) included at least one important and/or major methodological concern. Global major methodological concerns completely invalidated the analysis in seven dossiers (37%). Conclusion: The CEESP submission dossiers fail to adhere to the guidelines, potentially invalidating the health economics analysis and resulting in pricing negotiations. As these negotiations tend to be unfavourable for the manufacturer, the industry should strive to improve the quality of the analyses submitted to CEESP. PMID:28804600

Environmental development plan for transportation programs: FY80 update

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

Saricks, C.L.; Singh, M.K.; Bernard, M.J. III

1980-09-01

This is the second annual update of the environmental development plan (EDP) for transportation programs. It has been prepared as a cooperative effort of the Assistant Secretaries for Conservation and Solar Energy (ASCS) Office of Transportation Programs (CS/TP) and the Environment (ASEV) Office of Environmental Assessments. EDPs identify the ecosystem, resource, physical environment, health, safety, socioeconomic, and environmental control concerns associated with DOE programs. The programs include the research, development, demonstration, and assessment (RDD and A) of 14 transportation technologies and several strategy implementation projects. This EDP update presents a research and assessment plan for resolving any potentially adverse environmentalmore » concerns arising from these programs. The EDP process provides a framework for: incorporating environmental concerns into CS/TP planning and decision processes early to ensure they are assigned the same importance as technological, fiscal, and institutional concerns in decision making; resolving environmental concerns concurrently with energy technology and strategy development; and providing a research schedule that mitigates adverse environmental effects through sound technological design or policy analysis. This EDP also describes the status of each environmental concern and the plan for its resolution. Much of ongoing DOE reseirch and technology development is aimed at resolving concerns identified in this EDP. Each EDP is intended to be so comprehensive that no concerns escape notice. Care is taken to include any CS/TP action that may eventually require an Environmental Impact Statement. Because technology demonstration and commercialization tend to raise more environmental concerns than other portions of the transportation program, most of this EDP addresses these concerns.« less

Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework

PubMed Central

Horne, Rob; Chapman, Sarah C. E.; Parham, Rhian; Freemantle, Nick; Forbes, Alastair; Cooper, Vanessa

2013-01-01

Background Patients’ beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it. Objective To assess the utility of the NCF in explaining nonadherence to prescribed medicines. Data sources We searched EMBASE, Medline, PsycInfo, CDSR/DARE/CCT and CINAHL from January 1999 to April 2013 and handsearched reference sections from relevant articles. Study eligibility criteria Studies using the Beliefs about Medicines Questionnaire (BMQ) to examine perceptions of personal necessity for medication and concerns about potential adverse effects, in relation to a measure of adherence to medication. Participants Patients with long-term conditions. Study appraisal and synthesis methods Systematic review and meta-analysis of methodological quality was assessed by two independent reviewers. We pooled odds ratios for adherence using random effects models. Results We identified 3777 studies, of which 94 (N = 25,072) fulfilled the inclusion criteria. Across studies, higher adherence was associated with stronger perceptions of necessity of treatment, OR = 1.742, 95% CI [1.569, 1.934], p<0.0001, and fewer Concerns about treatment, OR = 0.504, 95% CI: [0.450, 0.564], p<0.0001. These relationships remained significant when data were stratified by study size, the country in which the research was conducted and the type of adherence measure used. Limitations Few prospective longitudinal studies using objective adherence measures were identified. Conclusions The Necessity-Concerns Framework is a useful conceptual model for understanding patients’ perspectives on prescribed medicines. Taking account of patients’ necessity beliefs and concerns could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions. PMID:24312488

Potential of Organic Matrix Composites for Liquid Oxygen Tank

NASA Technical Reports Server (NTRS)

Davis, Samuel E.; Herald, Stephen D.; Stolzfus, Joel M.; Engel, Carl D.; Bohlen, James W.; Palm, Tod; Robinson, Michael J.

2005-01-01

Composite materials are being considered for the tankage of cryogenic propellants in access to space because of potentially lower structural weights. A major hurdle for composites is an inherent concern about the safety of using flammable structural materials in contact with liquid and gaseous oxygen. A hazards analysis approach addresses a series of specific concerns that must be addressed based upon test data. Under the 2nd Generation Reusable Launch Vehicle contracts, testing was begun for a variety of organic matrix composite materials both to aid in the selection of materials and to provide needed test data to support hazards analyses. The work has continued at NASA MSFC and the NASA WSTF to provide information on the potential for using composite materials in oxygen systems. Appropriate methods for oxygen compatibility testing of structural materials and data for a range of composite materials from impact, friction, flammability and electrostatic discharge testing are presented. Remaining concerns and conclusions about composite tank structures, and recommendations for additional testing are discussed. Requirements for system specific hazards analysis are identified.

Self-medication for cough and the common cold: information needs of consumers.

PubMed

Kloosterboer, Sanne Maartje; McGuire, Treasure; Deckx, Laura; Moses, Geraldine; Verheij, Theo; van Driel, Mieke L

2015-07-01

Despite the high use of over-the-counter (OTC) cough and cold medicines, little is known about Australia's cough and cold medicines information needs. The aim of this study was to identify gaps in consumers' perceived knowledge and concerns, to better target consumer medicines information and improve quality use of medicines. We analysed cough-and-cold related enquiries from consumers who contacted an Australian national medicine call centre between September 2002 and June 2010. Of 5503 cough and cold calls, female callers made up 86% of the calls and 33% were related to children. Questions most frequently related to drug-drug interactions (29%). An analysis of narratives over an 18-month period (248 calls) revealed 20% of the calls concerned potentially clinically relevant interactions, particularly those involving psychotropic agents. The potential for interactions with cough and cold medicines purchased OTC is recognised by consumers. Patient information should address their concerns. Doctors should be aware of the common cough and cold interactions and communicate likely clinical symptoms to patients when prescribing medication to prevent potential harm.

Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

PubMed

Singh, Hardeep; Sittig, Dean F

2016-04-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings. 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/

Attitudes to in vitro meat: A survey of potential consumers in the United States

PubMed Central

Phillips, Clive J. C.

2017-01-01

Positivity towards meat consumption remains strong, despite evidence of negative environmental and ethical outcomes. Although awareness of these repercussions is rising, there is still public resistance to removing meat from our diets. One potential method to alleviate these effects is to produce in vitro meat: meat grown in a laboratory that does not carry the same environmental or ethical concerns. However, there is limited research examining public attitudes towards in vitro meat, thus we know little about the capacity for it be accepted by consumers. This study aimed to examine perceptions of in vitro meat and identify potential barriers that might prevent engagement. Through conducting an online survey with US participants, we identified that although most respondents were willing to try in vitro meat, only one third were definitely or probably willing to eat in vitro meat regularly or as a replacement for farmed meat. Men were more receptive to it than women, as were politically liberal respondents compared with conservative ones. Vegetarians and vegans were more likely to perceive benefits compared to farmed meat, but they were less likely to want to try it than meat eaters. The main concerns were an anticipated high price, limited taste and appeal and a concern that the product was unnatural. It is concluded that people in the USA are likely to try in vitro meat, but few believed that it would replace farmed meat in their diet. PMID:28207878

Evaluation of the hypersensitivity potential of alternative butter flavorings

PubMed Central

Anderson, Stacey E.; Franko, Jennifer; Wells, J.R.; Lukomska, Ewa; Meade, B. Jean

2015-01-01

Concern has been raised over the association of diacetyl with lung disease clinically resembling bronchiolitis obliterans in food manufacturing workers. This has resulted in the need for identification of alternative chemicals to be used in the manufacturing process. Structurally similar chemicals, 2,3-pentanedione, 2,3-hexanedione, 3,4-hexanedione and 2,3-heptanedione, used as constituents of synthetic flavoring agents have been suggested as potential alternatives for diacetyl, however, immunotoxicity data on these chemicals are limited. The present study evaluated the dermal irritation and sensitization potential of diacetyl alternatives using a murine model. None of the chemicals were identified as dermal irritants when tested at concentrations up to 50%. Similar to diacetyl (EC3 = 17.9%), concentration-dependent increases in lymphocyte proliferation were observed following exposure to all four chemicals, with calculated EC3 values of 15.4% (2,3-pentanedione), 18.2% (2,3-hexanedione), 15.5% (3,4-hexanedione) and 14.1% (2,3-heptanedione). No biologically significant elevations in local or total serum IgE were identified after exposure to 25–50% concentrations of these chemicals. These results demonstrate the potential for development of hypersensitivity responses to these proposed alternative butter flavorings and raise concern about the use of structurally similar replacement chemicals. Additionally, a contaminant with strong sensitization potential was found in varying concentrations in diacetyl obtained from different producers. PMID:24007741

Evaluation of the hypersensitivity potential of alternative butter flavorings.

PubMed

Anderson, Stacey E; Franko, Jennifer; Wells, J R; Lukomska, Ewa; Meade, B Jean

2013-12-01

Concern has been raised over the association of diacetyl with lung disease clinically resembling bronchiolitis obliterans in food manufacturing workers. This has resulted in the need for identification of alternative chemicals to be used in the manufacturing process. Structurally similar chemicals, 2,3-pentanedione, 2,3-hexanedione, 3,4-hexanedione and 2,3-heptanedione, used as constituents of synthetic flavoring agents have been suggested as potential alternatives for diacetyl, however, immunotoxicity data on these chemicals are limited. The present study evaluated the dermal irritation and sensitization potential of diacetyl alternatives using a murine model. None of the chemicals were identified as dermal irritants when tested at concentrations up to 50%. Similar to diacetyl (EC3=17.9%), concentration-dependent increases in lymphocyte proliferation were observed following exposure to all four chemicals, with calculated EC3 values of 15.4% (2,3-pentanedione), 18.2% (2,3-hexanedione), 15.5% (3,4-hexanedione) and 14.1% (2,3-heptanedione). No biologically significant elevations in local or total serum IgE were identified after exposure to 25-50% concentrations of these chemicals. These results demonstrate the potential for development of hypersensitivity responses to these proposed alternative butter flavorings and raise concern about the use of structurally similar replacement chemicals. Additionally, a contaminant with strong sensitization potential was found in varying concentrations in diacetyl obtained from different producers. Published by Elsevier Ltd.

Establishment of a building audit procedure and analysis for the Kansas Department of Transportation phase 2A : buildings.

DOT National Transportation Integrated Search

2013-11-01

Over the past few years, state governments and entities have become concerned with the energy : consumption and efficiency of their facilities. An effective manner to identify potential to reduce energy and : water consumption and increase building e...

An integrative review of information and communication technology based support interventions for carers of home dwelling older people

PubMed Central

Bergström, Aileen L.; Hanson, Elizabeth

2018-01-01

BACKGROUND: A growing number of studies of informal carers of older people reveal positive results concerning support via Information and Communication Technologies (ICT). Systematic examination of factors that have a potential impact on carer outcomes are needed to inform future research. OBJECTIVE: To explore studies concerning ICT support of adult carers of older people and to identify study characteristics that have a potential impact on carer outcomes. METHODS: This integrative review includes 123 studies published since 2005. Fundamental questions for designing sensitive support interventions; ‘who, what, and how’ were applied to a synthesis of the results. RESULTS: Identified characteristics from the studies responding to the who question included variables of the carers, such as their relationship with the care recipient or their ethnicity. Characteristics related to the what question related to the types of interventions, and the how question concerned the different services or programs offered, the idiosyncratic needs of the carers, and the types of technologies used. CONCLUSION: Results are discussed according to micro, meso and macro levels of analysis. This extensive review can inform future studies and highlight the evidence in the area for decision makers, practitioners and/or NGOs working with innovative forms of support for carers of older people. PMID:29527109

Primary care patients reporting concerns about their gambling frequently have other co-occurring lifestyle and mental health issues

PubMed Central

Goodyear-Smith, Felicity; Arroll, Bruce; Kerse, Ngaire; Sullivan, Sean; Coupe, Nicole; Tse, Samson; Shepherd, Robin; Rossen, Fiona; Perese, Lana

2006-01-01

Background Problem gambling often goes undetected by family physicians but may be associated with stress-related medical problems as well as mental disorders and substance abuse. Family physicians are often first in line to identify these problems and to provide a proper referral. The aim of this study was to compare a group of primary care patients who identified concerns with their gambling behavior with the total population of screened patients in relation to co-morbidity of other lifestyle risk factors or mental health issues. Methods This is a cross sectional study comparing patients identified as worrying about their gambling behavior with the total screened patient population for co morbidity. The setting was 51 urban and rural New Zealand practices. Participants were consecutive adult patients per practice (N = 2,536) who completed a brief multi-item tool screening primary care patients for lifestyle risk factors and mental health problems (smoking, alcohol and drug misuse, problem gambling, depression, anxiety, abuse, anger). Data analysis used descriptive statistics and non-parametric binomial tests with adjusting for clustering by practitioner using STATA survey analysis. Results Approximately 3/100 (3%) answered yes to the gambling question. Those worried about gambling more likely to be male OR 1.85 (95% CI 1.1 to 3.1). Increasing age reduced likelihood of gambling concerns – logistic regression for complex survey data OR = 0.99 (CI 95% 0.97 to 0.99) p = 0.04 for each year older. Patients concerned about gambling were significantly more likely (all p < 0.0001) to have concerns about their smoking, use of recreational drugs, and alcohol. Similarly there were more likely to indicate problems with depression, anxiety and anger control. No significant relationship with gambling worries was found for abuse, physical inactivity or weight concerns. Patients expressing concerns about gambling were significantly more likely to want help with smoking, other drug use, depression and anxiety. Conclusion Our questionnaire identifies patients who express a need for help with gambling and other lifestyle and mental health issues. Screening for gambling in primary care has the potential to identify individuals with multiple co-occurring disorders. PMID:16606465

An assessment of agricultural pesticide use in Iran, 2012-2014.

PubMed

Morteza, Zaim; Mousavi, Seyed Behzad; Baghestani, Mohammad Ali; Aitio, Antero

2017-01-01

This is the first published assessment on agricultural pesticide use in Iran with the aim to identify pesticide products with a potential of causing acute or chronic hazard to human health. It also establishes a baseline for future comparisons and for trend assessments. The amounts of imported technical materials for formulation by local manufacturers as well as imported final product formulations were extracted from the registration data of the Plant Protection Organization of Iran in 2012-2014. The hazard indicators used were acute oral toxicity and chronic toxicity. For the latter, carcinogenicity, mutagenicity, and adverse effects on reproduction or development (CMR toxicity), and low Acceptable Daily Intake (ADI) were used. The comparative potential of the active ingredients of concern in terms of chronic toxicity was assessed using the average annual volume of their estimated use divided by their respective ADI, called chronic hazard potential (CHP) in the present text. The contribution of individual pesticides in different use categories to the total CHP of the user category, was also calculated, using the average annual volume of the active ingredients of all pesticides used during the period 2012-2014. On average about 14,000 tonnes of agriculture pesticides, expressed in active ingredients (AI), were annually used in Iran. Herbicides constituted the largest volume (43%), followed by insecticides and acaricides (37%) and fungicides (19%). 0.1% and 47% of the formulated products met the criteria of WHO Class Ib (highly hazardous) and Class II (moderately hazardous) products respectively. Aluminium phosphide and magnesium phosphide were identified as products of primary concern and chlorpyrifos, diazinon and paraquat as products of secondary concern, in terms of their acute human health hazard. No compound in carcinogenicity category 1A or 1B or germ cell mutagenicity/reproduction toxicity category 1A was identified. Six compounds (diazinon, chlorpyrifos, dichlorvos, metam sodium, paraquat and dimethoate) were identified as products with chronic hazard potential based on a low ADI. The assessment identified and prioritized agriculture pesticide used in Iran in terms of their acute and chronic hazard to human health for re-registration scheme recently established by PPO and for risk mitigation. It also set priority for research into development of alternative products and practices to minimize pesticide risks. Chronic hazard potential - amount of use adjusted with toxicity may serve as a useful point of reference for trend analysis also in the use of less hazardous agricultural pesticide products.

Potential SSP Perfluorooctanoic Acid Related Fluoropolymer Materials Obsolescence

NASA Technical Reports Server (NTRS)

Segars, Matt G.

2006-01-01

The Shuttle Environmental Assurance Initiative (SEA) has identified a potential for the Space Shuttle Program (SSP) to incur materials obsolescence issues due to agreements between the fluoro-chemical industry and the United States Environmental Protection Agency (USEPA) to participate in a Global Stewardship Program for perfluorooctanoic acid (PFOA). This presentation will include discussions of the chemistry, regulatory drivers, affected types of fluoropolymer and fluoroelastomer products, timeline for reformulations, and methodology for addressing the issue. It will cover the coordination of assessment efforts with the International Space Station and Head Quarters Air Force Space Command, along with some examples of impacted materials. The presentation is directed at all members of the international aerospace community concerned with identifying potential environmentally driven materials obsolescence issues.

"Without bodily autonomy we are not free": exploring women's concerns about future access to contraception following the 2016 US presidential election.

PubMed

Judge, Colleen P; Wolgemuth, Tierney E; Hamm, Megan E; Borrero, Sonya

2017-11-01

Following the 2016US presidential election, social media posts and news stories amplified concerns about the potential for reduced access to contraception under the incoming administration and urged women to seek long-acting reversible contraception. We aimed to describe women's concerns about future access to contraception, in their own words. A social-media-based, anonymous online survey assessing thoughts and concerns about future access to contraception was distributed to reproductive-aged US women for 1 week in mid-January 2017. Participants who were concerned about future access to contraception could share their thoughts and feelings in an open-ended comments box. We qualitatively analyzed 449 written responses for content and themes, with the goal of characterizing key concerns. Women who provided written comments had a mean age of 28years; 85% were white, 88% had at least a college degree, and 93% identified as Democratic or Democratic-leaning. Women were highly concerned about future affordability of contraceptive methods due to potential loss of insurance, reduced insurance coverage for contraceptive methods and reduced access to low-cost care at Planned Parenthood. Many also worried about increased restrictions on abortion. Participants' concerns regarding access to contraception and abortion centered around themes of reproductive and bodily autonomy, which women described as fundamental rights. Women in this study expressed considerable fear and uncertainty regarding their future access to contraception and abortion following the 2016US presidential election. The potential for restricted access to affordable contraception and abortion was viewed as an unacceptable limitation on bodily autonomy. As the future of US health care policy is debated, many women are concerned about the impact of policy changes on their ability to access affordable contraception and abortion, which many view as essential to the preservation of bodily and reproductive autonomy. Copyright © 2017 Elsevier Inc. All rights reserved.

Active spacecraft potential control system selection for the Jupiter orbiter with probe mission

NASA Technical Reports Server (NTRS)

Beattie, J. R.; Goldstein, R.

1977-01-01

It is shown that the high flux of energetic plasma electrons and the reduced photoemission rate in the Jovian environment can result in the spacecraft developing a large negative potential. The effects of the electric fields produced by this charging phenomenon are discussed in terms of spacecraft integrity as well as charged particle and fields measurements. The primary area of concern is shown to be the interaction of the electric fields with the measuring devices on the spacecraft. The need for controlling the potential of the spacecraft is identified, and a system capable of active control of the spacecraft potential in the Jupiter environment is proposed. The desirability of using this system to vary the spacecraft potential relative to the ambient plasma potential is also discussed. Various charged particle release devices are identified as potential candidates for use with the spacecraft potential control system. These devices are evaluated and compared on the basis of system mass, power consumption, and system complexity and reliability.

Security Management Strategies for Protecting Your Library's Network.

ERIC Educational Resources Information Center

Ives, David J.

1996-01-01

Presents security procedures for protecting a library's computer system from potential threats by patrons or personnel, and describes how security can be breached. A sidebar identifies four areas of concern in security management: the hardware, the operating system, the network, and the user interface. A selected bibliography of sources on…

Establishment of a building audit procedure and analysis for the Kansas Department of Transportation phase 2A : buildings, [technical summary].

DOT National Transportation Integrated Search

2013-11-01

Over the past few years, state governments and entities have become concerned with the energy consumption : and efficiency of their facilities. An effective manner to identify potential to reduce energy and water : consumption and increase building e...

Poorly Performing Physicians: Does the Script Concordance Test Detect Bad Clinical Reasoning?

ERIC Educational Resources Information Center

Goulet, Francois; Jacques, Andre; Gagnon, Robert; Charlin, Bernard; Shabah, Abdo

2010-01-01

Introduction: Evaluation of poorly performing physicians is a worldwide concern for licensing bodies. The College des Medecins du Quebec currently assesses the clinical competence of physicians previously identified with potential clinical competence difficulties through a day-long procedure called the Structured Oral Interview (SOI). Two peer…

The Potential Role of Conflict Resolution Schemas in Adolescent Psychosocial Adjustment

ERIC Educational Resources Information Center

Jutengren, Goran; Palmerus, Kerstin

2007-01-01

Four specific schemas of cognitive structures that adolescents may hold concerning interpersonal disagreements with their parents were identified, each reflecting an authoritative, authoritarian, indulgent, or a neglecting parenting style. To examine the occurrence of such schemas across high and low levels of psychosocial adjustment, 120 Swedish…

Potential concerns for tree response from stem injection

Treesearch

Kevin T. Smith; Phillip A. Lewis

2005-01-01

Stem injection of imidacloprid is an available component of management strategies for hemlock woolly adelgid. Preliminary observations of similar treatments of maple and ash show that the injury sustained by injection warrants investigation of the wound response in eastern hemlock. Such investigations need adequate experimental controls to identify the role of...

Generalizability of Universal Screening Measures for Behavioral and Emotional Risk

ERIC Educational Resources Information Center

Tanner, Nicholas; Eklund, Katie; Kilgus, Stephen P.; Johnson, Austin H.

2018-01-01

Data derived from universal screening procedures are increasingly utilized by schools to identify and provide additional support to students at risk for behavioral and emotional concerns. As screening has the potential to be resource intensive, effort has been placed on the development of efficient screening procedures, including brief behavior…

Household Hazardous Waste: Assessing Public Attitudes and Awareness.

ERIC Educational Resources Information Center

Scudder, Karen; Blehm, Kenneth D.

1991-01-01

Residents of Larimer County, Colorado, were surveyed to determine their level of awareness and attitudes concerning the disposal of household waste. Results indicated that approximately 40 percent of the population were unable to identify hazardous products within their homes and nearly 70 percent were unaware of the potential environmental…

77 FR 12107 - Reports, Forms and Recordkeeping Requirements; Agency Information Collection Activity Under OMB...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

..., and transportation service providers to identify their specific plans, investment strategies, and perspectives concerning market trends, which are a critical part of the subject Study. Finally, the Maritime... (or will be developed) to address the potential impacts on their costs and routing strategies as a...

SoyBase Simple Semantic Web Architecture and Protocol (SSWAP) Services

USDA-ARS?s Scientific Manuscript database

Semantic web technologies offer the potential to link internet resources and data by shared concepts without having to rely on absolute lexical matches. Thus two web sites or web resources which are concerned with similar data types could be identified based on similar semantics. In the biological...

A Community-Scale Modeling System to Assess Port-Related Air Quality Impacts

EPA Science Inventory

Near-port air pollution has been identified by numerous organizations as a potential public health concern. Based upon multiple near-road and near-source monitoring studies, both busy roadways and large emission sources at the ports may impact local air quality within several hun...

Polybrominated diphenyl ether serum concentrations in a Californian population of children, their parents, and older adults: an exposure assessment study

EPA Science Inventory

BackgroundPolybrominated diphenyl ethers (PBDEs) are used as flame retardants in many household items. Given concerns over their potential adverse health effects, we identified predictors and evaluated temporal changes of PBDE serum concentrations.MethodsPBDE serum concentrations...

Potential role of remote sensing in disaster relief management

NASA Technical Reports Server (NTRS)

Rush, M.; Holguin, A.; Vernon, S.

1976-01-01

Baseline or predisaster data which would be useful to decision making in the immediate postdisaster period were suggested for the six areas of public health concern along with guidelines for organizing these data. Potential sources of these data are identified. In order to fully assess the impact of a disaster on an area, information about its predisaster status must be known. Aerial photography is one way of acquiring and recording such data.

SOCIODEMOGRAPHIC DATA USED FOR IDENTIFYING ...

EPA Pesticide Factsheets

Due to unique social and demographic characteristics, various segments of the population may experience exposures different from those of the general population, which, in many cases, may be greater. When risk assessments do not characterize subsets of the general population, the populations that may experience the greatest risk remain unidentified. When such populations are not identified, the social and demographic data relevant to these populations is not considered when preparing exposure estimates, which can underestimate exposure and risk estimates for at-risk populations. Thus, it is necessary for risk or exposure assessors characterizing a diverse population, to first identify and then enumerate certain groups within the general population who are at risk for greater contaminant exposures. The document entitled Sociodemographic Data Used for Identifying Potentially Highly Exposed Populations (also referred to as the Highly Exposed Populations document), assists assessors in identifying and enumerating potentially highly exposed populations. This document presents data relating to factors which potentially impact an individual or group's exposure to environmental contaminants based on activity patterns (how time is spent), microenvironments (locations where time is spent), and other socio-demographic data such as age, gender, race and economic status. Populations potentially more exposed to various chemicals of concern, relative to the general population

Identifying potential engaging leaders within medical education: The role of positive influence on peers.

PubMed

Michalec, Barret; Veloski, J Jon; Hojat, Mohammadreza; Tykocinski, Mark L

2014-08-26

Abstract Background: Previous research has paid little to no attention towards exploring methods of identifying existing medical student leaders. Aim: Focusing on the role of influence and employing the tenets of the engaging leadership model, this study examines demographic and academic performance-related differences of positive influencers and if students who have been peer-identified as positive influencers also demonstrate high levels of genuine concern for others. Methods: Three separate fourth-year classes were asked to designate classmates that had significant positive influences on their professional and personal development. The top 10% of those students receiving positive influence nominations were compared with the other students on demographics, academic performance, and genuine concern for others. Results: Besides age, no demographic differences were found between positive influencers and other students. High positive influencers were not found to have higher standardized exam scores but did receive significantly higher clinical clerkship ratings. High positive influencers were found to possess a higher degree of genuine concern for others. Conclusion: The findings lend support to (a) utilizing the engaging model to explore leaders and leadership within medical education, (b) this particular method of identifying existing medical student leaders, and (c) return the focus of leadership research to the power of influence.

Use of an objective structured clinical exam (OSCE) for early identification of communication skills deficits in interns.

PubMed

Goldhamer, Mary Ellen J; Cohen, Amy; Brooks, Michelle; Macklin, Eric A; Co, John Patrick T; Weinstein, Debra

2018-01-01

There is limited information about whether OSCE during GME orientation can identify trainee communication deficits before these become evident via clinical performance evaluations. Ninety-seven interns matriculating to eight residency programs in six specialties at four hospitals participated in a nine-station communication skills OSCE. Ratings were based on the "Kalamazoo, adapted" communication skills checklist. Possible association with intern performance evaluations was assessed by repeated-measures logistic regression and ROC curves were generated. The mean OSCE score was 4.08 ± 0.27 with a range of 3.3-4.6. Baseline OSCE scores were associated with subsequent communication concerns recorded by faculty, based on 1591 evaluations. A 0.1-unit decrease in the OSCE communication score was associated with an 18% higher odds of being identified with a communication concern by faculty evaluation (odds ratio 1.18, 95% CI 1.01-1.36, p = 0.034). ROC curves did not demonstrate a "cut-off" score (AUC= 0.558). Non-faculty evaluators were 3-5 times more likely than faculty evaluators to identify communication deficits, based on 1900 evaluations. Lower OSCE performance was associated with faculty communication concerns on performance evaluations; however, a "cut-off" score was not demonstrated that could identify trainees for potential early intervention. Multi-source evaluation also identified trainees with communication skills deficits.

Attitudes, perceptions, and trust. Insights from a consumer survey regarding genetically modified banana in Uganda.

PubMed

Kikulwe, Enoch M; Wesseler, Justus; Falck-Zepeda, Jose

2011-10-01

Genetically modified (GM) crops and food are still controversial. This paper analyzes consumers' perceptions and institutional awareness and trust toward GM banana regulation in Uganda. Results are based on a study conducted among 421 banana-consuming households between July and August 2007. Results show a high willingness to purchase GM banana among consumers. An explanatory factor analysis is conducted to identify the perceptions toward genetic modification. The identified factors are used in a cluster analysis that grouped consumers into segments of GM skepticism, government trust, health safety concern, and food and environmental safety concern. Socioeconomic characteristics differed significantly across segments. Consumer characteristics and perception factors influence consumers' willingness to purchase GM banana. The institutional awareness and trust varied significantly across segments as well. The findings would be essential to policy makers when designing risk-communication strategies targeting different consumer segments to ensure proper discussion and addressing potential concerns about GM technology. Copyright © 2011 Elsevier Ltd. All rights reserved.

Do accountable care organizations (ACOs) help or hinder primary care physicians' ability to deliver high-quality care?

PubMed

Berenson, Robert A; Burton, Rachel A; McGrath, Megan

2016-09-01

Many view advanced primary care models such as the patient-centered medical home as foundational for accountable care organizations (ACOs), but it remains unclear how these two delivery reforms are complementary and how they may produce conflict. The objective of this study was to identify how joining an ACO could help or hinder a primary care practice's efforts to deliver high-quality care. This qualitative study involved interviews with a purposive sample of 32 early adopters of advanced primary care and/or ACO models, drawn from across the U.S. and conducted in mid-2014. Interview notes were coded using qualitative data analysis software, permitting topic-specific queries which were then summarized. Respondents perceived many potential benefits of joining an ACO, including care coordination staff, data analytics, and improved communication with other providers. However, respondents were also concerned about added "bureaucratic" requirements, referral restrictions, and a potential inability to recoup investments in practice improvements. Interviewees generally thought joining an ACO could complement a practice's efforts to deliver high-quality care, yet noted some concerns that could undermine these synergies. Both the advantages and disadvantages of joining an ACO seemed exacerbated for small practices, since they are most likely to benefit from additional resources yet are most likely to chafe under added bureaucratic requirements. Our identification of the potential pros and cons of joining an ACO may help providers identify areas to examine when weighing whether to enter into such an arrangement, and may help ACOs identify potential areas for improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Stone, Alex, E-mail: alst461@ecy.wa.go; Delistraty, Damon, E-mail: ddel461@ecy.wa.go

Due to the large number of chemicals in commerce without adequate toxicity characterization data, coupled with an ineffective federal policy for chemical management in the United States, many states are grappling with the challenge to identify toxic chemicals that may pose a risk to human health and the environment. Specific populations (e.g., children, elderly) are particularly sensitive to these toxic chemicals. In 2008, the Children's Safe Product Act (CSPA) was passed in Washington State. The CSPA included specific requirements to identify High Priority Chemicals (HPCs) and Chemicals of High Concern to Children (CHCCs). To implement this legislation, a methodology wasmore » developed to identify HPCs from authoritative scientific and regulatory sources on the basis of toxicity criteria. Another set of chemicals of concern was then identified from authoritative sources, based on their potential exposure to children. Exposure potential was evaluated by identifying chemicals detected in biomonitoring studies (i.e., human tissues), as well as those present in residential exposure media (e.g., indoor air, house dust, drinking water, consumer products). Accordingly, CHCCs were defined as HPCs that also appear in biomonitoring studies or relevant exposure media. For chemicals with unique Chemical Abstracts Service (CAS) numbers, we identified 2044 HPCs and 2219 chemicals with potential exposure to children, resulting in 476 CHCCs. The process of chemical identification is dynamic, so that chemicals may be added or subtracted as new information becomes available. Although beyond the scope of this paper, the 476 CHCCs will be prioritized in a more detailed assessment, based on the strength and weight of evidence of toxicity and exposure data. Our approach was developed to be flexible which allows the addition or removal of specific sources of toxicity or exposure information, as well as transparent to allow clear identification of inputs. Although the methodology was constrained by specific requirements in the CSPA, the intent of this work was to identify HPCs and CHCCs that might guide future regulatory actions and inform chemical management policies, aimed at protecting children's health.« less

Veterinary public health capacity in the United States: opportunities for improvement.

PubMed

Jarman, Dwayne W; Liang, Jennifer L; Luce, Richard R; Wright, Jennifer G; Stennies, Gail M; Bisgard, Kristine M

2011-01-01

In 2006, the Association of American Veterinary Medical Colleges reported that the shortage (≥ 1,500) of public health veterinarians is expected to increase tenfold by 2020. In 2008, the Centers for Disease Control and Prevention (CDC) Preventive Medicine Fellows conducted a pilot project among CDC veterinarians to identify national veterinary public health workforce concerns and potential policy strategies. Fellows surveyed a convenience sample (19/91) of public health veterinarians at CDC to identify veterinary workforce recruitment and retention problems faced by federal agencies; responses were categorized into themes. A focus group (20/91) of staff veterinarians subsequently prioritized the categorized themes from least to most important. Participants identified activities to address the three recruitment concerns with the highest combined weight. Participants identified the following three highest prioritized problems faced by federal agencies when recruiting veterinarians to public health: (1) lack of awareness of veterinarians' contributions to public health practice, (2) competitive salaries, and (3) employment and training opportunities. Similarly, key concerns identified regarding retention of public health practice veterinarians included: (1) lack of recognition of veterinary qualifications, (2) competitive salaries, and (3) seamless integration of veterinary and human public health. Findings identified multiple barriers that can affect recruitment and retention of veterinarians engaged in public health practice. Next steps should include replicating project efforts among a national sample of public health veterinarians. A committed and determined long-term effort might be required to sustain initiatives and policy proposals to increase U.S. veterinary public health capacity.

Differential Evolution Optimization for Targeting Spacecraft Maneuver Plans

NASA Technical Reports Server (NTRS)

Mattern, Daniel

2016-01-01

Previous analysis identified specific orbital parameters as being safer for conjunction avoidance for the TDRS fleet. With TDRS-9 being considered an at-risk spacecraft, a potential conjunction concern was raised should TDRS-9 fail while at a longitude of 12W. This document summarizes the analysis performed to identify if these specific orbital parameters could be targeted using the remaining drift-termination maneuvers for the relocation of TDRS-9 from 41W longitude to 12W longitude.

Ethical Concerns of and Risk Mitigation Strategies for Crowdsourcing Contests and Innovation Challenges: Scoping Review

PubMed Central

Pan, Stephen W; Mathews, Allison; Stein, Gabriella; Bayus, Barry; Rennie, Stuart

2018-01-01

Background Crowdsourcing contests (also called innovation challenges, innovation contests, and inducement prize contests) can be used to solicit multisectoral feedback on health programs and design public health campaigns. They consist of organizing a steering committee, soliciting contributions, engaging the community, judging contributions, recognizing a subset of contributors, and sharing with the community. Objective This scoping review describes crowdsourcing contests by stage, examines ethical problems at each stage, and proposes potential ways of mitigating risk. Methods Our analysis was anchored in the specific example of a crowdsourcing contest that our team organized to solicit videos promoting condom use in China. The purpose of this contest was to create compelling 1-min videos to promote condom use. We used a scoping review to examine the existing ethical literature on crowdsourcing to help identify and frame ethical concerns at each stage. Results Crowdsourcing has a group of individuals solve a problem and then share the solution with the public. Crowdsourcing contests provide an opportunity for community engagement at each stage: organizing, soliciting, promoting, judging, recognizing, and sharing. Crowdsourcing poses several ethical concerns: organizing—potential for excluding community voices; soliciting—potential for overly narrow participation; promoting—potential for divulging confidential information; judging—potential for biased evaluation; recognizing—potential for insufficient recognition of the finalist; and sharing—potential for the solution to not be implemented or widely disseminated. Conclusions Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems. We present methods for the responsible conduct of crowdsourcing contests. PMID:29523500

Sexual concerns among kidney transplant recipients.

PubMed

Muehrer, Rebecca J; Lanuza, Dorothy M; Brown, Roger L; Djamali, Arjang

2014-11-01

Little is known about the specific sexual concerns of kidney transplant (KTx) recipients. The primary objectives of this study were to: (i) describe the importance of sexuality to KTx recipients; (ii) investigate the sexual concerns of KTx recipients; and (iii) examine the relationship between sexual concerns and quality of life (QOL). A secondary objective was to examine potential sexual concern differences by gender, pre-transplant dialysis status, and donor type. This study employed a cross-sectional, descriptive, correlational design. Sexual concerns were identified using the Sexual Concerns Questionnaire, which contains seven subscales. QOL was measured with the SF-8 and the QOL Uniscale. Nearly 73% of subjects rated sexuality as important. Subscales indicating highest area of sexual concerns were communication with healthcare providers about sexuality (Mean (M) = 2.70) and sexual pleasure concerns (M = 2.45). Higher concern ratings regarding health consequences of sexual activity, quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly, inversely related to QOL. Women had significantly higher scores on the Sexual Pleasure and Communication with Healthcare Providers subscales than men. This study reports the sexual concerns of KTx recipients' who are an average of four yr since surgery, and the relationship of these concerns to QOL. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Review of Recent Literature Relevant to the Environmental Effects of Marine and Hydrokinetic Energy Devices Task 2.1.3: Effects on Aquatic Organisms – Fiscal Year 2011 Progress Report Environmental Effects of Marine and Hydrokinetic Energy

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

Kropp, Roy K.

2011-09-30

A literature search was conducted by using the Web of Science® Databases component of the ISI Web of KnowledgeSM to identify recent articles that would be useful to help assess the potential environmental effects of renewable energy development in the ocean, with emphasis on marine mammals, seabirds, and fish. Several relatively recent general review articles that included possible effects of marine renewable energy devices on marine mammals and seabirds were examined to begin the search process (e.g., Boehlert et al. 2008; Thompson et al. 2008; Simas et al. 2009). From these articles, several general topics of potential environmental effects onmore » marine mammals, seabirds, and fish were derived. These topics were used as the primary search factors. Searches were conducted with reference to the potential effects of offshore wind farms and MHK devices on marine mammals, seabirds, and fish. Additional sources were identified by cross-checking the Web of Science databases for articles that cited the review articles. It also became clear that often the potential effects were offered as hypotheses that often were not supported by the presentation of appropriate documentation. Therefore, the search was refined and focused on trying to obtain the necessary information to support or challenge a proposed potential effect to a specific concern. One of the expressed concerns regarding MHK devices is that placing wave parks in coastal waters could compromise the migration patterns of whales. Disruption of the annual migration of the gray whale (Eschrichtius robustus), which swims at least 30,000 km on its round trip from breeding grounds in Baja California to feeding areas in the Bering Sea, is of particular concern. Among the hypothesized effects on the migrating gray whales are increased predation risk by constricting migration corridor to between array and shore or by forcing the whales to swim into deeper waters, increased metabolic energy costs and delays in reaching the destinations, and interrupting feeding by blocking access to benthic areas under arrays. The literature search focused on identifying published studies that could provide information to evaluate these concerns. The results were developed into a case study that evaluated the potential effects of the placement of wave parks in coastal waters along the migration route of the gray whale. Wave parks and other MHK arrays may have additional effects on gray whales and other marine mammals, including entanglement in mooring lines and interference with communications among other effects, that were not included in this case study. The case study results were rewritten into a simpler form that would be suitable for placement on a web blog« less

Tularaemia: a challenging zoonosis.

PubMed

Carvalho, C L; Lopes de Carvalho, I; Zé-Zé, L; Núncio, M S; Duarte, E L

2014-03-01

In recent years, several emerging zoonotic vector-borne infections with potential impact on human health have been identified in Europe, including tularaemia, caused by Francisella tularensis. This remarkable pathogen, one of the most virulent microorganisms currently known, has been detected in increasingly new settings and in a wide range of wild species, including lagomorphs, rodents, carnivores, fish and invertebrate arthropods. Also, a renewed concern has arisen with regard to F. tularensis: its potential use by bioterrorists. Based on the information published concerning the latest outbreaks, the aim of this paper is to review the main features of the agent, its biology, immunology and epidemiology. Moreover, special focus will be given to zoonotic aspects of the disease, as tularaemia outbreaks in human populations have been frequently associated with disease in animals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Direct Assistance: USAID Has Taken Positive Action to Assess Afghan Ministries’ Ability to Manage Donor Funds, but Concerns Remain

DTIC Science & Technology

2014-01-01

with the adverse event’s potential impact , ranging from negligible to catastrophic. Appendix V includes a matrix of how USAID/Afghanistan assigns risk...International Development (USAID) assigns risk ratings based on potential impact and probability of occurrence of an identified risk. The impact measures...frequent. Combining impact and probability factors categorize risk clusters of critical, high, medium and low categories. Although subjective, it is

In vitro-to-in vivo extrapolation of xenoestrogens using an estrogen responsive in vitro transcriptional activation assay and the in vivo uterotrophic assay##

EPA Science Inventory

Widespread contamination of waters with both natural and synthetic estrogens is a concern for potential adverse ecological and human health effects. In vitro assays are valuable screening tools for identifying contaminated environmental samples and chemical specific mechanisms of...

In vitro-to-in vivo extrapolation of xenoestrogens using an estrogen responsive in vitro transcriptional activation assay and the in vivo uterotrophic assay

EPA Science Inventory

Widespread contamination of waters with both natural and synthetic estrogens is a concern for potential adverse ecological and human health effects. In vitro assays are valuable screening tools for identifying contaminated environmental samples and chemical specific mechanisms o...

Quantifying targets to manage invasion risk: light gradients dominate the early regeneration niche of naturalized and pre-commercial Miscanthus populations

USDA-ARS?s Scientific Manuscript database

Prospective bioenergy crops have caused concern about their invasive potential because they often share characteristics with known invasive species. Studies that examine the factors that limit regeneration of these crop species will be crucial for identifying vulnerable habitats and devising managem...

Developing Student Potential in the 1990's. A Strategic Plan for Centralia College.

ERIC Educational Resources Information Center

Centralia Coll., WA.

This strategic planning report was prepared by Centralia College (CC) in order to assess the college's internal and external environment, identify problems, and prescribe recommendations. Material for the report was compiled by eight committees/task forces concerned with: (1) strategic planning; (2) institutional mission, philosophy, and goals;…

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

Not Available

The Monsanto Corporation 75-acre site is located in Augusta (Richmond County), Georgia. Preliminary on-site groundwater sampling results (the most recent occurring in 1986) identified arsenic, the only contaminant reported. Based on available information, the site is considered to be of potential public health concern because of the risk to human health caused by the possibility of human exposure to hazardous substances.

Porcine Hemagglutinating Encephalomyelitis Virus and Respiratory Disease in Exhibition Swine, Michigan, USA, 2015.

PubMed

Lorbach, Joshua N; Wang, Leyi; Nolting, Jacqueline M; Benjamin, Madonna G; Killian, Mary Lea; Zhang, Yan; Bowman, Andrew S

2017-07-01

Acute outbreaks of respiratory disease in swine at agricultural fairs in Michigan, USA, in 2015 raised concern for potential human exposure to influenza A virus. Testing ruled out influenza A virus and identified porcine hemagglutinating encephalomyelitis virus as the cause of influenza-like illness in the affected swine.

Porcine Hemagglutinating Encephalomyelitis Virus and Respiratory Disease in Exhibition Swine, Michigan, USA, 2015

PubMed Central

Lorbach, Joshua N.; Wang, Leyi; Nolting, Jacqueline M.; Benjamin, Madonna G.; Killian, Mary Lea

2017-01-01

Acute outbreaks of respiratory disease in swine at agricultural fairs in Michigan, USA, in 2015 raised concern for potential human exposure to influenza A virus. Testing ruled out influenza A virus and identified porcine hemagglutinating encephalomyelitis virus as the cause of influenza-like illness in the affected swine. PMID:28628449

40 CFR 304.21 - Referral of claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... identified PRPs for the facility concerned and provide such PRPs with an opportunity to discuss referral of... part. Alternatively, one or more PRPs at a facility may propose to EPA use of arbitration, after... alternative, either the PRPs or EPA shall notify the other PRPs at the facility of the potential use of...

EVALUATION OF DRINKING WATER TREATMENT TECHNOLOGIES FOR REMOVAL OF ENDOCRINE DISRUPTING CHEMICALS (EDCS)

EPA Science Inventory

A number of the chemicals identified as potential EDCs have been observed in surface and ground waters leading to concern over the possible presence of EDCs in finished drinking waters. Although there has not yet been a determination of risks posed by EDCs in finished waters, it ...

Rivers, runoff, and reefs

USGS Publications Warehouse

McLaughlin, C.J.; Smith, C.A.; Buddemeier, R.W.; Bartley, J.D.; Maxwell, B.A.

2003-01-01

The role of terrigenous sediment in controlling the occurrence of coral reef ecosystems is qualitatively understood and has been studied at local scales, but has not been systematically evaluated on a global-to-regional scale. Current concerns about degradation of reef environments and alteration of the hydrologic and sediment cycles place the issue at a focal point of multiple environmental concerns. We use a geospatial clustering of a coastal zone database of river and local runoff identified with 0.5?? grid cells to identify areas of high potential runoff effects, and combine this with a database of reported coral reef locations. Coastal cells with high runoff values are much less likely to contain reefs than low runoff cells and GIS buffer analysis demonstrates that this inhibition extends to offshore ocean cells as well. This analysis does not uniquely define the effects of sediment, since salinity, nutrients, and contaminants are potentially confounding variables also associated with runoff. However, sediment effects are likely to be a major factor and a basis is provided for extending the study to higher resolution with more specific variables. ?? 2003 Elsevier B.V. All rights reserved.

Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals.

PubMed

Ben-Arye, Eran; Samuels, Noah; Goldstein, Lee Hilary; Mutafoglu, Kamer; Omran, Suha; Schiff, Elad; Charalambous, Haris; Dweikat, Tahani; Ghrayeb, Ibtisam; Bar-Sela, Gil; Turker, Ibrahim; Hassan, Azza; Hassan, Esmat; Saad, Bashar; Nimri, Omar; Kebudi, Rejin; Silbermann, Michael

2016-02-15

The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects. Oncology HCPs from 16 Middle Eastern countries received a 17-item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety-related concerns associated with the products listed. A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety-related concerns were associated with 29 products, including herb-drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs). Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dose-density. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products. © 2015 American Cancer Society.

The Off-Site Plowshare and Vela Uniform Programs: Assessing Potential Environmental Liabilities through an Examination of Proposed Nuclear Projects,High Explosive Experiments, and High Explosive Construction Activities Volume 1 of 3

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

Beck Colleen M,Edwards Susan R.,King Maureen L.

2011-09-01

This document presents the results of nearly six years (2002-2008) of historical research and field studies concerned with evaluating potential environmental liabilities associated with U.S. Atomic Energy Commission projects from the Plowshare and Vela Uniform Programs. The Plowshare Program's primary purpose was to develop peaceful uses for nuclear explosives. The Vela Uniform Program focused on improving the capability of detecting, monitoring and identifying underground nuclear detonations. As a result of the Project Chariot site restoration efforts in the early 1990s, there were concerns that there might be other project locations with potential environmental liabilities. The Desert Research Institute conducted archivalmore » research to identify projects, an analysis of project field activities, and completed field studies at locations where substantial fieldwork had been undertaken for the projects. Although the Plowshare and Vela Uniform nuclear projects are well known, the projects that are included in this research are relatively unknown. They are proposed nuclear projects that were not executed, proposed and executed high explosive experiments, and proposed and executed high explosive construction activities off the Nevada Test Site. The research identified 170 Plowshare and Vela Uniform off-site projects and many of these had little or no field activity associated with them. However, there were 27 projects that merited further investigation and field studies were conducted at 15 locations.« less

The Off-Site Plowshare and Vela Uniform Programs: Assessing Potential Environmental Liabilities through an Examination of Proposed Nuclear Projects,High Explosive Experiments, and High Explosive Construction Activities Volume 3 of 3

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

Beck Colleen M.,Edwards Susan R.,King Maureen L.

2011-09-01

This document presents the results of nearly six years (2002-2008) of historical research and field studies concerned with evaluating potential environmental liabilities associated with U.S. Atomic Energy Commission projects from the Plowshare and Vela Uniform Programs. The Plowshare Program's primary purpose was to develop peaceful uses for nuclear explosives. The Vela Uniform Program focused on improving the capability of detecting, monitoring and identifying underground nuclear detonations. As a result of the Project Chariot site restoration efforts in the early 1990s, there were concerns that there might be other project locations with potential environmental liabilities. The Desert Research Institute conducted archivalmore » research to identify projects, an analysis of project field activities, and completed field studies at locations where substantial fieldwork had been undertaken for the projects. Although the Plowshare and Vela Uniform nuclear projects are well known, the projects that are included in this research are relatively unknown. They are proposed nuclear projects that were not executed, proposed and executed high explosive experiments, and proposed and executed high explosive construction activities off the Nevada Test Site. The research identified 170 Plowshare and Vela Uniform off-site projects and many of these had little or no field activity associated with them. However, there were 27 projects that merited further investigation and field studies were conducted at 15 locations.« less

The Off-Site Plowshare and Vela Uniform Programs: Assessing Potential Environmental Liabilities through an Examination of Proposed Nuclear Projects,High Explosive Experiments, and High Explosive Construction Activities Volume 2 of 3

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

Beck Colleen M.,Edwards Susan R.,King Maureen L.

2011-09-01

This document presents the results of nearly six years (2002-2008) of historical research and field studies concerned with evaluating potential environmental liabilities associated with U.S. Atomic Energy Commission projects from the Plowshare and Vela Uniform Programs. The Plowshare Program's primary purpose was to develop peaceful uses for nuclear explosives. The Vela Uniform Program focused on improving the capability of detecting, monitoring and identifying underground nuclear detonations. As a result of the Project Chariot site restoration efforts in the early 1990s, there were concerns that there might be other project locations with potential environmental liabilities. The Desert Research Institute conducted archivalmore » research to identify projects, an analysis of project field activities, and completed field studies at locations where substantial fieldwork had been undertaken for the projects. Although the Plowshare and Vela Uniform nuclear projects are well known, the projects that are included in this research are relatively unknown. They are proposed nuclear projects that were not executed, proposed and executed high explosive experiments, and proposed and executed high explosive construction activities off the Nevada Test Site. The research identified 170 Plowshare and Vela Uniform off-site projects and many of these had little or no field activity associated with them. However, there were 27 projects that merited further investigation and field studies were conducted at 15 locations.« less

13 CFR 121.109 - What must a concern do in order to be identified as a small business concern in any Federal...

Code of Federal Regulations, 2014 CFR

2014-01-01

... be identified as a small business concern in any Federal procurement databases? 121.109 Section 121... order to be identified as a small business concern in any Federal procurement databases? (a) In order to be identified as a small business concern in the System for Award Management (SAM) database (or any...

Needs and challenges for assessing the environmental impacts of engineered nanomaterials (ENMs)

PubMed Central

Romero-Franco, Michelle; Godwin, Hilary A; Bilal, Muhammad

2017-01-01

The potential environmental impact of nanomaterials is a critical concern and the ability to assess these potential impacts is top priority for the progress of sustainable nanotechnology. Risk assessment tools are needed to enable decision makers to rapidly assess the potential risks that may be imposed by engineered nanomaterials (ENMs), particularly when confronted by the reality of limited hazard or exposure data. In this review, we examine a range of available risk assessment frameworks considering the contexts in which different stakeholders may need to assess the potential environmental impacts of ENMs. Assessment frameworks and tools that are suitable for the different decision analysis scenarios are then identified. In addition, we identify the gaps that currently exist between the needs of decision makers, for a range of decision scenarios, and the abilities of present frameworks and tools to meet those needs. PMID:28546894

Technology and Economics, Inc. Technology Application Team

NASA Technical Reports Server (NTRS)

Ballard, T.; Macfadyen, D. J.

1981-01-01

Technology + Economics, Inc. (T+E), under contract to the NASA Headquarters Technology Transfer Division, operates a Technology Applications Team (TATeam) to assist in the transfer of NASA-developed aerospace technology. T+E's specific areas of interest are selected urban needs at the local, county, and state levels. T+E contacts users and user agencies at the local, state, and county levels to assist in identifying significant urban needs amenable to potential applications of aerospace technology. Once viable urban needs have been identified in this manner, or through independent research, T+E searches the NASA technology database for technology and/or expertise applicable to the problem. Activities currently under way concerning potential aerospace applications are discussed.

Debate continues on northwest's merits

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

Stremel, K.

1984-07-01

Estimates of northwest Montana's petroleum reserves range from barren Precambrian rock to reserves exceeding those of Alaska's Prudhoe Bay. Geological debates concerning the merits of the vast areas continues. Seismic data and geological studies indicate that the area holds considerable promise. Several large structures have been identified, and oil and gas seeps have been reported. The area's true potential, however, will be revealed only by drilling, which is both risky and expensive. Several wildcat drilling operations are underway but the area's hydrocarbon potential may not be released for several years.

Fall concern about older persons shifts to carers as changing health policy focuses on family, home-based care.

PubMed

Ang, Seng Giap Marcus; O'Brien, Anthony Paul; Wilson, Amanda

2018-01-01

With the Singaporean population ageing at an exponential rate, home carers are increasingly becoming essential partners in fall prevention and care delivery for older persons living at home and in the community. Singapore, like other Asian countries, regards the family as the main support structure for the older person, and national policies have been implemented to support this cultural expectation. Family carers experience similar concerns as older persons with regard to fall risk, and identifying and addressing these concerns can potentially lower fall risk and improve fall prevention for older persons. It is timely to remind ourselves - as concern about falls in older persons begins to shift to carers - to incorporate the influence of Asian cultural values and unique family dynamics of outsourcing family caregiving, in the management of older persons' fall risk in the community. Copyright: © Singapore Medical Association.

Multiple Intravenous Infusions Phase 2a: Ontario Survey

PubMed Central

Fan, Mark; Koczmara, Christine; Masino, Caterina; Cassano-Piché, Andrea; Trbovich, Patricia; Easty, Anthony

2014-01-01

Background Research conducted in earlier phases of this study prospectively identified a number of concerns related to the safe administration of multiple intravenous (IV) infusions in Ontario hospitals. Objective To investigate the potential prevalence of practices or policies that may contribute to the patient safety risks identified in Phase 1b of this study. Data Sources and Review Methods Sixty-four survey responses were analyzed from clinical units where multiple IV infusions may occur (e.g., adult intensive care units). Survey questions were organized according to the topics identified in Phase 1b as potential contributors to patient harm (e.g., labelling practices, patient transfer practices, secondary infusion policies). Results Survey results indicated suboptimal practices and policies in some clinical units, and variability in a number of infusion practices. Key areas of concern included the following: use of primary IV tubing without back check valves when administering secondary infusions administration of secondary infusions with/as high-alert continuous IV medications potential confusion about how IV tubing should be labelled to reflect replacement date and time interruptions to IV therapy due to IV pump and/or tubing changes when patients are transferred between clinical units coadministration of continuous or intermittent infusions on central venous pressure monitoring ports variability in respondents’ awareness of the infusion pump's bolus capabilities Limitations Due to the limited sample size, survey responses may not be representative of infusion practices across Ontario. Answers to some questions indicated that the intent of the questions might have been misunderstood. Due to a design error, 1 question about bolus administration methods was not shown to as many respondents as appropriate. Conclusions The Ontario survey revealed variability in IV infusion practice across the province and potential opportunities to improve safety. PMID:26257837

The exploitation of "Exploitation" in the tenofovir prep trial in Cameroon: Lessons learned from media coverage of an HIV prevention trial.

PubMed

Mack, Natasha; Robinson, Elizabeth T; MacQueen, Kathleen M; Moffett, Jill; Johnson, Laura M

2010-06-01

media coverage influences how clinical trials are perceived internationally and in communities where trials occur, affecting recruitment, retention, and political support for research. We conducted a discourse analysis of news coverage from 2004-2005 of a trial in Cameroon on oral PrEP for HIV prevention, to identify messages, communication techniques, and sources of messages that were amplified via media. We identified two parallel discourses: one on ethical concerns about the Cameroon trial, and a second, more general "science exploitation" discourse concerned with the potential for trials with vulnerable participant populations to be conducted unethically, benefiting only wealthy populations. Researchers should overtly address exploitation as an integral, ongoing component of research, particularly where historical or cultural conditions set the stage for controversy to emerge.

Health concerns associated with unconventional gas mining in rural Australia.

PubMed

Haswell, Melissa R; Bethmont, Anna

2016-01-01

Many governments globally are investigating the benefits and risks associated with unconventional gas mining for shale, tight and coal seam gas (coalbed methane) to determine whether the industry should proceed in their jurisdiction. Most locations likely to be developed are in rural areas, with potential impact on farmers and small communities. Despite significant health concerns, public health knowledge and growing evidence are often overlooked in decision-making. It is difficult to gain a broad but accurate understanding of the health concerns for rural communities because the evidence has grown very recently and rapidly, is complex and largely based in the USA, where the industry is advanced. In 2016, a concerned South Australian beef and lamb farmer in an area targeted for potential unconventional gas development organised visits to homes in developed unconventional gas areas of Pennsylvania and forums with leading researchers and lawyers in Pennsylvania and New York. Guided by priorities identified during this trip, this communication concisely distils the research evidence on these key concerns, highlighting the Australian situation where evidence exists. It summarises key information of particular concern to rural regions, using Australia as an example, to assist rural health professionals to be better prepared to engage in decision-making and address the challenges associated with this new industry. Discussions with communities and experts, supported by the expanding research from the USA and Australia, revealed increasing health concerns in six key areas. These are absence of a safe solution to the toxic wastewater management problems, air pollution, land and water competition, mental health and psychosocial wellbeing risks, fugitive methane emissions and lack of proven regulatory regimes. Emerging epidemiological studies suggesting interference with foetal development and birth outcomes, and exacerbation of asthma conditions, are particularly concerning to rural families and livestock. Rural residents in potentially affected areas should be supported to access and interpret the best current evidence regarding the multiple health concerns associated with unconventional gas mining. This knowledge should be part of wider discourse and decision-making processes driving local economic development and national and global energy choices.

77 FR 40376 - Outer Continental Shelf, Oil and Gas Lease Sales in the Central Gulf of Mexico Planning Area (CPA...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

..., archaeological and socioeconomic conditions or conflicts, or other information that might bear upon the potential leasing and development of this area. BOEM also seeks comments on possible conflicts between future OCS... Programs (CMPs). If possible, these comments should identify specific CMP policies of concern, the nature...

How "Boundaryless" Are the Careers of High Potentials, Key Experts and Average Performers?

ERIC Educational Resources Information Center

Dries, Nicky; Van Acker, Frederik; Verbruggen, Marijke

2012-01-01

The talent management literature declares talent management a prime concern for HRM professionals while the careers literature calls talent management archaic. Three sets of assumptions identified through comparative review of both streams of the literature were tested in a large-scale survey (n = 941). We found more support for the assumptions…

Is it hip? Identifying streams with high intrinsic potential to provide salmon and trout.

Treesearch

Jonathan Thompson

2005-01-01

Decisionmakers concerned with Pacific salmon and trout have, out of necessity, relied on limited, site-scale information when planning and evaluating efforts to protect or restore freshwater habitat. To help broaden the context of conservation approaches, scientists in the Coastal Landscape Analysis and Modeling Study (CLAMS) have developed tools that characterize the...

The Impact of the Taser on Suspect Resistance: Identifying Predictors of Effectiveness

ERIC Educational Resources Information Center

White, Michael D.; Ready, Justin

2010-01-01

Despite the Taser's increasing popularity among police agencies, questions have been raised concerning the weapon's use and effectiveness as well as its potential to cause serious injury or death. This article examines all Taser deployments by the New York City Police Department from 2002 to 2005 (N = 375) and uses two multivariate…

Social & Economic Issues in Siting a Hazardous Waste Facility: Ideas for Communities and Local Assessment Committees.

ERIC Educational Resources Information Center

Hurley, Mike

This handbook was prepared for communities selected as potential sites for hazardous waste facilities, identifying issues which need to be addressed and suggesting specific and positive steps that communities can take to shape proposals to meet their concerns. Following an introduction, specific areas addressed include: community controls,…

The Federal Research Action Plan on Recycled Tire Crumb Used on Playing Fields and Playgrounds - Background and Exposure Research Goals.

EPA Science Inventory

Concerns have been raised by the public about the safety of recycled tire crumb rubber used in synthetic turf fields and playgrounds in the United States (U.S.). Several studies have been identified that examine potential exposure to tire crumb rubber infill in these settings. Th...

National Air Toxic Assessments (NATA) Results

EPA Pesticide Factsheets

The National Air Toxics Assessment was conducted by EPA in 2002 to assess air toxics emissions in order to identify and prioritize air toxics, emission source types and locations which are of greatest potential concern in terms of contributing to population risk. This data source provides downloadable information on emissions at the state, county and census tract level.

Rotavirus an emerging enteropathogen of man and animals: an overview.

PubMed

Malik, S V; Kumar, A; Bhilegaonkar, K N

1995-12-01

Rota Viral infection is recognised as a significant global public health concern causing large numbers of potentially preventable illnesses and deaths, especially among young ones of man and animals. The paper presents an overview of the epidemiology, control, treatment, virology, diagnosis and the zoonotic aspects of the problem. Problems for further research are identified.

Immunotoxicity and allergic potential induced by topical application of dimethyl carbonate (DMC) in a murine model

PubMed Central

Anderson, Stacey E.; Franko, Jennifer; Anderson, Katie L.; Munson, Albert E.; Lukomska, Ewa; Meade, B. Jean

2015-01-01

Dimethyl carbonate (DMC) is an industrial chemical, used as a paint and adhesive solvent, with the potential for significant increases in production. Using select immune function assays, the purpose of these studies was to evaluate the immunotoxicity of DMC following dermal exposure using a murine model. Following a 28-day exposure, DMC produced a significant decrease in thymus weight at concentrations of 75% and greater. No effects on body weight, hematological parameters (erythrocytes, leukocytes, and their differentials), or immune cell phenotyping (B-cells, T-cells, and T-cell sub-sets) were identified. The IgM antibody response to sheep red blood cell (SRBC) was significantly reduced in the spleen but not the serum. DMC was not identified to be an irritant and evaluation of the sensitization potential, conducted using the local lymph node assay (LLNA) at concentrations ranging from 50–100%, did not identify increases in lymphocyte proliferation. These results demonstrate that dermal exposure to DMC induces immune suppression in a murine model and raise concern about potential human exposure and the need for occupational exposure regulations. PMID:22953780

Veterinary Public Health Capacity in the United States: Opportunities for Improvement

PubMed Central

Jarman, Dwayne W.; Liang, Jennifer L.; Luce, Richard R.; Wright, Jennifer G.; Stennies, Gail M.; Bisgard, Kristine M.

2011-01-01

Objectives In 2006, the Association of American Veterinary Medical Colleges reported that the shortage (≥1,500) of public health veterinarians is expected to increase tenfold by 2020. In 2008, the Centers for Disease Control and Prevention (CDC) Preventive Medicine Fellows conducted a pilot project among CDC veterinarians to identify national veterinary public health workforce concerns and potential policy strategies. Methods Fellows surveyed a convenience sample (19/91) of public health veterinarians at CDC to identify veterinary workforce recruitment and retention problems faced by federal agencies; responses were categorized into themes. A focus group (20/91) of staff veterinarians subsequently prioritized the categorized themes from least to most important. Participants identified activities to address the three recruitment concerns with the highest combined weight. Results Participants identified the following three highest prioritized problems faced by federal agencies when recruiting veterinarians to public health: (1) lack of awareness of veterinarians' contributions to public health practice, (2) competitive salaries, and (3) employment and training opportunities. Similarly, key concerns identified regarding retention of public health practice veterinarians included: (1) lack of recognition of veterinary qualifications, (2) competitive salaries, and (3) seamless integration of veterinary and human public health. Conclusions Findings identified multiple barriers that can affect recruitment and retention of veterinarians engaged in public health practice. Next steps should include replicating project efforts among a national sample of public health veterinarians. A committed and determined long-term effort might be required to sustain initiatives and policy proposals to increase U.S. veterinary public health capacity. PMID:22043103

Stopping Antidepressants and Anxiolytics as Major Concerns Reported in Online Health Communities: A Text Mining Approach.

PubMed

Abbe, Adeline; Falissard, Bruno

2017-10-23

Internet is a particularly dynamic way to quickly capture the perceptions of a population in real time. Complementary to traditional face-to-face communication, online social networks help patients to improve self-esteem and self-help. The aim of this study was to use text mining on material from an online forum exploring patients' concerns about treatment (antidepressants and anxiolytics). Concerns about treatment were collected from discussion titles in patients' online community related to antidepressants and anxiolytics. To examine the content of these titles automatically, we used text mining methods, such as word frequency in a document-term matrix and co-occurrence of words using a network analysis. It was thus possible to identify topics discussed on the forum. The forum included 2415 discussions on antidepressants and anxiolytics over a period of 3 years. After a preprocessing step, the text mining algorithm identified the 99 most frequently occurring words in titles, among which were escitalopram, withdrawal, antidepressant, venlafaxine, paroxetine, and effect. Patients' concerns were related to antidepressant withdrawal, the need to share experience about symptoms, effects, and questions on weight gain with some drugs. Patients' expression on the Internet is a potential additional resource in addressing patients' concerns about treatment. Patient profiles are close to that of patients treated in psychiatry. ©Adeline Abbe, Bruno Falissard. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.10.2017.

Psychological predictors of problem mobile phone use.

PubMed

Bianchi, Adriana; Phillips, James G

2005-02-01

Mobile phone use is banned or illegal under certain circumstances and in some jurisdictions. Nevertheless, some people still use their mobile phones despite recognized safety concerns, legislation, and informal bans. Drawing potential predictors from the addiction literature, this study sought to predict usage and, specifically, problematic mobile phone use from extraversion, self-esteem, neuroticism, gender, and age. To measure problem use, the Mobile Phone Problem Use Scale was devised and validated as a reliable self-report instrument, against the Addiction Potential Scale and overall mobile phone usage levels. Problem use was a function of age, extraversion, and low self-esteem, but not neuroticism. As extraverts are more likely to take risks, and young drivers feature prominently in automobile accidents, this study supports community concerns about mobile phone use, and identifies groups that should be targeted in any intervention campaigns.

Ethical Concerns of and Risk Mitigation Strategies for Crowdsourcing Contests and Innovation Challenges: Scoping Review.

PubMed

Tucker, Joseph D; Pan, Stephen W; Mathews, Allison; Stein, Gabriella; Bayus, Barry; Rennie, Stuart

2018-03-09

Crowdsourcing contests (also called innovation challenges, innovation contests, and inducement prize contests) can be used to solicit multisectoral feedback on health programs and design public health campaigns. They consist of organizing a steering committee, soliciting contributions, engaging the community, judging contributions, recognizing a subset of contributors, and sharing with the community. This scoping review describes crowdsourcing contests by stage, examines ethical problems at each stage, and proposes potential ways of mitigating risk. Our analysis was anchored in the specific example of a crowdsourcing contest that our team organized to solicit videos promoting condom use in China. The purpose of this contest was to create compelling 1-min videos to promote condom use. We used a scoping review to examine the existing ethical literature on crowdsourcing to help identify and frame ethical concerns at each stage. Crowdsourcing has a group of individuals solve a problem and then share the solution with the public. Crowdsourcing contests provide an opportunity for community engagement at each stage: organizing, soliciting, promoting, judging, recognizing, and sharing. Crowdsourcing poses several ethical concerns: organizing-potential for excluding community voices; soliciting-potential for overly narrow participation; promoting-potential for divulging confidential information; judging-potential for biased evaluation; recognizing-potential for insufficient recognition of the finalist; and sharing-potential for the solution to not be implemented or widely disseminated. Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems. We present methods for the responsible conduct of crowdsourcing contests. ©Joseph D Tucker, Stephen W Pan, Allison Mathews, Gabriella Stein, Barry Bayus, Stuart Rennie. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.03.2018.

Intelligent power wheelchair use in long-term care: potential users' experiences and perceptions.

PubMed

Rushton, Paula W; Mortenson, Ben W; Viswanathan, Pooja; Wang, Rosalie H; Miller, William C; Hurd Clarke, Laura

2017-10-01

Long-term care (LTC) residents with cognitive impairments frequently experience limited mobility and participation in preferred activities. Although a power wheelchair could mitigate some of these mobility and participation challenges, this technology is often not prescribed for this population due to safety concerns. An intelligent power wheelchair (IPW) system represents a potential intervention that could help to overcome these concerns. The purpose of this study was to explore a) how residents experienced an IPW that used three different modes of control and b) what perceived effect the IPW would have on their daily lives. We interviewed 10 LTC residents with mild or moderate cognitive impairment twice, once before and once after testing the IPW. Interviews were conducted using a semi-structured interview guide, audio recorded and transcribed verbatim for thematic analyses. Our analyses identified three overarching themes: (1) the difference an IPW would make, (2) the potential impact of the IPW on others and (3) IPW-related concerns. Findings from this study confirm the need for and potential benefits of IPW use in LTC. Future studies will involve testing IPW improvements based on feedback and insights from this study. Implications for rehabilitation Intelligent power wheelchairs may enhance participation and improve safety and feelings of well-being for long-term care residents with cognitive impairments. Intelligent power wheelchairs could potentially have an equally positive impact on facility staff, other residents, and family and friends by decreasing workload and increasing safety.

Clues to patients' explanations and concerns about their illnesses. A call for active listening.

PubMed

Lang, F; Floyd, M R; Beine, K L

2000-03-01

Most patients who experience illness symptoms develop an explanatory model. More frequently than physicians realize, these attributions involve serious and potentially life-threatening medical conditions. Only a minority of patients spontaneously disclose or "offer" their ideas, concerns, and expectations. Often patients suggest or imply their ideas through "clues." Active listening is a skill for recognizing and exploring patients' clues. Without this communication skill, patients' real concerns often go unrecognized by health care professionals. Qualitative techniques including videotape analysis, postinterviewing debriefing, and interpersonal process recall were used to identify types of clues. We propose a taxonomy of clues that includes (1) expression of feelings (especially concern or worry), (2) attempts to understand or explain symptoms, (3) speech clues that underscore particular concerns of the patient, (4) personal stories that link the patient with medical conditions or risks, and (5) behaviors suggestive of unresolved concerns or unmet expectations. This clue taxonomy will help physicians recognize patients' clues more readily and thereby improve their active listening skills. A deeper understanding of the true reasons for the visit should result in increased patient satisfaction and improved outcomes.

Culture-sensitive counselling, psychotherapy and support groups in the Orthodox-Jewish community: how they work and how they are experienced.

PubMed

Loewenthal, Kate Miriam; Rogers, Marian Brooke

2004-09-01

There is political and scientific goodwill towards the provision of culture-sensitive support, but as yet little knowledge about how such support works and what are its strengths and difficulties in practice. To study groups offering culture-sensitive psychological and other support to the strictly orthodox Jewish community in London. Semi-structured interviews with service providers, potential and actual users from the community, and professionals serving the community. Interviews asked about the aims, functioning and achievements of 10 support groups. Thematic analysis identified seven important themes: admiration for the work of the groups; appreciation of the benefits of culture-sensitive services; concerns over confidentiality and stigma; concerns over finance and fund-raising; concerns about professionalism; the importance of liaison with rabbinic authorities; need for better dissemination of information. The strengths and difficulties of providing culture-sensitive services in one community were identified. Areas for attention include vigilance regarding confidentiality, improvements in disseminating information, improvements in the reliability of funding and attention to systematic needs assessment, and to the examination of efficacy of these forms of service provision.

Pest management through Bacillus thuringiensis (Bt) in a tea-silkworm ecosystem: status and potential prospects.

PubMed

Dashora, Kavya; Roy, Somnath; Nagpal, Akanksha; Roy, Sudipta Mukhopadhyay; Flood, Julie; Prasad, Anjali Km; Khetarpal, Ravinder; Neave, Suzanne; Muraleedharan, N

2017-03-01

Bacillus thuringiensis (Bt) is a soil bacterium that forms spores containing crystals comprising one or more Cry or Cyt proteins having potential and specific insecticidal activity. Different strains of Bt produce different types of toxins, affecting a narrow taxonomic group of insects. Therefore, it is used in non-chemical pest management, including inherent pest resistance through GM crops. The specificity of action of Bt toxins reduces the concern of adverse effects on non-target species, a concern which remains with chemical insecticides as well. To make use of Bt more sustainable, new strains expressing novel toxins are actively being sought globally. Since Bt is successfully used against many pests including the lepidopteran pests in different crop groups, the insecticidal activity against Samia cynthia (Drury) (Eri silkworm) and Antheraea assamensis Helfer (Muga silkworm) becomes a concern in the state of Assam in India which is a predominantly tea- and silk-producing zone. Though Bt can be used as an effective non-chemical approach for pest management for tea pests in the same geographical region, yet, it may potentially affect the silk industry which depends on silkworm. There is a need to identify the potentially lethal impact (through evaluating their mortality potential) of local Bt strains on key silkworm species in North Eastern India. This will allow the use of existing Bt for which the silkworms have natural resistance. Through this review, the authors aim to highlight recent progress in the use of Bt and its insecticidal toxins in tea pest control and the potential sensitivity for tea- and silk-producing zone of Assam in India.

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review

PubMed Central

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors’ (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care. PMID:26257520

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review.

PubMed

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors' (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care.

Sources and perceptions of indoor and ambient air pollution in rural Alaska.

PubMed

Ware, Desirae; Lewis, Johnnye; Hopkins, Scarlett; Boyer, Bert; Noonan, Curtis; Ward, Tony

2013-08-01

Even though Alaska is the largest state in the United States, much of the population resides in rural and underserved areas with documented disparities in respiratory health. This is especially true in the Yukon-Kuskokwim (southwest) and Ahtna (southcentral) Regions of Alaska. In working with community members, the goal of this study was to identify the air pollution issues (both indoors and outdoors) of concern within these two regions. Over a two-year period, 328 air quality surveys were disseminated within seven communities in rural Alaska. The surveys focused on understanding the demographics, home heating practices, indoor activities, community/outdoor activities, and air quality perceptions within each community. Results from these surveys showed that there is elevated potential for PM10/PM2.5 exposures in rural Alaska communities. Top indoor air quality concerns included mold, lack of ventilation or fresh air, and dust. Top outdoor air pollution concerns identified were open burning/smoke, road dust, and vehicle exhaust (e.g., snow machines, ATVs, etc.). These data can now be used to seek additional funding for interventions, implementing long-term, sustainable solutions to the identified problems. Further research is needed to assess exposures to PM10/PM2.5 and the associated impacts on respiratory health, particularly among susceptible populations such as young children.

TOY SAFETY SURVEILLANCE FROM ONLINE REVIEWS

PubMed Central

Winkler, Matt; Abrahams, Alan S.; Gruss, Richard; Ehsani, Johnathan P.

2016-01-01

Toy-related injuries account for a significant number of childhood injuries and the prevention of these injuries remains a goal for regulatory agencies and manufacturers. Text-mining is an increasingly prevalent method for uncovering the significance of words using big data. This research sets out to determine the effectiveness of text-mining in uncovering potentially dangerous children’s toys. We develop a danger word list, also known as a ‘smoke word’ list, from injury and recall text narratives. We then use the smoke word lists to score over one million Amazon reviews, with the top scores denoting potential safety concerns. We compare the smoke word list to conventional sentiment analysis techniques, in terms of both word overlap and effectiveness. We find that smoke word lists are highly distinct from conventional sentiment dictionaries and provide a statistically significant method for identifying safety concerns in children’s toy reviews. Our findings indicate that text-mining is, in fact, an effective method for the surveillance of safety concerns in children’s toys and could be a gateway to effective prevention of toy-product-related injuries. PMID:27942092

How might health services capture patient-reported safety concerns in a hospital setting? An exploratory pilot study of three mechanisms.

PubMed

O'Hara, Jane Kathryn; Armitage, Gerry; Reynolds, Caroline; Coulson, Claire; Thorp, Liz; Din, Ikhlaq; Watt, Ian; Wright, John

2017-01-01

Emergent evidence suggests that patients can identify and report safety issues while in hospital. However, little is known about the best method for collecting information from patients about safety concerns. This study presents an exploratory pilot of three mechanisms for collecting data on safety concerns from patients during their hospital stay. Three mechanisms for capturing safety concerns were coproduced with healthcare professionals and patients, before being tested in an exploratory trial using cluster randomisation at the ward level. Nine wards participated, with each mechanism being tested over a 3-month study period. Patients were asked to feed back safety concerns via the mechanism on their ward (interviewing at their bedside, paper-based form or patient safety 'hotline'). Safety concerns were subjected to a two-stage review process to identify those that would meet the definition of a patient safety incident. Differences between mechanisms on a range of outcomes were analysed using inferential statistics. Safety concerns were thematically analysed to develop reporting categories. 178 patients were recruited. Patients in the face-to-face interviewing condition provided significantly more safety concerns per patient (1.91) compared with the paper-based form (0.92) and the patient safety hotline (0.43). They were also significantly more likely to report one or more concerns, with 64% reporting via the face-to-face mechanism, compared with 41% via the paper-based form and 19% via the patient safety hotline. No mechanism differed significantly in the number of classified patient safety incidents or physician-rated preventability and severity. Interviewing at the patient's bedside is likely to be the most effective means of gathering safety concerns from inpatients, potentially providing an opportunity for health services to gather patient feedback about safety from their perspective. 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/.

Yukon-Kuskokwim Delta Berry Outlook: Co-Producing Knowledge to Better Understand Changing Resources.

NASA Astrophysics Data System (ADS)

Herman-Mercer, N. M.; Loehman, R.; Paniyak, C.; Toohey, R.; Tonuchuk, V., Jr.

2017-12-01

The Yukon-Kuskokwim (YK) Delta Berry Outlook is a collaborative, interdisciplinary project with the objective of understanding changing berry resources in the YK Delta. Berries are an important subsistence resource culturally and nutritionally for Alaska Natives as well as an important resource for the large migratory bird population in the Yukon Delta wildlife refuge. As such understanding berry resources is essential for human and bird populations and is of interest to communities and land managers alike. Partnering with Tribal Councils in four YK Delta communities, cultural consensus surveys were administered to explore local knowledge concerning ecological drivers of berry abundance and distribution. Cultural consensus surveys are a specific type of survey, in which respondents are asked a series of questions concerning a particular knowledge, here ecological drivers of berry resources. Surveys were administered in four Alaska Native villages concerning five prominent berry species. Respondents identified five ecological drivers, and results suggest that drivers are not uniform across berry species. For example, salmonberries were identified as ripening earlier in the season than in the past though the timing of other berry species has generally stayed the same. Additionally, respondents were asked to map harvesting locations for each of these berries and indicate if locations had changed over time. The resulting maps have allowed us to identify locations of high density harvesting for specific berries as well as the different distances traveled in different communities. Identifying important berry harvesting locations is critical for understanding location specific changes that may occur and have the potential to impact the abundance and distribution of berries. The survey and mapping results were used to inform ecological modelling and forecast potential berry responses to future climate scenarios. This presentation will focus on the results of combining data from these three methods and highlight how local observations and scientific data can be used together to co-produce knowledge of changing resources.

Identifying geoscience knowledge likely to affect foreign policy

NASA Astrophysics Data System (ADS)

Kelmelis, J. A.

2006-12-01

The earth sciences play an important role in foreign policy and have done so throughout history. Whether it is access to resources, knowledge of weather or other earth system conditions, planning for or responding to disasters, protecting the environment, facilitating transportation and communication, or any of a number of other important topics, the geosciences continue to inform our decision making. The importance of science, technology, and health (STH) is being increasingly recognized in the foreign policy community. The National Research Council (NRC) recommended that the Department of State (State) expand its scientific base to address the importance of STH issues. In part, this consists of increasing the number of scientists within State. Another important aspect is not only identifying the STH issues that are of current concern, but also the issues that will be of importance in the future. A number of studies funded by the U.S. Government have identified some important STH areas of concern at a high level. These provide a basis for more in-depth investigations. However, there are additional phenomena, beyond those identified in the studies, which have foreign policy implications. The scientific findings may be well known to scientists but their foreign policy importance is not always obvious. The scientific and foreign policy communities could improve their dialog to better develop strategies for foreign policy and future scientific research. One way to help facilitate that is to ease identification of scientific issues with potential significance to foreign policy and to clarify uncertainties around those issues. A qualitative method relating the likelihood that the scientific finding has foreign policy importance to the potential level of foreign policy importance has been used to clarify the significance of a variety of scientific findings including Arctic warming, methane hydrates, atmospheric dust, disease, and natural hazards. From a foreign policy perspective, the significance of some scientific findings can cascade through emerging international issues and manifest themselves in ways that have both strategic and tactical concern.

Multisectoral prioritization of zoonotic diseases in Uganda, 2017: A One Health perspective

PubMed Central

Bulage, Lilian; Kihembo, Christine; Nantima, Noelina; Monje, Fred; Ndumu, Deo; Sentumbwe, Juliet; Mbolanyi, Betty; Aruho, Robert; Kaboyo, Winyi; Mutonga, David; Basler, Colin; Paige, Sarah; Barton Behravesh, Casey

2018-01-01

Background Zoonotic diseases continue to be a public health burden globally. Uganda is especially vulnerable due to its location, biodiversity, and population. Given these concerns, the Ugandan government in collaboration with the Global Health Security Agenda conducted a One Health Zoonotic Disease Prioritization Workshop to identify zoonotic diseases of greatest national concern to the Ugandan government. Materials and methods The One Health Zoonotic Disease Prioritization tool, a semi-quantitative tool developed by the U.S. Centers for Disease Control and Prevention, was used for the prioritization of zoonoses. Workshop participants included voting members and observers representing multiple government and non-governmental sectors. During the workshop, criteria for prioritization were selected, and questions and weights relevant to each criterion were determined. We used a decision tree to provide a ranked list of zoonoses. Participants then established next steps for multisectoral engagement for the prioritized zoonoses. A sensitivity analysis demonstrated how criteria weights impacted disease prioritization. Results Forty-eight zoonoses were considered during the workshop. Criteria selected to prioritize zoonotic diseases were (1) severity of disease in humans in Uganda, (2) availability of effective control strategies, (3) potential to cause an epidemic or pandemic in humans or animals, (4) social and economic impacts, and (5) bioterrorism potential. Seven zoonotic diseases were identified as priorities for Uganda: anthrax, zoonotic influenza viruses, viral hemorrhagic fevers, brucellosis, African trypanosomiasis, plague, and rabies. Sensitivity analysis did not indicate significant changes in zoonotic disease prioritization based on criteria weights. Discussion One Health approaches and multisectoral collaborations are crucial to the surveillance, prevention, and control strategies for zoonotic diseases. Uganda used such an approach to identify zoonoses of national concern. Identifying these priority diseases enables Uganda’s National One Health Platform and Zoonotic Disease Coordination Office to address these zoonoses in the future with a targeted allocation of resources. PMID:29715287

Subject anxiety and psychological considerations for centrifuge-simulated suborbital spaceflight.

PubMed

Mulcahy, Robert A; Blue, Rebecca S; Vardiman, Johnené L; Mathers, Charles H; Castleberry, Tarah L; Vanderploeg, James M

2014-08-01

Anxiety and psychological concerns may pose a challenge to future commercial spaceflight. To help identify potential measures of anxiousness and indicators of flight-related stress, the psychiatric histories and anxiousness responses of volunteers exposed to G forces in centrifuge-simulated spaceflight acceleration profiles were examined. Over 2 d, 86 individuals (63 men, 23 women), 20-78 yr old, underwent up to 7 centrifuge runs. Day 1 consisted of two +G(z) runs (peak = +3.5 G(z)) and two +Gx runs (peak = +6.0 G(x)). Day 2 consisted of three runs approximating suborbital spaceflight profiles (combined +G(x) and +G(z)). Hemodynamic data were collected during the profiles. Subjects completed a retrospective self-report anxiety questionnaire. Medical monitors identified individuals exhibiting varying degrees of anxiousness during centrifuge exposure, medical histories of psychiatric disease, and other potential indicators of psychological intolerance of spaceflight. The retrospective survey identified 18 individuals self-reporting anxiousness, commonly related to unfamiliarity with centrifuge acceleration and concerns regarding medical history. There were 12 individuals (5 men, 7 women, average age 46.2 yr) who were observed to have anxiety that interfered with their ability to complete training; of these, 4 reported anxiousness on their questionnaire and 9 ultimately completed the centrifuge profiles. Psychiatric history was not significantly associated with anxious symptoms. Anxiety is likely to be a relevant and potentially disabling problem for commercial spaceflight participants; however, positive psychiatric history and self-reported symptoms did not predict anxiety during centrifuge performance. Symptoms of anxiousness can often be ameliorated through training and coaching. Even highly anxious individuals are likely capable of tolerating commercial spaceflight.

Successful patient recruitment in CT imaging clinical trials: what factors influence patient participation?

PubMed

Hollada, Jacqueline; Marfori, Wanda; Tognolini, Alessia; Speier, William; Ristow, Lindsey; Ruehm, Stefan G

2014-01-01

Analyze factors that influence participation in research studies that use coronary computed tomography (CT) imaging. A 12-point survey using a questionnaire was conducted on 80 subjects, of whom 40 agreed to participate in a cardiovascular CT imaging research study (enrolling subjects) and 40 declined participation (non-enrolling subjects). Potential factors that motivated the acceptance or refusal of enrollment were evaluated using a 5-point Likert scale. The following aspects were addressed: (1) additional health information, (2) free imaging, (3) altruistic benefit to society, (4) monetary compensation, (5) radiation exposure, (6) role as an experimental subject, (7) possible loss of confidentiality, (8) contrast or investigational drug use, (9) premedication use, (10) blood draw or intravenous placement, (11) time commitment, and (12) personal medical opinion. Response distributions were obtained for each question and compared between enrolling and non-enrolling groups. Enrolling subjects gave significantly higher ratings than non-enrolling subjects for the following factors: additional health information (P < .001), free imaging (P < .001), and the altruistic benefit to society (P < .001). For non-enrolling subjects, concern for possible drug use or contrast injection (P < .001), concern for possible premedication (P < .001), and personal availability or time commitment (P < .001) were all given significantly higher ratings. Concern for radiation exposure (P = .002) and personal medical opinion (P < .001) received significantly high ratings among both groups but did not differ between groups. Several influential concerns and benefits were identified from potential research subjects. Knowledge of what influences patient participation in studies involving CT imaging may allow researchers to effectively address concerns and highlight the potential benefits related to participation. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

The pertinence of Sutton's law to exposure science: Lessons from unconventional shale gas drilling.

PubMed

Goldstein, Bernard D

2018-01-04

Sutton's Law urges the medical practitioner to utilize the test that goes directly to the problem. When applied to exposure science, Sutton's Law would argue that the major emphasis should be on techniques that directly measure exposure in or close to the human, animal or ecosystem receptors of concern. Exposure science largely and appropriately violates Sutton's Law by estimating exposure based on information on emissions or measurements obtained at a distance from the receptors of concern. I suggest four criteria to help determine whether Sutton's law should be violated for an innovative technology, and explore these criteria in relation to potential human exposure resulting from unconventional gas drilling (UGD): (1) The technological processes possibly leading to release of the chemical or physical agents of concern are reasonably understood; (2) the agents of concern are known; (3) the source and geographical location of the releases can be reasonably identified; and (4) there is information about the likely temporal pattern of the releases and resulting pollutant levels in relation to the temporal patterns of receptor susceptibility. For UGD, the complexity of the technology including many possible release points at different time periods; the existence of three variable mixtures of chemical and physical agents as well as possible unknown reactants; the demonstrated large variation in releases from site to site; and deficiencies in transparency and regulatory oversight, all suggest that studies of the potential health impact of UGD should follow Sutton's Law. This includes the use of techniques that more directly measure exposure close to or within the receptors of concern, such as biological markers or through community-based citizen science. Understanding the implications of Sutton's Law could help focus scientific and regulatory efforts on effective approaches to evaluate the potential health and ecosystem implications of new and evolving technologies.

Effective Interpersonal Health Communication for Linkage to Care After HIV Diagnosis in South Africa

PubMed Central

Mabuto, Tonderai; Charalambous, Salome

2017-01-01

Background: Early in the global response to HIV, health communication was focused toward HIV prevention. More recently, the role of health communication along the entire HIV care continuum has been highlighted. We sought to describe how a strategy of interpersonal communication allows for precision health communication to influence behavior regarding care engagement. Methods: We analyzed 1 to 5 transcripts from clients participating in longitudinal counseling sessions from a communication strategy arm of a randomized trial to accelerate entry into care in South Africa. The counseling arm was selected because it increased verified entry into care by 40% compared with the standard of care. We used thematic analysis to identify key aspects of communication directed specifically toward a client's goals or concerns. Results: Of the participants, 18 of 28 were female and 21 entered HIV care within 90 days of diagnosis. Initiating a communication around client-perceived consequences of HIV was at times effective. However, counselors also probed around general topics of life disruption—such as potential for child bearing—as a technique to direct the conversation toward the participant's needs. Once individual concerns and needs were identified, counselors tried to introduce clinical care seeking and collaboratively discuss potential barriers and approaches to overcome to accessing that care. Conclusions: Through the use of interpersonal communication messages were focused on immediate needs and concerns of the client. When effectively delivered, it may be an important communication approach to improve care engagement. PMID:27930608

Effective Interpersonal Health Communication for Linkage to Care After HIV Diagnosis in South Africa.

PubMed

Mabuto, Tonderai; Charalambous, Salome; Hoffmann, Christopher J

2017-01-01

Early in the global response to HIV, health communication was focused toward HIV prevention. More recently, the role of health communication along the entire HIV care continuum has been highlighted. We sought to describe how a strategy of interpersonal communication allows for precision health communication to influence behavior regarding care engagement. We analyzed 1 to 5 transcripts from clients participating in longitudinal counseling sessions from a communication strategy arm of a randomized trial to accelerate entry into care in South Africa. The counseling arm was selected because it increased verified entry into care by 40% compared with the standard of care. We used thematic analysis to identify key aspects of communication directed specifically toward a client's goals or concerns. Of the participants, 18 of 28 were female and 21 entered HIV care within 90 days of diagnosis. Initiating a communication around client-perceived consequences of HIV was at times effective. However, counselors also probed around general topics of life disruption-such as potential for child bearing-as a technique to direct the conversation toward the participant's needs. Once individual concerns and needs were identified, counselors tried to introduce clinical care seeking and collaboratively discuss potential barriers and approaches to overcome to accessing that care. Through the use of interpersonal communication messages were focused on immediate needs and concerns of the client. When effectively delivered, it may be an important communication approach to improve care engagement.

Applying item response theory and computer adaptive testing: the challenges for health outcomes assessment.

PubMed

Fayers, Peter M

2007-01-01

We review the papers presented at the NCI/DIA conference, to identify areas of controversy and uncertainty, and to highlight those aspects of item response theory (IRT) and computer adaptive testing (CAT) that require theoretical or empirical research in order to justify their application to patient reported outcomes (PROs). IRT and CAT offer exciting potential for the development of a new generation of PRO instruments. However, most of the research into these techniques has been in non-healthcare settings, notably in education. Educational tests are very different from PRO instruments, and consequently problematic issues arise when adapting IRT and CAT to healthcare research. Clinical scales differ appreciably from educational tests, and symptoms have characteristics distinctly different from examination questions. This affects the transferring of IRT technology. Particular areas of concern when applying IRT to PROs include inadequate software, difficulties in selecting models and communicating results, insufficient testing of local independence and other assumptions, and a need of guidelines for estimating sample size requirements. Similar concerns apply to differential item functioning (DIF), which is an important application of IRT. Multidimensional IRT is likely to be advantageous only for closely related PRO dimensions. Although IRT and CAT provide appreciable potential benefits, there is a need for circumspection. Not all PRO scales are necessarily appropriate targets for this methodology. Traditional psychometric methods, and especially qualitative methods, continue to have an important role alongside IRT. Research should be funded to address the specific concerns that have been identified.

Risk assessment for the reintroduction of anadromous salmonids upstream of Chief Joseph and Grand Coulee Dams, Northeastern Washington

USGS Publications Warehouse

Hardiman, Jill M.; Breyta, Rachel B.; Haskell, Craig A.; Ostberg, Carl O.; Hatten, James R.; Connolly, Patrick J.

2017-09-12

The Upper Columbia United Tribes (UCUT; Spokane, Colville, Kootenai, Coeur d’Alene, and Kalispel Tribes) and Washington Department of Fish and Wildlife want to reintroduce anadromous salmonids to their historical range to restore ecosystem function and lost cultural and spiritual relationships in the upper Columbia River, northeastern Washington. The UCUT contracted with the U.S. Geological Survey to assess risks to resident taxa (existing fish populations in the reintroduction area upstream of Chief Joseph and Grand Coulee Dams) and reintroduced salmon associated with reintroduction. We developed a risk assessment framework for reintroduction of anadromous salmonids upstream of Chief Joseph and Grand Coulee Dams. To accomplish this goal, we applied strategies identified in previous risk assessment frameworks for reintroduction. The risk assessment is an initial step towards an anadromous reintroduction strategy. An initial list of potential donor sources for reintroduction species was developed from previous published sources for Chinook Salmon (Oncorhynchus tshawytscha) donors in the Transboundary Reach of the Columbia River, British Columbia; an ecological risk assessment of upper Columbia River hatchery programs on non-target taxa of concern; and a review of existing hatchery programsDuring two workshops, we further identified and ranked potential donor sources of anadromous Redband Trout (steelhead; O. mykiss), Chinook Salmon, Sockeye Salmon (O. nerka), and Coho Salmon (O. kisutch). We also identified resident fish populations of interest and their primary habitat, location, status, and pathogen concerns to determine the potential risks of reintroduction. Species were deemed of interest based on resource management and potential interactions (that is, genetics, competition, and predation) with introduced species. We developed tables of potential donors by species and characterized potential sources (hatchery and natural origins), populations (individual runs), broodstock management and history, and potential constraints (that is, Endangered Species Act [ESA] listing, Evolutionarily Significant Unit concerns, pathogens, and availability). During the workshops, a group of regional fisheries and topic experts subjectively ranked the relative risks of pathogens, genetic effects, predation, and competition to resident fish and reintroduced salmonids. We assessed the pathogen risk of each potential donor for introducing new pathogens and the increased burden to existing pathogens for resident species upstream of the dams. We considered genetic risks to resident and downstream conspecifics and ecological impacts, including competition for food and space, predator-prey interactions, and ecosystem benefits/impacts. Each reintroduced species donor source was ranked based on abundance/viability (demographic risk to source and feasibility of collection), ancestral/genetic similarity (evolutionary similarity to historical populations), local adaptation (geographic proximity/similarity of source conditions to reintroduction conditions), and life history compatibility (including migration; spawn timing; and relative usage of reservoir, main-stem, or tributary habitats) with environmental conditions in the reintroduction area. We synthesized this information by species for all potential donors, in which an overall score and ranking system was established for decision support in donor selection for reintroduction into the upper Columbia River. We also provided information outside the ranking process by:Identifying predator-prey interactions and competition for food and space among species,Developing a decision support framework for donor selection, andProviding decision support for reintroduction strategies.

Keeping the Focus on Underserved Students, Privilege, and Power: A Reaction to Clements and Sarama

ERIC Educational Resources Information Center

Kitchen, Richard; Berk, Sarabeth

2017-01-01

In our response to Clements and Sarama (2017), we address the 5 issues that they identify as criticisms of our Research Commentary (Kitchen & Berk, 2016). As in our original commentary, we highlight concerns we have regarding the delivery of [computer-assisted instruction] CAI programs and potential misuses of CAI, particularly at Title I…

Zika Virus and Pregnancy.

PubMed

Stagg, Denise; Hurst, Helen M

2016-01-01

Recent outbreaks of Zika virus and reports linking infection in pregnant women with microcephaly in newborns have caused concern worldwide. Information has been evolving rapidly. Nurses and other clinicians, especially those who work with women of childbearing age, play a pivotal role in disseminating accurate information and identifying potential cases of Zika virus infection. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

How Management Information Systems Can Enhance the Air Force Drug Testing Program

DTIC Science & Technology

1989-12-01

promising processes to positively identify potential system users (46:401). Scope This study will cover issues concerning the Air Force drug testing...7 Scope....................10 Limitations of the Research . . . 10 Investigative Questions ............ 10 Expected Benefits of the Study . . . . 11...Resource Allocation. ....... 41 M1.>ethodology....................44 The Historical Research Method . . .. 44 The Historical Research Method for this Study

A risk-based classification scheme for genetically modified foods. I: Conceptual development.

PubMed

Chao, Eunice; Krewski, Daniel

2008-12-01

The predominant paradigm for the premarket assessment of genetically modified (GM) foods reflects heightened public concern by focusing on foods modified by recombinant deoxyribonucleic acid (rDNA) techniques, while foods modified by other methods of genetic modification are generally not assessed for safety. To determine whether a GM product requires less or more regulatory oversight and testing, we developed and evaluated a risk-based classification scheme (RBCS) for crop-derived GM foods. The results of this research are presented in three papers. This paper describes the conceptual development of the proposed RBCS that focuses on two categories of adverse health effects: (1) toxic and antinutritional effects, and (2) allergenic effects. The factors that may affect the level of potential health risks of GM foods are identified. For each factor identified, criteria for differentiating health risk potential are developed. The extent to which a GM food satisfies applicable criteria for each factor is rated separately. A concern level for each category of health effects is then determined by aggregating the ratings for the factors using predetermined aggregation rules. An overview of the proposed scheme is presented, as well as the application of the scheme to a hypothetical GM food.

Recreational System Optimization to Reduce Conflict on Public Lands

NASA Astrophysics Data System (ADS)

Shilling, Fraser; Boggs, Jennifer; Reed, Sarah

2012-09-01

In response to federal administrative rule, the Tahoe National Forest (TNF), California, USA engaged in trail-route prioritization for motorized recreation (e.g., off-highway-vehicles) and other recreation types. The prioritization was intended to identify routes that were suitable and ill-suited for maintenance in a transportation system. A recreational user survey was conducted online ( n = 813) for user preferences for trail system characteristics, recreational use patterns, and demographics. Motorized trail users and non-motorized users displayed very clear and contrasting preferences for the same system. As has been found by previous investigators, non-motorized users expressed antagonism to motorized use on the same recreational travel system, whereas motorized users either supported multiple-use routes or dismissed non-motorized recreationists' concerns. To help the TNF plan for reduced conflict, a geographic information system (GIS) based modeling approach was used to identify recreational opportunities and potential environmental impacts of all travel routes. This GIS-based approach was based on an expert-derived rule set. The rules addressed particular environmental and recreation concerns in the TNF. Route segments were identified that could be incorporated into minimal-impact networks to support various types of recreation. The combination of potential impacts and user-benefits supported an optimization approach for an appropriate recreational travel network to minimize environmental impacts and user-conflicts in a multi-purpose system.

A screening-level assessment of the health risks of chronic smoke exposure for wildland firefighters.

PubMed

Booze, Thomas F; Reinhardt, Timothy E; Quiring, Sharon J; Ottmar, Roger D

2004-05-01

A screening health risk assessment was performed to assess the upper-bound risks of cancer and noncancer adverse health effects among wildland firefighters performing wildfire suppression and prescribed burn management. Of the hundreds of chemicals in wildland fire smoke, we identified 15 substances of potential concern from the standpoints of concentration and toxicology; these included aldehydes, polycyclic aromatic hydrocarbons, carbon monoxide, benzene, and respirable particulate matter. Data defining daily exposures to smoke at prescribed burns and wildfires, potential days of exposure in a year, and career lengths were used to estimate average and reasonable maximum career inhalation exposures to these substances. Of the 15 substances in smoke that were evaluated, only benzene and formaldehyde posed a cancer risk greater than 1 per million, while only acrolein and respirable particulate matter exposures resulted in hazard indices greater than 1.0. The estimated upper-bound cancer risks ranged from 1.4 to 220 excess cancers per million, and noncancer hazard indices ranged from 9 to 360, depending on the exposure group. These values only indicate the likelihood of adverse health effects, not whether they will or will not occur. The risk assessment process narrows the field of substances that deserve further assessment, and the hazards identified by risk assessment generally agree with those identified as a concern in occupational exposure assessments.

Risk-Based High-Throughput Chemical Screening and Prioritization using Exposure Models and in Vitro Bioactivity Assays.

PubMed

Shin, Hyeong-Moo; Ernstoff, Alexi; Arnot, Jon A; Wetmore, Barbara A; Csiszar, Susan A; Fantke, Peter; Zhang, Xianming; McKone, Thomas E; Jolliet, Olivier; Bennett, Deborah H

2015-06-02

We present a risk-based high-throughput screening (HTS) method to identify chemicals for potential health concerns or for which additional information is needed. The method is applied to 180 organic chemicals as a case study. We first obtain information on how the chemical is used and identify relevant use scenarios (e.g., dermal application, indoor emissions). For each chemical and use scenario, exposure models are then used to calculate a chemical intake fraction, or a product intake fraction, accounting for chemical properties and the exposed population. We then combine these intake fractions with use scenario-specific estimates of chemical quantity to calculate daily intake rates (iR; mg/kg/day). These intake rates are compared to oral equivalent doses (OED; mg/kg/day), calculated from a suite of ToxCast in vitro bioactivity assays using in vitro-to-in vivo extrapolation and reverse dosimetry. Bioactivity quotients (BQs) are calculated as iR/OED to obtain estimates of potential impact associated with each relevant use scenario. Of the 180 chemicals considered, 38 had maximum iRs exceeding minimum OEDs (i.e., BQs > 1). For most of these compounds, exposures are associated with direct intake, food/oral contact, or dermal exposure. The method provides high-throughput estimates of exposure and important input for decision makers to identify chemicals of concern for further evaluation with additional information or more refined models.

Family physicians’ perspectives on personal health records

PubMed Central

Yau, Gary L.; Williams, Andrew S.; Brown, Judith Belle

2011-01-01

Abstract Objective To explore FPs’ perspectives on the value of personal health records (PHRs) in primary care and the implementation and adoption of PHRs in Canada. Design A qualitative design using semistructured interviews. Setting Southwestern Ontario. Participants Ten FPs. Methods The 10 FPs participated in semistructured interviews, which were audiotaped and transcribed verbatim. An iterative approach using immersion and crystallization was employed for analysis. Main findings Participants were generally positive about PHRs, and were attracted to their portability and potential to engage patients in health care. Their concerns focused on 3 main themes: data management, practice management, and the patient-physician relationship. Subthemes included security, privacy, reliability of data, workload, remuneration, physician obligations, patient misinterpretation of medical information, and electronic communication displacing face-to-face visits. Participants identified 3 key facilitators for adoption of PHR systems: integration with existing electronic health record systems, ease of use without being a burden on either time or money, and offering a demonstrated added value to family practice. Conclusion This study replicates previously published literature about FP concerns and opinions, and it further identifies remuneration as a potential barrier in Canadian fee-for-service payment models. Participants identified 3 key facilitators, which were suggested for implementation and adoption of PHRs, providing a basis for future research and development of these systems for use in Canadian family practice. PMID:21642732

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

Shin, Hyeong -Moo; Ernstoff, Alexi; Arnot, Jon A.

We present a risk-based high-throughput screening (HTS) method to identify chemicals for potential health concerns or for which additional information is needed. The method is applied to 180 organic chemicals as a case study. We first obtain information on how the chemical is used and identify relevant use scenarios (e.g., dermal application, indoor emissions). For each chemical and use scenario, exposure models are then used to calculate a chemical intake fraction, or a product intake fraction, accounting for chemical properties and the exposed population. We then combine these intake fractions with use scenario-specific estimates of chemical quantity to calculate dailymore » intake rates (iR; mg/kg/day). These intake rates are compared to oral equivalent doses (OED; mg/kg/day), calculated from a suite of ToxCast in vitro bioactivity assays using in vitro-to-in vivo extrapolation and reverse dosimetry. Bioactivity quotients (BQs) are calculated as iR/OED to obtain estimates of potential impact associated with each relevant use scenario. Of the 180 chemicals considered, 38 had maximum iRs exceeding minimum OEDs (i.e., BQs > 1). For most of these compounds, exposures are associated with direct intake, food/oral contact, or dermal exposure. The method provides high-throughput estimates of exposure and important input for decision makers to identify chemicals of concern for further evaluation with additional information or more refined models.« less

Recreational system optimization to reduce conflict on public lands.

PubMed

Shilling, Fraser; Boggs, Jennifer; Reed, Sarah

2012-09-01

In response to federal administrative rule, the Tahoe National Forest (TNF), California, USA engaged in trail-route prioritization for motorized recreation (e.g., off-highway-vehicles) and other recreation types. The prioritization was intended to identify routes that were suitable and ill-suited for maintenance in a transportation system. A recreational user survey was conducted online (n = 813) for user preferences for trail system characteristics, recreational use patterns, and demographics. Motorized trail users and non-motorized users displayed very clear and contrasting preferences for the same system. As has been found by previous investigators, non-motorized users expressed antagonism to motorized use on the same recreational travel system, whereas motorized users either supported multiple-use routes or dismissed non-motorized recreationists' concerns. To help the TNF plan for reduced conflict, a geographic information system (GIS) based modeling approach was used to identify recreational opportunities and potential environmental impacts of all travel routes. This GIS-based approach was based on an expert-derived rule set. The rules addressed particular environmental and recreation concerns in the TNF. Route segments were identified that could be incorporated into minimal-impact networks to support various types of recreation. The combination of potential impacts and user-benefits supported an optimization approach for an appropriate recreational travel network to minimize environmental impacts and user-conflicts in a multi-purpose system.

Multiorgan Involvement Confounding the Diagnosis of Bartonella henselae Infective Endocarditis in Children With Congenital Heart Disease.

PubMed

Ouellette, Christopher P; Joshi, Sarita; Texter, Karen; Jaggi, Preeti

2017-05-01

Two children with congenital heart disease status post surgical correction presented with prolonged constitutional symptoms, hepatosplenomegaly and pancytopenia. Concern for malignancy prompted bone marrow biopsies that were without evidence thereof. In case 1, echocardiography identified a multilobulated vegetation on the conduit valve. In case 2, transthoracic, transesophageal and intracardiac echocardiography were performed and were without evidence of cardiac vegetations; however, pulmonic emboli raised concern for infective endocarditis. Both patients underwent surgical resection of the infected material and had histopathologic evidence of infective endocarditis. Further diagnostics identified elevated cytoplasmic antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies in addition to acute kidney injury with crescentic glomerulonephritis on renal biopsy. Serologic evidence of infection with Bartonella henselae was observed in both patients. These 2 cases highlight the potential multiorgan involvement that may confound the diagnosis of culture-negative infective endocarditis caused by B. henselae.

TANF policy: past, present, and future directions.

PubMed

Washington, Gregory; Sullivan, Michael; Washington, Edwina Thomas

2006-01-01

The purpose of this article is to offer a brief and concise history of relevant public welfare policies for a discussion of the effects of public welfare reform, and how it impacts families in ways not comprehensively understood. Social scientists' concerns about the potential for the families to be thrust into an "extreme poverty" status due to the forced workforce participation requirement and expiration of time limited benefits is discussed. A second concern regarding a "one size fits all" approach to work requirements for TANF recipients being unrealistic and insensitive is also discussed. The authors recommend a comprehensive multi-system analysis to determine the impact of welfare reform. There is also a recommendation that the workforce requirements should correlate to an assessment score based on the ability of welfare recipients to function in identified areas. Implications of maintaining a welfare reform policy status quo are identified.

Caregiving by Teens for Family Members With Huntington Disease

PubMed Central

Williams, Janet K.; Ayres, Lioness; Specht, Janet; Sparbel, Kathleen; Klimek, Mary Lou

2016-01-01

The purpose of this report is to describe caregiving by teens for family members with Huntington disease (HD). Thirty-two teens in HD families in the United States and Canada participated in focus groups from 2002 to 2005 in a study to identify concerns and strategies to manage concerns. An unexpected finding was 24 (77%) described caregiving activities. Descriptive analysis of caregiving statements identified themes of Tasks and Responsibilities, Subjective Burden, Caregiving in Context of Personal Risk for HD, and Decisional Responsibility. Teens took an active part in nearly all aspects of care with the exception of contacting health care providers and attending doctors’ appointments. Some described emotional distress, and many provided care knowing they had the potential to develop HD. Teens recognized the need for decisions but lacked the authority to make these decisions. Findings may be relevant for other teens who strive to meet caregiver and student roles and developmental tasks. PMID:19465560

Scientific millenarianism

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

Weinberg, A.M.

Today, for the first time, scientific concerns are seriously being addressed that span future times--hundreds, even thousands, or more years in the future. One is witnessing what the author calls scientific millenarianism. Are such concerns for the distant future exercises in futility, or are they real issues that, to the everlasting gratitude of future generations, this generation has identified, warned about and even suggested how to cope with in the distant future? Can the four potential catastrophes--bolide impact, CO{sub 2} warming, radioactive wastes and thermonuclear war--be avoided by technical fixes, institutional responses, religion, or by doing nothing? These are themore » questions addressed in this paper.« less

'Hesitant compliers': Qualitative analysis of concerned fully-vaccinating parents.

PubMed

Enkel, Stephanie L; Attwell, Katie; Snelling, Thomas L; Christian, Hayley E

2017-10-11

Some parents are hesitant about vaccines and yet still vaccinate their children. Vaccine behaviours are not fixed and parents who are concerned but nonetheless adherent to standard schedules could switch to an unconventional schedule, delaying or cherry-picking vaccines. There is a need to better understand vaccine hesitancy in specific contexts, acknowledging cultural and geographical variation, to ensure interventions targeting hesitancy are well directed and received. To identify the behaviours, knowledge and attitudes of 'hesitant compliers' in Perth, Western Australia, nine one-on-one in-depth interviews were conducted with vaccinating parents of children (<5 years) who were identified as being hesitant. Interview transcripts were analysed qualitatively and themes developed inductively, following a constructivist paradigm. Parents saw vaccination as important for themselves and their community, despite their limited knowledge of vaccine preventable diseases. Parents reported concerns about potential side effects, and worried about the safety of the measles-mumps-rubella (MMR) and seasonal influenza vaccines. Concerned about the role of anti-vaccination information in the community, some sought to isolate themselves from parents who did not vaccinate, although others were concerned that this could entrench non-vaccinators' behaviours. Parents' views were all underlaid by two pivotal 'vaccine-related events' that had occurred in the community: the severe injury of a baby from seasonal influenza vaccination in 2010, and the death of a baby from whooping cough in 2015. Parents interpreted pivotal vaccine-related events in the community as requiring them to take personal responsibility for vaccine decisions. Their reports of continued vaccine fears (evident in international studies in recent decades) demonstrate that vaccine scares have long lasting effects. With vaccine rates high and stable, current strategies appear to be have little impact on addressing parental vaccine concerns. Further research is required to determine the prevalence of hesitancy amongst vaccinating parents and identify critical points for intervention. Copyright © 2017. Published by Elsevier Ltd.

Data-driven identification of potential Zika virus vectors

PubMed Central

Evans, Michelle V; Dallas, Tad A; Han, Barbara A; Murdock, Courtney C; Drake, John M

2017-01-01

Zika is an emerging virus whose rapid spread is of great public health concern. Knowledge about transmission remains incomplete, especially concerning potential transmission in geographic areas in which it has not yet been introduced. To identify unknown vectors of Zika, we developed a data-driven model linking vector species and the Zika virus via vector-virus trait combinations that confer a propensity toward associations in an ecological network connecting flaviviruses and their mosquito vectors. Our model predicts that thirty-five species may be able to transmit the virus, seven of which are found in the continental United States, including Culex quinquefasciatus and Cx. pipiens. We suggest that empirical studies prioritize these species to confirm predictions of vector competence, enabling the correct identification of populations at risk for transmission within the United States. DOI: http://dx.doi.org/10.7554/eLife.22053.001 PMID:28244371

Screening for Autism Spectrum Disorder in Young Children: US Preventive Services Task Force Recommendation Statement.

PubMed

Siu, Albert L; Bibbins-Domingo, Kirsten; Grossman, David C; Baumann, Linda Ciofu; Davidson, Karina W; Ebell, Mark; García, Francisco A R; Gillman, Matthew; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Owens, Douglas K; Phillips, William R; Phipps, Maureen G; Pignone, Michael P

2016-02-16

New US Preventive Services Task Force (USPSTF) recommendation on screening for autism spectrum disorder (ASD) in young children. The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of brief, formal screening instruments for ASD administered during routine primary care visits and the benefits and potential harms of early behavioral treatment for young children identified with ASD through screening. This recommendation applies to children aged 18 to 30 months who have not been diagnosed with ASD or developmental delay and for whom no concerns of ASD have been raised by parents, other caregivers, or health care professionals. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for ASD in young children for whom no concerns of ASD have been raised by their parents or a clinician. (I statement).

Individual and Social Factors Related to Mental Health Concerns among Bisexual Men in the Midwestern United States

PubMed Central

Dodge, Brian; Schnarrs, Phillip W.; Reece, Michael; Martinez, Omar; Goncalves, Gabriel; Malebranche, David; Van Der Pol, Barbara; Nix, Ryan; Fortenberry, J. Dennis

2012-01-01

Research has not yet explored the potential impact of social stress, biphobia, and other factors on the mental health of bisexual men. In-depth interviews were conducted with a diverse sample of 75 men who engaged in bisexual behavior within the past six months. Interviewers explored potential mental health stressors and supports. Many participants reported personal and social challenges associated with bisexuality, which in turn influenced their mental health. Reported instances of stigma toward bisexuality, from both homosexual and heterosexual individuals, impacted participants’ feelings regarding their own sexualities. Isolation was also commonly reported. Programs are greatly needed that focus on the specific mental health and other concerns voiced by these men. Based on our study findings, such programs should emphasize self-acceptance, social network and community building, and ways to maximize available social support, similar to community-level empowerment interventions that have shown success among gay-identified men. PMID:22745591

Civil Uses of Remotely Piloted Aircraft

NASA Technical Reports Server (NTRS)

Aderhold, J. R.; Gordon, G.; Scott, G. W.

1976-01-01

The technology effort is identified and assessed that is required to bring the civil uses of RPVs to fruition and to determine whether or not the potential market is real and economically practical, the technologies are within reach, the operational problems are manageable, and the benefits are worth the cost. To do so, the economic, technical, and environmental implications are examined. The time frame is 1980-85. Representative uses are selected; detailed functional and performance requirements are derived for RPV systems; and conceptual system designs are devised. Total system cost comparisons are made with non-RPV alternatives. The potential market demand for RPV systems is estimated. Environmental and safety requirements are examined, and legal and regulatory concerns are identified. A potential demand for 2,000-11,000 RPV systems is estimated. Typical cost savings of 25-35% compared to non-RPV alternatives are determined. There appear to be no environmental problems, and the safety issue appears manageable.

Accidental Falls Among Geriatric Patients: Can More Be Prevented?

PubMed Central

Johnson, Edwin T.

1985-01-01

The potential for accidental falls among geriatric patients is of mounting concern. Two hundred forty-one accidental falls over a 12-month period at the VA Medical Center were analyzed retrospectively and the literature reviewed in order to highlight factors that have bearing on the incidence and severity of falls. If a patient's potential for falling could be identified through a grading system based on these premonitory features, preventive measures might be more clearly focused where needed to reduce this frequent hazard in our hospital population. PMID:4046062

Minimizing the injury potential of deploying airbag interactions with car occupants.

PubMed

Mertz, Harold J; Prasad, Priya; Dalmotas, Dainius

2013-11-01

Minimizing the injury potential of the interactions between deploying airbags and car occupants is the major issue with the design of airbag systems. This concern was identified in 1964 by Carl Clark when he presented the results of human volunteer and dummy testing of the "Airstop" system that was being developed for aircraft. The following is a chronological summary of the actions taken by the car manufacturers, airbag suppliers, SAE and ISO task groups, research institutes and universities, and consumer and government groups to address this issue.

Information Science Panel joint meeting with Imaging Science Panel

NASA Technical Reports Server (NTRS)

1982-01-01

Specific activity in information extraction science (taken to include data handling) is needed to: help identify the bounds of practical missions; identify potential data handling and analysis scenarios; identify the required enabling technology; and identify the requirements for a design data base to be used by the disciplines in determining potential parameters for future missions. It was defined that specific analysis topics were a function of the discipline involved, and therefore no attempt was made to define any specific analysis developments required. Rather, it was recognized that a number of generic data handling requirements exist whose solutions cannot be typically supported by the disciplines. The areas of concern were therefore defined as: data handling aspects of system design considerations; enabling technology for data handling, with specific attention to rectification and registration; and enabling technology for analysis. Within each of these areas, the following topics were addressed: state of the art (current status and contributing factors); critical issues; and recommendations for research and/or development.

Clinicians' Reports in Electronic Health Records Versus Patients' Concerns in Social Media: A Pilot Study of Adverse Drug Reactions of Aspirin and Atorvastatin.

PubMed

Topaz, Maxim; Lai, Kenneth; Dhopeshwarkar, Neil; Seger, Diane L; Sa'adon, Roee; Goss, Foster; Rozenblum, Ronen; Zhou, Li

2016-03-01

Large databases of clinician reported (e.g., allergy repositories) and patient reported (e.g., social media) adverse drug reactions (ADRs) exist; however, whether patients and clinicians report the same concerns is not clear. Our objective was to compare electronic health record data and social media data to better understand differences and similarities between clinician-reported ADRs and patients' concerns regarding aspirin and atorvastatin. This pilot study explored a large repository of electronic health record data and social media data for clinician-reported ADRs and patients concerns for two common medications: aspirin (n = 31,817 ADRs accessible in clinical data; n = 19,186 potential ADRs accessible in social media data) and atorvastatin (n = 15,047 ADRs accessible in clinical data; n = 23,408 potential ADRs accessible in social media data). We found that the most frequently reported ADRs matched the most frequent patients' concerns. However, several less frequently reported reactions were more prevalent on social media (i.e., aspirin-induced hypoglycemia was discussed only on social media). Overall, we found a relatively strong positive and statistically significant correlation between the frequency ranking of reactions and patients' concerns for atorvastatin (Pearson's r = 0.61, p < 0.001) but not for aspirin (Pearson's r = 0.1, p = 0.69). Future studies should develop further natural language methods for a more detailed data analysis (i.e., identifying causality and temporal aspects in the social media data).

Metasynthesis findings: potential versus reality.

PubMed

Finfgeld-Connett, Deborah

2014-11-01

Early on, qualitative researchers predicted that metasynthesis research had the potential to significantly push knowledge development forward. More recently, scholars have questioned whether this is actually occurring. To examine this concern, a randomly selected sample of metasynthesis articles was systematically reviewed to identify the types of findings that have been produced. Based on this systematic examination, it appears that findings from metasynthesis investigations might not be reaching their full potential. Metasynthesis investigations frequently result in isolated findings rather than findings in relationship, and opportunities to generate research hypotheses and theoretical models are not always fully realized. With this in mind, methods for moving metasynthesis findings into relationship are discussed. © The Author(s) 2014.

Perceptions, motivations, and concerns about living organ donation among people living with HIV.

PubMed

Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Bollinger, Juli; Seaman, Shanti; Brown, Diane; Durand, Christine M; Segev, Dorry L; Sugarman, Jeremy

2018-05-03

Recent changes to United States law now permit people living with HIV (PLWH) to donate organs to HIV-infected (HIV+) recipients under research protocols. PLWH may have unique motivations for and concerns about living donation and understanding them is critical to ensuring the integrity of this novel approach to organ transplantation. We conducted in-depth interviews with PLWH from an urban HIV clinic who had previously indicated their willingness to be a living donor. Interviews elicited information on their motivations, perceived benefits, and concerns regarding living donation. Codes were identified inductively and then organized into themes and subthemes. Two coders independently analyzed the interviews and reconciled differences in coding by consensus. Thematic saturation was reached after 20 interviews. Motivations for living donation among PLWH included an altruistic desire to help others as well as HIV-specific motivations including solidarity with potential recipients and a desire to overcome HIV-related stigma. Perceived benefits of living donation included gratification from saving or improving the recipient's life and conferring a sense of normalcy for the HIV+ donor. Concerns about donation included the possibility of a prolonged recovery period, organ failure, and transmission of another strain of the virus to the recipients. PLWH had unique motivations, perceived benefits, and concerns about living donation in addition to those previously identified in the general population. These unique factors should be addressed in research protocols, informed consent processes, and the education and training of independent living donor advocates so that these endeavors are ethically sound.

Early concern and disregard for others as predictors of antisocial behavior

PubMed Central

Rhee, Soo Hyun; Friedman, Naomi P.; Boeldt, Debra L.; Corley, Robin P.; Hewitt, John. K.; Knafo, Ariel; Lahey, Benjamin B.; Robinson, JoAnn; Van Hulle, Carol A.; Waldman, Irwin D.; Young, Susan E.; Zahn-Waxler, Carolyn

2012-01-01

Background Prediction of antisocial behavior is important given its adverse impact on both the individuals engaging in antisocial behavior and society. Additional research identifying early predictors of future antisocial behavior, or antisocial propensity, is needed. The present study tested the hypothesis that both concern for others and active disregard for others in distress in toddlers and young children predict antisocial behavior during middle childhood and adolescence. Methods A representative sample of same-sex twins (N = 956) recruited in Colorado was examined. Mother-rated and researcher-observed concern and disregard for others assessed at age 14 to 36 months were examined as predictors of parent- (age 4 to 12), teacher- (age 7 to 12), and self-reported (age 17) antisocial behavior. Results Observed disregard for others predicted antisocial behavior assessed by three different informants (parents, teachers, and self), including antisocial behavior assessed 14 years later. It also predicted a higher-order antisocial behavior factor (β = .58, p < .01) after controlling for observed concern for others. Mother-rated disregard for others predicted parent-reported antisocial behavior. Contrary to predictions, neither mother-rated nor observed concern for others inversely predicted antisocial behavior. Results of twin analyses suggested that the covariation between observed disregard for others and antisocial behavior was due to shared environmental influences. Conclusions Disregard for others in toddlerhood/early childhood is a strong predictor of antisocial behavior in middle childhood and adolescence. The results suggest the potential need for early assessment of disregard for others and the development of potential interventions. PMID:23320806

Bacterial Populations Associated with Smokeless Tobacco Products

PubMed Central

Han, Jing; Sanad, Yasser M.; Deck, Joanna; Sutherland, John B.; Li, Zhong; Walters, Matthew J.; Duran, Norma; Holman, Matthew R.

2016-01-01

ABSTRACT There are an estimated 8 million users of smokeless tobacco products (STPs) in the United States, and yet limited data on microbial populations within these products exist. To better understand the potential microbiological risks associated with STP use, a study was conducted to provide a baseline microbiological profile of STPs. A total of 90 samples, representing 15 common STPs, were purchased in metropolitan areas in Little Rock, AR, and Washington, DC, in November 2012, March 2013, and July 2013. Bacterial populations were evaluated using culture, pyrosequencing, and denaturing gradient gel electrophoresis (DGGE). Moist-snuff products exhibited higher levels of bacteria (average of 1.05 × 106 CFU/g STP) and diversity of bacterial populations than snus (average of 8.33 × 101 CFU/g STP) and some chewing tobacco products (average of 2.54 × 105 CFU/g STP). The most common species identified by culturing were Bacillus pumilus, B. licheniformis, B. safensis, and B. subtilis, followed by members of the genera Oceanobacillus, Staphylococcus, and Tetragenococcus. Pyrosequencing analyses of the 16S rRNA genes identified the genera Tetragenococcus, Carnobacterium, Lactobacillus, Geobacillus, Bacillus, and Staphylococcus as the predominant taxa. Several species identified are of possible concern due to their potential to cause opportunistic infections and reported abilities to reduce nitrates to nitrites, which may be an important step in the formation of carcinogenic tobacco-specific N′-nitrosamines. This report provides a microbiological baseline to help fill knowledge gaps associated with microbiological risks of STPs and to inform potential regulations regarding manufacture and testing of STPs. IMPORTANCE It is estimated that there 8 million users of smokeless tobacco products (STPs) in the United States; however, there are limited data on microbial populations that exist within these products. The current study was undertaken to better understand the potential microbiological risks associated with STP use and provide a baseline microbiological profile of STPs. Several bacterial species were identified that are of possible concern due to their potential to cause opportunistic infections. In addition, some species have abilities to reduce nitrates to nitrites, which may be an important step in the formation of carcinogenic tobacco-specific N′-nitrosamines. Overall, this report provides a microbiological baseline to help fill knowledge gaps related to the microbiological risks of STPs and to inform potential regulations regarding the manufacture and testing of STPs. PMID:27565615

Spatial earthquake hazard assessment of Evansville, Indiana

USGS Publications Warehouse

Rockaway, T.D.; Frost, J.D.; Eggert, D.L.; Luna, R.

1997-01-01

The earthquake hazard has been evaluated for a 150-square-kilometer area around Evansville, Indiana. GIS-QUAKE, a system that combines liquefaction and ground motion analysis routines with site-specific geological, geotechnical, and seismological information, was used for the analysis. The hazard potential was determined by using 586 SPT borings, 27 CPT sounding, 39 shear-wave velocity profiles and synthesized acceleration records for body-wave magnitude 6.5 and 7.3 mid-continental earthquakes, occurring at distances of 50 km and 250 km, respectively. The results of the GIS-QUAKE hazard analyses for Evansville identify areas with a high hazard potential that had not previously been identified in earthquake zonation studies. The Pigeon Creek area specifically is identified as having significant potential for liquefaction-induced damage. Damage as a result of ground motion amplification is determined to be a moderate concern throughout the area. Differences in the findings of this zonation study and previous work are attributed to the size and range of the database, the hazard evaluation methodologies, and the geostatistical interpolation techniques used to estimate the hazard potential. Further, assumptions regarding the groundwater elevations made in previous studies are also considered to have had a significant effect on the results.

Barrier Coatings for Refractory Metals and Superalloys

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

SM Sabol; BT Randall; JD Edington

2006-02-23

In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements.more » Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life.« less

Identification of informative features for predicting proinflammatory potentials of engine exhausts.

PubMed

Wang, Chia-Chi; Lin, Ying-Chi; Lin, Yuan-Chung; Jhang, Syu-Ruei; Tung, Chun-Wei

2017-08-18

The immunotoxicity of engine exhausts is of high concern to human health due to the increasing prevalence of immune-related diseases. However, the evaluation of immunotoxicity of engine exhausts is currently based on expensive and time-consuming experiments. It is desirable to develop efficient methods for immunotoxicity assessment. To accelerate the development of safe alternative fuels, this study proposed a computational method for identifying informative features for predicting proinflammatory potentials of engine exhausts. A principal component regression (PCR) algorithm was applied to develop prediction models. The informative features were identified by a sequential backward feature elimination (SBFE) algorithm. A total of 19 informative chemical and biological features were successfully identified by SBFE algorithm. The informative features were utilized to develop a computational method named FS-CBM for predicting proinflammatory potentials of engine exhausts. FS-CBM model achieved a high performance with correlation coefficient values of 0.997 and 0.943 obtained from training and independent test sets, respectively. The FS-CBM model was developed for predicting proinflammatory potentials of engine exhausts with a large improvement on prediction performance compared with our previous CBM model. The proposed method could be further applied to construct models for bioactivities of mixtures.

Study of the Application of Separation Control by Unsteady Excitation to Civil Transport Aircraft

NASA Technical Reports Server (NTRS)

McLean, J. D.; Crouch, J. D.; Stoner, R. C.; Sakurai, S.; Seidel, G. E.; Feifel, W. M.; Rush, H. M.

1999-01-01

This study provides a preliminary assessment of the potential benefits of applying unsteady separation control to transport aircraft. Estimates are given for some of the costs associated with a specific application to high-lift systems. High-leverage areas for future research were identified during the course of the study. The study was conducted in three phases. Phase 1 consisted of a coarse screening of potential applications within the aerodynamics discipline. Potential benefits were identified and in some cases quantified in a preliminary way. Phase 2 concentrated on the application to the wing high-lift system, deemed to have the greatest potential benefit for commercial transports. A team of experts, including other disciplines (i.e. hydraulic, mechanical, and electrical systems, structures, configurations, manufacturing, and finance), assessed the feasibility, benefits, and costs to arrive at estimates of net benefits. In both phases of the study, areas of concern and areas for future research were identified. In phase 3 of this study, the high-leverage areas for future research were prioritized as a guide for future efforts aimed at the application of active flow control to commercial transport aircraft.

Identifying potential conflict associated with oil and gas exploration in Texas state coastal waters: A multicriteria spatial analysis.

PubMed

Brody, Samuel D; Grover, Himanshu; Bernhardt, Sarah; Tang, Zhenghong; Whitaker, Bianca; Spence, Colin

2006-10-01

Recent interest in expanding offshore oil production within waters of the United States has been met with opposition by groups concerned with recreational, environmental, and aesthetic values associated with the coastal zone. Although the proposition of new oil platforms off the coast has generated conflict over how coastal resources should be utilized, little research has been conducted on where these user conflicts might be most intense and which sites might be most suitable for locating oil production facilities in light of the multiple, and often times, competing interests. In this article, we develop a multiple-criteria spatial decision support tool that identifies the potential degree of conflict associated with oil and gas production activities for existing lease tracts in the coastal margin of Texas. We use geographic information systems to measure and map a range of potentially competing representative values impacted by establishing energy extraction infrastructure and then spatially identify which leased tracts are the least contentious sites for oil and gas production in Texas state waters. Visual and statistical results indicate that oil and gas lease blocks within the study area vary in their potential to generate conflict among multiple stakeholders.

Social media use for occupational lung disease.

PubMed

Harber, Philip; Leroy, Gondy

2017-04-01

Social media have great impact on all aspects of life throughout the world. The utilization of social media for occupational lung disease, however, has been much more limited. This article summarizes recent literature concerning social media for occupational lung disease and identifies areas for additional use. Social media are used in six relevant areas: information dissemination, peer-to-peer communication, survey research data collection, participatory research and exposome data acquisition, assessing public concerns, and knowledge generation. There are very clear advantages for information dissemination from experts to workers and on a peer-to-peer basis, although variable credibility and accuracy concerns persist. For research, social media have been used for acquiring data posted for nonresearch purposes and for efficiently collecting information specifically for research. The benefits of efficiency, democracy, and very large data sources may counterbalance concerns about inadequate specification of recruitment strategies and limited control over data quality. The potential benefits of using social media for lung health-workplace interactions are much greater than the very limited current utilization.

Cognitive, personality, and social factors associated with adolescents' online personal information disclosure.

PubMed

Liu, Cong; Ang, Rebecca P; Lwin, May O

2013-08-01

The current study aims to understand the factors that influence adolescents' disclosure of personally identifiable information (PII) on social networking sites (SNSs). A survey was conducted among 780 adolescent participants (between 13 and 18) who were Facebook users. Structural equation modeling was used for analyzing the data and obtaining an overarching model that include cognitive, personality, and social factors that influence adolescents' PII disclosure. Results showed privacy concern as the cognitive factor reduces adolescents' PII disclosure and it serves as a potential mediator for personality and social factors. Amongst personality factors, narcissism was found to directly increase PII disclosure, and social anxiety indirectly decreases PII disclosure by increasing privacy concern. Amongst social factors, active parental mediation decreases PII disclosure directly and indirectly by increasing privacy concern. Restrictive parental mediation decreases PII disclosure only indirectly by increasing privacy concern. Implications of the findings to parents, educators, and policy makers were discussed. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

AN EXPLORATORY INVESTIGATION OF SELECTED STUDENT TYPES AT THREE UNIVERSITY OF CALIFORNIA CAMPUSES, A PRELIMINARY REPORT.

ERIC Educational Resources Information Center

MOCK, KATHLEEN; AND OTHERS

A CONCERN OVER THE LOSS OF POTENTIALLY CAPABLE STUDENTS LED RESEARCH PERSONNEL ON THE DAVIS, LOS ANGELES, AND SANTA BARBARA CAMPUSES OF THE UNIVERSITY OF CALIFORNIA TO JOIN FORCES IN A STUDY TO IDENTIFY WAYS FOR ACCOMMODATING THE VARIOUS TYPES OF STUDENTS ADMITTED TO THE THREE SCHOOLS. A 2-YEAR PROJECT WAS PLANNED. THIS INTERIM REPORT COVERED A…

Identifying Issues and Concerns with the Use of Interval-Based Systems in Single Case Research Using a Pilot Simulation Study

ERIC Educational Resources Information Center

Ledford, Jennifer R.; Ayres, Kevin M.; Lane, Justin D.; Lam, Man Fung

2015-01-01

Momentary time sampling (MTS), whole interval recording (WIR), and partial interval recording (PIR) are commonly used in applied research. We discuss potential difficulties with analyzing data when these systems are used and present results from a pilot simulation study designed to determine the extent to which these issues are likely to be…

[Internet and video games among students of Reunion Island in 2010: uses, misuses, perceptions and associated factors].

PubMed

Ricquebourg, M; Bernède-Bauduin, C; Mété, D; Dafreville, C; Stojcic, I; Vauthier, M; Galland, M-C

2013-12-01

Describe the uses of Internet and video games and quantify associated problematic uses. Information on student practices concerning the use of the Internet and video games was collected with a self-administered questionnaire. Problematic uses were identified with specific tools (Young criteria and Tejeiro criteria) and with self-evaluative questions. Information on life events with traumatic potential and use of psychoactive substances was also collected. Logistic regression models were applied to identify possible associated factors. Based on a sample of 1119 subjects, this study showed that students in Reunion Island are very concerned by the uses of the Internet and video games (98% and 46% of respondents). The prevalence of problematic use of the Internet accounted for 6% of respondents. Problematic uses of video games involved 8% of students (18% of gamers). Young people seemed unaware of their problematic practices and were seeking informations. The public respondent was also characterized by vulnerable situations (traumatic events induring their lives, consumption of psychoactive substances). Significant associations (with no identified causality) were examined, in particular between problematic uses of Internet and video games, and life events with traumatic potential. These first estimates of the prevalence of problematic use of Internet and video games on Reunion Island are important to promote locally collective awareness about these modern addictions. These results will be used to guide local actions of prevention and care, especially among younger generations. But it is necessary to conduct further work to better identify the factors associated with these problematic uses (determinants, comorbidities addictive…). Copyright © 2013. Published by Elsevier Masson SAS.

Let's face it: patient and parent perspectives on incorporating a Facebook group into a multidisciplinary weight management program.

PubMed

Woolford, Susan J; Esperanza Menchaca, Alicia D M; Sami, Areej; Blake, Natalie

2013-08-01

Social media may have the potential to enhance weight management efforts. However, the acceptability of incorporating this entity into pediatrics is unknown. The objective of this project was to explore patients' and parents' perspectives about developing a Facebook group as a component of a pediatric weight management program. Semistructured interviews were performed between September, 2011, and February, 2012, with patients and parents in a multidisciplinary weight management program. Interviews explored participants' perceptions of potential benefits, concerns, and preferences related to a program-specific Facebook group. Transcripts were reviewed and themes identified. The study concluded when thematic saturation was achieved. Participants (n=32) were largely enthusiastic about the idea of a program-specific Facebook group for adolescents. Most preferred a secret group, where only participants would know of the group's existence or group members' identity. No parents expressed concern about security or privacy related to a program-specific Facebook group; one parent expressed concern about undesirable advertisements. Participants endorsed a variety of ideas for inclusion on the page, including weight loss tips, live chats with providers, quizzes, and an incentive system where participants could gain points for making healthy choices. Many parents requested a separate parent-focused page, an idea that was supported by the adolescents. This study suggests that participants perceive potential benefits from incorporating social media interventions into pediatric weight management efforts. Privacy and security issues do not appear to be major parental concerns. Future work should explore the impact of program-specific social media interventions on outcomes for patients in weight management programs.

Circular RNA expression in basal cell carcinoma.

PubMed

Sand, Michael; Bechara, Falk G; Sand, Daniel; Gambichler, Thilo; Hahn, Stephan A; Bromba, Michael; Stockfleth, Eggert; Hessam, Schapoor

2016-05-01

Circular RNAs (circRNAs), are nonprotein coding RNAs consisting of a circular loop with multiple miRNA, binding sites called miRNA response elements (MREs), functioning as miRNA sponges. This study was performed to identify differentially expressed circRNAs and their MREs in basal cell carcinoma (BCC). Microarray circRNA expression profiles were acquired from BCC and control followed by qRT-PCR validation. Bioinformatical target prediction revealed multiple MREs. Sequence analysis was performed concerning MRE interaction potential with the BCC miRNome. We identified 23 upregulated and 48 downregulated circRNAs with 354 miRNA response elements capable of sequestering miRNA target sequences of the BCC miRNome. The present study describes a variety of circRNAs that are potentially involved in the molecular pathogenesis of BCC.

Review of bulimia nervosa in males.

PubMed

Carlat, D J; Camargo, C A

1991-07-01

The authors describe the distribution of bulimia nervosa among males and identify characteristics that distinguish male bulimics from their female counterparts. Potential references were identified through an English-language literature search using MEDLINE (1966 to April 1990) and through extensive manual searching of textbooks and reviews. All published works with original data or hypotheses concerning bulimia in males were included. Bulimia affects approximately 0.2% of adolescent boys and young adult men, and males account for 10%-15% of all bulimic subjects identified in community-based studies. Compared to their female counterparts, male bulimics appear to have a later age of onset; higher prevalences of premorbid obesity, homosexuality, and asexuality; and less concern with strict weight control. These findings are discussed from biological, psychological, and cultural perspectives to develop a fuller understanding of the pathogenesis of bulimia in males. Bulimia in males has received relatively little attention in the literature. Future research should focus on more rigorous analytic studies that include matched comparison groups of female bulimic and male nonbulimic subjects. Such studies would not only benefit male bulimics but might provide insight into the nature of bulimia in both sexes.

Evaluation of biological and male reproductive-function responses to potential lead exposures in 155-mm-howitzer crewmen. Technical report, Jul 90-Dec 91

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

Weyandt, T.B.

1992-01-01

A collaborative pilot study between the U.S. Army Biomedical Research and Development Laboratory and the National Institute for Occupational Safety and Health was designed to assess the fecundity of male artillery soldiers with potential exposures to airborne lead aerosols. Many soldiers in the initial control population reported possible job-related microwave exposure as radar equipment operators. As a result, a third group of soldiers without potential for lead or microwave exposure, but with similar duty-associated environmental exposure conditions, was selected as a comparison population. Blood hormone levels and semen analyses were conducted on artillerymen (n=30), radar equipment operators (n=20), and themore » comparison group (n=31). Analysis of the questionnaire information revealed that concern about fertility problems motivated participation of some soldiers with potential artillery or microwave exposures. Data analysis was complicated by the small study population size and the confounding variable of perceived infertility. Although the small number of subjects and infertility concerns somewhat compromise the statistical power and general applicability of the study, several statistically significant findings were identified.« less

Stakeholders' views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs.

PubMed

Kalkman, Shona; van Thiel, Ghislaine J M W; Grobbee, Diederick E; Meinecke, Anna-Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M

2016-08-22

We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. We conducted semistructured, in-depth interviews among individuals from different key stakeholder groups (academia and independent research institutions, the pharmaceutical industry, regulators, Health Technology Assessment (HTA) agencies and patients' organizations) through telephone or face-to-face sessions. Interviews were structured around the question "what challenges were experienced or perceived during the design, conduct and/or review of pragmatic trials." Respondents were additionally asked about their views on implementation of pragmatic trials in the drug development process. Thematic analysis was used to identify the ethically relevant features across data sets. We interviewed 34 stakeholders in 25 individual sessions and four group sessions. The four perceived challenges of ethical relevance were: (1) less controlled conditions creating safety concerns, (2) comparison with usual care potentially compromising clinical equipoise, (3) tailored or waivers of informed consent affecting patient autonomy, and (4) minimal interference with "real-world" practice reducing the knowledge value of trial results. We identified stakeholder concerns regarding risk assessment, use of suboptimal usual care as a comparator, tailoring of informed consent procedures and ensuring the social value of pragmatic trials. These concerns increased when respondents were asked about pragmatic trials conducted before market authorization.

The costs versus the perceived benefits of an LCME institutional self-study.

PubMed

Simpson, D E; Golden, D L; Rehm, J M; Kochar, M S; Simons, K B

1998-09-01

To calculate the costs versus the perceived benefits of an institutional self-study done to satisfy the requirements of the Liaison Committee on Medical Education's (LCME's) accreditation process. From postcard questionnaires, the authors determined the hours spent over 18 months from 1994 to 1996 on the institutional self-study by 131 self-study committee members and 64 database compilers at the Medical College of Wisconsin. The committee members also rated the potential utility of the self-study process and the probability that the concerns identified by their subcommittees would be addressed. Administrative costs (self-study coordinating team's hours, supplies, and other expenses) were tracked using calendars and budget subaccount numbers. Personnel costs were calculated using salary data from the Association of American Medical Colleges and the College and Universities Personnel Administrators' survey. Supplies and equipment for the self-study cost $12,158, and the personnel costs, based on an 81% response rate, were estimated at $207,384, for a total of $219,542. The participants in the self-study rated the process as moderately useful, but believed that there was only a medium degree of probability that concerns they had identified would be addressed. Considering the costs of self-study, the process might be more useful if attention were focused less on identifying concerns and more on an institution's demonstrated ability to successfully respond to problems.

Central site monitoring: results from a test of accuracy in identifying trials and sites failing Food and Drug Administration inspection.

PubMed

Lindblad, Anne S; Manukyan, Zorayr; Purohit-Sheth, Tejashri; Gensler, Gary; Okwesili, Paul; Meeker-O'Connell, Ann; Ball, Leslie; Marler, John R

2014-04-01

Site monitoring and source document verification account for 15%-30% of clinical trial costs. An alternative is to streamline site monitoring to focus on correcting trial-specific risks identified by central data monitoring. This risk-based approach could preserve or even improve the quality of clinical trial data and human subject protection compared to site monitoring focused primarily on source document verification. To determine whether a central review by statisticians using data submitted to the Food and Drug Administration (FDA) by clinical trial sponsors can identify problem sites and trials that failed FDA site inspections. An independent Analysis Center (AC) analyzed data from four anonymous new drug applications (NDAs) where FDA had performed site inspections overseen by FDA's Office of Scientific Investigations (OSI). FDA team members in the OSI chose the four NDAs from among all NDAs with data in Study Data Tabulation Model (SDTM) format. Two of the NDAs had data that OSI had deemed unreliable in support of the application after FDA site inspections identified serious data integrity problems. The other two NDAs had clinical data that OSI deemed reliable after site inspections. At the outset, the AC knew only that the experimental design specified two NDAs with significant problems. FDA gave the AC no information about which NDAs had problems, how many sites were inspected, or how many were found to have problems until after the AC analysis was complete. The AC evaluated randomization balance, enrollment patterns, study visit scheduling, variability of reported data, and last digit reference. The AC classified sites as 'High Concern', 'Moderate Concern', 'Mild Concern', or 'No Concern'. The AC correctly identified the two NDAs with data deemed unreliable by OSI. In addition, central data analysis correctly identified 5 of 6 (83%) sites for which FDA recommended rejection of data and 13 of 15 sites (87%) for which any regulatory deviations were identified during inspection. Of the six sites for which OSI reviewed inspections and found no deviations, the central process flagged four at the lowest level of concern, one at a moderate level, and one was not flagged. Central data monitoring during the conduct of a trial while data checking was in progress was not evaluated. Systematic central monitoring of clinical trial data can identify problems at the same trials and sites identified during FDA site inspections. Central data monitoring in conjunction with an overall monitoring process that adapts to identify risks as a trial progresses has the potential to reduce the frequency of site visits while increasing data integrity and decreasing trial costs compared to processes that are dependent primarily on source documentation.

Identification of unique food handling practices that could represent food safety risks for minority consumers.

PubMed

Henley, Shauna C; Stein, Susan E; Quinlan, Jennifer J

2012-11-01

Foodborne illness caused by Salmonella and Campylobacter is a concern for consumers, and there is evidence that minority racial-ethnic populations experience greater rates of illness because of these pathogens. The limited body of research concerning food safety knowledge and practices among minority consumers has focused more on general food safety knowledge than on culturally specific food handling practices. The purpose of the research reported here was to explore food handling behaviors of minority racial-ethnic consumers through in-depth discussions in focus group settings. In this way, we hoped to identify potential unique, previously unidentified food handling practices among these consumers. Nine focus groups were held in Philadelphia, PA. Three focus groups were conducted with African American consumers, three with Hispanic consumers, and three with Asian consumers. In all, 56 consumers participated. Data were recorded, transcribed, and analyzed for unique and potentially unsafe food handling behaviors. Potentially unsafe food handling practices identified among all three groups included extended time to transport food from retail to home and washing of raw poultry. Culturally unique behaviors within groups included (i) using hot water (Asian, Hispanic) or acidic solutions (African American, Hispanic) to clean raw poultry, (ii) purchasing live poultry (Asian, Hispanic), (iii) cooking poultry overnight (African American), and (iv) preparing bite-size pieces of meat prior to cooking (Asian, Hispanic). To have focus groups include a limited number of participants and nonrandom sampling means that these themes and trends cannot be extrapolated to represent food mishandling among these populations in general. Results presented here allow modification of an existing food safety survey to identify the prevalence of these food handling practices among consumers of different demographics.

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

Corley, Courtney D.; Noonan, Christine F.; Bartholomew, Rachel A.

The U.S. Department of Homeland Security (DHS) National Biosurveillance Integration Center (NBIC) was established in 2008 with a primary mission to “(1) enhance the capability of the Federal Government to (A) rapidly identify, characterize, localize, and track a biological event of national concern by integrating and analyzing data relating to human health, animal, plant, food, and environmental monitoring systems (both national and international); and (B) disseminate alerts and other information to Member Agencies and, in coordination with (and where possible through) Member Agencies, to agencies of State, local, and tribal governments, as appropriate, to enhance the ability of such agenciesmore » to respond to a biological event of national concern; and (2) oversee development and operation of the National Biosurveillance Integration System (NBIS).” Inherent in its mission then and the broader NBIS, NBIC is concerned with the identification, understanding, and use of a variety of biosurveillance models and systems. The goal of this project is to characterize, evaluate, classify, and catalog existing disease forecast and prediction models that could provide operational decision support for recognizing a biological event having a potentially significant impact. Additionally, gaps should be identified and recommendations made on using disease models in an operational environment to support real-time decision making.« less

Prioritizing environmental issues around the world: opinions from an international Central and Eastern European environmental health conference.

PubMed

Craft, Elena S; Donnelly, Kirby C; Neamtiu, Iulia; McCarty, Kathleen M; Bruce, Erica; Surkova, Irina; Kim, David; Uhnakova, Iveta; Gyorffy, Erika; Tesarova, Eva; Anderson, Beth

2006-12-01

As the next generation of scientists enters the field of environmental health, it is imperative that they view their contributions in the context of global environmental stewardship. In this commentary, a group of international graduate students facilitated by three experienced environmental health scientists present their views on what they consider to be the global environmental health concerns of today. This group convened initially in October 2004 at an international health conference in Prague, Czech Republic. In this report we identify perceived environmental health concerns that exist around the world, with a focus on Central and Eastern Europe. Additionally, we address these perceived problems and offers some potential solutions. At the meeting, students were invited to participate in two panel discussions. One group of young international scientists identified several significant global environmental health concerns, including air pollution, occupational hazards, and risk factors that may exacerbate current environmental health issues. The second panel determined that communication, education, and regulation were the mechanisms for addressing current environmental challenges. In this commentary we expand on the views presented at the meeting and represent the concerns of young investigators from nine different countries. We provide ideas about and support the exchange of information between developed and developing countries on how to handle the environmental health challenges that face the world today.

Case studies on genetically modified organisms (GMOs): Potential risk scenarios and associated health indicators.

PubMed

de Santis, Barbara; Stockhofe, Norbert; Wal, Jean-Michel; Weesendorp, Eefke; Lallès, Jean-Paul; van Dijk, Jeroen; Kok, Esther; De Giacomo, Marzia; Einspanier, Ralf; Onori, Roberta; Brera, Carlo; Bikker, Paul; van der Meulen, Jan; Kleter, G

2018-07-01

Within the frame of the EU-funded MARLON project, background data were reviewed to explore the possibility of measuring health indicators during post-market monitoring for potential effects of feeds, particularly genetically modified (GM) feeds, on livestock animal health, if applicable. Four case studies (CSs) of potential health effects on livestock were framed and the current knowledge of a possible effect of GM feed was reviewed. Concerning allergenicity (CS-1), there are no case-reports of allergic reactions or immunotoxic effects resulting from GM feed consumption as compared with non-GM feed. The likelihood of horizontal gene transfer (HGT; CS-2) of GMO-related DNA to different species is not different from that for other DNA and is unlikely to raise health concerns. Concerning mycotoxins (CS-3), insect-resistant GM maize may reduce fumonisins contamination as a health benefit, yet other Fusarium toxins and aflatoxins show inconclusive results. For nutritionally altered crops (CS-4), the genetic modifications applied lead to compositional changes which require special considerations of their nutritional impacts. No health indicators were thus identified except for possible beneficial impacts of reduced mycotoxins and nutritional enhancement. More generally, veterinary health data should ideally be linked with animal exposure information so as to be able to establish cause-effect relationships. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gender differences and demographic influences in perceived concern for driver safety and support for impaired driving countermeasures.

PubMed

Butters, Jennifer; Mann, Robert E; Wickens, Christine M; Boase, Paul

2012-12-01

Driving safety, impaired driving, and legislation to address these concerns remain important issues. It is imperative countermeasures be targeted toward the most appropriate groups. This paper explores the potential relationship between gender and driving attitudes toward safety issues and impaired-driving countermeasures. The data are from the 2007 Impaired Driving Survey commissioned by Transport Canada and Mothers Against Drunk Driving (MADD) Canada. The survey is a, stratified by region, telephone survey of 1,514 Canadian drivers 18years of age and older with a valid driver's license who had driven within the past 30days. The findings illustrate a consistent impact of gender on these issues. Other variables were also identified as relevant factors although less consistently. Current findings suggest that strategies for building support for interventions, or for changing risk perception/concern for risky driving behaviors should be tailored by gender to maximize the potential for behavior change. This information may assist program and policy developers through the identification of more or less receptive target groups. Future research directions are also presented. Copyright © 2012 National Safety Council and Elsevier Ltd. All rights reserved.

An analysis of electronic health record-related patient safety concerns

PubMed Central

Meeks, Derek W; Smith, Michael W; Taylor, Lesley; Sittig, Dean F; Scott, Jean M; Singh, Hardeep

2014-01-01

Objective A recent Institute of Medicine report called for attention to safety issues related to electronic health records (EHRs). We analyzed EHR-related safety concerns reported within a large, integrated healthcare system. Methods The Informatics Patient Safety Office of the Veterans Health Administration (VA) maintains a non-punitive, voluntary reporting system to collect and investigate EHR-related safety concerns (ie, adverse events, potential events, and near misses). We analyzed completed investigations using an eight-dimension sociotechnical conceptual model that accounted for both technical and non-technical dimensions of safety. Using the framework analysis approach to qualitative data, we identified emergent and recurring safety concerns common to multiple reports. Results We extracted 100 consecutive, unique, closed investigations between August 2009 and May 2013 from 344 reported incidents. Seventy-four involved unsafe technology and 25 involved unsafe use of technology. A majority (70%) involved two or more model dimensions. Most often, non-technical dimensions such as workflow, policies, and personnel interacted in a complex fashion with technical dimensions such as software/hardware, content, and user interface to produce safety concerns. Most (94%) safety concerns related to either unmet data-display needs in the EHR (ie, displayed information available to the end user failed to reduce uncertainty or led to increased potential for patient harm), software upgrades or modifications, data transmission between components of the EHR, or ‘hidden dependencies’ within the EHR. Discussion EHR-related safety concerns involving both unsafe technology and unsafe use of technology persist long after ‘go-live’ and despite the sophisticated EHR infrastructure represented in our data source. Currently, few healthcare institutions have reporting and analysis capabilities similar to the VA. Conclusions Because EHR-related safety concerns have complex sociotechnical origins, institutions with long-standing as well as recent EHR implementations should build a robust infrastructure to monitor and learn from them. PMID:24951796

Does language ambiguity in clinical practice justify the introduction of standard terminology? An integrative review.

PubMed

Stallinga, Hillegonda A; ten Napel, Huib; Jansen, Gerard J; Geertzen, Jan H B; de Vries Robbé, Pieter F; Roodbol, Petrie F

2015-02-01

To research the use of ambiguous language in written information concerning patients' functioning and to identify problems resulting from the use of ambiguous language in clinical practice. Many projects that aimed to introduce standard terminology concerning patients' functioning in clinical practice are unsuccessful because standard terminology is rarely used in clinical practice. These projects mainly aim to improve communication by reducing ambiguous language. Considering their lack of success, the validity of the argument that language ambiguity is used in clinical practice is questioned. An integrative literature review. A systematic search of the MEDLINE (1950-2012) and CINAHL (1982-2012) databases was undertaken, including empirical and theoretical literature. The selected studies were critically appraised using a data assessment and extraction form. Seventeen of 767 papers were included in the review and synthesis. The use of ambiguous language in written information concerning patients' functioning was demonstrated. Problems resulting from the use of ambiguous language in clinical practice were not identified. However, several potential problems were suggested, including hindered clinical decision-making and limited research opportunities. The results of this review demonstrated the use of ambiguous language concerning patients' functioning, but health professionals in clinical practice did not experience this issue as a problem. This finding might explain why many projects aimed at introducing standard terminology concerning functioning in clinical practice to solve problems caused by ambiguous language are often unsuccessful. Language ambiguity alone is not a valid argument to justify the introduction of standard terminology. The introduction of standard terminology concerning patients' functioning will only be successful when clinical practice requires the aggregation and reuse of data from electronic patient records for different purposes, including multidisciplinary decision-making and research. © 2014 John Wiley & Sons Ltd.

Promoting health in response to global tourism expansion in Cuba.

PubMed

Spiegel, J M; Gonzalez, M; Cabrera, G J; Catasus, S; Vidal, C; Yassi, A

2008-03-01

The ability of communities to respond to the pressures of globalization is an important determinant of community health. Tourism is a rapidly growing industry and there is an increasing concern about its health impact on local communities. Nonetheless, little research has been conducted to identify potential mitigating measures. We therefore took advantage of the 'natural experiment' provided by the expansion of tourism in Cuba, and conducted four focus groups and key informants interviews in each of two coastal communities. Participants expressed concerns about psycho-social impacts as well as occupational and environmental concerns, and both infectious and chronic diseases. A wide array of programs that had been developed to mitigate potential negative were described. Some of the programs were national in scope and others were locally developed. The programs particularly targeted youth as the most vulnerable population at risk of addictions and sexually transmitted infections. Occupational health concerns for workers in the tourism sector were also addressed, with many of the measures implemented protecting tourists as well. The health promotion and various other participatory action initiatives implemented showed a strong commitment to address the impacts of tourism and also contributed to building capacity in the two communities. Although longitudinal studies are needed to assess the sustainability of these programs and to evaluate their long-term impact in protecting health, other communities can learn from the initiatives taken.

Applying Human Factors Principles to Mitigate Usability Issues Related to Embedded Assumptions in Health Information Technology Design

PubMed Central

Lowry, Svetlana Z; Patterson, Emily S

2014-01-01

Background There is growing recognition that design flaws in health information technology (HIT) lead to increased cognitive work, impact workflows, and produce other undesirable user experiences that contribute to usability issues and, in some cases, patient harm. These usability issues may in turn contribute to HIT utilization disparities and patient safety concerns, particularly among “non-typical” HIT users and their health care providers. Health care disparities are associated with poor health outcomes, premature death, and increased health care costs. HIT has the potential to reduce these disparate outcomes. In the computer science field, it has long been recognized that embedded cultural assumptions can reduce the usability, usefulness, and safety of HIT systems for populations whose characteristics differ from “stereotypical” users. Among these non-typical users, inappropriate embedded design assumptions may contribute to health care disparities. It is unclear how to address potentially inappropriate embedded HIT design assumptions once detected. Objective The objective of this paper is to explain HIT universal design principles derived from the human factors engineering literature that can help to overcome potential usability and/or patient safety issues that are associated with unrecognized, embedded assumptions about cultural groups when designing HIT systems. Methods Existing best practices, guidance, and standards in software usability and accessibility were subjected to a 5-step expert review process to identify and summarize those best practices, guidance, and standards that could help identify and/or address embedded design assumptions in HIT that could negatively impact patient safety, particularly for non-majority HIT user populations. An iterative consensus-based process was then used to derive evidence-based design principles from the data to address potentially inappropriate embedded cultural assumptions. Results Design principles that may help identify and address embedded HIT design assumptions are available in the existing literature. Conclusions Evidence-based HIT design principles derived from existing human factors and informatics literature can help HIT developers identify and address embedded cultural assumptions that may underlie HIT-associated usability and patient safety concerns as well as health care disparities. PMID:27025349

Applying Human Factors Principles to Mitigate Usability Issues Related to Embedded Assumptions in Health Information Technology Design.

PubMed

Gibbons, Michael C; Lowry, Svetlana Z; Patterson, Emily S

2014-12-18

There is growing recognition that design flaws in health information technology (HIT) lead to increased cognitive work, impact workflows, and produce other undesirable user experiences that contribute to usability issues and, in some cases, patient harm. These usability issues may in turn contribute to HIT utilization disparities and patient safety concerns, particularly among "non-typical" HIT users and their health care providers. Health care disparities are associated with poor health outcomes, premature death, and increased health care costs. HIT has the potential to reduce these disparate outcomes. In the computer science field, it has long been recognized that embedded cultural assumptions can reduce the usability, usefulness, and safety of HIT systems for populations whose characteristics differ from "stereotypical" users. Among these non-typical users, inappropriate embedded design assumptions may contribute to health care disparities. It is unclear how to address potentially inappropriate embedded HIT design assumptions once detected. The objective of this paper is to explain HIT universal design principles derived from the human factors engineering literature that can help to overcome potential usability and/or patient safety issues that are associated with unrecognized, embedded assumptions about cultural groups when designing HIT systems. Existing best practices, guidance, and standards in software usability and accessibility were subjected to a 5-step expert review process to identify and summarize those best practices, guidance, and standards that could help identify and/or address embedded design assumptions in HIT that could negatively impact patient safety, particularly for non-majority HIT user populations. An iterative consensus-based process was then used to derive evidence-based design principles from the data to address potentially inappropriate embedded cultural assumptions. Design principles that may help identify and address embedded HIT design assumptions are available in the existing literature. Evidence-based HIT design principles derived from existing human factors and informatics literature can help HIT developers identify and address embedded cultural assumptions that may underlie HIT-associated usability and patient safety concerns as well as health care disparities.

Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak.

PubMed

El Emam, Khaled; Mercer, Jay; Moreau, Katherine; Grava-Gubins, Inese; Buckeridge, David; Jonker, Elizabeth

2011-06-09

Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to understand the privacy barriers which could potentially influence family physicians' reporting of patient-level surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak. Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009. They also completed a survey about the data they were willing to disclose to public health units. Descriptive statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based on grounded theory. The family doctors were reluctant to disclose patient data to public health units. This was due to concerns about the extent to which public health agencies are dependable to protect health information (trusting beliefs), and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that public health units can take which would affect these beliefs, and potentially increase the willingness to disclose patient information for public health purposes. The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable reporting during future outbreaks.

Exploratory Mediation Analysis via Regularization

PubMed Central

Serang, Sarfaraz; Jacobucci, Ross; Brimhall, Kim C.; Grimm, Kevin J.

2017-01-01

Exploratory mediation analysis refers to a class of methods used to identify a set of potential mediators of a process of interest. Despite its exploratory nature, conventional approaches are rooted in confirmatory traditions, and as such have limitations in exploratory contexts. We propose a two-stage approach called exploratory mediation analysis via regularization (XMed) to better address these concerns. We demonstrate that this approach is able to correctly identify mediators more often than conventional approaches and that its estimates are unbiased. Finally, this approach is illustrated through an empirical example examining the relationship between college acceptance and enrollment. PMID:29225454

Risk assessment for produced water discharges to Louisiana open bays. Final report

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

Meinhold, A.F.; DePhillips, M.P.; Holtzman, S.

1996-03-22

The US Department of Energy (USDOE) has a program of research in the environmental aspects of oil and gas extraction. This sampling project will characterize the environmental impacts associated with the discharge of naturally occurring radioactive materials (NORM), metals and organics in produced water. This report is part of a series of studies of the health and ecological risks from discharges of produced water to the Gulf of Mexico, supported by the USDOE. These assessments are being coordinated with the field study, using the collected data to perform human health and ecological risk assessments. These assessments will provide input tomore » regulators in the development of guidelines and permits, and to industry in the development and use of appropriate discharge practices. The initial human health and ecological risk assessments consist of conservative screening analyses meant to identify potentially important contaminants, and to eliminate others from further consideration. More quantitative assessments were done for contaminants identified, in the screening analysis, as being of potential concern. Section 2 gives an overview of human health and ecological risk assessment to help put the analyses presented here in perspective. Section 3 provides the hazard assessment portion of the risk assessment, and identifies the important receptors and pathways of concern. Section 3 also outlines the approach taken to the risk assessments presented in the rest of the report. The remaining sections (4 through 9) present the human health and ecological risk assessments for discharges of produced water to open bays in Louisiana.« less

Risk-based high-throughput chemical screening and prioritization using exposure models and in vitro bioactivity assays

DOE PAGES

Shin, Hyeong -Moo; Ernstoff, Alexi; Arnot, Jon A.; ...

2015-05-01

We present a risk-based high-throughput screening (HTS) method to identify chemicals for potential health concerns or for which additional information is needed. The method is applied to 180 organic chemicals as a case study. We first obtain information on how the chemical is used and identify relevant use scenarios (e.g., dermal application, indoor emissions). For each chemical and use scenario, exposure models are then used to calculate a chemical intake fraction, or a product intake fraction, accounting for chemical properties and the exposed population. We then combine these intake fractions with use scenario-specific estimates of chemical quantity to calculate dailymore » intake rates (iR; mg/kg/day). These intake rates are compared to oral equivalent doses (OED; mg/kg/day), calculated from a suite of ToxCast in vitro bioactivity assays using in vitro-to-in vivo extrapolation and reverse dosimetry. Bioactivity quotients (BQs) are calculated as iR/OED to obtain estimates of potential impact associated with each relevant use scenario. Of the 180 chemicals considered, 38 had maximum iRs exceeding minimum OEDs (i.e., BQs > 1). For most of these compounds, exposures are associated with direct intake, food/oral contact, or dermal exposure. The method provides high-throughput estimates of exposure and important input for decision makers to identify chemicals of concern for further evaluation with additional information or more refined models.« less

Assessment of Peruvian biofuel resources and alternatives

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

Harper, J.P.; Smith, W.; Mariani, E.

1979-08-01

Comprehensive assessment of the biofuel potential of Peru is based on: determination of current biofuel utilization practices, evauation of Peruvian biomass productivity, identification of Peruvian agricultural and forestry resources, assessment of resource development and management concerns, identification of market considerations, description of biofuel technological options, and identification of regional biofuel technology applications. Discussion of current biofuel utilization centers on a qualitative description of the main conversion approaches currently being practiced in Peru. Biomass productivity evaluations consider the terrain and soil, and climatic conditions found in Peru. The potential energy from Peruvian agricultural and forestry resources is described quantitatively. Potental regionalmore » production of agricultural residues and forest resources that could supply energy are identified. Assessment of resource development and management concerns focuses on harvesting, reforestation, training, and environmental consequences of utilization of forest resources. Market factors assessed include: importation, internal market development, external market development, energy policy and pricing, and transportation. Nine biofuel technology options for Peru are identified: (1) small-to-medium-scale gasification, (2) a wood waste inventory, (3) stationary and mobile charcoal production systems, (4) wood distillation, (5) forest resource development and management, (6) electrical cogeneration, (7) anaerobic digestion technology, (8) development of ethanol production capabilities, and (9) agricultural strategies for fuel production. Applications of these biofuel options are identified for each of the three major regions - nine applications for the Costa Region, eight for the Sierra Region, and ten for the Selva Region.« less

The financial hazard of personalized medicine and supportive care.

PubMed

Carrera, Pricivel M; Olver, Ian

2015-12-01

Personalized medicine is revolutionizing the delivery of oncological care, promising benefits both at the patient and health system levels. The cost of targeted therapies, unfortunately, is becoming more expensive and unaffordable. Where supportive care in cancer concerns the prevention and management of the adverse effects of cancer and its treatment and is the thrust of the Multinational Association of Supportive Care in Cancer, financing of and value in personalized medicine is an important area of research and engagement for the association. Discussing patients' concerns with and identifying those at most risk for the financial hazard of cancer treatment and offering financial counseling and assistance and/or referral to support networks are potential key areas for (exploring and providing) better supportive care. The time is now to turn the concern of patients and their carers, providers, and other advocates regarding the affordability of cancer treatment into a collective cause towards coordinated action.

Adversity, emotion recognition, and empathic concern in high-risk youth.

PubMed

Quas, Jodi A; Dickerson, Kelli L; Matthew, Richard; Harron, Connor; Quas, Catherine M

2017-01-01

Little is known about how emotion recognition and empathy jointly operate in youth growing up in contexts defined by persistent adversity. We investigated whether adversity exposure in two groups of youth was associated with reduced empathy and whether deficits in emotion recognition mediated this association. Foster, rural poor, and comparison youth from Swaziland, Africa identified emotional expressions and rated their empathic concern for characters depicted in images showing positive, ambiguous, and negative scenes. Rural and foster youth perceived greater anger and happiness in the main characters in ambiguous and negative images than did comparison youth. Rural children also perceived less sadness. Youth's perceptions of sadness in the negative and ambiguous expressions mediated the relation between adversity and empathic concern, but only for the rural youth, who perceived less sadness, which then predicted less empathy. Findings provide new insight into processes that underlie empathic tendencies in adversity-exposed youth and highlight potential directions for interventions to increase empathy.

The characteristics and experiences of mature nursing students.

PubMed

Montgomery, Laura E A; Tansey, Etain A; Roe, Sean M

To explore the characteristics of mature nursing students, including how they perceive themselves, and to identify the problems they experience, which may influence whether they continue with their course. A sample of 239 students completed an anonymous questionnaire at the end of their first year of study for a diploma in nursing science. A question concerning age was included to enable identification of mature students, of which there were 90. Mature students as a group were desirable students, tending to perform better academically than their younger counterparts and bringing a wealth of caring experience to the course. However, mature students experienced additional pressures, for example financial concerns. When considering the potential benefits of educating mature students, the government and universities should be encouraging their recruitment and retention. An increase in the bursary and free or heavily subsidised childcare would help to alleviate financial concerns.

Joint Peru/United States report on Peru/United States cooperative energy assessment. Volume 4 of 4 Volumes Annexes 8-11

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

Not Available

1979-08-01

A comprehensive assessment of the biofuel potential of Peru is presented. Topics discussed cover current biofuel utilization practices; evaluation of Peruvian biomass productivity; identification of Peruvian agricultural and forestry resources; assessment of resource development and management concerns; identification of market considerations; description of biofuel technological options; and regional identification of biofuel technology applications. The discussion of current biofuel utilization centers on a qualitative description of the main conversion approaches now being practiced in Peru. Biomass productivity is evaluated in the context of the terrain, soil, and climatic conditions found in Peru. A quantitative description of the energy potential that couldmore » be realized from agricultural and forestry resources of Peru follows. A regional picture is given for the production of agricultural residues and forest resources that could potentially supply energy. The assessment of resource development and management concerns focuses on harvesting, reforestation, training, and the environmental consequences of utilization of forest resources. Market factors assessed include: importation, internal market development, external market development, energy policy and pricing, and transportation. Ten biofuel technology options for Peru were identified: small- to medium-scale gasification, a wood waste inventory, stationary and mobile charcoal production systems, wood distillation, forest resource development and management, electrical cogeneration, anaerobic digestion technology, development of ethanol production capabilities, and agricultural strategies for fuel production.Based upon these biofuel options, nine applications were identified for the Costa Region, eight for the Sierra Region, and ten for the Selva Region.« less

Progranulin as a biomarker and potential therapeutic agent.

PubMed

Abella, Vanessa; Pino, Jesús; Scotece, Morena; Conde, Javier; Lago, Francisca; Gonzalez-Gay, Miguel Angel; Mera, Antonio; Gómez, Rodolfo; Mobasheri, Ali; Gualillo, Oreste

2017-10-01

Progranulin is a cysteine-rich secreted protein with diverse pleiotropic actions and participates in several processes, such as inflammation or tumorigenesis. Progranulin was first identified as a growth factor and, recently, it was characterised as an adipokine implicated in obesity, insulin resistance and rheumatic disease. At a central level, progranulin acts as a neurotropic and neuroprotective factor and protects from neural degeneration. In this review, we summarise the most recent research advances concerning the potential role of progranulin as a therapeutic target and biomarker in cancer, neurodegenerative and inflammatory diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

Demonstration of an In-Situ Friction-Sound Probe for Mapping Particle Size at Contaminated Sediment Sites

DTIC Science & Technology

2013-09-01

management practices resulting in the release of contaminants to soil , sediment, and groundwater in coastal environments. At contaminated sediment sites it...the release of contaminants to soil , sediment, and groundwater in coastal environments. Areas of potential concern at these sites are identified by...study will acquire additional soil and groundwater data necessary to satisfactorily evaluate remedial technologies and develop cleanup goals supporting

Overcoming Degraded Communications under A2AD: A Doctrinal Solution

DTIC Science & Technology

2014-05-15

against an A2AD challenge. 3 While retaining the counterinsurgency expertise paid for in blood over the last decade, the U.S. military must refine and...We now carry with us invaluable new lessons paid for in blood and treasure concerning counterinsurgency and stability operations. But we may also...attempting to address the competency shortfall. It specifically identifies capability gaps regarding operations in a potential stressed -communications

High-Temperature Alloys for Automotive Stirling Engines

NASA Technical Reports Server (NTRS)

Stephens, J. R.; Titran, R. H.

1986-01-01

Stirling engine is external-combustion engine that offers fuel economy, low emissions, low noise, and low vibrations. One of most critical areas in engine development concerns material selection for component parts. Alloys CG-27 and XF-818 identified capable of withstanding rigorous requirements of automotive Stirling engine. Alloys chosen for availability, performance, and manufacturability. Advanced iron-base alloys have potential for variety of applications, including stationary solar-power systems.

We're All in This Together: How One University Drew on Collective Impact Principles to Advance Student Success in Higher Education

ERIC Educational Resources Information Center

Jones, Bruce; Croft, Maureen; Longacre, Teri

2017-01-01

Student attrition rates in higher education are an ongoing concern in the U.S, and are costly to students themselves, colleges and universities, and the economy in terms of dollars and human potential. Thus, the need to identify solutions to student attrition is pressing for both students who are enrolled in institutions of higher education today,…

Microsystems: from technologies to products

NASA Astrophysics Data System (ADS)

Ryser, Peter

2003-10-01

In this paper, we outline the process leading from technologies to successful products in the MEMS (Microelectromechanical Systems) and MST (Microsystems Technology) field. The development of new products involves a lot of factors, such as mature technologies, interdisciplinary team, identifying the right business potential and long term oriented investors. The paper summarizes a survey of different technologies and point out that packaging, test and calibration are still major shortcomings for the concerned industries.

Preliminary Assessment of Potential Avian Interactions at Four Proposed Wind Energy Facilities on Vandenberg Air Force Base, California

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

Not Available

The United States Air Force (USAF) is investigating whether to install wind turbines to provide a supplemental source of electricity at Vandenberg Air Force Base (VAFB) near Lompoc, California. As part of that investigation, VAFB sought assistance from the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) to provide a preliminary characterization of the potential risk to wildlife resources (mainly birds and bats) from wind turbine installations. With wind power development expanding throughout North America and Europe, concerns have surfaced over the number of bird fatalities associated with wind turbines. Guidelines developed for the wind industry by the Nationalmore » Wind Coordinating Committee (NWCC) recommend assessing potential impacts to birds, bats, and other potentially sensitive resources before construction. The primary purpose of an assessment is to identify potential conflicts with sensitive resources, to assist developers with identifying their permitting needs, and to develop strategies to avoid impacts or to mitigate their effects. This report provides a preliminary (Phase I) biological assessment of potential impacts to birds and bats that might result from construction and operation of the proposed wind energy facilities on VAFB.« less

Identifying unintended consequences of quality indicators: a qualitative study.

PubMed

Lester, Helen E; Hannon, Kerin L; Campbell, Stephen M

2011-12-01

For the first 5 years of the UK primary care pay for performance scheme, the Quality and Outcomes Framework (QOF), quality indicators were introduced without piloting. However, in 2009, potential new indicators were piloted in a nationally representative sample of practices. This paper describes an in-depth exploration of family physician, nurse and other primary-care practice staff views of the value of piloting with a particular focus on unintended consequences of 13 potential new QOF indicators. Fifty-seven family-practice professionals were interviewed in 24 representative practices across England. Almost all interviewees emphasised the value of piloting in terms of an opportunity to identify unintended consequences of potential QOF indicators in 'real world' settings with staff who deliver day-to-day care to patients. Four particular types of unintended consequences were identified: measure fixation, tunnel vision, misinterpretation and potential gaming. 'Measure fixation,' an inappropriate attention on isolated aspects of care, appeared to be the key unintended consequence. In particular, if the palliative care indicator had been introduced without piloting, this might have incentivised poorer care in a minority of practices with potential harm to vulnerable patients. It is important to identify concerns and experiences about unintended consequences of indicators at an early stage when there is time to remove or adapt problem indicators. Since the UK government currently spends over £1 billion each year on QOF, the £150,000 spent on each piloting cohort (0.0005% of the total QOF budget) appears to be good value for money.

Youth Sport-Related Concussions: Perceived and Measured Baseline Knowledge of Concussions Among Community Coaches, Athletes, and Parents.

PubMed

Nanos, Katherine N; Franco, John M; Larson, Dirk; Mara, Kristin; Laskowski, Edward R

2017-12-01

To assess concussion knowledge of athletes, coaches, and parents/guardians in a community setting and to understand trends/gaps in knowledge among subgroups to tailor efforts toward creating educational interventions. This prospective cross-sectional study involved 262 individuals (142 [55%] female): 115 athletes participating in noncontact and contact sports (ages 13-19 years), 15 coaches, and 132 parents. Recruitment occurred from August 30, 2015, through August 30, 2016, at 3 local high schools. Participants completed a questionnaire developed by the investigators to assess concussion experience and basic knowledge. Females, health care employees, and parents showed stronger concern for potential long-term sequelae of concussion, whereas athletes were most concerned about not being able to return to sport. Those with higher perceived concussion knowledge were slightly older (median age, 42.5 vs 33 years), more educated (college or higher: 42 [70%] vs 100 [50%]), and more likely to be health care workers (22 [37.9%] vs 34 [17.7%]) and scored higher on knowledge questions (average correct: 75.5% vs 60%). Most participants could identify potential concussion sequelae, but only 86 (34.3%) identified a concussion as a brain injury. Of the subgroups, coaches scored highest on knowledge questions. Those with a concussion history tended to consider themselves more knowledgeable but were also less concerned about sequelae. Overall, those with a concussion history scored slightly higher on knowledge questions (average correct: 69.8% vs 61.9%). Participants involved in contact sports were more likely to have had a concussion vs those in noncontact sports (57 [26%] vs 4 [10.3%]). Significant differences in perceived and actual concussion knowledge across different subgroups of study participants involved in high school sports were identified. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Acceptability and perceived barriers and facilitators to creating a national research register to enable ’direct to patient’ enrolment into research: the Scottish Health Research Register (SHARE)

PubMed Central

2013-01-01

Background Difficulties with recruitment pose a major, increasingly recognised challenge to the viability of research. We sought to explore whether a register of volunteers interested in research participation, with data linkage to electronic health records to identify suitable research participants, would prove acceptable to healthcare staff, patients and researchers. Methods We undertook a qualitative study in which a maximum variation sampling approach was adopted. Focus groups and interviews were conducted with patients, general practitioners (GP), practice managers and health service researchers in two Scottish health boards. Analysis was primarily thematic to identify a range of issues and concerns for all stakeholder groups. Results The concept of a national research register was, in general, acceptable to all stakeholder groups and was widely regarded as beneficial for research and for society. Patients, however, highlighted a number of conditions which should be met in the design of a register to expedite confidence and facilitate recruitment. They also gave their perceptions on how a register should operate and be promoted, favouring a range of media. GPs and practice managers were primarily concerned with the security and confidentiality of patient data and the impact a register may have on their workload. Researchers were supportive of the initiative seeing advantages in more rapid access to a wider pool of patients. They did raise concerns that GPs may be able to block access to personal patient data held in general practice clinical systems and that the register may not be representative of the whole population. Conclusions This work suggests that patients, healthcare staff and researchers have a favourable view of the potential benefits of a national register to identify people who are potentially eligible and willing to participate in health related research. It has highlighted a number of issues for the developers to incorporate in the design of research registers. PMID:24139174

Acceptability and perceived barriers and facilitators to creating a national research register to enable 'direct to patient' enrolment into research: the Scottish Health Research Register (SHARE).

PubMed

Grant, Aileen; Ure, Jenny; Nicolson, Donald J; Hanley, Janet; Sheikh, Aziz; McKinstry, Brian; Sullivan, Frank

2013-10-18

Difficulties with recruitment pose a major, increasingly recognised challenge to the viability of research. We sought to explore whether a register of volunteers interested in research participation, with data linkage to electronic health records to identify suitable research participants, would prove acceptable to healthcare staff, patients and researchers. We undertook a qualitative study in which a maximum variation sampling approach was adopted. Focus groups and interviews were conducted with patients, general practitioners (GP), practice managers and health service researchers in two Scottish health boards. Analysis was primarily thematic to identify a range of issues and concerns for all stakeholder groups. The concept of a national research register was, in general, acceptable to all stakeholder groups and was widely regarded as beneficial for research and for society. Patients, however, highlighted a number of conditions which should be met in the design of a register to expedite confidence and facilitate recruitment. They also gave their perceptions on how a register should operate and be promoted, favouring a range of media. GPs and practice managers were primarily concerned with the security and confidentiality of patient data and the impact a register may have on their workload. Researchers were supportive of the initiative seeing advantages in more rapid access to a wider pool of patients. They did raise concerns that GPs may be able to block access to personal patient data held in general practice clinical systems and that the register may not be representative of the whole population. This work suggests that patients, healthcare staff and researchers have a favourable view of the potential benefits of a national register to identify people who are potentially eligible and willing to participate in health related research. It has highlighted a number of issues for the developers to incorporate in the design of research registers.

Early concern and disregard for others as predictors of antisocial behavior.

PubMed

Rhee, Soo Hyun; Friedman, Naomi P; Boeldt, Debra L; Corley, Robin P; Hewitt, John K; Knafo, Ariel; Lahey, Benjamin B; Robinson, JoAnn; Van Hulle, Carol A; Waldman, Irwin D; Young, Susan E; Zahn-Waxler, Carolyn

2013-02-01

Prediction of antisocial behavior is important, given its adverse impact on both the individuals engaging in antisocial behavior and society. Additional research identifying early predictors of future antisocial behavior, or antisocial propensity, is needed. The present study tested the hypothesis that both concern for others and active disregard for others in distress in toddlers and young children predict antisocial behavior during middle childhood and adolescence. A representative sample of same-sex twins (N=956) recruited in Colorado was examined. Mother-rated and researcher-observed concern and disregard for others assessed at age 14-36 months were examined as predictors of parent- (age 4-12), teacher- (age 7-12), and self-reported (age 17) antisocial behavior.   Observed disregard for others predicted antisocial behavior assessed by three different informants (parents, teachers, and self), including antisocial behavior assessed 14 years later. It also predicted a higher order antisocial behavior factor (β=.58, p<.01) after controlling for observed concern for others. Mother-rated disregard for others predicted parent-reported antisocial behavior. Contrary to predictions, neither mother-rated nor observed concern for others inversely predicted antisocial behavior. RESULTS of twin analyses suggested that the covariation between observed disregard for others and antisocial behavior was due to shared environmental influences. Disregard for others in toddlerhood/early childhood is a strong predictor of antisocial behavior in middle childhood and adolescence. The results suggest the potential need for early assessment of disregard for others and the development of potential interventions. © 2012 The Author. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Memory Loss, Alzheimer's Disease and General Anesthesia: A Preoperative Concern.

PubMed

Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S; Chen, Linda; Liu, Renyu

2012-02-20

The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient's or the patient family member has made a request to address their concern on memory loss, Alzheimer's disease and general anesthesia before surgery. Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer's disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using "anesthesia memory loss" as a search phrase. Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer's disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer's disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2 nd , 2011, searching "anesthesia memory loss" in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer's disease without conclusive scientific literature support. The potential link between memory loss and Alzheimer's disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member's preoperative anxiety related to this concern.

Memory Loss, Alzheimer’s Disease and General Anesthesia: A Preoperative Concern

PubMed Central

Thaler, Adam; Siry, Read; Cai, Lufan; García, Paul S.; Chen, Linda; Liu, RenYu

2012-01-01

Background The long-term cognitive effects of general anesthesia are under intense scrutiny. Here we present 5 cases from 2 academic institutions to analyze some common features where the patient’s or the patient family member has made a request to address their concern on memory loss, Alzheimer’s disease and general anesthesia before surgery. Methods Records of anesthesia consultation separate from standard preoperative evaluation were retrieved to identify consultations related to memory loss and Alzheimer’s disease from the patient and/or patient family members. The identified cases were extensively reviewed for features in common. We used Google® (http://www. google.com/) to identify available online information using “anesthesia memory loss” as a search phrase. Results Five cases were collected as a specific preoperative consultation related to memory loss, Alzheimer’s disease and general anesthesia from two institutions. All of the individuals either had perceived memory impairment after a prior surgical procedure with general anesthesia or had a family member with Alzheimer’s disease. They all accessed public media sources to find articles related to anesthesia and memory loss. On May 2nd, 2011, searching “anesthesia memory loss” in Google yielded 764,000 hits. Only 3 of the 50 Google top hits were from peer-reviewed journals. Some of the lay media postings made a causal association between general anesthesia and memory loss and/or Alzheimer’s disease without conclusive scientific literature support. Conclusion The potential link between memory loss and Alzheimer’s disease with general anesthesia is an important preoperative concern from patients and their family members. This concern arises from individuals who have had history of cognitive impairment or have had a family member with Alzheimer disease and have tried to obtain information from public media. Proper preoperative consultation with the awareness of the lay literature can be useful in reducing patient and patient family member’s preoperative anxiety related to this concern. PMID:23853740

Identification of Substandard Medicines via Disproportionality Analysis of Individual Case Safety Reports.

PubMed

Trippe, Zahra Anita; Brendani, Bruno; Meier, Christoph; Lewis, David

2017-04-01

The distribution and use of substandard medicines (SSMs) is a public health concern worldwide. The detection of SSMs is currently limited to expensive large-scale assay techniques such as high-performance liquid chromatography (HPLC). Since 2013, the Pharmacovigilance Department at Novartis Pharma AG has been analyzing drug-associated adverse events related to 'product quality issues' with the aim of detecting defective medicines using spontaneous reporting. The method of identifying SSMs with spontaneous reporting was pioneered by the Monitoring Medicines project in 2011. This retrospective review was based on data from the World Health Organization (WHO) Global individual case safety report (ICSR) database VigiBase ® collected from January 2001 to December 2014. We conducted three different stratification analyses using the Multi-item Gamma Poisson Shrinker (MGPS) algorithm through the Oracle Empirica data-mining software. In total, 24 preferred terms (PTs) from the Medical Dictionary for Regulatory Activities (MedDRA ® ) were used to identify poor-quality medicines. To identify potential SSMs for further evaluation, a cutoff of 2.0 for EB05, the lower 95% interval of the empirical Bayes geometric mean (EBGM) was applied. We carried out a literature search for advisory letters related to defective medicinal products to validate our findings. Furthermore, we aimed to assess whether we could confirm two SSMs first identified by the Uppsala Monitoring Centre (UMC) with our stratification method. The analysis of ICSRs based on the specified selection criteria and threshold yielded 2506 hits including medicinal products with an excess of reports of product quality defects relative to other medicines in the database. Further investigations and a pilot study in five authorized medicinal products (proprietary and generic) licensed by a single marketing authorization holder, containing valsartan, methylphenidate, rivastigmine, clozapine, or carbamazepine, were performed. This resulted in an output of 23 potential SSMs. The literature search identified two communications issued to health professionals concerning a substandard rivastigmine patch, which validated our initial findings. Furthermore, we identified excess reporting of product quality issues with an ethinyl estradiol/norgestrel combination and with salbutamol. These were categorized as confirmed clusters of substandard/spurious/falsely labelled/falsified/counterfeit (SSFFC) medical products by the UMC in 2014. This study illustrates the value of data mining of spontaneous adverse event reports and the applicability of disproportionality analysis to identify potential SSMs.

Identification of exposure to environmental chemicals in children and older adults using human biomonitoring data sorted by age: Results from a literature review.

PubMed

Choi, Judy; Knudsen, Lisbeth E; Mizrak, Seher; Joas, Anke

2017-03-01

Human biomonitoring (HBM) provides the tools for exposure assessment by direct measurements of biological specimens such as blood and urine. HBM can identify new chemical exposures, trends and changes in exposure, establish distribution of exposure among the general population, and identify vulnerable groups and populations with distinct exposures such as children and older adults. The objective of this review is to demonstrate the use of HBM to identify environmental chemicals that might be of concern for children or older adults due to higher body burden. To do so, an extensive literature search was performed, and using a set of defined criteria, ten large-scale, cross-sectional national HBM programs were selected for data review and evaluation. A comparative analysis of the age-stratified data from these programs and other relevant HBM studies indicated twelve chemicals/classes of chemicals with potentially higher body burden in children or older adults. Children appear to have higher body burden of bisphenol A (BPA), some phytoestrogens, perchlorate, and some metabolites of polycyclic aromatic hydrocarbons and benzene. On the other hand, older adults appear to have higher body burden of heavy metals and organochlorine pesticides. For perfluoroalkyl substances, polybrominated diphenyl ethers, parabens, and phthalates, both children and older adults have higher body burden depending on the specific biomarkers analyzed, and this might be due to the exposure period and/or sources from different countries. Published data from the DEMOCOPHES project (a pilot study to harmonize HBM efforts across Europe) also showed elevated exposures to BPA and some phthalate metabolites in children across several European countries. In summary, age-stratified HBM data can provide useful knowledge of identifying environmental chemicals that might be of concern for children and older adults, which, combined with additional efforts to identify potential sources of exposure, could assist policy makers in prioritizing their actions in order to reduce chemical exposure and potential risks of adverse health effects. Copyright © 2016 Elsevier GmbH. All rights reserved.

Compulsive fantasy: proposed evidence of an under-reported syndrome through a systematic study of 90 self-identified non-normative fantasizers.

PubMed

Bigelsen, Jayne; Schupak, Cynthia

2011-12-01

The experiences of 90 individuals who self-identify as "excessive" or "maladaptive" fantasizers are summarized in this report. Our sample consisted of 75 female and 15 male participants, ranging in age from 18 to 63 who responded to online announcements. Participants completed a 14-question emailed survey requesting descriptions of their fantasy habits and causes of potential distress regarding fantasy. Results demonstrated that participants shared a number of remarkably specific behaviors and concerns regarding their engagement in extensive periods of highly-structured, immersive imaginative experiences, including the use of kinesthetic activity which accompanies the fantasies of 79% of participants. Participants reported distress stemming from three factors: difficulty in controlling the need or desire to engage in fantasizing; concern that the quantity of fantasizing interfered with actual relationships and endeavors; and intense shame and exhaustive efforts to keep this behavior hidden from others. It is hoped that this report will encourage interest in this elusive syndrome. Copyright © 2011 Elsevier Inc. All rights reserved.

NASA Aviation Safety Reporting System (ASRS)

NASA Technical Reports Server (NTRS)

Connell, Linda

2011-01-01

The NASA Aviation Safety Reporting System (ASRS) collects, analyzes, and distributes de-identified safety information provided through confidentially submitted reports from frontline aviation personnel. Since its inception in 1976, the ASRS has collected over 900,000 reports and has never breached the identity of the people sharing their information about events or safety issues. From this volume of data, the ASRS has released over 5,500 aviation safety alerts concerning potential hazards and safety concerns. The ASRS processes these reports, evaluates the information, and provides de-identified report information through the online ASRS Database at http://asrs.arc.nasa.gov. The NASA ASRS is also a founding member of the International Confidential Aviation Safety Systems (ICASS) group which is a collection of other national aviation reporting systems throughout the world. The ASRS model has also been replicated for application to improving safety in railroad, medical, fire fighting, and other domains. This presentation \\vill discuss confidential, voluntary, and non-punitive reporting systems and their advantages in providing information for safety improvements.

NASA Aviation Safety Reporting System (ASRS)

NASA Technical Reports Server (NTRS)

Connell, Linda J.

2017-01-01

The NASA Aviation Safety Reporting System (ASRS) collects, analyzes, and distributes de-identified safety information provided through confidentially submitted reports from frontline aviation personnel. Since its inception in 1976, the ASRS has collected over 1.4 million reports and has never breached the identity of the people sharing their information about events or safety issues. From this volume of data, the ASRS has released over 6,000 aviation safety alerts concerning potential hazards and safety concerns. The ASRS processes these reports, evaluates the information, and provides selected de-identified report information through the online ASRS Database at http:asrs.arc.nasa.gov. The NASA ASRS is also a founding member of the International Confidential Aviation Safety Systems (ICASS) group which is a collection of other national aviation reporting systems throughout the world. The ASRS model has also been replicated for application to improving safety in railroad, medical, fire fighting, and other domains. This presentation will discuss confidential, voluntary, and non-punitive reporting systems and their advantages in providing information for safety improvements.

What's good for the goose is good for the gander. Guiding principles for the use of financial incentives in health behaviour change.

PubMed

Lynagh, Marita C; Sanson-Fisher, Rob W; Bonevski, Billie

2013-03-01

The use of financial incentives or pay-for-performance programs for health care providers has triggered emerging interest in the use of financial incentives for encouraging health behaviour change. This paper aims to identify key conditions under which the use of financial incentives for improvements in public health outcomes is most likely to be effective and appropriate. We review recent systematic reviews on their effectiveness in changing health behaviour and identify existing moral concerns concerning personal financial incentives. Current evidence indicates that incentives can be effective in driving health behaviour change under certain provisos, while a number of misgivings continue to be deliberated on. We outline a number of key principles for consideration in decisions about the potential use of incentives in leading to public health improvements. These key principles can assist policy makers in making decisions on the use of financial incentives directed at achieving improvements in public health.

Summary of Tiger Team Assessment and Technical Safety Appraisal recurring concerns in the Maintenance Area

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

Not Available

1993-01-01

Tiger Team Assessments and Technical Safety Appraisals (TSA) were reviewed and evaluated for concerns in the Maintenance Area (MA). Two hundred and thirty one (231) maintenance concerns were identified by the Tiger Team Assessments and TSA reports. These recurring concerns appear below. A summary of the Noteworthy Practices that were identified and a compilation of the maintenance concerns for each performance objective that were not considered as recurring are also included. Where the Tiger Team Assessment and TSA identified the operating contractor or facility by name, the concern has been modified to remove the name while retaining the intent ofmore » the comment.« less

Applying genotoxicology tools to identify environmental stressors in support of river management.

PubMed

Oberholster, Paul J; Hill, Liesl; Jappie, Shaamiela; Truter, Johannes C; Botha, Anna-Maria

2016-02-01

Although bioassay approaches are useful for identifying chemicals of potential concern, they provide little understanding of the mechanisms of chemical toxicity. Without this understanding, it is difficult to address some of the key challenges that currently face aquatic ecotoxicology. To overcome this, the toxicity potential of the water samples was assessed and surviving organisms (Physa acuta) were used for protein activity measurements and gene expression profiling by making use of complementary DNA amplified fragment length polymorphism (cDNA-AFLP) analysis. From the data it was evident that the impacts of specific pollutants (e.g. sewage) on organisms at the cellular level could be identified, and that the expressed stressor genes can be used as bioindicators/markers/genetic signatures or fingerprints during identification of point source pollution. From an ecosystem management point of view these insights could assist with the forecasting and reduction of environmental risks on catchment level by implementing suitable management interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

From sense of place to visualization of place: examining people-place relationships for insight on developing geovisualizations.

PubMed

Newell, Robert; Canessa, Rosaline

2018-02-01

Effective resource planning incorporates people-place relationships, allowing these efforts to be inclusive of the different local beliefs, interests, activities and needs. 'Geovisualizations' can serve as potentially powerful tools for facilitating 'place-conscious' resource planning, as they can be developed with high degrees of realism and accuracy, allowing people to recognize and relate to them as 'real places'. However, little research has been done on this potential, and the place-based applications of these visual tools are poorly understood. This study takes steps toward addressing this gap by exploring the relationship between sense of place and 'visualization of place'. Residents of the Capital Regional District of BC, Canada, were surveyed about their relationship with local coastal places, concerns for the coast, and how they mentally visualize these places. Factor analysis identified four sense of place dimensions - nature protection values, community and economic well-being values, place identity and place dependence, and four coastal concerns dimensions - ecological, private opportunities, public space and boating impacts. Visualization data were coded and treated as dependent variables in a series of logistic regressions that used sense of place and coastal concerns dimensions as predictors. Results indicated that different aspects of sense of place and (to a lesser degree) concerns for places influence the types of elements people include in their mental visualization of place. In addition, sense of place influenced the position and perspective people assume in these visualizations. These findings suggest that key visual elements and perspectives speak to different place relationships, which has implications for developing and using geovisualizations in terms of what elements should be included in tools and (if appropriate) depicted as affected by potential management or development scenarios.

Let's Face It: Patient and Parent Perspectives on Incorporating a Facebook Group into a Multidisciplinary Weight Management Program

PubMed Central

Esperanza Menchaca, Alicia D. M.; Sami, Areej; Blake, Natalie

2013-01-01

Abstract Background Social media may have the potential to enhance weight management efforts. However, the acceptability of incorporating this entity into pediatrics is unknown. The objective of this project was to explore patients' and parents' perspectives about developing a Facebook group as a component of a pediatric weight management program. Methods Semistructured interviews were performed between September, 2011, and February, 2012, with patients and parents in a multidisciplinary weight management program. Interviews explored participants' perceptions of potential benefits, concerns, and preferences related to a program-specific Facebook group. Transcripts were reviewed and themes identified. The study concluded when thematic saturation was achieved. Results Participants (n=32) were largely enthusiastic about the idea of a program-specific Facebook group for adolescents. Most preferred a secret group, where only participants would know of the group's existence or group members' identity. No parents expressed concern about security or privacy related to a program-specific Facebook group; one parent expressed concern about undesirable advertisements. Participants endorsed a variety of ideas for inclusion on the page, including weight loss tips, live chats with providers, quizzes, and an incentive system where participants could gain points for making healthy choices. Many parents requested a separate parent-focused page, an idea that was supported by the adolescents. Conclusions This study suggests that participants perceive potential benefits from incorporating social media interventions into pediatric weight management efforts. Privacy and security issues do not appear to be major parental concerns. Future work should explore the impact of program-specific social media interventions on outcomes for patients in weight management programs. PMID:23869854

Beyond strategy: exploring the brokerage role of facilities manager in hospitals.

PubMed

Heng, H K S; McGeorge, W D; Loosemore, M

2005-01-01

Seeks to explore the brokerage role of facilities manager in hospitals, based on the premise that facilities management (FM) is largely concerned with "strategic brokerage". Strategic brokerage is the term coined by Akhaghi to explain the integration of a wide range of support services to ensure the effective operation of the core business of an organization. The research was conducted in the health service sector using a single case study approach to examine the brokerage potential for FM in a hospital in the Sydney Metropolitan area. A social network analysis technique was used to identify and analyse the communication networks of players in a hospital environment. Two general questions guided the analysis. First, what is the brokerage potential within the FM process? Second, where are the opportunities for brokerage? The results indicate that identifying relationship linkages between different functional units can create potential brokerage opportunities. The proposition is made that viewing FM from a brokerage perspective can add value to the delivery of health-care services.

Thermostructural Analysis of the SOFIA Fine Field and Wide Field Imagers Subjected to Convective Thermal Shock

NASA Technical Reports Server (NTRS)

Kostyk, Christopher B.

2012-01-01

The Stratospheric Observatory For Infrared Astronomy (SOFIA) is a highly modified Boeing 747-SP with a 17- ton infrared telescope installed in the aft portion of the aircraft. Unlike ground- and space-based platforms, SOFIA can deploy to make observations anytime, anywhere, in the world. The originally designed aircraft configuration included a ground pre-cool system, however, due to various factors in the history of the project, that system was not installed. This lack of ground pre-cooling was the source of the concern about whether or not the imagers would be exposed to a potentially unsafe thermostructural environment. This concern was in addition to the already-existing concern of some project members that the air temperature rate of change during flight (both at the same altitude as well as ascent or descent) could cause the imagers to be exposed to an unsafe thermostructural environment. Four optical components were identified as the components of concern: two of higher concern (one in each imager), and two of lower concern (one in each imager). The analysis effort began by analyzing one component, after which the analyses for the other components was deemed unnecessary. The purpose of this report is to document these findings as well as lessons learned from the effort.

Family caregiving at the intersection of private care by migrant home care workers and public care by nursing staff.

PubMed

Ayalon, Liat; Halevy-Levin, Sara; Ben-Yizhak, Zvi; Friedman, Gideon

2013-09-01

This study evaluated private family caregiving at the intersection of private migrant home care and public nursing care on the hospitalization of an older patient. Seventy-three individuals were interviewed, including older hospitalized patients, their family members, accompanying migrant home care workers, and nursing personnel. There was no clear consensus concerning the role of family members. Although family members emphasized care management as their main role, the other three groups emphasized that the family members' mere physical presence was their main role. All four groups identified potential barriers to family caregiving, rather than motives for family caregiving, hence pointing to a potential discrepancy between expected and performed family caregiving roles. An indication of the lack of clarity concerning family caregiving roles stems from the finding that family members were frequently viewed as unengaged and neglectful, yet at times they were criticized for being overly involved in patient care. Implications for the care of hospitalized older adults are discussed.

Evaluation of potential relationships between benthic community structure and toxic metals in Laizhou Bay.

PubMed

Wu, Bin; Song, Jinming; Li, Xuegang

2014-10-15

The objective of the present study was to examine the relationships between benthic community structure and toxic metals using bivariate/multivariate techniques at 17 sediment locations in Laizhou Bay, North China. Sediment chemical data were evaluated against geochemical background values and sediment quality guidelines, which identified Cu and As as contaminants of concern with a moderate potential for adverse effects. Benthic community data were subjected to non-metric multidimensional scaling, which generated four groups of stations. Spearman rank correlation was then employed to explore the relationships between the major axes of heavy metals and benthic community structure. However, weak and insignificant correlations were found between these axes, indicating that contaminants of concern may not be the primary explanatory factors. Polychaeta were abundant in southern Laizhou Bay, serving as a warning regarding the health status of the ecosystem. Integrated sediment quality assessment showed sediments from northern central locations were impaired, displaying less diverse benthos and higher metal contamination. Copyright © 2014 Elsevier Ltd. All rights reserved.

The identification of criteria to evaluate prehospital trauma care using the Delphi technique.

PubMed

Rosengart, Matthew R; Nathens, Avery B; Schiff, Melissa A

2007-03-01

Current trauma system performance improvement emphasizes hospital- and patient-based outcome measures such as mortality and morbidity, with little focus upon the processes of prehospital trauma care. Little data exist to suggest which prehospital criteria should serve as potential filters. This study identifies the most important filters for auditing prehospital trauma care using a Delphi technique to achieve consensus of expert opinion. Experts in trauma care from the United States (n = 81) were asked to generate filters of potential utility in monitoring the prehospital aspect of the trauma system, and were then required to rank these questions in order of importance to identify those of greatest importance. Twenty-eight filters ranking in the highest tertile are proposed. The majority (54%) pertains to aspects of emergency medical services, which comprise 7 of the top 10 (70%) filters. Triage filters follow in priority ranking, comprising 29% of the final list. Filters concerning interfacility transfers and transportation ranked lowest. This study identifies audit filters representing the most important aspects of prehospital trauma care that merit continued evaluation and monitoring. A subsequent trial addressing the utility of these filters could potentially enhance the sensitivity of identifying deviations in prehospital care, standardize the performance improvement process, and translate into an improvement in patient care and outcome.

Patient perspectives on online health information and communication with doctors: a qualitative study of patients 50 years old and over.

PubMed

Silver, Michelle Pannor

2015-01-13

As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn't want to hear about it, (3) belief that there is no need to bring it up, and (4) forgetting to bring it up. Facilitators of communication included: (1) having a family member present at doctor visits, (2) doctor-initiated inquiries, and (3) encountering an advertisement that suggested talking with a doctor. Overall, participants displayed awareness of potential problems related to online health information seeking. Findings from this study point to a set of barriers as well as facilitators of communication about online health information seeking between patients and doctors. This study highlights the need for enhanced patient communication skills, eHealth literacy assessments that are accompanied by targeted resources pointing individuals to high-quality credible online health information, and the need to remind patients of the importance of consulting a medical professional when they use online health resources to diagnose and treat a health issue.

Patient Perspectives on Online Health Information and Communication With Doctors: A Qualitative Study of Patients 50 Years Old and Over

PubMed Central

2015-01-01

Background As health care systems around the world shift toward models that emphasize self-care management, there is increasing pressure for patients to obtain health information online. It is critical that patients are able to identify potential problems with using the Internet to diagnose and treat a health issue and that they feel comfortable communicating with their doctor about the health information they acquire from the Internet. Objective Our aim was to examine patient-identified (1) problems with using the Internet to identify and treat a health issue, (2) barriers to communication with a doctor about online health information seeking, and (3) facilitators of communication with a doctor about patient searches for health information on the Internet. Methods For this qualitative exploratory study, semistructured interviews were conducted with a sample of 56 adults age 50 years old and over. General concerns regarding use of the Internet to diagnose and treat a health issue were examined separately for participants based on whether they had ever discussed health information obtained through the Internet with a doctor. Discussions about barriers to and facilitators of communication about patient searches for health information on the Internet with a doctor were analyzed using thematic analysis. Results Six higher-level general concerns emerged: (1) limitations in own ability, (2) credibility/limitations of online information, (3) anxiety, (4) time consumption, (5) conflict, and (6) non-physical harm. The most prevalent concern raised by participants who communicated with a doctor about their online health information seeking related to the credibility or limitations in online information. Participants who had never communicated with a doctor about their online health information seeking most commonly reported concerns about non-physical harm. Four barriers to communication emerged: (1) concerns about embarrassment, (2) concerns that the doctor doesn’t want to hear about it, (3) belief that there is no need to bring it up, and (4) forgetting to bring it up. Facilitators of communication included: (1) having a family member present at doctor visits, (2) doctor-initiated inquiries, and (3) encountering an advertisement that suggested talking with a doctor. Conclusions Overall, participants displayed awareness of potential problems related to online health information seeking. Findings from this study point to a set of barriers as well as facilitators of communication about online health information seeking between patients and doctors. This study highlights the need for enhanced patient communication skills, eHealth literacy assessments that are accompanied by targeted resources pointing individuals to high-quality credible online health information, and the need to remind patients of the importance of consulting a medical professional when they use online health resources to diagnose and treat a health issue. PMID:25586865

A device-specific prioritization strategy based on the potential for harm to human health in informal WEEE recycling.

PubMed

Cesaro, Alessandra; Belgiorno, Vincenzo; Vaccari, Mentore; Jandric, Aleksander; Chung, Tran Duc; Dias, Maria Isabel; Hursthouse, Andrew; Salhofer, Stefan

2018-01-01

In developing countries, the recovery of valuable materials from Waste Electrical and Electronic Equipment (WEEE) is carried out via uncontrolled practices, posing potentially severe risks both to human health and the environment. The assessment of the risk, which depends on both the kind and hazardous properties of the substances contained in WEEE, is currently limited as the exposure scenario for the single informal practice cannot be fully characterized for this purpose. In this context, this work proposes and evaluates a strategy to identify the relative potential harm of different kinds of WEEE by their content in metals, selected as the target substances of concern. This was based on the individual metal content, primarily located in the printed circuit boards (PCBs) of the different devices. The metal composition of the individual PCBs was identified and the dominant unregulated metal recovery practices were reviewed to identify the most suitable parameter to express the toxicity of these metals. Based on a mass-normalized cumulative toxicity, via the inhalation route, individual components were assessed from compositional variation found in the literature. The results is a semiquantitative ranking of individual components, revealing significant differences in potential harm posed by different electronic appliances and an opportunity to provide prioritization strategies in future management.

Best practices: an electronic drug alert program to improve safety in an accountable care environment.

PubMed

Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

2015-04-01

The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total potential adverse drug events were identified with baseline data from the DSAP initiatives, and nearly 8,000 were resolved by changes in prescribing.  Implications and additional thoughts from The Working Group on Optimizing Medication Therapy in Value-Based Healthcare were provided for the following categories: leveraging electronic health records, importance of data collection and reassessment, preventing alert fatigue utilizing various techniques, relevance to ACO quality measurement, and limitations of a retrospective system. While health information technologies have been recognized as a cornerstone for an ACO's success, additional research is needed on comparing these types of technological innovations. Future research should focus on reviewing comparable scoring criteria and alert systems utilized in a variety of ACOs. In addition, an examination of different data mining procedures used within different electronic health record platforms would prove useful to ACOs looking to improve the care of not only the subpopulations with specific metrics associated with them, but their patient population as a whole. The authors also highlight the need for additional research on health information exchanges, including the cost and resource requirements needed to successfully participate in these types of networks.

Systems to identify potentially inappropriate prescribing in people with advanced dementia: a systematic review.

PubMed

Disalvo, Domenica; Luckett, Tim; Agar, Meera; Bennett, Alexandra; Davidson, Patricia Mary

2016-05-31

Systems for identifying potentially inappropriate medications in older adults are not immediately transferrable to advanced dementia, where the management goal is palliation. The aim of the systematic review was to identify and synthesise published systems and make recommendations for identifying potentially inappropriate prescribing in advanced dementia. Studies were included if published in a peer-reviewed English language journal and concerned with identifying the appropriateness or otherwise of medications in advanced dementia or dementia and palliative care. The quality of each study was rated using the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist. Synthesis was narrative due to heterogeneity among designs and measures. Medline (OVID), CINAHL, the Cochrane Database of Systematic Reviews (2005 - August 2014) and AMED were searched in October 2014. Reference lists of relevant reviews and included articles were searched manually. Eight studies were included, all of which were scored a high quality using the STROBE checklist. Five studies used the same system developed by the Palliative Excellence in Alzheimer Care Efforts (PEACE) Program. One study used number of medications as an index, and two studies surveyed health professionals' opinions on appropriateness of specific medications in different clinical scenarios. Future research is needed to develop and validate systems with clinical utility for improving safety and quality of prescribing in advanced dementia. Systems should account for individual clinical context and distinguish between deprescribing and initiation of medications.

Utilizing Societal Concerns in Nanomaterials R and D Decision-Making

NASA Astrophysics Data System (ADS)

Beaver, E. R.

2007-12-01

Nanotechnology has demonstrated the potential to transform many aspects of human existence. From extraordinary ways to deliver pharmaceuticals to the tiniest of electronic circuits to the finest of filters, technologies made with nanomaterials can shrink the computer chip or remove contaminants from water. Nanotechnology systems can deliver drugs to targets inside individual cells or serve as components in sensors that detect chemical and biological agents. As nanomaterials are commercialized, there are potential consequences, both positive and negative. At each stage of development of nanotechnology, it is important to assess both the potential benefits and the potential costs. Scientists need more tools to simultaneously develop new technologies and consider whether their methods or materials might contribute to health or environmental hazards down the line. Early information on potential risks guides the development of these materials as they move toward industrial production. Some indications of problems have turned-up. If thorough assessments are not done, the potential exists to extend projects (and their related expense) long past the point where "fatal flaws" could be identified. As nanotechnology graduates from infancy and it is possible to predict the course and impacts of the technology beyond the next several years. There are well-founded concerns with nanotechnology, especially relating to human health, the environment, and public perception in general. This paper will include a matrix of potential effects, means of ranking or scoring them and examples of how the technique can be applied to current research and development.

Impossible Predictions of the Unprecedented: Analogy, History, and the Work of Prognostication

NASA Astrophysics Data System (ADS)

Denning, Kathryn

At the beginning of exobiology and SETI as research programs circa 1960, it was reasonable and responsible for scientists and others to consider the potential effects of a detection of other life, or contact with it, upon humanity. It is no coincidence that this was a time of reckoning with the power of science and technology. The Cold War was settling in, space programs were beginning, and the technologies of war and those of discovery were then, as now, intertwined, in a way that made Carl Sagan, Philip Morrison, Joshua Lederberg, and others, concerned for humanity's future, and the future of life. Those concerns are as well-founded as ever. However, 50 years on, after half a century of predictions and untested hypotheses, we still only know that a detection of extraterrestrial life could come tomorrow, in the next century, or never. Many potential scenarios have been identified and explored, planetary protection protocols have been implemented for astrobiology, policy concerning SETI detections has been created and debated, and some valuable empirical work has been done concerning potential cultural reactions. We might now reasonably ask: what are our real goals here? And do they match what we are actually accomplishing? Are these exercises still beneficial, or are they reaching the point of diminishing returns? Might there be undesirable effects of prognostications about detection and contact? Elsewhere, I have discussed at some length what I think can sensibly be done to prepare for a detection. This leaves me with a further argument to make here: first, that the use of historical analogies of intercultural contact on Earth to predict or explore the potential consequences of contact with ETI may now be essentially useless or perhaps worse than useless; second, that the longstanding practice of prediction about contact now also invites scrutiny in terms of its utility; and third, that turning our attention to pressing topics at the intersection of astrobiology, SETI, and society, could be worthwhile for scholars of humanity.

The medication appropriateness index at 20: where it started, where it has been, and where it may be going.

PubMed

Hanlon, Joseph T; Schmader, Kenneth E

2013-11-01

Potentially inappropriate prescribing for older adults is a major public health concern. While there are multiple measures of potentially inappropriate prescribing, the medication appropriateness index (MAI) is one of the most common implicit approaches published in the scientific literature. The objective of this narrative review is to describe findings regarding the MAI's reliability, comparison of the MAI with other quality measures of potentially inappropriate prescribing, its predictive validity with important health outcomes, and its responsiveness to change within the framework of randomized controlled trials. A search restricted to English-language literature involving humans aged 65+ years from January 1992 to June 2013 was conducted using MEDLINE and EMBASE databases using the search term 'medication appropriateness index'. A manual search of the reference lists from identified articles and the authors' article files, book chapters, and recent reviews was conducted to identify additional articles. A total of 26 articles were identified for inclusion in this narrative review. The main findings were that the MAI has acceptable inter- and intra-rater reliability, it more frequently detects potentially inappropriate prescribing than a commonly used set of explicit criteria, it predicts adverse health outcomes, and it is able to demonstrate the positive impact of interventions to improve this public health problem. We conclude that the MAI may serve as a valuable tool for measuring potentially inappropriate prescribing in older adults.

Concern for Lost Income Following Donation Deters Some Patients From Talking to Potential Living Donors.

PubMed

Rodrigue, James R; Schold, Jesse D; Mandelbrot, Didier A; Taber, David J; Phan, Van; Baliga, Prabhakar K

2016-12-01

Some living kidney donors report lost income during recovery from surgery. Little is known about whether concern for living donor's lost income affects the decision to undergo donation evaluation and the willingness of transplant candidates to discuss living kidney donation (LKD) with others. To examine whether transplant patients were told by potential donors about lost income concerns and whether patients chose not to discuss LKD with others due to lost income concerns. Kidney transplant patients (185 wait-listed candidates, 171 deceased donor recipients, and 100 live donor recipients) at 2 centers completed a questionnaire to assess whether concern about donor's lost income was a consideration in discussion about LKD with others. One-third (32%) were told by a family member/friend that they were willing to donate but were concerned about potential lost income. The majority of those who expressed financial concern (64%) did not initiate donation evaluation. Many patients (42%) chose not to discuss living donation with a family member/friend due to concern about the impact of lost income on the donor. In the multivariable model, lower annual household income was the only statistically significant predictor of both having a potential donor expressing lost income concern and choosing not to talk to someone because of lost income concern. Findings from the current study underscore how concern about income loss for living donors may affect decision-making by both transplant candidates and potential donors.

Evaluation of customer satisfaction level of different projects.

PubMed

Das, Nandini; Samanta, Niladri

2005-01-01

Customer satisfaction as the key element for success in business is a major concern for any industry. In this paper we propose a customer satisfaction index using principal component analysis for a software solution company. This index was used as an input to the marketing division to identify their potential customers from their past experience. Since this is a very common problem for any industry, the same approach can be used in similar situations.

The Combat Vehicle Command and Control System: Combat Performance of Armor Battalions Using Interactive Simulation

DTIC Science & Technology

1994-05-01

Command and Control display. Using Ml tank simulators in the Mounted Warfare Test Bed at Fort Knox, Kentucky, the researchers evaluated tank battalion... Warfare Test Bed (MWTB) at Fort Knox, Kentucky, eight MOS-qualified armor crews (battalion commander, battalion opera- tions officer, three company...concerned with identifying ways that the CVCC system might best benefit the battlefield commander, and potential modifications to mounted warfare TTPs

Health assessment for Lang Property National Priorities List (NPL) site, Pemberton Township, Burlington County, New Jersey, Region 2. CERCLIS No. NJD980505382. Final report

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

Not Available

1989-04-17

The Lang Property National Priorities List Site is located in Pemberton Township, Burlington County, New Jersey. Unauthorized disposal of hazardous wastes occurred on approximately two acres of the 40-acre site. The contaminant classes that were identified on the site are volatile organic compounds (VOCs), semi-volatile organic compounds (semi-VOCs), polynuclear aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), pesticides, and metals. The contaminant classes of concern are PCBs, VOCs, and semi-VOCs for on-site ground water. VOCs is the contaminant class of concern for sediments and surface water. The on-site ground water is highly contaminated; at the maximum chemical concentrations detected, use of thismore » water without treatment would pose a human health concern. The potential does exist for human exposure to ground water contaminants by ingestion, inhalation of volatilized VOCs from ground water, and dermal absorption. The surface soils are also highly contaminated and represent a current possible as well as future human health concern for trespassers, blueberry farm workers and harvesters, and construction and remedial workers.« less

CrossCheck plagiarism screening : Experience of the Journal of Epidemiology

NASA Astrophysics Data System (ADS)

Hashimoto, Katsumi

Due to technological advances in the past two decades, researchers now have unprecedented access to a tremendous amount of useful information. However, because of the extreme pressure to publish, this abundance of information can sometimes tempt researchers to commit scientific misconduct. A serious form of such misconduct is plagiarism. Editors are always concerned about the possibility of publishing plagiarized manuscripts. The plagiarism detection tool CrossCheck allows editors to scan and analyze manuscripts effectively. The Journal of Epidemiology took part in a trial of CrossCheck, and this article discusses the concerns journal editors might have regarding the use of CrossCheck and its analysis. In addition, potential problems identified by CrossCheck, including self-plagiarism, are introduced.

Biological phenotypes associated with individuals at high risk for developing alcohol-related disorders: Part 1.

PubMed

Hill, S Y

2000-01-01

This article reviews the results of studies concerning particular classes of biological phenotypes that may have relevance for alcohol dependence. Broadly defined, these classes include brain neurotransmitter systems and neuroelectric potentials. Evidence is presented concerning genotypic variation in alcoholics and high-risk relatives suggesting that the etiology of alcoholism and other addictive diseases is mediated in part through suboptimal neurotransmitter functioning. Research opportunities are offered with respect to specific candidate genes that have been cloned from these neurotransmitter systems that could be most fully utilized in family-based genetic analyses. Additional evidence is offered, suggesting that characteristics of particular neuroelectric potentials (e.g. the amplitude of the P300 component of the event-related potential) may provide another dimension of potential markers that could be used to identify children at risk. Finally, methodological considerations specific to high risk studies are discussed. Among these are the need to include a plan for studying more severe cases of alcohol dependence that are relatively uncomplicated by other major psychiatric disorders. Plans for long-term follow-up of children at highest risk for developing the disorder should also be included. Multiple domains of inquiry should not be viewed as "unfocused" but rather as an economical means for utilizing highly characterized samples of individuals meeting rigorous research criteria.

A risk assessment approach to contaminants in Port Curtis, Queensland, Australia.

PubMed

Jones, Mary-Anne; Stauber, Jenny; Apte, Simon; Simpson, Stuart; Vicente-Beckett, Vicky; Johnson, Rod; Duivenvoorden, Leo

2005-01-01

Port Curtis is one of Australia's leading ports for which substantial industrial expansion is proposed over the next decade. However, there has been little attempt to date to assess the extent of contamination in waters, sediments and biota or to characterize the potential impacts of contaminants on aquatic biota. Contaminants of potential concern to biota and human health were investigated in the Port Curtis estuary using a screening-level risk assessment approach. Dissolved metal concentrations in waters were below [ANZECC/ARMCANZ, 2000. Australian and New Zealand Guidelines for Fresh and Marine Water Quality, Vol. 1. The Guidelines, Australian and New Zealand Environment and Conservation Council and Agriculture and Resource Management Council of Australia and New Zealand] trigger values, suggesting low risk of these contaminants. In sediments, arsenic, nickel and chromium concentrations exceeded interim sediment quality guidelines-low (ISQG-low), but were also high in the reference zone suggesting a natural origin. Historical data on naphthalene in Harbour sediments showed that it was also of potential concern. Bioaccumulation of contaminants in a range of biota was also used as an indicator of contaminant exposure. Biota were generally enriched in metals and tributyltin, which was also elevated in water and sediments. Although not unique to Port Curtis, mercury in barramundi was identified as a potential risk to human health.

Printed paper and board food contact materials as a potential source of food contamination.

PubMed

Van Bossuyt, Melissa; Van Hoeck, Els; Vanhaecke, Tamara; Rogiers, Vera; Mertens, Birgit

2016-11-01

Food contact materials (FCM) are estimated to be the largest source of food contamination. Apart from plastics, the most commonly used FCM are made of printed paper and board. Unlike their plastic counterparts, these are not covered by a specific European regulation. Several contamination issues have raised concerns towards potential adverse health effects caused by exposure to substances migrating from printed paper and board FCM. In the current study, an inventory combining the substances which may be used in printed paper and board FCM, was created. More than 6000 unique compounds were identified, the majority (77%) considered non-evaluated in terms of potential toxicity. Based on a preliminary study of their physicochemical properties, it is estimated that most of the non-evaluated single substances have the potential to migrate into the food and become bioavailable after oral intake. Almost all are included in the FACET tool, indicating that their use in primary food packaging has been confirmed by industry. Importantly, 19 substances are also present in one of the lists with substances of concern compiled by the European Chemicals Agency (ECHA). To ensure consumer safety, the actual use of these substances in printed paper and board FCM should be investigated urgently. Copyright © 2016 Elsevier Inc. All rights reserved.

Older and wiser? Changes in unprofessional content on urologists' social media after transition from residency to practice.

PubMed

Koo, Kevin; Bowman, Max S; Ficko, Zita; Gormley, E Ann

2018-04-25

To characterize changes in the frequency and nature of unprofessional content on urologists' Facebook accounts during the transition from residency to practice. Facebook was queried with the names of all 2015 US urology graduates 1 year after completion of residency. We identified unprofessional and potentially objectionable content on the public Facebook accounts using a rubric based on professionalism guidelines by the American Urological Association, the American Medical Association and the Accreditation Council for Graduate Medical Education. Comparisons of unprofessional content were made with data from this cohort collected at the completion of residency. To assess how professional identities were reflected on social media, we determined which urologists self-identified as a urologist on Facebook and any changes in their unprofessional content. Of 281 urologists, 198 (70%) had publicly identifiable Facebook accounts. Of these, 85 (43%) contained any unprofessional or potentially objectionable content, including 35 (18%) with explicitly unprofessional content. Examples included images of and references to intoxication, explicit profanity, and offensive comments about patients. Of the 201 Facebook accounts that had been publicly identifiable at the completion of residency, most profiles (182, 91%) had remained public; of the 19 that were no longer public, about half had previously contained unprofessional content. Similarly, of the 80 urologists without public profiles 1 year previously, most (64, 80%) had remained unidentifiable on Facebook; of the 16 accounts that had since become publicly identifiable, half had unprofessional content. Among the urologists on Facebook overall, 11 (6%) had posted new unprofessional or potentially objectionable content since entering practice. Comparing this cohort in practice vs at the completion of residency, there were no significant differences in how many urologists had public Facebook accounts (70% vs 71%) or whose accounts had concerning content (43% vs 40%). The presence of unprofessional content at the completion of residency strongly predicted having unprofessional content later in practice. More urologists overall self-identified as being a urologist on Facebook, and a larger proportion of these profiles also displayed unprofessional content (53% vs 47% 1 year previously). Most urologists maintained public Facebook accounts after the transition to practice, and about half of these contained unprofessional or potentially objectionable content. Amidst their increasing self-identification as urologists on social media, the majority of practising urologists had posted concerning content, which could have an impact on their professional identities and public perceptions of the specialty. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Ethics, Risk and Benefits Associated with Different Applications of Nanotechnology: a Comparison of Expert and Consumer Perceptions of Drivers of Societal Acceptance.

PubMed

Gupta, N; Fischer, A R H; Frewer, L J

Examining those risk and benefit perceptions utilised in the formation of attitudes and opinions about emerging technologies such as nanotechnology can be useful for both industry and policy makers involved in their development, implementation and regulation. A broad range of different socio-psychological and affective factors may influence consumer responses to different applications of nanotechnology, including ethical concerns. A useful approach to identifying relevant consumer concerns and innovation priorities is to develop predictive constructs which can be used to differentiate applications of nanotechnology in a way which is meaningful to consumers. This requires elicitation of attitudinal constructs from consumers, rather than measuring attitudes assumed to be important by the researcher. Psychological factors influencing societal responses to 15 applications of nanotechnology drawn from different application areas (e.g. medicine, agriculture and environment, food, military, sports, and cosmetics) were identified using repertory grid method in conjunction with generalised Procrustes analysis. The results suggested that people differentiate nanotechnology applications based on the extent to which they perceive them to be beneficial, useful, necessary and important. The benefits may be offset by perceived risks focusing on fear and ethical concerns. Compared to an earlier expert study on societal acceptance of nanotechnology, consumers emphasised ethical issues compared to experts but had less concern regarding potential physical contact with the product and time to market introduction. Consumers envisaged fewer issues with several applications compared to experts, in particular food applications.

Factors associated with perceived donation-related financial burden among living kidney donors.

PubMed

Ruck, Jessica M; Holscher, Courtenay M; Purnell, Tanjala S; Massie, Allan B; Henderson, Macey L; Segev, Dorry L

2018-03-01

The perception of living kidney donation-related financial burden affects willingness to donate and the experience of donation, yet no existing tools identify donors who are at higher risk of perceived financial burden. We sought to identify characteristics that predicted higher risk of perceived financial burden. We surveyed 51 living kidney donors (LKDs) who donated from 01/2015 to 3/2016 about socioeconomic characteristics, predonation cost concerns, and perceived financial burden. We tested associations between both self-reported and ZIP code-level characteristics and perceived burden using Fisher's exact test and bivariate modified Poisson regression. Donors who perceived donation-related financial burden were less likely to have an income above their ZIP code median (14% vs. 72%, P = .006); however, they were more likely than donors who did not perceive burden to rent their home (57% vs. 16%, P = .03), have an income <$60 000 (86% vs. 20%, P = .002), or have had predonation cost concerns (43% vs. 7%, P = .03). Perceived financial burden was 3.6-fold as likely among those with predonation cost concerns and 10.6-fold as likely for those with incomes <$60 000. Collecting socioeconomic characteristics and asking about donation-related cost concerns prior to donation might allow transplant centers to target financial support interventions toward potential donors at higher risk of perceiving donation-related financial burden. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Concerns and Responses for Integrating Health Systems Science Into Medical Education.

PubMed

Gonzalo, Jed D; Caverzagie, Kelly J; Hawkins, Richard E; Lawson, Luan; Wolpaw, Daniel R; Chang, Anna

2018-06-01

With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders. The authors identify several widely perceived challenges to integrating HSS into medical school curricula, respond to each concern, and provide potential strategies to address these concerns, based on their experiences designing and integrating HSS curricula. They identify two broad categories of concerns: the (1) relevance and importance of learning HSS-including the perception that there is inadequate urgency for change; HSS education is too complex and should occur in later years; early students would not be able to contribute, and the roles already exist; and the science is too nascent-and (2) logistics and practicality of teaching HSS-including limited curricular time, scarcity of faculty educators with expertise, lack of support from accreditation agencies and licensing boards, and unpreparedness of evolving health care systems to partner with schools with HSS curricula. The authors recommend the initiation and continuation of discussions between educators, clinicians, basic science faculty, health system leaders, and accrediting and regulatory bodies about the goals and priorities of medical education, as well as about the need to collaborate on new methods of education to reach these goals.

Use of mechanism-based structure-activity relationships analysis in carcinogenic potential ranking for drinking water disinfection by-products.

PubMed Central

Woo, Yin-Tak; Lai, David; McLain, Jennifer L; Manibusan, Mary Ko; Dellarco, Vicki

2002-01-01

Disinfection by-products (DBPs) are formed when disinfectants such as chlorine, chloramine, and ozone react with organic and inorganic matter in water. The observations that some DBPs such as trihalomethanes (THMs), di-/trichloroacetic acids, and 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX) are carcinogenic in animal studies have raised public concern over the possible adverse health effects of DBPs. To date, several hundred DBPs have been identified. To prioritize research efforts, an in-depth, mechanism-based structure-activity relationship analysis, supplemented by extensive literature search for genotoxicity and other data, was conducted for ranking the carcinogenic potential of DBPs that met the following criteria: a) detected in actual drinking water samples, b) have insufficient cancer bioassay data for risk assessment, and c) have structural features/alerts or short-term predictive assays indicative of carcinogenic potential. A semiquantitative concern rating scale of low, marginal, low-moderate, moderate, high-moderate, and high was used along with delineation of scientific rationale. Of the 209 DBPs analyzed, 20 were of priority concern with a moderate or high-moderate rating. Of these, four were structural analogs of MX and five were haloalkanes that presumably will be controlled by existing and future THM regulations. The other eleven DBPs, which included halonitriles (6), haloketones (2), haloaldehyde (1), halonitroalkane (1), and dialdehyde (1), are suitable priority candidates for future carcinogenicity testing and/or mechanistic studies. PMID:11834465

Condoms and conflict: AIDS and the military.

PubMed

Winsbury, R

1992-11-01

Worldwide, many thousands of soldiers are infected with HIV. Their actual or potential presence within the ranks of military forces may generate anxiety among military leaders and general personnel. Troops may be concerned over the risk of being infected with HIV through emergency front-line blood transfusions. Leaders and politicians worry about HIV in the military for more political and cultural reasons, including the potential fallout of being accused of sending troops to spread AIDS on foreign peace-keeping missions. US chiefs of staff have even accused HIV+ servicemen of being comparatively unstable, and that they constitute a security risk, especially where control over nuclear armaments is concerned. These concerns fuel the U.S. military argument for expelling homosexuals from service. Over 13,000 troops identified as homosexual were expelled from the Navy over the period 1982-91. $27 million were spent in 1990 to replace identified gay soldiers. HIV is prevalent to varying degrees in virtually every army in the world. AIDS has decimated some African armies. 1 sub-Saharan country has lost so many pilots to AIDS that it has reportedly recruited soldiers from Yugoslavia to compensate for the loss. Uganda's army may have a 20% prevalence of HIV. War is the harbinger of AIDS; as populations are displaced during war, servicemen turn to prostitutes for sex, and women sell sex to provide their families. Wartime rapes spread HIV and other sexually transmitted diseases. While the military may contribute to the spread of HIV, it also has the capacity to help prevent transmission. Mandatory HIV-antibody testing is many armies may help research and practical efforts to monitor and control HIV prevalence and incidence in populations. Additional steps may be and have been taken by military forces to educate the public and promote and develop AIDS control programs.

Social processes explaining the benefits of Al-Anon participation.

PubMed

Timko, Christine; Halvorson, Max; Kong, Calvin; Moos, Rudolf H

2015-12-01

This study examined social processes of support, goal direction, provision of role models, and involvement in rewarding activities to explain benefits of participating in Al-Anon, a 12-step mutual-help program for people concerned about another person's substance use. Newcomers to Al-Anon were studied at baseline and 6 months later, at which time they were identified as having either sustained attendance or dropped out. Among both newcomers and established Al-Anon members ("old-timers"), we also used number of Al-Anon meetings attended during follow-up to indicate extent of participation. Social processes significantly mediated newcomers' sustained attendance status versus dropped out and outcomes of Al-Anon in the areas of life context (e.g., better quality of life, better able to handle problems due to the drinker), improved positive symptoms (e.g., higher self-esteem, more hopeful), and decreased negative symptoms (e.g., less abuse, less depressed). Social processes also significantly mediated newcomers' number of meetings attended and outcomes. However, among old-timers, Al-Anon attendance was not associated with outcomes, so the potential mediating role of social processes could not be examined, but social processes were associated with outcomes. Findings add to the growing body of work identifying mechanisms by which 12-step groups are effective, by showing that bonding, goal direction, and access to peers in recovery and rewarding pursuits help to explain associations between sustained Al-Anon participation among newcomers and improvements on key concerns of Al-Anon attendees. Al-Anon is free of charge and widely available, making it a potentially cost-effective public health resource for help alleviating negative consequences of concern about another's addiction. (c) 2016 APA, all rights reserved).

Occupational safety and health criteria for responsible development of nanotechnology

NASA Astrophysics Data System (ADS)

Schulte, P. A.; Geraci, C. L.; Murashov, V.; Kuempel, E. D.; Zumwalde, R. D.; Castranova, V.; Hoover, M. D.; Hodson, L.; Martinez, K. F.

2014-01-01

Organizations around the world have called for the responsible development of nanotechnology. The goals of this approach are to emphasize the importance of considering and controlling the potential adverse impacts of nanotechnology in order to develop its capabilities and benefits. A primary area of concern is the potential adverse impact on workers, since they are the first people in society who are exposed to the potential hazards of nanotechnology. Occupational safety and health criteria for defining what constitutes responsible development of nanotechnology are needed. This article presents five criterion actions that should be practiced by decision-makers at the business and societal levels—if nanotechnology is to be developed responsibly. These include (1) anticipate, identify, and track potentially hazardous nanomaterials in the workplace; (2) assess workers' exposures to nanomaterials; (3) assess and communicate hazards and risks to workers; (4) manage occupational safety and health risks; and (5) foster the safe development of nanotechnology and realization of its societal and commercial benefits. All these criteria are necessary for responsible development to occur. Since it is early in the commercialization of nanotechnology, there are still many unknowns and concerns about nanomaterials. Therefore, it is prudent to treat them as potentially hazardous until sufficient toxicology, and exposure data are gathered for nanomaterial-specific hazard and risk assessments. In this emergent period, it is necessary to be clear about the extent of uncertainty and the need for prudent actions.

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review

PubMed Central

Weber, Samuel R.; Lomax, James W.; Pargament, Kenneth I.

2017-01-01

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients. PMID:28379161

Healthcare Engagement as a Potential Source of Psychological Distress among People without Religious Beliefs: A Systematic Review.

PubMed

Weber, Samuel R; Lomax, James W; Pargament, Kenneth I

2017-04-05

Research into religion and mental health is increasing, but nonbelievers in terms of religion are often overlooked. Research has shown that nonbelievers experience various forms of psychological distress and that the negative perception of nonbelievers by others is a potential source of distress. This review builds on that research by identifying another potential source of psychological distress for nonbelievers: engagement with the healthcare system. Poor understanding of nonbelievers by healthcare professionals may lead to impaired communication in the healthcare setting, resulting in distress. Attempts by nonbelievers to avoid distress may result in different patterns of healthcare utilization. Awareness of these concerns may help healthcare providers to minimize distress among their nonbelieving patients.

Development, evaluation, and application of sediment quality targets for assessing and managing contaminated sediments in Tampa Bay, Florida

USGS Publications Warehouse

MacDonald, D.D.; Carr, R.S.; Eckenrod, D.; Greening, H.; Grabe, S.; Ingersoll, C.G.; Janicki, S.; Janicki, T.; Lindskoog, R.A.; Long, E.R.; Pribble, R.; Sloane, G.; Smorong, D.E.

2004-01-01

Tampa Bay is a large, urban estuary that is located in west central Florida. Although water quality conditions represent an important concern in this estuary, information from numerous sources indicates that sediment contamination also has the potential to adversely affect aquatic organisms, aquatic-dependent wildlife, and human health. As such, protecting relatively uncontaminated areas of the bay from contamination and reducing the amount of toxic chemicals in contaminated sediments have been identified as high-priority sediment management objectives for Tampa Bay. To address concerns related to sediment contamination in the bay, an ecosystem-based framework for assessing and managing sediment quality conditions was developed that included identification of sediment quality issues and concerns, development of ecosystem goals and objectives, selection of ecosystem health indicators, establishment of metrics and targets for key indicators, and incorporation of key indicators, metrics, and targets into watershed management plans and decision-making processes. This paper describes the process that was used to select and evaluate numerical sediment quality targets (SQTs) for assessing and managing contaminated sediments. These SQTs included measures of sediment chemistry, whole-sediment and pore-water toxicity, and benthic invertebrate community structure. In addition, the paper describes how the SQTs were used to develop site-specific concentration-response models that describe how the frequency of adverse biological effects changes with increasing concentrations of chemicals of potential concern. Finally, a key application of the SQTs for defining sediment management areas is discussed.

High temperature molten salt containment

NASA Astrophysics Data System (ADS)

Wang, K. Y.; West, R. E.; Kreith, F.; Lynn, P. P.

1985-05-01

The feasibility of several design options for high-temperature, sensible heat storage containment is examined. The major concerns for a successful containment design include heat loss, corrosive tolerance, structural integrity, and cost. This study is aimed at identifying the most promising high-temperature storage tank among eight designs initially proposed. The study is based on the heat transfer calculations and the structure study of the tank wall and the tank foundation and the overall cost analyses. The results indicate that the single-tank, two-media sloped wall tank has the potential of being lowest in cost. Several relevant technical uncertainties that warrant further research efforts are also identified.

The Outdoor Air Pollution and Brain Health Workshop

PubMed Central

Block, Michelle L.; Elder, Alison; Auten, Rick L.; Bilbo, Staci D.; Chen, Honglei; Chen, Jiu-Chiuan; Cory-Slechta, Deborah A.; Costa, Daniel; Diaz-Sanchez, David; Dorman, David C.; Gold, Diane; Gray, Kimberly; Jeng, Hueiwang Anna; Kaufman, Joel D.; Kleinman, Michael T.; Kirshner, Annette; Lawler, Cindy; Miller, David S.; Nadadur, Sri; Ritz, Beate; Semmens, Erin O.; Tonelli, Leonardo H.; Veronesi, Bellina; Wright, Robert O.; Wright, Rosalind

2013-01-01

Accumulating evidence suggests that outdoor air pollution may have a significant impact on central nervous system (CNS) health and disease. To address this issue, the National Institute of Environmental Health Sciences/National Institute of Health convened a panel of research scientists that was assigned the task of identifying research gaps and priority goals essential for advancing this growing field and addressing an emerging human health concern. Here, we review recent findings that have established the effects of inhaled air pollutants in the brain, explore the potential mechanisms driving these phenomena, and discuss the recommended research priorities/approaches that were identified by the panel. PMID:22981845

A new threat to bees? Entomopathogenic nematodes used in biological pest control cause rapid mortality in Bombus terrestris.

PubMed

Dutka, Alexandrea; McNulty, Alison; Williamson, Sally M

2015-01-01

There is currently a great deal of concern about population declines in pollinating insects. Many potential threats have been identified which may adversely affect the behaviour and health of both honey bees and bumble bees: these include pesticide exposure, and parasites and pathogens. Whether biological pest control agents adversely affect bees has been much less well studied: it is generally assumed that biological agents are safer for wildlife than chemical pesticides. The aim of this study was to test whether entomopathogenic nematodes sold as biological pest control products could potentially have adverse effects on the bumble bee Bombus terrestris. One product was a broad spectrum pest control agent containing both Heterorhabditis sp. and Steinernema sp., the other product was specifically for weevil control and contained only Steinernema kraussei. Both nematode products caused ≥80% mortality within the 96 h test period when bees were exposed to soil containing entomopathogenic nematodes at the recommended field concentration of 50 nematodes per cm(2) soil. Of particular concern is the fact that nematodes from the broad spectrum product could proliferate in the carcasses of dead bees, and therefore potentially infect a whole bee colony or spread to the wider environment.

From cottage industry to a dominant mode of primary care: stages in the diffusion of a health care innovation (retail clinics).

PubMed

McKinlay, John B; Marceau, Lisa D

2012-09-01

Primary health care is essential to population health and there is increasing need for it, especially with an aging population with multiple comorbidities. Primary health care in the U.S. is widely considered in an ever-deepening crisis. This paper presents a detailed case study of the recent rise of a "disruptive innovation" - retail clinics - which have the potential to transform the face of primary health care in the US. We describe six stages in the diffusion of retail clinics, from cottage industry to a dominant mode for the delivery of primary health care, and consider sociopolitical influences that facilitate and impede their emerging potential. Retail clinics may provide a strategic opportunity to re-engineer the primary health care system, although they may also produce worrisome unanticipated consequences. Discussion concerning the potential threats and opportunities posed by retail clinics occurs in the absence of sound evidence concerning their comparative effectiveness and quality-of-care. This case study identifies the sociopolitical influences and processes that determine whether health care innovations rise or fall, and highlights critically important points along the pathway to health system change. Copyright © 2012 Elsevier Ltd. All rights reserved.

Nontargeted multicomponent analytical screening of plastic food contact materials using fast interpretation of deliverables via expert structure-activity relationship software.

PubMed

Rothenbacher, Thorsten; Schwack, Wolfgang

2009-01-01

Plastic packaging materials may release compounds into packed foodstuffs. To identify potential migrants of toxicological concern, resins, and multilayer foils (mainly polyethylene) intended for the production of food contact materials were extracted and analyzed by GC/mass spectrometry. To identify even compounds of low concentrations, AMDIS software was used and data evaluation was safeguarded by the Kovats retention index (RI) system. In this way, 46 compounds were identified as possible migrants. The expert structure-activity relationship software DEREK for Windows was utilized to evaluate all identified substances in terms of carcinogenicity, genotoxicity, thyroid toxicity, and miscellaneous endpoints for humans. Additionally, a literature search for these compounds was performed with Sci-Finder, but relevant data were missing for 28 substances. Seven compounds with adverse toxicological effects were identified. In addition, the RIs of 24 commercial additive standards, measured with a GC capillary column of intermediate polarity, are given.

Medical and pharmacy student concerns about participating on international service-learning trips.

PubMed

Chuang, Chih; Khatri, Siddique H; Gill, Manpal S; Trehan, Naveen; Masineni, Silpa; Chikkam, Vineela; Farah, Guillaume G; Khan, Amber; Levine, Diane L

2015-12-23

International Service Learning Trips (ISLT) provide health professional students the opportunity to provide healthcare, under the direction of trained faculty, to underserved populations in developing countries. Despite recent increases in international service learning trips, there is scant literature addressing concerns students have prior to attending such trips. This study focuses on identifying concerns before and after attending an ISLT and their impact on students. A survey comprised of closed and open-ended questions was developed to elucidate student concerns prior to attending an ISLT and experiences which might influence concerns. A five-point Likert-scale (extremely concerned = 1, minimally concerned = 5) was used to rate apprehension and satisfaction. Paired t-test was used to compare pre- and post-trip concerns; Chi-Square test was used to compare groups. Thirty-five students (27 medical, 8 pharmacy) attended ISLTs in December 2013. All completed pre and post-trip surveys. Significant decreases were seen in concerns related to cultural barriers (4.14 vs 4.46, P = .047), disease/epidemics (3.34 vs 4.60, P < .001), natural disasters (3.94 vs 4.94, P < .001), terrorism (4.34 vs 4.94, P < .001), travel (3.86 vs 4.51, P < .001) monetary issues (3.80 vs 4.60, P < .001), hospitality (3.94 vs 4.74, P = .001) and food (3.83 vs 4.60, P < .001). Language and group dynamics remained concerns post-trip. On open-ended questions, students described benefits of attending an ISLT. Students had multiple concerns prior to attending an ISLT. Most decreased upon return. Addressing concerns has the potential to decrease student apprehension. The results of this study highlight the benefits of providing ISLTs and supporting development of a curriculum incorporating trip-related concerns.

When synthetic chemicals degrade in the environment: What are the absolute fate, effects, and potential risks to humans and the ecosystem?

USGS Publications Warehouse

Boxall, Alistair; Sinclair, C.; Fenner, Kathrin; Kolpin, Dana W.; Maund, S.

2004-01-01

Although some regulatory schemes require information about the impacts of degradates on human and environmental health, that information does not exist for many compounds (25, 26). Pesticides are the exception. In this article, we bring together the available data to address the environmental behavior of degradates and their effects on organisms and discuss how to identify substances of potential concern. In addition, we cite gaps in the current knowledge and make recommendations for future research requirements. While the article focuses on pesticides, we believe these observations can be extended to biologically active compounds and some industrial substances.

One-to-one comparison of sunscreen efficacy, aesthetics and potential nanotoxicity

NASA Astrophysics Data System (ADS)

Barnard, Amanda S.

2010-04-01

Numerous reports have described the superior properties of nanoparticles and their diverse range of applications. Issues of toxicity, workplace safety and environmental impact have also been a concern. Here we show a theoretical comparison of how the size of titanium dioxide nanoparticles and their concentration in sunscreens can affect efficacy, aesthetics and potential toxicity from free radical production. The simulation results reveal that, unless very small nanoparticles can be shown to be safe, there is no combination of particle size and concentration that will deliver optimal performance in terms of sun protection and aesthetics. Such a theoretical method complements well the experimental approach for identifying these characteristics.

Civil Uses of Remotely Piloted Aircraft

NASA Technical Reports Server (NTRS)

Aderhold, J. R.; Gordon, G.; Scott, G. W.

1976-01-01

The economic, technical, and environmental implications of remotely piloted vehicles (RVP) are examined. The time frame is 1980-85. Representative uses are selected; detailed functional and performance requirements are derived for RPV systems; and conceptual system designs are devised. Total system cost comparisons are made with non-RPV alternatives. The potential market demand for RPV systems is estimated. Environmental and safety requirements are examined, and legal and regulatory concerns are identified. A potential demand for 2,000-11,000 RVP systems is estimated. Typical cost savings of 25 to 35% compared to non-RPV alternatives are determined. There appear to be no environmental problems, and the safety issue appears manageable.

Probabilistic risk assessment of the Space Shuttle. Phase 3: A study of the potential of losing the vehicle during nominal operation. Volume 2: Integrated loss of vehicle model

NASA Technical Reports Server (NTRS)

Fragola, Joseph R.; Maggio, Gaspare; Frank, Michael V.; Gerez, Luis; Mcfadden, Richard H.; Collins, Erin P.; Ballesio, Jorge; Appignani, Peter L.; Karns, James J.

1995-01-01

The application of the probabilistic risk assessment methodology to a Space Shuttle environment, particularly to the potential of losing the Shuttle during nominal operation is addressed. The different related concerns are identified and combined to determine overall program risks. A fault tree model is used to allocate system probabilities to the subsystem level. The loss of the vehicle due to failure to contain energetic gas and debris, to maintain proper propulsion and configuration is analyzed, along with the loss due to Orbiter, external tank failure, and landing failure or error.

Integrating social and value dimensions into sustainability assessment of lignocellulosic biofuels

PubMed Central

Raman, Sujatha; Mohr, Alison; Helliwell, Richard; Ribeiro, Barbara; Shortall, Orla; Smith, Robert; Millar, Kate

2015-01-01

The paper clarifies the social and value dimensions for integrated sustainability assessments of lignocellulosic biofuels. We develop a responsible innovation approach, looking at technology impacts and implementation challenges, assumptions and value conflicts influencing how impacts are identified and assessed, and different visions for future development. We identify three distinct value-based visions. From a techno-economic perspective, lignocellulosic biofuels can contribute to energy security with improved GHG implications and fewer sustainability problems than fossil fuels and first-generation biofuels, especially when biomass is domestically sourced. From socio-economic and cultural-economic perspectives, there are concerns about the capacity to support UK-sourced feedstocks in a global agri-economy, difficulties monitoring large-scale supply chains and their potential for distributing impacts unfairly, and tensions between domestic sourcing and established legacies of farming. To respond to these concerns, we identify the potential for moving away from a one-size-fits-all biofuel/biorefinery model to regionally-tailored bioenergy configurations that might lower large-scale uses of land for meat, reduce monocultures and fossil-energy needs of farming and diversify business models. These configurations could explore ways of reconciling some conflicts between food, fuel and feed (by mixing feed crops with lignocellulosic material for fuel, combining livestock grazing with energy crops, or using crops such as miscanthus to manage land that is no longer arable); different bioenergy applications (with on-farm use of feedstocks for heat and power and for commercial biofuel production); and climate change objectives and pressures on farming. Findings are based on stakeholder interviews, literature synthesis and discussions with an expert advisory group. PMID:26664147

Integrating social and value dimensions into sustainability assessment of lignocellulosic biofuels.

PubMed

Raman, Sujatha; Mohr, Alison; Helliwell, Richard; Ribeiro, Barbara; Shortall, Orla; Smith, Robert; Millar, Kate

2015-11-01

The paper clarifies the social and value dimensions for integrated sustainability assessments of lignocellulosic biofuels. We develop a responsible innovation approach, looking at technology impacts and implementation challenges, assumptions and value conflicts influencing how impacts are identified and assessed, and different visions for future development. We identify three distinct value-based visions. From a techno-economic perspective, lignocellulosic biofuels can contribute to energy security with improved GHG implications and fewer sustainability problems than fossil fuels and first-generation biofuels, especially when biomass is domestically sourced. From socio-economic and cultural-economic perspectives, there are concerns about the capacity to support UK-sourced feedstocks in a global agri-economy, difficulties monitoring large-scale supply chains and their potential for distributing impacts unfairly, and tensions between domestic sourcing and established legacies of farming. To respond to these concerns, we identify the potential for moving away from a one-size-fits-all biofuel/biorefinery model to regionally-tailored bioenergy configurations that might lower large-scale uses of land for meat, reduce monocultures and fossil-energy needs of farming and diversify business models. These configurations could explore ways of reconciling some conflicts between food, fuel and feed (by mixing feed crops with lignocellulosic material for fuel, combining livestock grazing with energy crops, or using crops such as miscanthus to manage land that is no longer arable); different bioenergy applications (with on-farm use of feedstocks for heat and power and for commercial biofuel production); and climate change objectives and pressures on farming. Findings are based on stakeholder interviews, literature synthesis and discussions with an expert advisory group.

Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease.

PubMed

Van Gosen, Bradley S; Blitz, Thomas A; Plumlee, Geoffrey S; Meeker, Gregory P; Pierson, M Patrick

2013-08-01

Erionite, a mineral series within the zeolite group, is classified as a Group 1 known respiratory carcinogen. This designation resulted from extremely high incidences of mesothelioma discovered in three small villages from the Cappadocia region of Turkey, where the disease was linked to environmental exposures to fibrous forms of erionite. Natural deposits of erionite, including fibrous forms, have been identified in the past in the western United States. Until recently, these occurrences have generally been overlooked as a potential hazard. In the last several years, concerns have emerged regarding the potential for environmental and occupational exposures to erionite in the United States, such as erionite-bearing gravels in western North Dakota mined and used to surface unpaved roads. As a result, there has been much interest in identifying locations and geologic environments across the United States where erionite occurs naturally. A 1996 U.S. Geological Survey report describing erionite occurrences in the United States has been widely cited as a compilation of all US erionite deposits; however, this compilation only focused on one of several geologic environments in which erionite can form. Also, new occurrences of erionite have been identified in recent years. Using a detailed literature survey, this paper updates and expands the erionite occurrences database, provided in a supplemental file (US_erionite.xls). Epidemiology, public health, and natural hazard studies can incorporate this information on known erionite occurrences and their characteristics. By recognizing that only specific geologic settings and formations are hosts to erionite, this knowledge can be used in developing management plans designed to protect the public.

Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research

PubMed Central

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E.

2013-01-01

Background Body image is a critical psychosocial issue for cancer patients as they often undergo significant changes to appearance and functioning. In this review article, our primary purpose was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. Methods We provided an overview of theoretical models of body image relevant to cancer patients, and presented findings from published literature on body image and cancer from 2003–2013. We integrated these data with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Results Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. We identified potential indicators of body image difficulties to alert healthcare professionals when to refer patients for psychosocial care, and proposed a framework for approaching conversations about body image that can be used by the oncologic treatment team. Conclusions Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the healthcare communication literature to develop practical strategies for treating body image concerns of cancer patients. PMID:24895287

Managing body image difficulties of adult cancer patients: lessons from available research.

PubMed

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E

2014-03-01

Body image is a critical psychosocial issue for patients with cancer because they often undergo significant changes to appearance and functioning. The primary purpose of this review article was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. An overview was provided of theoretical models of body image relevant to cancer patients, and findings were presented from published literature on body image and cancer from 2003 to 2013. These data were integrated with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. Potential indicators of body image difficulties were identified to alert health care professionals when to refer patients for psychosocial care, and a framework was proposed for approaching conversations about body image that can be used by the oncologic treatment team. Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the health care communication literature to develop practical strategies for treating body image concerns of patients with cancer. © 2013 American Cancer Society.

Electronic cigarettes: incorporating human factors engineering into risk assessments

PubMed Central

Yang, Ling; Rudy, Susan F; Cheng, James M; Durmowicz, Elizabeth L

2014-01-01

Objective A systematic review was conducted to evaluate the impact of human factors (HF) on the risks associated with electronic cigarettes (e-cigarettes) and to identify research gaps. HF is the evaluation of human interactions with products and includes the analysis of user, environment and product complexity. Consideration of HF may mitigate known and potential hazards from the use and misuse of a consumer product, including e-cigarettes. Methods Five databases were searched through January 2014 and publications relevant to HF were incorporated. Voluntary adverse event (AE) reports submitted to the US Food and Drug Administration (FDA) and the package labelling of 12 e-cigarette products were analysed. Results No studies specifically addressing the impact of HF on e-cigarette use risks were identified. Most e-cigarette users are smokers, but data on the user population are inconsistent. No articles focused specifically on e-cigarette use environments, storage conditions, product operational requirements, product complexities, user errors or misuse. Twelve published studies analysed e-cigarette labelling and concluded that labelling was inadequate or misleading. FDA labelling analysis revealed similar concerns described in the literature. AE reports related to design concerns are increasing and fatalities related to accidental exposure and misuse have occurred; however, no publications evaluating the relationship between AEs and HF were identified. Conclusions The HF impacting e-cigarette use and related hazards are inadequately characterised. Thorough analyses of user–product–environment interfaces, product complexities and AEs associated with typical and atypical use are needed to better incorporate HF engineering principles to inform and potentially reduce or mitigate the emerging hazards associated with e-cigarette products. PMID:24732164

Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease

USGS Publications Warehouse

Van Gosen, Bradley S.; Blitz, Thomas A.; Plumlee, Geoffrey S.; Meeker, Gregory P.; Pierson, M. Patrick

2013-01-01

Erionite, a mineral series within the zeolite group, is classified as a Group 1 known respiratory carcinogen. This designation resulted from extremely high incidences of mesothelioma discovered in three small villages from the Cappadocia region of Turkey, where the disease was linked to environmental exposures to fibrous forms of erionite. Natural deposits of erionite, including fibrous forms, have been identified in the past in the western United States. Until recently, these occurrences have generally been overlooked as a potential hazard. In the last several years, concerns have emerged regarding the potential for environmental and occupational exposures to erionite in the United States, such as erionite-bearing gravels in western North Dakota mined and used to surface unpaved roads. As a result, there has been much interest in identifying locations and geologic environments across the United States where erionite occurs naturally. A 1996 U.S. Geological Survey report describing erionite occurrences in the United States has been widely cited as a compilation of all US erionite deposits; however, this compilation only focused on one of several geologic environments in which erionite can form. Also, new occurrences of erionite have been identified in recent years. Using a detailed literature survey, this paper updates and expands the erionite occurrences database, provided in a supplemental file (US_erionite.xls). Epidemiology, public health, and natural hazard studies can incorporate this information on known erionite occurrences and their characteristics. By recognizing that only specific geologic settings and formations are hosts to erionite, this knowledge can be used in developing management plans designed to protect the public.

Assessing the potential impacts of a revised set of on-farm nutrient and sediment 'basic' control measures for reducing agricultural diffuse pollution across England.

PubMed

Collins, A L; Newell Price, J P; Zhang, Y; Gooday, R; Naden, P S; Skirvin, D

2018-04-15

The need for improved abatement of agricultural diffuse water pollution represents cause for concern throughout the world. A critical aspect in the design of on-farm intervention programmes concerns the potential technical cost-effectiveness of packages of control measures. The European Union (EU) Water Framework Directive (WFD) calls for Programmes of Measures (PoMs) to protect freshwater environments and these comprise 'basic' (mandatory) and 'supplementary' (incentivised) options. Recent work has used measure review, elicitation of stakeholder attitudes and a process-based modelling framework to identify a new alternative set of 'basic' agricultural sector control measures for nutrient and sediment abatement across England. Following an initial scientific review of 708 measures, 90 were identified for further consideration at an industry workshop and 63 had industry support. Optimisation modelling was undertaken to identify a shortlist of measures using the Demonstration Test Catchments as sentinel agricultural landscapes. Optimisation selected 12 measures relevant to livestock or arable systems. Model simulations of 95% implementation of these 12 candidate 'basic' measures, in addition to business-as-usual, suggested reductions in the national agricultural nitrate load of 2.5%, whilst corresponding reductions in phosphorus and sediment were 11.9% and 5.6%, respectively. The total cost of applying the candidate 'basic' measures across the whole of England was estimated to be £450 million per annum, which is equivalent to £52 per hectare of agricultural land. This work contributed to a public consultation in 2016. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

A decision analysis framework for estimating the potential hazards for drinking water resources of chemicals used in hydraulic fracturing fluids.

PubMed

Yost, Erin E; Stanek, John; Burgoon, Lyle D

2017-01-01

Despite growing concerns over the potential for hydraulic fracturing to impact drinking water resources, there are limited data available to identify chemicals used in hydraulic fracturing fluids that may pose public health concerns. In an effort to explore these potential hazards, a multi-criteria decision analysis (MCDA) framework was employed to analyze and rank selected subsets of these chemicals by integrating data on toxicity, frequency of use, and physicochemical properties that describe transport in water. Data used in this analysis were obtained from publicly available databases compiled by the United States Environmental Protection Agency (EPA) as part of a larger study on the potential impacts of hydraulic fracturing on drinking water. Starting with nationwide hydraulic fracturing chemical usage data from EPA's analysis of the FracFocus Chemical Disclosure Registry 1.0, MCDAs were performed on chemicals that had either noncancer toxicity values (n=37) or cancer-specific toxicity values (n=10). The noncancer MCDA was then repeated for subsets of chemicals reported in three representative states (Texas, n=31; Pennsylvania, n=18; and North Dakota, n=20). Within each MCDA, chemicals received scores based on relative toxicity, relative frequency of use, and physicochemical properties (mobility in water, volatility, persistence). Results show a relative ranking of these chemicals based on hazard potential, and provide preliminary insight into chemicals that may be more likely than others to impact drinking water resources. Comparison of nationwide versus state-specific analyses indicates regional differences in the chemicals that may be of more concern to drinking water resources, although many chemicals were commonly used and received similar overall hazard rankings. Several chemicals highlighted by these MCDAs have been reported in groundwater near areas of hydraulic fracturing activity. This approach is intended as a preliminary analysis, and represents one possible method for integrating data to explore potential public health impacts. Published by Elsevier B.V.

Ethical considerations and potential threats to validity for three methods commonly used to collect geographic information in studies among people who use drugs.

PubMed

Rudolph, Abby E; Bazzi, Angela Robertson; Fish, Sue

2016-10-01

Analyses with geographic data can be used to identify "hot spots" and "health service deserts", examine associations between proximity to services and their use, and link contextual factors with individual-level data to better understand how environmental factors influence behaviors. Technological advancements in methods for collecting this information can improve the accuracy of contextually-relevant information; however, they have outpaced the development of ethical standards and guidance, particularly for research involving populations engaging in illicit/stigmatized behaviors. Thematic analysis identified ethical considerations for collecting geographic data using different methods and the extent to which these concerns could influence study compliance and data validity. In-depth interviews with 15 Baltimore residents (6 recruited via flyers and 9 via peer-referral) reporting recent drug use explored comfort with and ethics of three methods for collecting geographic information: (1) surveys collecting self-reported addresses/cross-streets, (2) surveys using web-based maps to find/confirm locations, and (3) geographical momentary assessments (GMA), which collect spatiotemporally referenced behavioral data. Survey methods for collecting geographic data (i.e., addresses/cross-streets and web-based maps) were generally acceptable; however, participants raised confidentiality concerns regarding exact addresses for illicit/stigmatized behaviors. Concerns specific to GMA included burden of carrying/safeguarding phones and responding to survey prompts, confidentiality, discomfort with being tracked, and noncompliance with study procedures. Overall, many felt that confidentiality concerns could influence the accuracy of location information collected for sensitive behaviors and study compliance. Concerns raised by participants could result in differential study participation and/or study compliance and questionable accuracy/validity of location data for sensitive behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of newspaper articles for coverage of public reporting data: a case study of unadjusted cancer survival data.

PubMed

Higashi, Takahiro; Nakamura, Fumiaki; Saruki, Nobuhiro; Takegami, Misa; Hosokawa, Takayo; Fukuhara, Shunichi; Nakayama, Takeo; Sobue, Tomotaka

2013-01-01

The Japanese Association of Clinical Cancer Centers recently published the unadjusted 5-year survival rates of patients receiving care at each facility. A primary concern is that the media may cover this topic differently than originally intended. We examined all 13 newspaper articles that addressed the topic to assess their coverage of the public reporting program's key points, which were identified through interviews with the leader of the program. On average, 4.5 of the 10 key points identified were at least superficially covered. Although most articles mentioned the incomparability of the unadjusted data, eight created comparative tables that listed the survival data across facilities and seven sorted the facilities in descending order of survival. Four articles provided potentially misleading descriptions about the use of the relative survival. We concluded that caution is required because newspaper reports may convey potentially contradicting messages and technical details may be described inaccurately.

A new simplex chemometric approach to identify olive oil blends with potentially high traceability.

PubMed

Semmar, N; Laroussi-Mezghani, S; Grati-Kamoun, N; Hammami, M; Artaud, J

2016-10-01

Olive oil blends (OOBs) are complex matrices combining different cultivars at variable proportions. Although qualitative determinations of OOBs have been subjected to several chemometric works, quantitative evaluations of their contents remain poorly developed because of traceability difficulties concerning co-occurring cultivars. Around this question, we recently published an original simplex approach helping to develop predictive models of the proportions of co-occurring cultivars from chemical profiles of resulting blends (Semmar & Artaud, 2015). Beyond predictive model construction and validation, this paper presents an extension based on prediction errors' analysis to statistically define the blends with the highest predictability among all the possible ones that can be made by mixing cultivars at different proportions. This provides an interesting way to identify a priori labeled commercial products with potentially high traceability taking into account the natural chemical variability of different constitutive cultivars. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Inconvenienced Youth? Ageism and its Potential Intergenerational Roots

PubMed Central

North, Michael S.; Fiske, Susan T.

2013-01-01

Age is the only social category identifying subgroups that everyone may eventually join. Despite this, and despite the well-known growth of the older population, age-based prejudice remains an under-studied topic in social psychology. This paper systematically reviews the literature on ageism, highlighting extant research on its consequences and theoretical perspectives on its causes. We then identify a crucial gap in the literature: potential intergenerational tensions, speculating how a growing older population—and society’s efforts to accommodate it—might stoke intergenerational fires, particularly among the younger generation. Presenting both sides of this incipient issue, we review relevant empirical work that introduces reasons for both optimism and pessimism concerning intergenerational relations within an aging society. We conclude by suggesting future avenues for ageism research, emphasizing the importance of understanding forthcoming intergenerational dynamics for the benefit of the field and broader society. PMID:22448913

Protective factors for HIV infection among Mexican American men who have sex with men.

PubMed

Meyer, Mark A; Champion, Jane Dimmitt

2010-01-01

Latinos in the United States have been disproportionately affected by the HIV epidemic. The purpose of this study was to identify potential themes for inclusion in effective HIV prevention interventions for Mexican American men who have sex with men (MSM). The authors used a phenomenological design to explore the lived experiences of Mexican American MSM who had grown up in Dallas, Texas, regarding protective factors for HIV infection. A total of 20 30- to 60-year-old Mexican American MSM participated in semistructured interviews. During data analysis, the following themes concerning protective behaviors for HIV emerged: (a) accepting one's sexuality; (b) machismo; (c) being in love; (d) respect for family, self, and life; and (e) having HIV-living now. Strategies for potential inclusion in HIV prevention interventions geared toward Mexican American MSM were identified based on these themes. The recommendations encompass modification of behavioral interventions and related social policies.

Aeromonas hydrophila and Aeromonas veronii Predominate among Potentially Pathogenic Ciprofloxacin- and Tetracycline-Resistant Aeromonas Isolates from Lake Erie

PubMed Central

Shinko, Jasmine; Augustyniak, Alexander; Gee, Christopher; Andraso, Greg

2014-01-01

Members of the genus Aeromonas are ubiquitous in nature and have increasingly been implicated in numerous diseases of humans and other animal taxa. Although some species of aeromonads are human pathogens, their presence, density, and relative abundance are rarely considered in assessing water quality. The objectives of this study were to identify Aeromonas species within Lake Erie, determine their antibiotic resistance patterns, and assess their potential pathogenicity. Aeromonas strains were isolated from Lake Erie water by use of Aeromonas selective agar with and without tetracycline and ciprofloxacin. All isolates were analyzed for hemolytic ability and cytotoxicity against human epithelial cells and were identified to the species level by using 16S rRNA gene restriction fragment length polymorphisms and phylogenetic analysis based on gyrB gene sequences. A molecular virulence profile was identified for each isolate, using multiplex PCR analysis of six virulence genes. We demonstrated that Aeromonas comprised 16% of all culturable bacteria from Lake Erie. Among 119 Aeromonas isolates, six species were identified, though only two species (Aeromonas hydrophila and A. veronii) predominated among tetracycline- and ciprofloxacin-resistant isolates. Additionally, both of these species demonstrated pathogenic phenotypes in vitro. Virulence gene profiles demonstrated a high prevalence of aerolysin and serine protease genes among A. hydrophila and A. veronii isolates, a genetic profile which corresponded with pathogenic phenotypes. Together, our findings demonstrate increased antibiotic resistance among potentially pathogenic strains of aeromonads, illustrating an emerging potential health concern. PMID:24242249

Spoilage potential of Vagococcus salmoninarum in preservative-free, MAP-stored brown shrimp and differentiation from Brochothrix thermosphacta on streptomycin thallous acetate actidione agar.

PubMed

Calliauw, F; Horemans, B; Broekaert, K; Michiels, C; Heyndrickx, M

2016-05-01

During a previous study concerning brown shrimp (Crangon crangon), selective streptomycin thallous acetate actidione (STAA) agar was used to determine the growth of Brochothrix thermosphacta. However, the growth of Vagococcus salmoninarum on this medium was also noticed. This study explores the spoilage potential of this organism when inoculated on sterile shrimp. Isolates growing on STAA were identified using (GTG)5 clustering followed by partial 16S rRNA gene sequence analysis. Their biochemical spoilage potential was analysed for H2 S production and enzymatic activities were tested using an APIZYM test. Headspace solid phase micro-extraction (SPME) and gas chromatography-mass spectrometry (GC-MS) were used to analyse the volatile organic compounds (VOCs) produced during storage of inoculated shrimp. Fifty-five per cent of isolates taken from STAA could be identified as V. salmoninarum, while no apparent morphological difference with B. thermosphacta isolates was identified upon the prescribed incubation conditions. For isolates identified as V. salmoninarum, production of 2-heptanone, 2-nonanone, 2-undecanone was found, as was the possibility to form H2 S. When using the STAA medium for detecting B. thermosphacta, one should consider the possible abundant presence of V. salmoninarum as well. Based on this study, V. salmoninarum does not exhibit great spoilage potential, although it can produce H2 S and formed VOCs which are also found in other spoiled seafood products. © 2016 The Society for Applied Microbiology.

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

De Feo, Giovanni, E-mail: g.defeo@unisa.it; De Gisi, Sabino; Williams, Ian D.

Highlights: ► Effects of closing MSW facilities on perception of odour and pollution studied. ► Residents’ perception of odour nuisance considerably diminished post closure. ► Odour perception showed an association with distance from MSW facilities. ► Media coverage increased knowledge about MSW facilities and how they operate. ► Economic compensation possibly affected residents’ views and concerns. - Abstract: If residents’ perceptions, concerns and attitudes towards waste management facilities are either not well understood or underestimated, people can produce strong opposition that may include protest demonstrations and violent conflicts such as those experienced in the Campania Region of Italy. The aimmore » of this study was to verify the effects of the closure of solid waste treatment and disposal facilities (two landfills and one RDF production plant) on public perception of odour and environmental pollution. The study took place in four villages in Southern Italy. Identical questionnaires were administered to residents during 2003 and after the closure of the facilities occurred in 2008. The residents’ perception of odour nuisance considerably diminished between 2003 and 2009 for the nearest villages, with odour perception showing an association with distance from the facilities. Post closure, residents had difficulty in identifying the type of smell due to the decrease in odour level. During both surveys, older residents reported most concern about the potentially adverse health impacts of long-term exposure to odours from MSW facilities. However, although awareness of MSW facilities and concern about potentially adverse health impacts varied according to the characteristics of residents in 2003, substantial media coverage produced an equalisation effect and increased knowledge about the type of facilities and how they operated. It is possible that residents of the village nearest to the facilities reported lower awareness of and concern about odour and environmental pollution because the municipality received economic compensation for their presence.« less

Future potential distribution of the emerging amphibian chytrid fungus under anthropogenic climate change.

PubMed

Rödder, Dennis; Kielgast, Jos; Lötters, Stefan

2010-11-01

Anthropogenic climate change poses a major threat to global biodiversity with a potential to alter biological interactions at all spatial scales. Amphibians are the most threatened vertebrates and have been subject to increasing conservation attention over the past decade. A particular concern is the pandemic emergence of the parasitic chytrid fungus Batrachochytrium dendrobatidis, which has been identified as the cause of extremely rapid large-scale declines and species extinctions. Experimental and observational studies have demonstrated that the host-pathogen system is strongly influenced by climatic parameters and thereby potentially affected by climate change. Herein we project a species distribution model of the pathogen onto future climatic scenarios generated by the IPCC to examine their potential implications on the pandemic. Results suggest that predicted anthropogenic climate change may reduce the geographic range of B. dendrobatidis and its potential influence on amphibian biodiversity.

Human Factors Research Under Ground-Based and Space Conditions. Part 1

NASA Technical Reports Server (NTRS)

1997-01-01

Session TP2 includes short reports concerning: (1) Human Factors Engineering of the International space Station Human Research Facility; (2) Structured Methods for Identifying and Correcting Potential Human Errors in Space operation; (3) An Improved Procedure for Selecting Astronauts for Extended Space Missions; (4) The NASA Performance Assessment Workstation: Cognitive Performance During Head-Down Bedrest; (5) Cognitive Performance Aboard the Life and Microgravity Spacelab; and (6) Psychophysiological Reactivity Under MIR-Simulation and Real Micro-G.

Searching for Information Online: Using Big Data to Identify the Concerns of Potential Army Recruits

DTIC Science & Technology

2016-01-01

software. For instance, such Internet search engines as Google or Yahoo! often gather anonymized data regarding the topics that people search for, as...suggesting that these and other information needs may be fur- ther reflected in usage of online search engines . Google makes aggregated and anonymized...Internet search engines such as Google or Yahoo! often gather anonymized data regarding the topics that people search for, as well as the date and

Quality of life and functional vision concerns of children with cataracts and their parents.

PubMed

Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

2016-09-01

PurposeTo identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves.MethodsIndividual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5-17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme.ResultsRegarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%).ConclusionsA wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts.

Quality of life and functional vision concerns of children with cataracts and their parents

PubMed Central

Castañeda, Y S; Cheng-Patel, C S; Leske, D A; Wernimont, S M; Hatt, S R; Liebermann, L; Birch, E E; Holmes, J M

2016-01-01

Purpose To identify specific health-related quality of life (HRQOL) and functional vision concerns affecting children with cataracts and common associated conditions as expressed by children or one of their parents (proxy), and HRQOL concerns affecting the parents themselves. Methods Individual semi-structured interviews were conducted with parents of children with cataracts (N=31) and with the children themselves (ages 5–17 years; N=16). Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified and coded, and broad themes were identified. The frequency of each theme was calculated, with the frequency of specific concerns within each theme. Results Regarding the child's experience, 6 themes were identified: Visual Function (mentioned by 16 of 16 children (100%) and by 26 of 31 parents (84%), Social (94 and 65%), Treatment (81 and 90%), Worry (75 and 10%), Emotions (63 and 68%), and Physical Discomfort (63 and 26%). Worry showed the largest discrepancy between child and their parent; although 75% children reported Worry, only 6% of parents reported that their child experienced Worry (P=0.0009). Regarding the parents' own experience, 5 themes were identified: Worry (100%), Compensation for Condition (100%), Treatment (94%), Emotions (90%), and Affects Family (52%). Conclusions A wide range of concerns were identified from interviews of children with cataracts and their parents. Concerns reflect the impact of cataracts in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the quality of life and functional vision effects of cataracts. PMID:27391939

Hierarchical Marginal Land Assessment for Land Use Planning

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

Kang, Shujiang; Post, Wilfred M; Wang, Dali

2013-01-01

Marginal land provides an alternative potential for food and bioenergy production in the face of limited land resources; however, effective assessment of marginal lands is not well addressed. Concerns over environmental risks, ecosystem services and sustainability for marginal land have been widely raised. The objective of this study was to develop a hierarchical marginal land assessment framework for land use planning and management. We first identified major land functions linking production, environment, ecosystem services and economics, and then classified land resources into four categories of marginal land using suitability and limitations associated with major management goals, including physically marginal land,more » biologically marginal land, environmental-ecological marginal land, and economically marginal land. We tested this assessment framework in south-western Michigan, USA. Our results indicated that this marginal land assessment framework can be potentially feasible on land use planning for food and bioenergy production, and balancing multiple goals of land use management. We also compared our results with marginal land assessment from the Conservation Reserve Program (CRP) and land capability classes (LCC) that are used in the US. The hierarchical assessment framework has advantages of quantitatively reflecting land functions and multiple concerns. This provides a foundation upon which focused studies can be identified in order to improve the assessment framework by quantifying high-resolution land functions associated with environment and ecosystem services as well as their criteria are needed to improve the assessment framework.« less

A feasibility assessment for the application of biogas and wind power in the farm environment as sustainable sources of energy

NASA Astrophysics Data System (ADS)

Carbo, Laura C.

The depletion of energy sources and the ever-increasing energy demand---and consequently price escalation---is a problem that concerns the global population. Despite the concept of energy crisis being widely accepted nowadays, there is a lot of scepticism and misinformation on the possible alternatives to alleviate the environmental and economic impacts of conventional energy generation. Renewable energy technologies are constantly experiencing significant innovation and improvements. This thesis sought to assess the potential of small dairy farms to make an energy shift and identify the practical benefits and possible downfalls of this shift. Wind power and biogas digestion were analysed in this thesis, and a model to assess these technologies at any given farm was developed on VBA. For the case studied in this research both technologies were concluded to be feasible from an economic point of view. Although the initial investment can seem costly, considering the relatively low payback period and the currently available subsidies the economic implications are not an obstacle. The model developed on VBA is applicable to any region, given the right data is put into the programme. Considering the global energy concern, models such as the one developed in this thesis are an appropriate tool to identify potential shifts to greener solutions and prove to users that it can be economically profitable for them as well as environmentally beneficial.

Hazard assessment of hydraulic fracturing chemicals using an indexing method.

PubMed

Hu, Guangji; Liu, Tianyi; Hager, James; Hewage, Kasun; Sadiq, Rehan

2018-04-01

The rapid expansion of unconventional natural gas production has triggered considerable public concerns, particularly regarding environmental and human health (EHH) risks posed by various chemical additives used in hydraulic fracturing (HF) operations. There is a need to assess the potential EHH hazards of additives used in real-world HF operations. In this study, HF additive and fracturing fluid data was acquired, and EHH hazards were assessed using an indexing approach. The indexing system analyzed chemical toxicological data of different ingredients contained within additives and produced an aggregated EHH safety index for each additive, along with an indicator describing the completeness of the chemical toxicological data. The results show that commonly used additives are generally associated with medium-level EHH hazards. In each additive category, ingredients of high EHH concern were identified, and the high hazard designation was primarily attributed to ingredients' high aquatic toxicity and carcinogenic effects. Among all assessed additive categories, iron control agents were identified as the greatest EHH hazards. Lack of information, such as undisclosed ingredients and chemical toxicological data gaps, has resulted in different levels of assessment uncertainties. In particular, friction reducers show the highest data incompleteness with regards to EHH hazards. This study reveals the potential EHH hazards associated with chemicals used in current HF field operations and can provide decision makers with valuable information to facilitate sustainable and responsible unconventional gas production. Copyright © 2017 Elsevier B.V. All rights reserved.

Perceptions of current and potential public health involvement of pharmacists in developing nations: The case of Zimbabwe.

PubMed

Mdege, Noreen Dadirai; Chevo, Tafadzwa; Toner, Paul

There is increasing recognition of the potential significant contribution that pharmacy personnel can make to improve the public's health. However, there is an evidence gap in developing countries on the public health role of pharmacy personnel. This study aimed to explore the current public health activities that pharmacy professionals in Zimbabwe are currently involved in, and the potential of expanding this role. The study utilized individual, face-to-face, semi-structured qualitative interviews with 9 key informants. The sample reflected the diversity of pharmacy practice groups and levels as well as professional experience, and included a representative from a patient group, and a non-pharmacist national level public health expert. Data collection and analysis was an iterative process informed both by the currently available literature on the topic, as well as themes emerging from the data. Framework analysis was utilized with two independent analyses performed. There was a general consensus among participants that pharmacy practice in Zimbabwe was mainly focused on curative services, with very limited involvement in public health oriented activities. The following were identified as pharmacists' current public health activities: supply chain management of pharmaceutical products, provision of medications and other pharmaceutical products to patients, therapy monitoring, identification and monitoring of chronic illnesses, information provision and training of pharmacists. Nevertheless, there were concerns regarding the quality of some of these services, and lack of consistency in provision across pharmacies. Other potential areas for pharmacists' public health practice were identified as emergency response, drug abuse, addressing social determinants of health particularly promoting healthy lifestyles, applied health research, counterfeit and substandard medicines, and advocacy. There is perceived potential for Zimbabwean pharmacists to become more involved in public health oriented services. However, concerns regarding the quality of services and lack of consistency in provision need to be addressed. Copyright © 2015 Elsevier Inc. All rights reserved.

Adversity, emotion recognition, and empathic concern in high-risk youth

PubMed Central

Quas, Jodi A.; Matthew, Richard; Harron, Connor; Quas, Catherine M.

2017-01-01

Little is known about how emotion recognition and empathy jointly operate in youth growing up in contexts defined by persistent adversity. We investigated whether adversity exposure in two groups of youth was associated with reduced empathy and whether deficits in emotion recognition mediated this association. Foster, rural poor, and comparison youth from Swaziland, Africa identified emotional expressions and rated their empathic concern for characters depicted in images showing positive, ambiguous, and negative scenes. Rural and foster youth perceived greater anger and happiness in the main characters in ambiguous and negative images than did comparison youth. Rural children also perceived less sadness. Youth’s perceptions of sadness in the negative and ambiguous expressions mediated the relation between adversity and empathic concern, but only for the rural youth, who perceived less sadness, which then predicted less empathy. Findings provide new insight into processes that underlie empathic tendencies in adversity-exposed youth and highlight potential directions for interventions to increase empathy. PMID:28738074

Mothers' Concerns for Personal Safety and Privacy While Breastfeeding: An Unexplored Phenomenon.

PubMed

Rosen-Carole, Casey; Allen, Katherine; Fagnano, Maria; Dozier, Ann; Halterman, Jill

2018-04-01

Preliminary qualitative research in upstate NY shows new mothers are worried about safety while breastfeeding. Little is known regarding prevalence of these concerns and their effect on breastfeeding outcomes. (1) Determine frequency of breastfeeding safety and privacy concerns; (2) Explore their association with breastfeeding outcomes. Mothers were surveyed immediately and 1-month postpartum about breastfeeding goals; both surveys addressed privacy and safety concerns at home, work, and in public. Outcome data included breastfeeding intent, exclusivity, and duration. Breastfeeding/non-breastfeeding mothers were compared using Chi-square and multivariate analyses. A total of 279 women enrolled. Of these 82.8% initiated breastfeeding; at 1-month 72% provided any breast milk, and 44% were exclusively breastfeeding. About 99% felt safe breastfeeding at home; 25% reported privacy concerns; and 5% felt "vulnerable or unsafe" while breastfeeding. At 1-month, 49% agreed there was a safe place to breastfeed/express milk at work (20% unsure). Non-breastfeeding mothers expressed more safety concerns outside home/at work: 18% breastfeeding versus 28% non-breastfeeding outside home; 27% breastfeeding versus 40% non-breastfeeding at work. Nearly 54% who reported feeling vulnerable/unsafe with breastfeeding initiated breastfeeding, compared with 86% not reporting this concern (p = 0.008). Fewer women initiating breastfeeding reported vulnerability/safety (3% breastfeeding versus 14% non-breastfeeding, p = 0.008) or privacy (22% breastfeeding versus 40% non-breastfeeding, p = 0.19) concerns. Associations held after controlling for age, race, parity, insurance, geography, and marital-status. Significant associations between initiation, privacy, and safety concerns did not extend to duration or exclusivity. Many breastfeeding women reported safety and privacy concerns, especially outside the home and at work, which may influence breastfeeding initiation. Further study may identify methods to address these issues, potentially increasing breastfeeding rates.

Parents’ concerns regarding the growth characteristics of their adolescents: a qualitative inquiry in Iran

PubMed Central

Vedadhir, AbouAli; Taghizadeh, Ziba; Samadanifard, Seyyed Hossein

2018-01-01

ABSTRACT In recent times, parents have become increasingly concerned, both subjectively and objectively, about their adolescents' body height/weight growth. Parent-adolescent interactions about this issue and the potential socio-psychological consequences of such interactions should be considered as an important influencing factor on the future of adolescents' sexual and reproductive health. To achieve a greater understanding of such concerns, it is necessary to further elucidate parents' experiences on this topic, so as to expand the existing literature. This study aimed to explain the perceptions of parents' concerns regarding their adolescents' growth characteristics in the socio-cultural context of Iran as a transitional society. This paper is part of a larger qualitative study designed using the Constructivist Grounded Theory Methodology (CGTM). We conducted open-ended intensive interviews with eleven parents individually and recruited them through purposeful and theoretical sampling from a teaching hospital, community, and a primary school in Tehran with theoretical sampling variation in terms of teenagers' age, sex, and birth order, place of residence, parents' occupation and education, and the self-reported socio-economic status. Using the analytical procedures of the CGTM, we performed analyses. In the findings, the concept of 'living with constant sense of uncertainty' emerged from the subcategories including 'feeling existing and potential concern about expected minimum and maximum bio-positions of growth,' 'feeling potential concern about biological health consequences,' 'feeling potential concern about the emergence of early/late maturity signs,' 'feeling potential concern about adolescent's emotional threat,' 'feeling concerned about future employment, education, marriage, and fertility,' and 'feeling potential concern about the society's view'. These findings suggest that parents are living with a constant sense of uncertainty about their teens' growth characteristics throughout the transition from adolescence. All stakeholders including parents, health-care practitioners and policymakers, and anthropologists/sociologists should be focus on such concerns, in order to manage them and their possible socio-psychological burdens. PMID:29648944

Parents' concerns regarding the growth characteristics of their adolescents: a qualitative inquiry in Iran.

PubMed

Cheraghi, Mohammad Ali; Rezasoltani, Parvaneh; Vedadhir, AbouAli; Taghizadeh, Ziba; Samadanifard, Seyyed Hossein

2018-12-01

In recent times, parents have become increasingly concerned, both subjectively and objectively, about their adolescents' body height/weight growth. Parent-adolescent interactions about this issue and the potential socio-psychological consequences of such interactions should be considered as an important influencing factor on the future of adolescents' sexual and reproductive health. To achieve a greater understanding of such concerns, it is necessary to further elucidate parents' experiences on this topic, so as to expand the existing literature. This study aimed to explain the perceptions of parents' concerns regarding their adolescents' growth characteristics in the socio-cultural context of Iran as a transitional society. This paper is part of a larger qualitative study designed using the Constructivist Grounded Theory Methodology (CGTM). We conducted open-ended intensive interviews with eleven parents individually and recruited them through purposeful and theoretical sampling from a teaching hospital, community, and a primary school in Tehran with theoretical sampling variation in terms of teenagers' age, sex, and birth order, place of residence, parents' occupation and education, and the self-reported socio-economic status. Using the analytical procedures of the CGTM, we performed analyses. In the findings, the concept of 'living with constant sense of uncertainty' emerged from the subcategories including 'feeling existing and potential concern about expected minimum and maximum bio-positions of growth,' 'feeling potential concern about biological health consequences,' 'feeling potential concern about the emergence of early/late maturity signs,' 'feeling potential concern about adolescent's emotional threat,' 'feeling concerned about future employment, education, marriage, and fertility,' and 'feeling potential concern about the society's view'. These findings suggest that parents are living with a constant sense of uncertainty about their teens' growth characteristics throughout the transition from adolescence. All stakeholders including parents, health-care practitioners and policymakers, and anthropologists/sociologists should be focus on such concerns, in order to manage them and their possible socio-psychological burdens.

24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

Code of Federal Regulations, 2014 CFR

2014-04-01

... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

Code of Federal Regulations, 2013 CFR

2013-04-01

... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

Code of Federal Regulations, 2012 CFR

2012-04-01

... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

Code of Federal Regulations, 2011 CFR

2011-04-01

... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

24 CFR 1000.508 - If the recipient monitoring identifies programmatic concerns, what happens?

Code of Federal Regulations, 2010 CFR

2010-04-01

... concerns, what happens? If the recipient's monitoring activities identify areas of concerns, the recipient... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false If the recipient monitoring... INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient...

Deep brain stimulation for obsessive-compulsive disorder: Knowledge and concerns among psychiatrists, psychotherapists and patients.

PubMed

Naesström, Matilda; Blomstedt, Patric; Hariz, Marwan; Bodlund, Owe

2017-01-01

Deep brain stimulation (DBS) is under investigation for severe obsessive-compulsive disorder (OCD) resistant to other therapies. The number of implants worldwide is slowly increasing. Therefore, it is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. Especially, for future study designs and the creation of information targeting healthcare professionals and patients. The aim of this study was to explore the knowledge and concerns toward DBS among patients with OCD, psychiatrists, and cognitive behavioral therapists. The study was conducted through web-based surveys for the aimed target groups -psychiatrist, patients, and cognitive behavioral therapists. The surveys contained questions regarding previous knowledge of DBS, source of knowledge, attitudes, and concerns towards the therapy. The main source of information was from scientific sources among psychiatrists and psychotherapists. The patient's main source of information was the media. Common concerns among the groups included complications from surgery, anesthesia, stimulation side effects, and the novelty of the treatment. Specific concerns for the groups included; personality changes mentioned by patients and psychotherapists, and ethical concerns among psychiatrists. There are challenges for DBS in OCD as identified by the participants of this study; source and quality of information, efficacy, potential adverse effects, and eligibility. In all of which the current evidence base still is limited. A broad research agenda is needed for studies going forward.

Antimicrobial resistance determinant microarray for analysis of multi-drug resistant isolates

NASA Astrophysics Data System (ADS)

Taitt, Chris Rowe; Leski, Tomasz; Stenger, David; Vora, Gary J.; House, Brent; Nicklasson, Matilda; Pimentel, Guillermo; Zurawski, Daniel V.; Kirkup, Benjamin C.; Craft, David; Waterman, Paige E.; Lesho, Emil P.; Bangurae, Umaru; Ansumana, Rashid

2012-06-01

The prevalence of multidrug-resistant infections in personnel wounded in Iraq and Afghanistan has made it challenging for physicians to choose effective therapeutics in a timely fashion. To address the challenge of identifying the potential for drug resistance, we have developed the Antimicrobial Resistance Determinant Microarray (ARDM) to provide DNAbased analysis for over 250 resistance genes covering 12 classes of antibiotics. Over 70 drug-resistant bacteria from different geographic regions have been analyzed on ARDM, with significant differences in patterns of resistance identified: genes for resistance to sulfonamides, trimethoprim, chloramphenicol, rifampin, and macrolide-lincosamidesulfonamide drugs were more frequently identified in isolates from sources in Iraq/Afghanistan. Of particular concern was the presence of genes responsible for resistance to many of the last-resort antibiotics used to treat war traumaassociated infections.

Addressing semen loss concerns: towards culturally appropriate HIV/AIDS interventions in Gujarat, India.

PubMed

Lakhani, A; Gandhi, K; Collumbien, M

2001-11-01

A situation analysis of sexual networking and sexual health in an industrial area of Gujarat, India, identified anxiety about masturbation and other semen loss concerns as major preoccupations among young men. This paper describes how the Deepak Charitable Trust addressed these concerns in their HIV prevention programme for young men aged 15 to 30. Flowcharts were used as participatory learning tools and to obtain data on the perceived consequences of masturbation, both before and after intervention activities. Research was also done on the relation between semen-related anxieties and sexual risk behaviour by DCT and two other NGOs among young men engaging in unsafe sexual behaviour. DCT advocates addressing masturbation and other semen loss concerns in all sexual health campaigns in South Asia, based on the magnitude of these concerns, their potential to confound syndromic management of STIs and their significance as an idiom of psychosocial distress. Masturbation and associated anxieties about sexual performance are seen as health issues and discussed as such by the programme. There is immediate identification among young men, whether or not they are already sexually active, and it provides an excellent entry point for sexual health and safer sex education. The community response to these efforts has been entirely positive.

Supplemental final environmental impact statement for advanced solid rocket motor testing at Stennis Space Center

NASA Technical Reports Server (NTRS)

1990-01-01

Since the Final Environmental Impact Statement (FEIS) and Record of Decision on the FEIS describing the potential impacts to human health and the environment associated with the program, three factors have caused NASA to initiate additional studies regarding these issues. These factors are: (1) The U.S. Army Corps of Engineers and the Environmental Protection Agency (EPA) agreed to use the same comprehensive procedures to identify and delineate wetlands; (2) EPA has given NASA further guidance on how best to simulate the exhaust plume from the Advanced Solid Rocket Motor (ASRM) testing through computer modeling, enabling more realistic analysis of emission impacts; and (3) public concerns have been raised concerning short and long term impacts on human health and the environment from ASRM testing.

Potential and Actual Health Hazards in the Dense Urban Operational Environment: Critical Gaps and Solutions for Military Occupational Health.

PubMed

Patterson, Steven L; Dancy, Blair C R; Ippolito, Danielle L; Stallings, Jonathan D

2017-11-01

: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring.As populations continue to concentrate in cities, civilian and military leaders will need to meet emerging environmental health concerns by developing and delivering adequate technology and policy solutions.

Alternative Green Solvents Project

NASA Technical Reports Server (NTRS)

Maloney, Phillip R.

2012-01-01

Necessary for safe and proper functioning of equipment. Mainly halogenated solvents. Tetrachloride, Trichloroethylene (TCE), CFC-113. No longer used due to regulatory/safety concerns. Precision Cleaning at KSC: Small % of total parts. Used for liquid oxygen (LOX) systems. Dual solvent process. Vertrel MCA (decafluoropentane (DFP) and trons-dichloroethylene) HFE-7100. DFP has long term environmental concerns. Project Goals: a) Identify potential replacements. b) 22 wet chemical processes. c) 3 alternative processes. d) Develop test procedures. e) Contamination and cleaning. f) Analysis. g) Use results to recommend alternative processes. Conclusions: a) No alternative matched Vertrel in this study. b) No clear second place solvent. c) Hydrocarbons- easy; Fluorinated greases- difficult. d) Fluorinated component may be needed in replacement solvent. e) Process may need to make up for shortcoming of the solvent. f) Plasma and SCC02 warrant further testing.

Review of 'emerging' organic contaminants in biosolids and assessment of international research priorities for the agricultural use of biosolids.

PubMed

Clarke, Bradley O; Smith, Stephen R

2011-01-01

A broad spectrum of organic chemicals is essential to modern society. Once discharged from industrial, domestic and urban sources into the urban wastewater collection system they may transfer to the residual solids during wastewater treatment and assessment of their significance and implications for beneficial recycling of the treated sewage sludge biosolids is required. Research on organic contaminants (OCs) in biosolids has been undertaken for over thirty years and the increasing body of evidence demonstrates that the majority of compounds studied do not place human health at risk when biosolids are recycled to farmland. However, there are 143,000 chemicals registered in the European Union for industrial use and all could be potentially found in biosolids. Therefore, a literature review of 'emerging' OCs in biosolids has been conducted for a selection of chemicals of potential concern for land application based upon human toxicity, evidence of adverse effects on the environment and endocrine disruption. To identify monitoring and research priorities the selected chemicals were ranked using an assessment matrix approach. Compounds were evaluated based upon environmental persistence, human toxicity, evidence of bioaccumulation in humans and the environment, evidence of ecotoxicity and the number and quality of studies focussed on the contaminant internationally. The identified chemicals of concern were ranked in decreasing order of priority: perfluorinated chemicals (PFOS, PFOA); polychlorinated alkanes (PCAs), polychlorinated naphthalenes (PCNs); organotins (OTs), polybrominated diphenyl ethers (PBDEs), triclosan (TCS), triclocarban (TCC); benzothiazoles; antibiotics and pharmaceuticals; synthetic musks; bisphenol A, quaternary ammonium compounds (QACs), steroids; phthalate acid esters (PAEs) and polydimethylsiloxanes (PDMSs). A number of issues were identified and recommendations for the prioritisation of further research and monitoring of 'emerging' OCs for the agricultural use of biosolids are provided. In particular, a number of 'emerging' OCs (PFOS, PFOA and PCAs) were identified for priority attention that are environmentally persistent and potentially toxic with unique chemical properties, or are present in large concentrations in sludge, that make it theoretically possible for them to enter human and ecological food-chains from biosolids-amended soil. Copyright © 2010 Elsevier Ltd. All rights reserved.

Understanding the underlying drivers of inpatient cost growth: a literature review.

PubMed

Goetghebeur, Mireille M; Forrest, Sharon; Hay, Joel W

2003-06-01

After the declining growth in inpatient hospital spending that occurred from 1994 through 1998, the recent trend in increased spending has been of concern to many. Understanding the underlying reasons for this new growth will aid decision makers in finding best means to manage inpatient costs. To identify potential contributors to recent growth in inpatient spending. Literature review. Healthcare and economic databases, prominent Web sites, and key journals were searched to identify potential drivers for the 1999-2001 rise in inpatient spending. Initial literature review and state-level regression analyses published in a companion paper were used to identify key explanatory factors, which were further explored. Although many of the contributors to the rise in inpatient costs overlap and are interrelated, the major cost drivers were identified as (1) workforce shortage; (2) new technology; (3) less tightly managed care; and (4) shifting hospital business directions. Underlying factors such as legislation, quality of care, limited access to noninpatient care, pressures on the safety net, population aging, and increasing chronic illness prevalence were found to influence the contributors and healthcare spending in general. Future trends in inpatient spending will depend on the response of the healthcare system to these cost drivers and underlying factors. Potential avenues to control inpatient spending include expanding access to primary care, encouraging cost-effective technology and more efficient hospital market structures, and developing incentives for the healthcare workforce.

Highly Pathogenic Avian Influenza A(H5N1) Viruses at the Animal-Human Interface in Vietnam, 2003-2010.

PubMed

Creanga, Adrian; Hang, Nguyen Le Khanh; Cuong, Vuong Duc; Nguyen, Ha T; Phuong, Hoang Vu Mai; Thanh, Le Thi; Thach, Nguyen Co; Hien, Pham Thi; Tung, Nguyen; Jang, Yunho; Balish, Amanda; Dang, Nguyen Hoang; Duong, Mai Thuy; Huong, Ngo Thu; Hoa, Do Ngoc; Tho, Nguyen Dang; Klimov, Alexander; Kapella, Bryan K; Gubareva, Larisa; Kile, James C; Hien, Nguyen Tran; Mai, Le Quynh; Davis, C Todd

2017-09-15

Mutation and reassortment of highly pathogenic avian influenza A(H5N1) viruses at the animal-human interface remain a major concern for emergence of viruses with pandemic potential. To understand the relationship of H5N1 viruses circulating in poultry and those isolated from humans, comprehensive phylogenetic and molecular analyses of viruses collected from both hosts in Vietnam between 2003 and 2010 were performed. We examined the temporal and spatial distribution of human cases relative to H5N1 poultry outbreaks and characterized the genetic lineages and amino acid substitutions in each gene segment identified in humans relative to closely related viruses from avian hosts. Six hemagglutinin clades and 8 genotypes were identified in humans, all of which were initially identified in poultry. Several amino acid mutations throughout the genomes of viruses isolated from humans were identified, indicating the potential for poultry viruses infecting humans to rapidly acquire molecular markers associated with mammalian adaptation and antiviral resistance. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak

PubMed Central

2011-01-01

Background Privacy concerns by providers have been a barrier to disclosing patient information for public health purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been argued that the public good should supersede an individual's right to privacy. The precise nature of these provider privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to understand the privacy barriers which could potentially influence family physicians' reporting of patient-level surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak. Methods Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009. They also completed a survey about the data they were willing to disclose to public health units. Descriptive statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based on grounded theory. Results The family doctors were reluctant to disclose patient data to public health units. This was due to concerns about the extent to which public health agencies are dependable to protect health information (trusting beliefs), and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that public health units can take which would affect these beliefs, and potentially increase the willingness to disclose patient information for public health purposes. Conclusions The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable reporting during future outbreaks. PMID:21658256

Participation in a mentored quality-improvement program for insulin pen safety: Opportunity to augment internal evaluation and share with peers.

PubMed

Rosenberg, Amy F

2016-10-01

UF Health's participation in a mentored quality-improvement impact program for health professionals as part of an ASHP initiative-"Strategies for Ensuring the Safe Use of Insulin Pens in the Hospital"-is described. ASHP invited hospitals to participate in its initiative at a time when UF Health was evaluating the risks and benefits of insulin pen use due to external reports of safety concerns and making a commitment to continue insulin pen use and optimize safeguards. Improvement opportunities in insulin pen best practices and staff education on insulin pen preparation and injection technique were identified and implemented. The storage of insulin pens for patients with contact isolation precautions was identified as a problem in certain patient care areas, and a practical solution was devised. Other process improvements included implementation of barcode medication administration, with scanning of insulin pens designated for specific patients to avoid inadvertent and intentional sharing of pens among multiple patients. Mentored calls with teams at other hospitals conducted as part of the program provided the opportunity to share experiences and solutions to improve insulin pen use. Participating with a knowledgeable mentor and other hospital teams struggling with the same issues and concerns related to safe insulin pen use facilitated problem solving. Discussing challenges and sharing ideas for solutions to safety concerns with other hospitals identified new process enhancements, which have the potential to improve the safety of insulin pen use at UF Health. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[Health impact assessment of "white-collar exemption" in Japan].

PubMed

Fujino, Yoshihisa; Matsuda, Shinya

2007-03-01

This work conducted a health impact assessment (HIA) of the Japanese Government's proposal concerning the introduction of so called "white-collar exemption" into the Japanese labor market. We adopted the Merseyside model and performed a rapid health impact assessment to assess the potential health effects of white-collar exemption. In this HIA, several health determinants which may possibly be affected, both positively and negatively, were identified based on experts' judgments. Literature evidence was assessed using PubMed and other databases. In addition, we searched for the opinions of those affected by white-collar exemption from internet web sites, and six concerns were identified. Long working hours were identified as the most serious concern by both experts and those affected. White-collar exemption may increase irregular working patterns which may be related to sleep disorder, stress, and cardiovascular disease. Family function and social participation will also be affected by irregular working patterns. On the other hand, in terms of stress, white-collar exemption may benefit from a higher degree of job control. There are possibilities that white-collar exemption may enable an improved work-life balance and enable access of some groups of the population, such as people with disabilities or parents looking after children, greater access to the labour market. However, it is uncertain whether the benefits of white-collar exemption would overcome those of the current free-time or flex-time systems. The present work provides a wide range of health impacts of white-collar exemption, and will hopefully attract the attentions of decision-makers and those likely to be affected in order to contribute to policy-making.

An adaptive community-based participatory approach to formative assessment with high schools for obesity intervention*.

PubMed

Kong, Alberta S; Farnsworth, Seth; Canaca, Jose A; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L

2012-03-01

In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity. © 2012, American School Health Association.

An Adaptive Community-Based Participatory Approach to Formative Assessment With High Schools for Obesity Intervention*

PubMed Central

Kong, Alberta S.; Farnsworth, Seth; Canaca, Jose A.; Harris, Amanda; Palley, Gabriel; Sussman, Andrew L.

2013-01-01

BACKGROUND In the emerging debate around obesity intervention in schools, recent calls have been made for researchers to include local community opinions in the design of interventions. Community-based participatory research (CBPR) is an effective approach for forming community partnerships and integrating local opinions. We used CBPR principles to conduct formative research in identifying acceptable and potentially sustainable obesity intervention strategies in 8 New Mexico school communities. METHODS We collected formative data from 8 high schools on areas of community interest for school health improvement through collaboration with local School Health Advisory Councils (SHACs) and interviews with students and parents. A survey based on formative results was created to assess acceptability of specific intervention strategies and was provided to SHACs. Quantitative data were analyzed using descriptive statistics while qualitative data were evaluated using an iterative analytic process for thematic identification. RESULTS Key themes identified through the formative process included lack of healthy food options, infrequent curricular/extracurricular physical activity opportunities, and inadequate exposure to health/nutritional information. Key strategies identified as most acceptable by SHAC members included healthier food options and preparation, a healthy foods marketing campaign, yearly taste tests, an after-school noncompetitive physical activity program, and community linkages to physical activity opportunities. CONCLUSION An adaptive CBPR approach for formative assessment can be used to identify obesity intervention strategies that address community school health concerns. Eight high school SHACs identified 6 school-based strategies to address parental and student concerns related to obesity. PMID:22320339

Safety huddles to proactively identify and address electronic health record safety

PubMed Central

Menon, Shailaja; Singh, Hardeep; Giardina, Traber D; Rayburn, William L; Davis, Brenda P; Russo, Elise M

2017-01-01

Objective: Methods to identify and study safety risks of electronic health records (EHRs) are underdeveloped and largely depend on limited end-user reports. “Safety huddles” have been found useful in creating a sense of collective situational awareness that increases an organization’s capacity to respond to safety concerns. We explored the use of safety huddles for identifying and learning about EHR-related safety concerns. Design: Data were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. Huddles were attended by key administrative, clinical, and information technology staff. We conducted a content analysis of huddle notes to identify what EHR-related safety concerns were discussed. We expanded a previously developed EHR-related error taxonomy to categorize types of EHR-related safety concerns recorded in the notes. Results: On review of daily huddle notes spanning 249 days, we identified 245 EHR-related safety concerns. For our analysis, we defined EHR technology to include a specific EHR functionality, an entire clinical software application, or the hardware system. Most concerns (41.6%) involved “EHR technology working incorrectly,” followed by 25.7% involving “EHR technology not working at all.” Concerns related to “EHR technology missing or absent” accounted for 16.7%, whereas 15.9% were linked to “user errors.” Conclusions: Safety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns. Based on our findings, we recommend that health care organizations consider huddles as a strategy to promote understanding and improvement of EHR safety. PMID:28031286

Pilot Testing of Commercial Refrigeration-Based Demand Response

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

Hirsch, Adam; Clark, Jordan; Deru, Michael

Supermarkets potentially offer a substantial demand response (DR) resource because of their high energy intensity and use patterns. This report describes a pilot project conducted to better estimate supermarket DR potential. Previous work has analyzed supermarket DR using heating, ventilating, and air conditioning (HVAC), lighting, and anti-condensate heaters. This project was concerned with evaluating DR using the refrigeration system and quantifying the DR potential inherent in supermarket refrigeration systems. Ancillary aims of the project were to identify practical barriers to the implementation of DR programs in supermarkets and to determine which high-level control strategies were most appropriate for achieving certainmore » DR objectives. The scope of this project does not include detailed control strategy development for DR or development of a strategy for regional implementation of DR in supermarkets.« less

Bioinformatic prediction of leader genes in human periodontitis.

PubMed

Covani, Ugo; Marconcini, Simone; Giacomelli, Luca; Sivozhelevov, Victor; Barone, Antonio; Nicolini, Claudio

2008-10-01

Genes involved in different biologic processes form complex interaction networks. However, only a few have a high number of interactions with the other genes in the network. In previous bioinformatics and experimental studies concerning the T lymphocyte cell cycle, these genes were identified and termed "leader genes." In this work, genes involved in human periodontitis were tentatively identified and ranked according to their number of interactions to obtain a preliminary, broader view of molecular mechanisms of periodontitis and plan targeted experimentation. Genes were identified with interrelated queries of several databases. The interactions among these genes were mapped and given a significance score. The weighted number of links (weighted sum of scores for every interaction in which the given gene is involved) was calculated for each gene. Genes were clustered according to this parameter. The genes in the highest cluster were termed leader genes. Sixty-one genes involved or potentially involved in periodontitis were identified. Only five were identified as leader genes, whereas 12 others were ranked in an immediately lower cluster. For 10 of 17 genes there is evidence of involvement in periodontitis; seven new genes that are potentially involved in this disease were identified. The involvement in periodontitis has been completely established for only two leader genes. We applied a validated bioinformatics algorithm to increase our knowledge of molecular mechanisms of periodontitis. Even with the limitations of this ab initio analysis, this theoretical study can suggest ad hoc experimentation targeted on significant genes and, therefore, simpler than mass-scale molecular genomics. Moreover, the identification of leader genes might suggest new potential risk factors and therapeutic targets.

Respect, trust, and the management of sickle cell disease pain in hospital: comparative analysis of concern-raising behaviors, preliminary model, and agenda for international collaborative research to inform practice

PubMed Central

Elander, James; Beach, Mary Catherine; Haywood, Carlton

2011-01-01

Background/objectives Qualitative interview studies suggest that adult patients’ experiences of hospital treatment for sickle cell disease (SCD) pain reflect an absence of respect by providers for patients, and an absence or breakdown of trust. Systematic comparisons between treatment settings could help identify contextual influences on respect and trust. Design Quantitative comparison of concern-raising behaviors (pain treatment outcomes indicating breakdowns of trust) among adult SCD patients in Baltimore, Maryland, USA, and London, UK, followed by analysis of potential explanations for differences, including socio-cultural and behavioral factors, with a preliminary model of the processes leading to concern-raising behaviors. Results Rates of concern-raising behaviors were significantly higher in Baltimore than London. The model identifies respect and trust as key factors which could be targeted in efforts to improve the quality of SCD pain management in hospital. Conclusion An agenda for international, interdisciplinary research to improve the treatment of SCD pain in hospital should include: comparative analyses between countries and treatment settings of factors that could influence respect and trust; research to test hypotheses derived from models about the roles of respect and trust in the treatment of pain; studies of the impact of healthcare structures and policy on patients’ experiences of care; research focusing on developmental and interpersonal processes related to respect and trust; applications of attribution and other social psychology theories; and development and evaluation of interventions to improve the hospital treatment of SCD pain by increasing respect and trust. PMID:21797726

The concentration of no toxicologic concern (CoNTC) and airborne mycotoxins.

PubMed

Hardin, Bryan D; Robbins, Coreen A; Fallah, Payam; Kelman, Bruce J

2009-01-01

The threshold of toxicologic concern (TTC) concept was developed as a method to identify a chemical intake level that is predicted to be without adverse human health effects assuming daily intake over the course of a 70-yr life span. The TTC values are based on known structure-activity relationships and do not require chemical-specific toxicity data. This allows safety assessment (or prioritization for testing) of chemicals with known molecular structure but little or no toxicity data. Recently, the TTC concept was extended to inhaled substances by converting a TTC expressed in micrograms per person per day to an airborne concentration (ng/m(3)), making allowance for intake by routes in addition to inhalation and implicitly assuming 100% bioavailability of inhaled toxicants. The resulting concentration of no toxicologic concern (CoNTC), 30 ng/m(3), represents a generic airborne concentration that is expected to pose no hazard to humans exposed continuously throughout a 70-yr lifetime. Published data on the levels of mycotoxins in agricultural dusts or in fungal spores, along with measured levels of airborne mycotoxins, spores, or dust in various environments, were used to identify conditions under which mycotoxin exposures might reach the CoNTC. Data demonstrate that airborne concentrations of dusts and mold spores sometimes encountered in agricultural environments have the potential to produce mycotoxin concentrations greater than the CoNTC. On the other hand, these data suggest that common exposures to mycotoxins from airborne molds in daily life, including in the built indoor environment, are below the concentration of no toxicologic concern.

Prospective aquatic risk assessment for chemical mixtures in agricultural landscapes

PubMed Central

Brown, Colin D.; Hamer, Mick; Jones, Russell; Maltby, Lorraine; Posthuma, Leo; Silberhorn, Eric; Teeter, Jerold Scott; Warne, Michael St J; Weltje, Lennart

2018-01-01

Abstract Environmental risk assessment of chemical mixtures is challenging because of the multitude of possible combinations that may occur. Aquatic risk from chemical mixtures in an agricultural landscape was evaluated prospectively in 2 exposure scenario case studies: at field scale for a program of 13 plant‐protection products applied annually for 20 yr and at a watershed scale for a mixed land‐use scenario over 30 yr with 12 plant‐protection products and 2 veterinary pharmaceuticals used for beef cattle. Risk quotients were calculated from regulatory exposure models with typical real‐world use patterns and regulatory acceptable concentrations for individual chemicals. The results could differentiate situations when there was concern associated with single chemicals from those when concern was associated with a mixture (based on concentration addition) with no single chemical triggering concern. Potential mixture risk was identified on 0.02 to 7.07% of the total days modeled, depending on the scenario, the taxa, and whether considering acute or chronic risk. Taxa at risk were influenced by receiving water body characteristics along with chemical use profiles and associated properties. The present study demonstrates that a scenario‐based approach can be used to determine whether mixtures of chemicals pose risks over and above any identified using existing approaches for single chemicals, how often and to what magnitude, and ultimately which mixtures (and dominant chemicals) cause greatest concern. Environ Toxicol Chem 2018;37:674–689. © 2017 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC. PMID:29193235

Prospective aquatic risk assessment for chemical mixtures in agricultural landscapes.

PubMed

Holmes, Christopher M; Brown, Colin D; Hamer, Mick; Jones, Russell; Maltby, Lorraine; Posthuma, Leo; Silberhorn, Eric; Teeter, Jerold Scott; Warne, Michael St J; Weltje, Lennart

2018-03-01

Environmental risk assessment of chemical mixtures is challenging because of the multitude of possible combinations that may occur. Aquatic risk from chemical mixtures in an agricultural landscape was evaluated prospectively in 2 exposure scenario case studies: at field scale for a program of 13 plant-protection products applied annually for 20 yr and at a watershed scale for a mixed land-use scenario over 30 yr with 12 plant-protection products and 2 veterinary pharmaceuticals used for beef cattle. Risk quotients were calculated from regulatory exposure models with typical real-world use patterns and regulatory acceptable concentrations for individual chemicals. The results could differentiate situations when there was concern associated with single chemicals from those when concern was associated with a mixture (based on concentration addition) with no single chemical triggering concern. Potential mixture risk was identified on 0.02 to 7.07% of the total days modeled, depending on the scenario, the taxa, and whether considering acute or chronic risk. Taxa at risk were influenced by receiving water body characteristics along with chemical use profiles and associated properties. The present study demonstrates that a scenario-based approach can be used to determine whether mixtures of chemicals pose risks over and above any identified using existing approaches for single chemicals, how often and to what magnitude, and ultimately which mixtures (and dominant chemicals) cause greatest concern. Environ Toxicol Chem 2018;37:674-689. © 2017 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC. © 2017 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC.

External Peer Review Team Report for Corrective Action Unit 97: Yucca Flat/Climax Mine, Nevada National Security Site, Nye County, Nevada, Revision 0

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

Marutzky, Sam J.; Andrews, Robert

The peer review team commends the Navarro-Intera, LLC (N-I), team for its efforts in using limited data to model the fate of radionuclides in groundwater at Yucca Flat. Recognizing the key uncertainties and related recommendations discussed in Section 6.0 of this report, the peer review team has concluded that U.S. Department of Energy (DOE) is ready for a transition to model evaluation studies in the corrective action decision document (CADD)/corrective action plan (CAP) stage. The DOE, National Nuclear Security Administration Nevada Field Office (NNSA/NFO) clarified the charge to the peer review team in a letter dated October 9, 2014, frommore » Bill R. Wilborn, NNSA/NFO Underground Test Area (UGTA) Activity Lead, to Sam J. Marutzky, N-I UGTA Project Manager: “The model and supporting information should be sufficiently complete that the key uncertainties can be adequately identified such that they can be addressed by appropriate model evaluation studies. The model evaluation studies may include data collection and model refinements conducted during the CADD/CAP stage. One major input to identifying ‘key uncertainties’ is the detailed peer review provided by independent qualified peers.” The key uncertainties that the peer review team recognized and potential concerns associated with each are outlined in Section 6.0, along with recommendations corresponding to each uncertainty. The uncertainties, concerns, and recommendations are summarized in Table ES-1. The number associated with each concern refers to the section in this report where the concern is discussed in detail.« less

Limits of acceptable change as tool for tourism development sustainability in Pangandaran West Java

NASA Astrophysics Data System (ADS)

Komsary, K. C.; Tarigan, W. P.; Wiyana, T.

2018-03-01

Pangandaran since 2006 has become a model of sustainable tourism development. A program aimed to empower local communities to prepare work plans and activities to enrich the various potential development of sustainable tourism. By empowering local community, business competition has led to the undesired development of the tourism sector. This becomes the concern of the negative impact of physical changes in the area. This study aims to identify and measure the acceptable changes (limits of acceptable change-LAC) of tourism development in Pangandaran to remain adaptable as a tourist attraction. This study considers how to determine acceptable levels of impact that occurs in the Pangandaran area. This method involves stakeholders in determining the values, issues, and concerns the acceptable levels of impact for this region. The result of acceptance rate then compared with the effects of the current state. Through review and analysis methods used in this study, the LAC situation in Pangandaran outlined. Results from this study are expected to identify indicators of sustainable development of tourism sector through LAC approach.

The role of micronutrients in the response to ambient air pollutants: Potential mechanisms and suggestions for research design.

PubMed

Miller, Colette N; Rayalam, Srujana

2017-01-01

People living in regions of low socioeconomic status are thought to be prone to higher exposures to environmental pollutants, poor nutrition, and numerous preventable diseases and infections. Poverty correlates with pollution and malnutrition; however, limited studies examined their interrelationship. The well-studied, deleterious health effects attributed to environmental pollutants and poor nutrition may act in combination with produce more severe adverse health outcomes than any one factor alone. Deficiencies in specific nutrients render the body more susceptible to injury which may influence the pathways that serve as the mechanistic responses to ambient air pollutants. This review (1) explores specific micronutrients that are of global concern, (2) explains how these nutrients may impact the body's response to ambient air pollution, and (3) provides guidance on designing animal models of nutritional deficiency. It is likely that those individuals who reside in regions of high ambient air pollution are similarly malnourished. Therefore, it is important that research identifies specific nutrients of concern and their impact in identified regions of high ambient air pollution.

Inroads into Equestrian Safety: Rider-Reported Factors Contributing to Horse-Related Accidents and Near Misses on Australian Roads.

PubMed

Thompson, Kirrilly; Matthews, Chelsea

2015-07-22

Horse riding and horse-related interactions are inherently dangerous. When they occur on public roads, the risk profile of equestrian activities is complicated by interactions with other road users. Research has identified speed, proximity, visibility, conspicuity and mutual misunderstanding as factors contributing to accidents and near misses. However, little is known about their significance or incidence in Australia. To explore road safety issues amongst Australian equestrians, we conducted an online survey. More than half of all riders (52%) reported having experienced at least one accident or near miss in the 12 months prior to the survey. Whilst our findings confirm the factors identified overseas, we also identified issues around rider misunderstanding of road rules and driver misunderstanding of rider hand signals. Of particular concern, we also found reports of potentially dangerous rider-directed road rage. We identify several areas for potential safety intervention including (1) identifying equestrians as vulnerable road users and horses as sentient decision-making vehicles (2) harmonising laws regarding passing horses, (3) mandating personal protective equipment, (4) improving road signage, (5) comprehensive data collection, (6) developing mutual understanding amongst road-users, (7) safer road design and alternative riding spaces; and (8) increasing investment in horse-related safety initiatives.

Striving for collaborative science and communication through the Consortium for Research and Education on Emerging Contaminants (CREEC)

USGS Publications Warehouse

Brown, Juliane B.; Battaglin, William A.

2007-01-01

Current analytical capabilities are allowing scientists to identify possible contaminants in the environment that were previously unmonitored or were present at concentrations too low for detection. New scientific evidence about the exposure pathways and potential impacts of some of these compounds on human or environmental health is regularly being published (Woodling et al., 2006; Drewes et al., 2005; Kinney et al., 2006; Gibs et al., 2007; Veldhoen et al., 2006). Recent news headlines have declared potential human health and ecological concerns regarding the occurrence of personal care products and pharmaceuticals in our environment. These are products that we regularly use (or create) in our homes, businesses, farms and industry, including plasticizers, flame retardants, detergents, pesticides and herbicides, antibacterial agents, steroids, antibiotics, and disinfection byproducts. These ‘emerging contaminants’ (ECs) are compounds that have recently been shown to occur widely in one or more environmental media, have been identified as being a potential public health or ecological risk, and yet adequate data are lacking to determine their actual risk (Younos, 2005; Soin and Smagghe, 2007; Hutchinson, 2007).

How much does transgenesis affect wheat allergenicity?: Assessment in two GM lines over-expressing endogenous genes.

PubMed

Lupi, R; Denery-Papini, S; Rogniaux, H; Lafiandra, D; Rizzi, C; De Carli, M; Moneret-Vautrin, D A; Masci, S; Larré, C

2013-03-27

Wheat kernel albumins/globulins (A/G) and gluten proteins are responsible for baker's asthma and food allergy in atopic subjects. Although no commercial genetically modified wheats are currently being grown, they are under study and the allergenicity of GM products is a major concern. In order to establish the expected and unexpected effects of genetic transformation on allergenicity and also to carry out a safety assessment of genetic transformation, two GM wheat lines (bread and pasta wheat) transformed with endogenous genes were compared to their untransformed counterparts (wt), first by an allergenomic approach, and second, using ELISA with sera from patients suffering from food allergy to wheat and baker's asthma. The 2D immunoblots performed on sera from patients suffering from food allergy and baker's asthma on the A/G fraction of the four lines (two GM and two wt) revealed comparable IgE-binding profiles. A total of 109 IgE-binding spots were analyzed by mass spectrometry, and most of the proteins identified had already been described as allergens or potential allergens. Only two IgE-binding proteins were specific to one GM line. The concentration of specific IgE against the A/G fractions of GM wheat lines and their wt genotypes differed for some sera. The originality of our paper is to relate the transformation of wheat lines with their potential allergenicity using patient sera, such focus has never been done before in wheat and should be of interest to the researches working in this field. Another interesting point of this paper is the study of two types of allergies (respiratory and food) on two wheat genotypes and their GM which reveals that some allergens already known in respiratory allergy could be involved in children suffering from wheat food allergy. In this paper we used a classical 2D proteomic analysis and the protein identifications were performed by mass spectrometry after spot picking and in gel trypsin hydrolysis. Concerning the LC-MS/MS analyses classical software and parameters were used as described in Material and methods. We worked on wheat which is actually not fully sequenced that was a difficulty; we therefore searched against two databanks (proteins and ESTs) in order to compare the results. Moreover all proteins reported in our paper were identified with at least three unique peptides. The identified proteins were checked for their potential allergenicity. In order to have a best interpretation of protein identified in terms of potential allergens, BLAST alignments were performed by using an allergen databank (SDAP). This allows the determination of the cross-reactivity of these identified proteins with known allergens of other species and also the prediction of a potential allergenicity. Copyright © 2013 Elsevier B.V. All rights reserved.

Surveying the opinions of Pennsylvania Chiefs of Police toward officers carrying and administering naloxone.

PubMed

Smyser, Paul A; Lubin, Jeffrey S

2018-01-01

Recent legislation in Pennsylvania allows police officers to administer naloxone to individuals in an opioid overdose. Pressure has subsequently been placed on police departments to adopt naloxone programs. To survey Pennsylvania Chiefs of Police regarding potential obstacles to officer-administered naloxone, and their overall opinion toward such programs. A confidential survey was administered at the Annual Conference for the Pennsylvania Chiefs of Police Association and online over the organization's listserv. Respondents rated their level of concern toward four potential obstacles on a Likert scale from 1 to 5. A fifth question asked the degree to which they agree that the benefits of naloxone programs outweigh the risks. Of 180 attendees, 36 Chiefs of Police responded at the conference and 48 to the online survey. The potential agitation of revived victims was their largest reported concern, with 60% responding either a 4 or 5; this was followed by officers correctly identifying situations to use naloxone (42%), the cost of the medication (38%), and the additional administrative duties of the department (32%). Overall 60% responded they "Strongly Agree" or "Agree" the benefits of naloxone programs outweigh the risks, while 23% responded "Strongly Disagree" or "Disagree." No significant differences were seen when separating participants from rural and urban counties or from counties with high, medium, and low rates of overdose fatalities. The results suggest that although a significant subset shows concern for the above obstacles, the majority of Chiefs of Police believe that the benefits of equipping officers with naloxone outweigh the risks.

Early Detection Of Breast Cancer using Post-Translationally Modified Biomarkers

DTIC Science & Technology

2012-03-01

methods are widely used to screen many potential diseases based on changes in blood proteins. Changes in proteins identified by proteomic studies are...suggest that circulating PTM levels can be used as a biomarker for endothelial cell dysfunction, which is of concern in several human diseases . We have...plasmid expressing the wild type PTENP1 3’UTR (pGLU/ψ3’UTR) or the 3’UTR in which the seed matches of the 5 PTEN-targeting microRNAs have been

What Is the Sense of Agency and Why Does it Matter?

PubMed Central

Moore, James W.

2016-01-01

Sense of agency refers to the feeling of control over actions and their consequences. In this article I summarize what we currently know about sense of agency; looking at how it is measured and what theories there are to explain it. I then explore some of the potential applications of this research, something that the sense of agency research field has been slow to identify and implement. This is a pressing concern given the increasing importance of ‘research impact.’ PMID:27621713

[Find your way in the jungle of mAbs].

PubMed

Watier, H

2017-09-01

The rapidly increasing number of approved monoclonal antibodies (mAbs) and the huge number of mAbs in clinical development are a matter of concern for who wants to easily identify targets, indications, mechanisms of action and possible adverse effects. The current nomenclature being of limited interest, simple rationales will be presented for helping practitioners in rapidly classify mAbs depending on their structure-pharmacology relationship and in evaluating their potential effects, particularly in transfusion medicine. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Coastal wetlands and global change: overview

USGS Publications Warehouse

Guntenspergen, G.R.; Vairin, B.; Burkett, V.R.

1997-01-01

The potential impacts of climate change are of great practical concern to those interested in coastal wetland resources. Among the areas of greatest risk in the United States are low-lying coastal habitats with easily eroded substrates which occur along the northern Gulf of Mexico and southeast Atlantic coasts. The Intergovernmental Panel on Climate Change (IPCC) and the World Meteorological Organization (WMO) have identified coastal wetlands as ecosystems most vulnerable to direct, large-scale impacts of climate change, primarily because of their sensitivity to increases in sea-level rise.

Land availability and land value assessment for solar ponds in the United States

NASA Technical Reports Server (NTRS)

1982-01-01

The land availability and land values for solar ponds in the United States as they concern the residential, commercial, and institutional land use categories were investigated. Solar ponds were identified as efficient and economical means for collecting and storing direct and diffuse solar energy. Innovative methodologies were applied to arrive at regional projections regarding the amount of land that might potentially be available for retrofit or future solar pond applications. Regional land values were also documented and analyzed.

tDCS potentiation provides no evidence for a link between right dorsal-lateral prefrontal cortical activity and empathic responding.

PubMed

Snowdon, Marion E; Cathcart, Stuart

2018-04-01

Previous studies suggest the dorsolateral prefrontal cortex (DLPFC) is involved in processing of empathic concern. This has not been experimentally tested to date. We tested the hypotheses that electrical potentiation in the right DLPFC would be associated with increased empathic concern and prosocial behavior. Participants were randomly allocated to one of three transcranial Direct Current Stimulation (tDCS) conditions: (a) relative right potentiation, (b) relative left potentiation, and (c) sham. Participants viewed images of African children in distressing circumstances, and completed measures of empathic concern pre- and post-tDCS manipulation. Contrary to our prediction, neither effects, nor interactions of heightened empathic concern were observed. These results conflict with previous studies using this bilateral tDCS montage. Explanations could be that stimulation used in this study had been simply too weak (1.5 mA). Alternatively, the area of the DLPFC involved in emotion regulation is closer to the cortex than the area involved in empathic concern, and more easily potentiated by tDCS. Therefore, the DLPFC potentiation in the present study may have linked empathic concern with adaptive emotion regulation strategies. Future research could examine this possibility using measures of emotion regulation and higher fidelity neurostimulation (e.g., repetitive Transcranial Magnetic Stimulation [rTMS]).

Familiar ethical issues amplified: how members of research ethics committees describe ethical distinctions between disaster and non-disaster research.

PubMed

Tansey, Catherine M; Anderson, James; Boulanger, Renaud F; Eckenwiler, Lisa; Pringle, John; Schwartz, Lisa; Hunt, Matthew

2017-06-28

The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. We aim to answer the following questions: 1) what do research ethics committee (REC) members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries (LMICs) perceive as the key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members. Four key ethical issues were identified as presenting distinctive considerations for disaster research to be implemented in LMICs, and were described by participants as familiar research ethics issues that were amplified in these contexts. First, REC members viewed disaster research as having strong social value due to its potential for improving disaster response, but also as requiring a higher level of justification compared to other research settings. Second, they identified vulnerability as an overarching concern for disaster research ethics, and a feature that required careful and critical appraisal when assessing protocols. They noted that research participants' vulnerabilities frequently change in the aftermath of a disaster and often in unpredictable ways. Third, they identified concerns related to promoting and maintaining safety, confidentiality and data security in insecure or austere environments. Lastly, though REC members endorsed the need and usefulness of community engagement, they noted that there are significant challenges in a disaster setting over and above those typically encountered in global health research to achieve meaningful community engagement. Disaster research presents distinctive ethical considerations that require attention to ensure that participants are protected. As RECs review disaster research protocols, they should address these concerns and consider how justification, vulnerability, security and confidentially, and community engagement are shaped by the realities of conducting research in a disaster.

Problems associated with the utilization of algae in bioregenerative life support systems

NASA Technical Reports Server (NTRS)

Averner, M. M.; Karel, M.; Radmer, R.

1984-01-01

A workshop was conducted to identify the potential problems associated with the use of microalgae in biorregenerative life support systems, and to identify algae rlated research issues that must be addressed through space flight experimentation. Major questions to be resolved relate to the choice of algal species for inclusion in a bioregenerative life support system, their long term behavior in the space environment, and the nature of the techniques required for the continuous growth of algae on the scale required. Consideration was given to the problems associated with the conversion of algal biomass into edible components. Specific concerns were addressed and alternative transformation processes identified and compared. The workshop identified the following major areas to be addressed by space flight experimentation: (1) long term culture stability, (2) optimal design of algal growth reactors, and (3) post growth harvesting and processing in the space environment.

Do negative emotions expressed during follow-up consultations with adolescent survivors of childhood cancer reflect late effects?

PubMed

Mellblom, Anneli V; Ruud, Ellen; Loge, Jon Håvard; Lie, Hanne C

2017-11-01

To explore whether negative emotions expressed by adolescent cancer survivors during follow-up consultations were associated with potential late effects (persisting disease or treatment-related health problems). We video-recorded 66 follow-up consultations between 10 pediatricians and 66 adolescent survivors of leukemia, lymphoma or stem-cell transplantations. In transcripts of the recordings, we identified utterances coded as both 1) expressions of negative emotions (VR-CoDES), and 2) late effect-related discussions. Principles of thematic content analysis were used to investigate associations between the two. Of the 66 video-recorded consultations, 22 consultations contained 56 (49%) utterances coded as both emotional concerns and discussions of potential late effects. Negative emotions were most commonly associated with late effects such as fatigue ("I'm struggling with not having energy"), psychosocial distress ("When I touch this (scar) I become nauseous"), pain ("I'm wondering how long I am going to have this pain?"), and treatment-related effects on physical appearance ("Am I growing?"). Negative emotions expressed by adolescent cancer survivors during follow-up consultations were frequently associated with potential late effects. These late effects were not the medically most serious ones, but reflected issues affecting the adolescents' daily life. Eliciting and exploring patients' emotional concerns serve as means to obtain clinically relevant information regarding potential late effect and to provide emotional support. Copyright © 2017 Elsevier B.V. All rights reserved.

Barriers to uptake and use of pre-exposure prophylaxis (PrEP) among communities most affected by HIV in the UK: findings from a qualitative study in Scotland.

PubMed

Young, Ingrid; Flowers, Paul; McDaid, Lisa M

2014-11-20

To explore the acceptability of pre-exposure prophylaxis (PrEP) among gay, bisexual and men who have sex with men (MSM) and migrant African communities in Scotland, UK. Consecutive mixed qualitative methods consisting of focus groups (FGs) and in-depth interviews (IDIs) explored PrEP acceptability. Data were digitally recorded, transcribed and analysed thematically to identify anticipated and emerging themes. Participants were recruited through community sexual health and outreach support services, and from non-sexual health settings across Scotland. Inclusion criteria included identification as either MSM and/or from migrant African communities; 18 years and older; living in Scotland at the time of participation. 7 FGs were conducted (n=33): 5 with MSM (n=22) and 2 mixed-sex groups with African participants (n=11, women=8), aged 18-75 years. 34 IDIs were conducted with MSM (n=20) and African participants (n=14, women=10), aged 19-60 years. The sample included participants who were HIV-positive and HIV-negative or untested (HIV-positive FG participants, n=22; HIV-positive IDI participants, n=17). Understandings of PrEP effectiveness and concerns about maintaining regular adherence were identified as barriers to potential PrEP uptake and use. Low perception of HIV risk due to existing risk management strategies meant few participants saw themselves as PrEP candidates. Participants identified risk of other sexually transmitted infections and pregnancy as a concern which PrEP did not address for either themselves or their sexual partners. PrEP emerged as a contentious issue because of the potentially negative implications it had for HIV prevention. Many participants viewed PrEP as problematic because they perceived that others would stop using condoms if PrEP was to become available. PrEP implementation needs to identify appropriate communication methods in the context of diverse HIV literacy; address risk-reduction concerns and; demonstrate how PrEP can be part of a safe and comprehensive risk management strategy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Deployment Effects of Marine Renewable Energy Technologies: Wave Energy Scenarios

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

Mirko Previsic

2010-06-17

Given proper care in siting, design, deployment, operation and maintenance, wave energy conversion could become one of the more environmentally benign sources of electricity generation. In order to accelerate the adoption of these emerging hydrokinetic and marine energy technologies, navigational and environmental concerns must be identified and addressed. All developing hydrokinetic projects involve a wide variety of stakeholders. One of the key issues that site developers face as they engage with this range of stakeholders is that, due to a lack of technical certainty, many of the possible conflicts (e.g., shipping and fishing) and environmental issues are not well-understood,. Inmore » September 2008, re vision consulting, LLC was selected by the Department of Energy (DoE) to apply a scenario-based assessment to the emerging hydrokinetic technology sector in order to evaluate the potential impact of these technologies on the marine environment and navigation constraints. The project’s scope of work includes the establishment of baseline scenarios for wave and tidal power conversion at potential future deployment sites. The scenarios capture variations in technical approaches and deployment scales to properly identify and characterize environmental effects and navigational effects. The goal of the project is to provide all stakeholders with an improved understanding of the potential range of technical attributes and potential effects of these emerging technologies and focus all stakeholders on the critical issues that need to be addressed. By identifying and addressing navigational and environmental concerns in the early stages of the industry’s development, serious mistakes that could potentially derail industry-wide development can be avoided. This groundwork will also help in streamlining siting and associated permitting processes, which are considered key hurdles for the industry’s development in the U.S. today. Re vision is coordinating its efforts with two other project teams funded by DoE which are focused on regulatory issues (Pacific Energy Ventures) and navigational issues (PCCI). The results of this study are structured into three reports: (1) Wave power scenario description (2) Tidal power scenario description (3) Framework for Identifying Key Environmental Concerns This is the first report in the sequence and describes the results of conceptual feasibility studies of wave power plants deployed in Humboldt County, California and Oahu, Hawaii. These two sites contain many of the same competing stakeholder interactions identified at other wave power sites in the U.S. and serve as representative case studies. Wave power remains at an early stage of development. As such, a wide range of different technologies are being pursued by different manufacturers. In order to properly characterize potential effects, it is useful to characterize the range of technologies that could be deployed at the site of interest. An industry survey informed the process of selecting representative wave power devices. The selection criteria requires that devices are at an advanced stage of development to reduce technical uncertainties, and that enough data are available from the manufacturers to inform the conceptual design process of this study. Further, an attempt is made to cover the range of different technologies under development to capture variations in potential environmental effects. Table 1 summarizes the selected wave power technologies. A number of other developers are also at an advanced stage of development, but are not directly mentioned here. Many environmental effects will largely scale with the size of the wave power plant. In many cases, the effects of a single device may not be measurable, while larger scale device arrays may have cumulative impacts that differ significantly from smaller scale deployments. In order to characterize these effects, scenarios are established at three deployment scales which nominally represent (1) a small pilot deployment, (2) a small commercial deployment, and (3) a large commercial scale plant. It is important to understand that the purpose of this study was to establish baseline scenarios based on basic device data that was provided to use by the manufacturer for illustrative purposes only.« less

Health assessment for Bee Cee Manufacturing Company, Malden, Missouri, Region 7. CERCLIS No. MOD980860522. Preliminary report

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

Not Available

The Bee Cee Manufacturing site (BCM) is listed on the National Priorities List. The 2-acre site is located in Malden (Dunklin County), Missouri. BCM is a former manufacturer of aluminum storm windows and doors. Preliminary on-site sludge sampling results have identified chromium (9 ppm) and aluminum (3 ppm). Off-site sampling results have identified chromium (32 ppb) and aluminum (1 ppm) in ground water from a residential well. The site is considered to be of potential public health concern because area residents may increase their risk of exposure through ingestion of contaminated water and possibly through direct contact of contaminated soil.

Talent identification and development in soccer.

PubMed

Williams, A M; Reilly, T

2000-09-01

In this review, we attempt to integrate the main research findings concerned with talent identification and development in soccer. Research approaches in anthropometry, physiology, psychology and sociology are considered and, where possible, integrated. Although some progress has been made in identifying correlates of playing success, it appears that no unique characteristics can be isolated with confidence. Both biological and behavioural scientists have indicated a strong genetic component in performance of sports such as soccer; nevertheless, the influence of systematic training and development programmes should not be underestimated. We conclude that the sport and exercise sciences have an important support role in the processes of identifying, monitoring and nurturing talented soccer players towards realizing their potential.

Integrated pathway-based approach identifies association between genomic regions at CTCF and CACNB2 and schizophrenia.

PubMed

Juraeva, Dilafruz; Haenisch, Britta; Zapatka, Marc; Frank, Josef; Witt, Stephanie H; Mühleisen, Thomas W; Treutlein, Jens; Strohmaier, Jana; Meier, Sandra; Degenhardt, Franziska; Giegling, Ina; Ripke, Stephan; Leber, Markus; Lange, Christoph; Schulze, Thomas G; Mössner, Rainald; Nenadic, Igor; Sauer, Heinrich; Rujescu, Dan; Maier, Wolfgang; Børglum, Anders; Ophoff, Roel; Cichon, Sven; Nöthen, Markus M; Rietschel, Marcella; Mattheisen, Manuel; Brors, Benedikt

2014-06-01

In the present study, an integrated hierarchical approach was applied to: (1) identify pathways associated with susceptibility to schizophrenia; (2) detect genes that may be potentially affected in these pathways since they contain an associated polymorphism; and (3) annotate the functional consequences of such single-nucleotide polymorphisms (SNPs) in the affected genes or their regulatory regions. The Global Test was applied to detect schizophrenia-associated pathways using discovery and replication datasets comprising 5,040 and 5,082 individuals of European ancestry, respectively. Information concerning functional gene-sets was retrieved from the Kyoto Encyclopedia of Genes and Genomes, Gene Ontology, and the Molecular Signatures Database. Fourteen of the gene-sets or pathways identified in the discovery dataset were confirmed in the replication dataset. These include functional processes involved in transcriptional regulation and gene expression, synapse organization, cell adhesion, and apoptosis. For two genes, i.e. CTCF and CACNB2, evidence for association with schizophrenia was available (at the gene-level) in both the discovery study and published data from the Psychiatric Genomics Consortium schizophrenia study. Furthermore, these genes mapped to four of the 14 presently identified pathways. Several of the SNPs assigned to CTCF and CACNB2 have potential functional consequences, and a gene in close proximity to CACNB2, i.e. ARL5B, was identified as a potential gene of interest. Application of the present hierarchical approach thus allowed: (1) identification of novel biological gene-sets or pathways with potential involvement in the etiology of schizophrenia, as well as replication of these findings in an independent cohort; (2) detection of genes of interest for future follow-up studies; and (3) the highlighting of novel genes in previously reported candidate regions for schizophrenia.

Considering connections between Hollywood and biodiversity conservation.

PubMed

Silk, Matthew J; Crowley, Sarah L; Woodhead, Anna J; Nuno, Ana

2018-06-01

Cinema offers a substantial opportunity to share messages with a wide audience. However, there is little research or evidence about the potential benefits and risks of cinema for conservation. Given their global reach, cinematic representations could be important in raising awareness of conservation issues and species of concern, as well as encouraging greater audience engagement due to their heightened emotional impact on viewers. Yet there are also risks associated with increased exposure, including heightened visitor pressure to environmentally sensitive areas or changes to consumer demand for endangered species. Conservationists can better understand and engage with the film industry by studying the impact of movies on audience awareness and behavior, identifying measurable impacts on conservation outcomes, and engaging directly with the movie industry, for example, in an advisory capacity. This improved understanding and engagement can harness the industry's potential to enhance the positive impacts of movies featuring species, sites, and issues of conservation concern and to mitigate any negative effects. A robust evidence base for evaluating and planning these engagements, and for informing related policy and management decisions, needs to be built. © 2017 Society for Conservation Biology.

ESH assessment of advanced lithography materials and processes

NASA Astrophysics Data System (ADS)

Worth, Walter F.; Mallela, Ram

2004-05-01

The ESH Technology group at International SEMATECH is conducting environment, safety, and health (ESH) assessments in collaboration with the lithography technologists evaluating the performance of an increasing number of new materials and technologies being considered for advanced lithography such as 157nm photresist and extreme ultraviolet (EUV). By performing data searches for 75 critical data types, emissions characterizations, and industrial hygiene (IH) monitoring during the use of the resist candidates, it has been shown that the best performing resist formulations, so far, appear to be free of potential ESH concerns. The ESH assessment of the EUV lithography tool that is being developed for SEMATECH has identified several features of the tool that are of ESH concern: high energy consumption, poor energy conversion efficiency, tool complexity, potential ergonomic and safety interlock issues, use of high powered laser(s), generation of ionizing radiation (soft X-rays), need for adequate shielding, and characterization of the debris formed by the extreme temperature of the plasma. By bringing these ESH challenges to the attention of the technologists and tool designers, it is hoped that the processes and tools can be made more ESH friendly.

Patient and partner perspectives on patient-delivered partner screening: acceptability, benefits, and barriers.

PubMed

McBride, Kimberly R; Goldsworthy, Richard C; Fortenberry, J Dennis

2010-10-01

The study examined willingness to engage in patient-delivered partner screening (PDPS) and preferences for expedited partner services (EPS). Forty urban U.S. sexually transmitted infection (STI) clinic patients participated in individual mixed-methods interviews exploring EPS preferences and PDPS willingness. Most participants selected PDPS and PDPT together and uptake varied by patient–partner relationship closeness. For PDPS, several potentially important barriers and benefits were identified. Perceived benefits included improved sexual health for patients and their sexual partner(s) as well as convenience, privacy, and the potential to enhance trust between sexual partners. Perceived barriers included concerns about PDPS processes (e.g., time it would take to receive the result, risk of sample contamination), the accuracy of results, STI stigma and associated blame, lack of trust for a sexual partner, and the packaging/appearance of the screening kit. PDPS affords benefits and may overcome treatment barriers in some situations; however, it shares common PDPT barriers and has its own unique challenges. There are also concerns regarding how the offer of PDPS may interact with PDPT utilization.

Potential Aquifer Vulnerability in Regions Down-Gradient from ...

EPA Pesticide Factsheets

Sandstone-hosted roll-front uranium ore deposits originate when U(VI) dissolved in groundwater is reduced and precipitated as insoluble U(IV) minerals. Groundwater redox geochemistry, aqueous complexation, and solute migration are instrumental in leaching uranium from source rocks and transporting it in low concentrations to a chemical redox interface where it is deposited in an ore zone typically containing the uranium minerals uraninite, pitchblende, and/or coffinite; various iron sulfides; native selenium; clays; and calcite. In situ recovery (ISR) of these uranium ores is a process of contacting the uranium mineral deposit with leaching (lixiviant) fluids via injection of the lixiviant into wells drilled into the subsurface aquifer that hosts uranium ore, while other extraction wells pump the dissolved uranium after dissolution of the uranium minerals. Environmental concerns during and after ISR include water quality impacts from: 1) potential excursions of leaching solutions away from the injection zone into down-dip, underlying, or overlying aquifers; 2) potential migration of uranium and its decay products (e.g., Ra, Rn, Pb); and, 3) potential migration of redox-sensitive trace metals (e.g., Fe, Mn, Mo, Se, V), metalloids (e.g., As), and anions (e.g., sulfate). This review describes the geochemical processes that control roll-front uranium transport and fate in groundwater systems, identifies potential aquifer vulnerabilities to ISR operations, identifies

Comorbidity in ADHD: implications for research, practice, and DSM-V.

PubMed

Jensen, P S; Martin, D; Cantwell, D P

1997-08-01

Since the introduction of DSM-III/III-R, clinicians and investigators have shown increasing interest in the study of conditions comorbid with attention-deficit hyperactivity disorder (ADHD). Better understanding ADHD comorbidity patterns is needed to guide treatment, research and future classification approaches. The ADHD literature from the past 15 years was reviewed to (1) explore the most prevalent patterns of ADHD comorbidity; (2) examine the correlates and longitudinal predictors of comorbidity; and (3) determine the extent to which comorbid patterns convey unique information concerning ADHD etiology, treatment and outcomes. To identify potential new syndromes, the authors examined comorbid patterns based on eight validational criteria. The largest available body of literature concerned the comorbidity with ADHD and conduct disorder/aggression, with a substantially smaller amount of data concerning other comorbid conditions. In many areas the literature was sparse, and pertinent questions concerning comorbidity patterns remain unexplored. Nonetheless available data warrant the delineation of two new subclassifications of ADHD: (1) ADHD aggressive subtype, and (2) ADHD, anxious subtype. Additional studies of the frequency of comorbidity and associated factors are greatly needed to include studies of differential effects of treatment of children with various comorbid ADHD disorders, as well as of ADHD children who differ on etiological factors.

Characterization of occupational exposures to cleaning products used for common cleaning tasks--a pilot study of hospital cleaners.

PubMed

Bello, Anila; Quinn, Margaret M; Perry, Melissa J; Milton, Donald K

2009-03-27

In recent years, cleaning has been identified as an occupational risk because of an increased incidence of reported respiratory effects, such as asthma and asthma-like symptoms among cleaning workers. Due to the lack of systematic occupational hygiene analyses and workplace exposure data, it is not clear which cleaning-related exposures induce or aggravate asthma and other respiratory effects. Currently, there is a need for systematic evaluation of cleaning products ingredients and their exposures in the workplace. The objectives of this work were to: a) identify cleaning products' ingredients of concern with respect to respiratory and skin irritation and sensitization; and b) assess the potential for inhalation and dermal exposures to these ingredients during common cleaning tasks. We prioritized ingredients of concern in cleaning products commonly used in several hospitals in Massachusetts. Methods included workplace interviews, reviews of product Materials Safety Data Sheets and the scientific literature on adverse health effects to humans, reviews of physico-chemical properties of cleaning ingredients, and occupational hygiene observational analyses. Furthermore, the potential for exposure in the workplace was assessed by conducting qualitative assessment of airborne exposures and semi-quantitative assessment of dermal exposures. Cleaning products used for common cleaning tasks were mixtures of many chemicals, including respiratory and dermal irritants and sensitizers. Examples of ingredients of concern include quaternary ammonium compounds, 2-butoxyethanol, and ethanolamines. Cleaning workers are at risk of acute and chronic inhalation exposures to volatile organic compounds (VOC) vapors and aerosols generated from product spraying, and dermal exposures mostly through hands. Cleaning products are mixtures of many chemical ingredients that may impact workers' health through air and dermal exposures. Because cleaning exposures are a function of product formulations and product application procedures, a combination of product evaluation with workplace exposure assessment is critical in developing strategies for protecting workers from cleaning hazards. Our task based assessment methods allowed classification of tasks in different exposure categories, a strategy that can be employed by epidemiological investigations related to cleaning. The methods presented here can be used by occupational and environmental health practitioners to identify intervention strategies.

Characterization of occupational exposures to cleaning products used for common cleaning tasks-a pilot study of hospital cleaners

PubMed Central

2009-01-01

Background In recent years, cleaning has been identified as an occupational risk because of an increased incidence of reported respiratory effects, such as asthma and asthma-like symptoms among cleaning workers. Due to the lack of systematic occupational hygiene analyses and workplace exposure data, it is not clear which cleaning-related exposures induce or aggravate asthma and other respiratory effects. Currently, there is a need for systematic evaluation of cleaning products ingredients and their exposures in the workplace. The objectives of this work were to: a) identify cleaning products' ingredients of concern with respect to respiratory and skin irritation and sensitization; and b) assess the potential for inhalation and dermal exposures to these ingredients during common cleaning tasks. Methods We prioritized ingredients of concern in cleaning products commonly used in several hospitals in Massachusetts. Methods included workplace interviews, reviews of product Materials Safety Data Sheets and the scientific literature on adverse health effects to humans, reviews of physico-chemical properties of cleaning ingredients, and occupational hygiene observational analyses. Furthermore, the potential for exposure in the workplace was assessed by conducting qualitative assessment of airborne exposures and semi-quantitative assessment of dermal exposures. Results Cleaning products used for common cleaning tasks were mixtures of many chemicals, including respiratory and dermal irritants and sensitizers. Examples of ingredients of concern include quaternary ammonium compounds, 2-butoxyethanol, and ethanolamines. Cleaning workers are at risk of acute and chronic inhalation exposures to volatile organic compounds (VOC) vapors and aerosols generated from product spraying, and dermal exposures mostly through hands. Conclusion Cleaning products are mixtures of many chemical ingredients that may impact workers' health through air and dermal exposures. Because cleaning exposures are a function of product formulations and product application procedures, a combination of product evaluation with workplace exposure assessment is critical in developing strategies for protecting workers from cleaning hazards. Our task based assessment methods allowed classification of tasks in different exposure categories, a strategy that can be employed by epidemiological investigations related to cleaning. The methods presented here can be used by occupational and environmental health practitioners to identify intervention strategies. PMID:19327131

The role of information in supporting self-care in vascular conditions: a conceptual and empirical review.

PubMed

Blickem, Christian; Bower, Peter; Protheroe, Joanne; Kennedy, Anne; Vassilev, Ivaylo; Sanders, Caroline; Kirk, Sue; Chew-Graham, Carolyn; Rogers, Anne

2011-09-01

Self-care has the potential to make a significant contribution to vascular conditions, but engagement with self-care support has been limited. Lack of relevant information is highlighted by patients and policy-makers as an important barrier to effective self-care, and information provides a potentially efficient platform for changing behaviour. However, work within the social sciences has generally seen information as a necessary but insufficient driver of health behaviours. Furthermore, some groups (such as the socially disadvantaged) are expected to be less amenable to information interventions. We conducted an integrated conceptual and empirical review on information-based interventions for people with vascular disease (diabetes, heart disease and kidney disease). We reviewed conceptual and empirical work concerning the role and impact of information in self-care support to generate an explanatory framework to determine why information was effective or ineffective in encouraging self-care in patients with vascular conditions. This involved mapping relevant theories and models linking information and self-care. We also explored published systematic reviews of educational interventions in diabetes, coronary heart disease and chronic kidney disease to examine the role of information and evidence concerning its effectiveness and impact in different patient populations. The conceptual review identified variation among information interventions in terms of type, function, and their relationship to behaviour change techniques and psychological mediators of behaviour change. Key moderators of the effect of information included types of disorder, and patient capacity and resources. A wealth of educational interventions exists for diabetes and heart conditions, but the precise components of these interventions that are effective are difficult to identify. There is little evidence concerning optimal ways of tailoring interventions for socially disadvantaged groups other than ethnic minorities. A focus on printed information may not provide access to effective methods of information delivery (e.g. tailored information, use of narratives and user generated content). Developing a framework for the effective use of information needs to take account the full range of the factors identified. © 2010 Blackwell Publishing Ltd.

An occupational reproductive research agenda for the third millennium.

PubMed Central

Lawson, Christina C; Schnorr, Teresa M; Daston, George P; Grajewski, Barbara; Marcus, Michele; McDiarmid, Melissa; Murono, Eisuke; Perreault, Sally D; Schrader, Steven M; Shelby, Michael

2003-01-01

There is a significant public health concern about the potential effects of occupational exposure to toxic substances on reproductive outcomes. Several toxicants with reported reproductive and developmental effects are still in regular commercial or therapeutic use and thus present potential exposure to workers. Examples of these include heavy metals, organic solvents, pesticides and herbicides, and sterilants, anesthetic gases, and anticancer drugs used in health care. Many other substances are suspected of producing reproductive or developmental toxicity but lack sufficient data. Progress has been limited in identifying hazards and quantifying their potencies and in separating the contribution of these hazards from other etiologic factors. Identifying the causative agents, mechanisms by which they act, and any potential target populations, present the opportunity to intervene and protect the reproductive health of workers. The pace of laboratory studies to identify hazards and to underpin the biologic plausibility of effects in humans has not matched the pace at which new chemicals are introduced into commerce. Though many research challenges exist today, recent technologic and methodologic advances have been made that allow researchers to overcome some of these obstacles. The objective of this article is to recommend future directions in occupational reproductive health research. By bridging interdisciplinary gaps, the scientific community can work together to improve health and reduce adverse outcomes. PMID:12676620

Allelopathic Effects of Common Landscape and Nursery Mulch Materials on Weed Control

PubMed Central

Saha, Debalina; Marble, S. Chris; Pearson, Brian J.

2018-01-01

Use of organic mulch materials such as pinebark, pinestraw, or various hardwood chips for weed control is a common practice in residential and commercial landscapes. Mulch can inhibit weed seed germination and growth through light exclusion, acting as physical barrier, reducing available moisture to weed seeds within the mulch layer, and through release of allelochemicals that may inhibit germination or growth of some weed species. Previous and current research on allelopathic chemicals present in mulch have focused on cover crops and their residues with an emphasis on agronomic crops. These materials would not be suitable in a landscape setting due to rapid decomposition, lack of commercial availability, and little aesthetic appeal. Research is needed concerning identification, quantification, extraction, mechanism of release, persistence, selectivity, genetic regulation, and mode of action of potential allelochemicals present in mulch materials used for landscape purposes. More knowledge of these natural chemicals could aid practitioners and homeowners in the selection of mulch and identify potential new mulch materials that could be utilized in these industries. The purpose of this review is to summarize previous research pertaining to allelopathic compounds present in commonly used mulch materials and identify new potential mulch materials that could be utilized in the landscape sector based upon allelopathic properties. Current areas where additional research is needed are also identified. PMID:29899752

The Healthcare Needs of Latinos with Serious Mental Illness and the Potential of Peer Navigators.

PubMed

Corrigan, Patrick W; Torres, Alessandra; Lara, Juana L; Sheehan, Lindsay; Larson, Jonathon E

2017-07-01

Latinos with serious mental illness get sick and die much younger than other adults. In this paper, we review findings of a community based participatory research project meant to identify important healthcare needs, barriers to these needs, solutions to the barriers, and the promise of peer navigators as a solution. Findings from focus groups reflected general concerns of people with mental illness (e.g., insurance, engagement, accessibility) and Latinos with serious mental illness (e.g., immigration, language, and family). Feedback and analyses especially focused on the potential of peer navigators. Implications of these findings for integrated care of Latinos with serious mental illness are discussed.

Beyond the Entrepreneurial University: The Potential Role of South Africa's Historically Disadvantaged Institutions in Reconstruction and Development

NASA Astrophysics Data System (ADS)

Subotzky, George

1999-11-01

The author identifies two tendencies affecting higher education. On the one hand, universities and colleges are under pressure to become more market-oriented and to respond to rapid changes in information technology and knowledge production. On the other hand, there is a growing concern that they should work for the benefit of society, promoting social equity and responding to community needs. The author argues that partnerships between the community and institutions of higher education are an effective way of contributing to community development. He describes the potential of South Africa's historically disadvantaged institutions to contribute to reconstruction and development in the aftermath of apartheid.

[The possibility of three-dimensional modeling of the mechanisms of damage formation in the framework of situational expertise].

PubMed

Shakir'yanova, Yu P; Leonov, S V; Pinchuk, P V; Sukhareva, M A

This article was designed to share the experience gained with the three-dimensional modeling for the purpose of situational expertise intended to reconstruct the occurrence circumstances and check up the alternative investigative leads concerning formation of potential injuries to a concrete person. Simulation was performed with the use of the dimensionally scaled model of the place of occurrence as well as the models of the human head and body totally consistent with the anthropometric characteristics of the victim. The results of this work made it possible to reject several potential opportunities for the formation of injuries to the victim and identify the most probable version.

Childhood esotropia: child and parent concerns.

PubMed

Liebermann, Laura; Leske, David A; Castañeda, Yolanda S; Hatt, Sarah R; Wernimont, Suzanne M; Cheng, Christina S; Birch, Eileen E; Holmes, Jonathan M

2016-08-01

To identify specific health-related quality of life (HRQOL) concerns affecting children with esotropia as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. Sixty children with esotropia (0-17 years of age) and 1 parent for each child were prospectively enrolled. Individual semistructured interviews were conducted with children aged 5-17 years (n = 40) and 1 parent each for child ages 0-17 years. Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified from both child and parent interviews and coded. From these specific codes, broad themes were identified. Frequency of each theme was calculated, along with the frequency of specific codes within each theme. Regarding the child's experience 6 broad themes were identified: visual function (mentioned by 32 of 40 children (80%) and by 50 of 60 parents (proxy assessment of child, 83%), treatment (78% and 85%), emotions (65% and 67%), social (58% and 68%), physical (58% and 32%), and worry (45% and 7%). Regarding the parents' own experience, 5 broad themes were identified: treatment (59 of 60 parents, 98%), worry (97%), emotions (82%), compensation for condition (80%), and affects family (23%). A wide range of concerns were identified from interviews of children with esotropia and their parents. Concerns reflect the impact of esotropia in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the effects of esotropia on children's and parents' quality of life. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

The case for living kidney sales: rationale, objections and concerns.

PubMed

Matas, Arthur J

2004-12-01

Currently, potential kidney transplant candidates are dying on the waiting list. One potential solution would be a regulated system of living kidney sales (with safeguards to protect the vendor). Potential objections and practical concerns are discussed.

Halogenated methanesulfonic acids: A new class of organic micropollutants in the water cycle.

PubMed

Zahn, Daniel; Frömel, Tobias; Knepper, Thomas P

2016-09-15

Mobile and persistent organic micropollutants may impact raw and drinking waters and are thus of concern for human health. To identify such possible substances of concern nineteen water samples from five European countries (France, Switzerland, The Netherlands, Spain and Germany) and different compartments of the water cycle (urban effluent, surface water, ground water and drinking water) were enriched with mixed-mode solid phase extraction. Hydrophilic interaction liquid chromatography - high resolution mass spectrometry non-target screening of these samples led to the detection and structural elucidation of seven novel organic micropollutants. One structure could already be confirmed by a reference standard (trifluoromethanesulfonic acid) and six were tentatively identified based on experimental evidence (chloromethanesulfonic acid, dichloromethanesulfonic acid, trichloromethanesulfonic acid, bromomethanesulfonic acid, dibromomethanesulfonic acid and bromochloromethanesulfonic acid). Approximated concentrations for these substances show that trifluoromethanesulfonic acid, a chemical registered under the European Union regulation REACH with a production volume of more than 100 t/a, is able to spread along the water cycle and may be present in concentrations up to the μg/L range. Chlorinated and brominated methanesulfonic acids were predominantly detected together which indicates a common source and first experimental evidence points towards water disinfection as a potential origin. Halogenated methanesulfonic acids were detected in drinking waters and thus may be new substances of concern. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Case Study] CityCenter and Cosmopolitan Construction Projects, Las Vegas, Nevada: lessons learned from the use of multiple sources and mixed methods in a safety needs assessment.

PubMed

Gittleman, Janie L; Gardner, Paige C; Haile, Elizabeth; Sampson, Julie M; Cigularov, Konstantin P; Ermann, Erica D; Stafford, Pete; Chen, Peter Y

2010-06-01

The present study describes a response to eight tragic deaths over an eighteen month times span on a fast track construction project on the largest commercial development project in U.S. history. Four versions of a survey were distributed to workers, foremen, superintendents, and senior management. In addition to standard Likert-scale safety climate scale items, an open-ended item was included at the end of the survey. Safety climate perceptions differed by job level. Specifically, management perceived a more positive safety climate as compared to workers. Content analysis of the open-ended item was used to identify important safety and health concerns which might have been overlooked with the qualitative portion of the survey. The surveys were conducted to understand workforce issues of concern with the aim of improving site safety conditions. Such efforts can require minimal investment of resources and time and result in critical feedback for developing interventions affecting organizational structure, management processes, and communication. The most important lesson learned was that gauging differences in perception about site safety can provide critical feedback at all levels of a construction organization. Implementation of multi-level organizational perception surveys can identify major safety issues of concern. Feedback, if acted upon, can potentially result in fewer injuries and fatal events. (c) 2010 Elsevier Ltd. All rights reserved.

Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges.

PubMed

Maiorana, Andre; Steward, Wayne T; Koester, Kimberly A; Pearson, Charles; Shade, Starley B; Chakravarty, Deepalika; Myers, Janet J

2012-04-19

Concerns about the confidentiality of personal health information have been identified as a potential obstacle to implementation of Health Information Exchanges (HIEs). Considering the stigma and confidentiality issues historically associated with human immunodeficiency virus (HIV) disease, we examine how trust-in technology, processes, and people-influenced the acceptability of data sharing among stakeholders prior to implementation of six HIEs intended to improve HIV care in parts of the United States. Our analyses identify the kinds of concerns expressed by stakeholders about electronic data sharing and focus on the factors that ultimately facilitated acceptability of the new exchanges. We conducted 549 surveys with patients and 66 semi-structured interviews with providers and other stakeholders prior to implementation of the HIEs to assess concerns about confidentiality in the electronic sharing of patient data. The patient quantitative data were analyzed using SAS 9.2 to yield sample descriptive statistics. The analysis of the qualitative interviews with providers and other stakeholders followed an open-coding process, and convergent and divergent perspectives emerging from those data were examined within and across the HIEs. We found widespread acceptability for electronic sharing of HIV-related patient data through HIEs. This acceptability appeared to be driven by growing comfort with information technologies, confidence in the security protocols utilized to protect data, trust in the providers and institutions who use the technologies, belief in the benefits to the patients, and awareness that electronic exchange represents an enhancement of data sharing already taking place by other means. HIE acceptability depended both on preexisting trust among patients, providers, and institutions and on building consensus and trust in the HIEs as part of preparation for implementation. The process of HIE development also resulted in forging shared vision among institutions. Patients and providers are willing to accept the electronic sharing of HIV patient data to improve care for a disease historically seen as highly stigmatized. Acceptability depends on the effort expended to understand and address potential concerns related to data sharing and confidentiality, and on the trust established among stakeholders in terms of the nature of the systems and how they will be used.

Risk Prioritization Tool to Identify the Public Health Risks of Wildlife Trade: The Case of Rodents from Latin America.

PubMed

Bueno, I; Smith, K M; Sampedro, F; Machalaba, C C; Karesh, W B; Travis, D A

2016-06-01

Wildlife trade (both formal and informal) is a potential driver of disease introduction and emergence. Legislative proposals aim to prevent these risks by banning wildlife imports, and creating 'white lists' of species that are cleared for importation. These approaches pose economic harm to the pet industry, and place substantial burden on importers and/or federal agencies to provide proof of low risk for importation of individual species. As a feasibility study, a risk prioritization tool was developed to rank the pathogens found in rodent species imported from Latin America into the United States with the highest risk of zoonotic consequence in the United States. Four formally traded species and 16 zoonotic pathogens were identified. Risk scores were based on the likelihood of pathogen release and human exposure, and the severity of the disease (consequences). Based on the methodology applied, three pathogens (Mycobacterium microti, Giardia spp. and Francisella tularensis) in one species (Cavia porcellus) were ranked as highest concern. The goal of this study was to present a methodological approach by which preliminary management resources can be allocated to the identified high-concern pathogen-species combinations when warranted. This tool can be expanded to other taxa and geographic locations to inform policy surrounding the wildlife trade. © 2015 Blackwell Verlag GmbH.

"Best care on home ground" versus "elitist healthcare": concerns and competing expectations for medical tourism development in Barbados.

PubMed

Johnston, Rory; Adams, Krystyna; Bishop, Lisa; Crooks, Valorie A; Snyder, Jeremy

2015-02-03

Many countries have demonstrated interest in expanding their medical tourism sectors because of its potential economic and health system benefits. However, medical tourism poses challenges to the equitable distribution of health resources between international and local patients and private and public medical facilities. Currently, very little is known about how medical tourism is perceived among front line workers and users of health systems in medical tourism 'destinations'. Barbados is one such country currently seeking to expand its medical tourism sector. Barbadian nurses and health care users were consulted about the challenges and benefits posed by ongoing medical tourism development there. Focus groups were held with two stakeholder groups in May, 2013. Nine (n = 9) citizens who use the public health system participated in the first focus group and seven (n = 7) nurses participated in the second. Each focus group ran for 1.5 hours and was digitally recorded. Following transcription, thematic analysis of the digitally coded focus group data was conducted to identify cross-cutting themes and issues. Three core concerns regarding medical tourism's health equity impacts were raised; its potential to 1) incentivize migration of health workers from public to private facilities, 2) burden Barbados' lone tertiary health care centre, and 3) produce different tiers of quality of care within the same health system. These concerns were informed and tempered by the existing a) health system structure that incorporates both universal public healthcare and a significant private medical sector, b) international mobility among patients and health workers, and c) Barbados' large recreational tourism sector, which served as the main reference in discussions about medical tourism's impacts. Incorporating these concerns and contextual influences, participants' shared their expectations of how medical tourism should locally develop and operate. By engaging with local health workers and users, we begin to unpack how potential health equity impacts of medical tourism in an emerging destination are understood by local stakeholders who are not directing sector development. This further outlines how these groups employ knowledge from their home context to ground and reconcile their hopes and concerns for the impacts posed by medical tourism.

Potential impacts on groundwater resources of deep CO2 storage: natural analogues for assessing potential chemical effects

NASA Astrophysics Data System (ADS)

Lions, J.; Gale, I.; May, F.; Nygaard, E.; Ruetters, H.; Beaubien, S.; Sohrabi, M.; Hatzignatiou, D. G.; CO2GeoNet Members involved in the present study Team

2011-12-01

Carbon dioxide Capture and Storage (CCS) is considered as one of the promising options for reducing atmospheric emissions of CO2 related to human activities. One of the main concerns associated with the geological storage of CO2 is that the CO2 may leak from the intended storage formation, migrate to the near-surface environment and, eventually, escape from the ground. This is a concern because such leakage may affect aquifers overlying the storage site and containing freshwater that may be used for drinking, industry and agriculture. The IEA Greenhouse Gas R&D Programme (IEAGHG) recently commissioned the CO2GeoNet Association to undertake a review of published and unpublished literature on this topic with the aim of summarizing 'state of the art' knowledge and identifying knowledge gaps and research priorities in this field. Work carried out by various CO2GeoNet members was also used in this study. This study identifies possible areas of conflict by combining available datasets to map the global and regional superposition of deep saline formations (DSF) suitable for CO2 storage and overlying fresh groundwater resources. A scenario classification is developed for the various geological settings where conflict could occur. The study proposes two approaches to address the potential impact mechanisms of CO2 storage projects on the hydrodynamics and chemistry of shallow groundwater. The first classifies and synthesizes changes of water quality observed in natural/industrial analogues and in laboratory experiments. The second reviews hydrodynamic and geochemical models, including coupled multiphase flow and reactive transport. Various models are discussed in terms of their advantages and limitations, with conclusions on possible impacts on groundwater resources. Possible mitigation options to stop or control CO2 leakage are assessed. The effect of CO2 pressure in the host DSF and the potential effects on shallow aquifers are also examined. The study provides a review of CO2 storage-specific regulations in the main countries undertaking CCS evaluation and research. It aims to identify the constraints imposed by existing regulations on the protection of groundwater resources and highlight the inconsistencies and gaps between CCS regulations and Water Protection regulations. The present paper focuses specifically on potential risks on groundwater quality caused by CO2 storage in DSF assessed via natural CO2 analogues from both the literature and detailed European case studies.

Epibenthic assessment of a renewable tidal energy site.

PubMed

Sheehan, Emma V; Gall, Sarah C; Cousens, Sophie L; Attrill, Martin J

2013-01-01

Concern over global climate change as a result of fossil fuel use has resulted in energy production from renewable sources. Marine renewable energy devices provide clean electricity but can also cause physical disturbance to the local environment. There is a considerable paucity of ecological data at potential marine renewable energy sites that is needed to assess potential future impacts and allow optimal siting of devices. Here, we provide a baseline benthic survey for the Big Russel in Guernsey, UK, a potential site for tidal energy development. To assess the suitability of proposed sites for marine renewable energy in the Big Russel and to identify potential control sites, we compared species assemblages and habitat types. This baseline survey can be used to select control habitats to compare and monitor the benthic communities after installation of the device and contribute towards the optimal siting of any future installation.

Transcranial electric motor evoked potential monitoring during spine surgery: is it safe?

PubMed

Schwartz, Daniel M; Sestokas, Anthony K; Dormans, John P; Vaccaro, Alexander R; Hilibrand, Alan S; Flynn, John M; Li, P Mark; Shah, Suken A; Welch, William; Drummond, Denis S; Albert, Todd J

2011-06-01

Retrospective review. To report on the safety of repetitive transcranial electric stimulation (RTES) for eliciting motor-evoked potentials during spine surgery. Theoretical concerns over the safety of RTES have hindered broader acceptance of transcranial electric motor-evoked potentials (tceMEP), despite successful implementation of spinal cord monitoring with tceMEPs in many large spine centers, as well as their apparent superiority over mixed-nerve somatosensory-evoked potentials (SSEP) for detection of spinal cord injury. The records of 18,862 consecutive patients who met inclusion criteria and underwent spine surgery with tceMEP monitoring were reviewed for RTES-related complications. This large retrospective review identified only 26 (0.14%) cases with RTES-related complications; all but one of these were tongue lacerations, most of which were self-limiting. The results demonstrate that RTES is a highly safe modality for monitoring spinal cord motor tract function intraoperatively.

“We can’t get along without each other”: Qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety

PubMed Central

Lehoux, Pascale; Ducey, Ariel; Easty, Anthony; Ross, Sue; Bell, Chaim; Trbovich, Patricia

2017-01-01

Objectives Physician relationships with device industry representatives have not been previously assessed. This study explored interactions with device industry representatives among physicians who use implantable cardiovascular and orthopedic devices to identify whether conflict of interest (COI) is a concern and how it is managed. Design A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites, and interviewed about their relationships with device industry representatives. Sampling was concurrent with data collection and analysis. Data were analyzed and discussed using constant comparative technique by all members of the research team. Results Twenty-two physicians (10 cardiovascular, 12 orthopedic) were interviewed. Ten distinct representative roles were identified: purchasing, training, trouble-shooting, supplying devices, assisting with device assembly and insertion, supporting operating room staff, mitigating liability, conveying information about recalls, and providing direct and indirect financial support. Participants recognized the potential for COI but representatives were present for the majority of implantations. Participants revealed a tension between physicians and representatives that was characterized as “symbiotic”, but required physicians to be vigilant about COI and patient safety, particularly because representatives varied regarding disclosure of device defects. They described a concurrent tension between hospitals, whose policies and business practices were focused on cost-control, and physicians who were required to comply with those policies and use particular devices despite concerns about their safety and effectiveness. Conclusions Given the potential for COI and threats to patient safety, further research is needed to establish the clinical implications of the role of, and relationship with device industry representatives; and whether and how hospitals do and should govern interaction with representatives, or support their staff in this regard. PMID:28358886

Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

PubMed

Jenaro, C; Vega, V; Flores, N; Cruz, M

2013-06-01

Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Applying feminist, multicultural, and social justice theory to diverse women who function as caregivers in end-of-life and palliative home care.

PubMed

Mackinnon, Christopher J

2009-12-01

Women are largely responsible for providing care to terminally ill family members at home. The goal of this review is to conceptualize diverse women's experiences in palliative home care from feminist, multicultural, and social justice perspectives. Peer-reviewed manuscripts were identified using the following databases: CIMAHL, psycINFO, and pubMED. The following search terms were used: women/mothers/daughters, Caregiving, family caregivers, feminism, culture, multiculturalism, and palliative home care. Article reference lists were also reviewed. The majority of penitent articles which formed the basis for the arguments presented were drawn from nursing, medicine, and counseling psychology scholarship. The application of feminist, multicultural, and social justice theory brings to attention several potential issues female caregivers may experience. First, there exist diverse ways in which women's Caregiving is manifested that tend to correspond with variations in culture, relationship, and age. Second, it is important to attend to changing expectations placed on women as a result of Caregiving at the end of life. Third, the changing power dynamics women may experience in end of life Caregiving are very complex. The principle finding of the review was the highlighting of potential risks that culturally diverse female caregivers are likely to face at the end of life. The application of social justice theory provides a number of implications for practice and policy. Specifically, the identifying significant concerns regarding female caregivers in palliative home care, as well as suggesting ways to appropriately attend to these concerns, and oppression of women is less likely to be perpetuated, specific areas for future research in this domain are identified.

Bridging cross-cultural gaps: monitoring herbal use during chemotherapy in patients referred to integrative medicine consultation in Israel.

PubMed

Almog, Limor; Lev, Efraim; Schiff, Elad; Linn, Shai; Ben-Arye, Eran

2014-10-01

The high prevalence of the use of traditional herbs among patients with cancer is a cause for concern with regard to potentially adverse interactions with conventional oncology treatments. In this study, we explore herbal use among patients with cancer in northern Israel who are referred by their health care providers to complementary and traditional medicine (CTM) consultations provided to them within the conventional oncology department. The study's objectives were to identify which herbs patients use and to examine the scope of current research on the efficacy and safety regarding the identified herbs. Herbal use by patients receiving oncology care was assessed prospectively from July 2009 to July 2012 by integrative physicians (IPs) trained in herbal medicine. Historical, ethnobotanical, basic research, and clinical data regarding the identified herbs were explored by using a keyword search in PubMed and Middle Eastern ethnohistorical literature. Disclosure of herbal use was reported by 154 of the 305 patients (50.5 %) interviewed by IPs. The use of 85 single herbs and 30 different herbal formulas was documented during the initial or follow-up IP assessments. Patients reported 14 quality of life-associated indications for herbal use. The ten most prevalent herbs displaying in vitro/in vivo anticancer activity and nine other herbs were preliminarily assessed concerning potential risks, safety, and interaction with chemotherapy. Herbal use by patients with cancer in northern Israel is widespread and calls for further study in order to address issues of safety and effectiveness. We recommend constructing a multinational and multidisciplinary team of researchers with ethnopharmacological and clinical expertise that will explore the use of herbs among patients with cancer in a cross-cultural perspective attuned with patients' affinity to traditional herbal medicine.

"We can't get along without each other": Qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety.

PubMed

Gagliardi, Anna R; Lehoux, Pascale; Ducey, Ariel; Easty, Anthony; Ross, Sue; Bell, Chaim; Trbovich, Patricia; Urbach, David R

2017-01-01

Physician relationships with device industry representatives have not been previously assessed. This study explored interactions with device industry representatives among physicians who use implantable cardiovascular and orthopedic devices to identify whether conflict of interest (COI) is a concern and how it is managed. A descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites, and interviewed about their relationships with device industry representatives. Sampling was concurrent with data collection and analysis. Data were analyzed and discussed using constant comparative technique by all members of the research team. Twenty-two physicians (10 cardiovascular, 12 orthopedic) were interviewed. Ten distinct representative roles were identified: purchasing, training, trouble-shooting, supplying devices, assisting with device assembly and insertion, supporting operating room staff, mitigating liability, conveying information about recalls, and providing direct and indirect financial support. Participants recognized the potential for COI but representatives were present for the majority of implantations. Participants revealed a tension between physicians and representatives that was characterized as "symbiotic", but required physicians to be vigilant about COI and patient safety, particularly because representatives varied regarding disclosure of device defects. They described a concurrent tension between hospitals, whose policies and business practices were focused on cost-control, and physicians who were required to comply with those policies and use particular devices despite concerns about their safety and effectiveness. Given the potential for COI and threats to patient safety, further research is needed to establish the clinical implications of the role of, and relationship with device industry representatives; and whether and how hospitals do and should govern interaction with representatives, or support their staff in this regard.

The role of patient experience surveys in quality assurance and improvement: a focus group study in English general practice.

PubMed

Boiko, Olga; Campbell, John L; Elmore, Natasha; Davey, Antoinette F; Roland, Martin; Burt, Jenni

2015-12-01

Despite widespread adoption of patient feedback surveys in international health-care systems, including the English NHS, evidence of a demonstrable impact of surveys on service improvement is sparse. To explore the views of primary care practice staff regarding the utility of patient experience surveys. Qualitative focus groups. Staff from 14 English general practices. Whilst participants engaged with feedback from patient experience surveys, they routinely questioned its validity and reliability. Participants identified surveys as having a number of useful functions: for patients, as a potentially therapeutic way of getting their voice heard; for practice staff, as a way of identifying areas of improvement; and for GPs, as a source of evidence for professional development and appraisal. Areas of potential change stimulated by survey feedback included redesigning front-line services, managing patient expectations and managing the performance of GPs. Despite this, practice staff struggled to identify and action changes based on survey feedback alone. Whilst surveys may be used to endorse existing high-quality service delivery, their use in informing changes in service delivery is more challenging for practice staff. Drawing on the Utility Index framework, we identified concerns relating to reliability and validity, cost and feasibility acceptability and educational impact, which combine to limit the utility of patient survey feedback. Feedback from patient experience surveys has great potential. However, without a specific and renewed focus on how to translate feedback into action, this potential will remain incompletely realized. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Chemicals in Household Products: Problems with Solutions

NASA Astrophysics Data System (ADS)

Glegg, Gillian A.; Richards, Jonathan P.

2007-12-01

The success of a regulatory regime in decreasing point-source emissions of some harmful chemicals has highlighted the significance of other sources. A growing number of potentially harmful chemicals have been incorporated into an expanding range of domestic household products and are sold worldwide. Tighter regulation has been proposed, and the European Commission has introduced the Regulation on the Registration, Evaluation, and Authorisation of Chemicals to address this concern. However, it is clear that in addition to the regulation, there is a potential to effect change through retailer and consumer attitudes and behaviours. Interviews were conducted with 7 key stakeholder groups to identify critical issues, which were then explored using a public survey questionnaire (1,008 respondents) and 8 subsequent focus groups. The findings demonstrated that the issue of chemicals in products is of concern to consumers for reasons of personal health rather than environmental protection. Key obstacles to the wider purchase of “green-alternative” products included perceived high cost and poor performance, lack of availability of products, and poor information concerning such products. Although improved regulation was seen as part of the solution, consumers must also play a role. It was clear from this study that consumers are not currently able to make informed choices about the chemicals they use but that they would be receptive to moving toward a more sustainable use of chemicals in the future if empowered to do so.

Chemicals in household products: problems with solutions.

PubMed

Glegg, Gillian A; Richards, Jonathan P

2007-12-01

The success of a regulatory regime in decreasing point-source emissions of some harmful chemicals has highlighted the significance of other sources. A growing number of potentially harmful chemicals have been incorporated into an expanding range of domestic household products and are sold worldwide. Tighter regulation has been proposed, and the European Commission has introduced the Regulation on the Registration, Evaluation, and Authorisation of Chemicals to address this concern. However, it is clear that in addition to the regulation, there is a potential to effect change through retailer and consumer attitudes and behaviours. Interviews were conducted with 7 key stakeholder groups to identify critical issues, which were then explored using a public survey questionnaire (1,008 respondents) and 8 subsequent focus groups. The findings demonstrated that the issue of chemicals in products is of concern to consumers for reasons of personal health rather than environmental protection. Key obstacles to the wider purchase of "green-alternative" products included perceived high cost and poor performance, lack of availability of products, and poor information concerning such products. Although improved regulation was seen as part of the solution, consumers must also play a role. It was clear from this study that consumers are not currently able to make informed choices about the chemicals they use but that they would be receptive to moving toward a more sustainable use of chemicals in the future if empowered to do so.

Student Attitudes toward Learning Analytics in Higher Education: "The Fitbit Version of the Learning World".

PubMed

Roberts, Lynne D; Howell, Joel A; Seaman, Kristen; Gibson, David C

2016-01-01

Increasingly, higher education institutions are exploring the potential of learning analytics to predict student retention, understand learning behaviors, and improve student learning through providing personalized feedback and support. The technical development of learning analytics has outpaced consideration of ethical issues surrounding their use. Of particular concern is the absence of the student voice in decision-making about learning analytics. We explored higher education students' knowledge, attitudes, and concerns about big data and learning analytics through four focus groups ( N = 41). Thematic analysis of the focus group transcripts identified six key themes. The first theme, "Uninformed and Uncertain," represents students' lack of knowledge about learning analytics prior to the focus groups. Following the provision of information, viewing of videos and discussion of learning analytics scenarios three further themes; "Help or Hindrance to Learning," "More than a Number," and "Impeding Independence"; represented students' perceptions of the likely impact of learning analytics on their learning. "Driving Inequality" and "Where Will it Stop?" represent ethical concerns raised by the students about the potential for inequity, bias and invasion of privacy and the need for informed consent. A key tension to emerge was how "personal" vs. "collective" purposes or principles can intersect with "uniform" vs. "autonomous" activity. The findings highlight the need the need to engage students in the decision making process about learning analytics.

Independent Orbiter Assessment (IOA): Assessment of the reaction control system, volume 1

NASA Technical Reports Server (NTRS)

Prust, Chet D.; Hartman, Dan W.

1988-01-01

The results of the Independent Orbiter Assessment (IOA) of the Failure Modes and Effects Analysis (FMEA) and Critical Items List (CIL) are presented. The IOA effort first completed an analysis of the aft and forward Reaction Control System (RCS) hardware, and Electrical Power Distribution and Control (EPD and C), generating draft failure modes and potential critical items. To preserve independence, this analysis was accomplished without reliance upon the results contained within the NASA FMEA/CIL documentation. The IOA results were then compared to the proposed Post 51-L NASA FMEA/CIL baseline. This report documents the results of that comparison for the Orbiter RCS hardware and EPD and C systems. The IOA product for the RCS analysis consisted of 208 hardware and 2064 EPD and C failure mode worksheets that resulted in 141 hardware and 449 EPD and C potential critical items (PCIs) being identified. A comparison was made of the IOA product to the NASA FMEA/CIL baseline. After comparison and discussions with the NASA subsystem manager, 96 hardware issues, 83 of which concern CIL items or PCIs, and 280 EPD and C issues, 158 of which concern CIL items or PCIs, and 280 EPD and C issues, 158 of which concern CIL items or PCIs, remain unresolved. Volume 1 contains the subsystem description, assessment results, and some of the IOA worksheets.

Screening physical health? Yes! But...: nurses' views on physical health screening in mental health care.

PubMed

Happell, Brenda; Scott, David; Nankivell, Janette; Platania-Phung, Chris

2013-08-01

To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Qualitative exploratory study. Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a systematic approach to physical health care is taken. © 2013 John Wiley & Sons Ltd.

Trace elements of concern affecting urban agriculture in industrialized areas: A multivariate approach.

PubMed

Boente, C; Matanzas, N; García-González, N; Rodríguez-Valdés, E; Gallego, J R

2017-09-01

The urban and peri-urban soils used for agriculture could be contaminated by atmospheric deposition or industrial releases, thus raising concerns about the potential risk to public health. Here we propose a method to evaluate potential soil pollution based on multivariate statistics, geostatistics (kriging), a novel soil pollution index, and bioavailability assessments. This approach was tested in two districts of a highly populated and industrialized city (Gijón, Spain). The soils showed anomalous content of several trace elements, such as As and Pb (up to 80 and 585 mg kg -1 respectively). In addition, factor analyses associated these elements with anthropogenic activity, whereas other elements were attributed to natural sources. Subsequent clustering also facilitated the differentiation between the northern area studied (only limited Pb pollution found) and the southern area (pattern of coal combustion, including simultaneous anomalies of trace elements and benzo(a)pyrene). A normalized soil pollution index (SPI) was calculated by kriging, using only the elements falling above threshold levels; therefore point-source polluted zones in the northern area and diffuse contamination in the south were identified. In addition, in the six mapping units with the highest SPIs of the fifty studied, we observed low bioavailability for most of the elements that surpassed the threshold levels. However, some anomalies of Pb contents and the pollution fingerprint in the central area of the southern grid call for further site-specific studies. On the whole, the combination of a multivariate (geo) statistic approach and a bioavailability assessment allowed us to efficiently identify sources of contamination and potential risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Content Analysis of US News Stories About E-Cigarettes in 2015.

PubMed

Wackowski, Olivia A; Giovenco, Daniel P; Singh, Binu; Lewis, M Jane; Steinberg, Michael B; Delnevo, Cristine D

2017-08-03

Coverage of e-cigarettes in the news media may shape public perceptions about them but little is known about such news content. This content analysis characterized discussion of e-cigarettes in leading print and online US news sources in 2015. We searched Access World News and Factiva databases for e-cigarette-related news articles appearing in the top 30 circulating newspapers, 4 newswires, and 4 online news sources in the United States in 2015 (n = 295). Coders identified the presence of various e-cigarette topics (e.g. regulation), and benefit and risk statements. Nearly half of articles (45.1%) focused primarily on e-cigarette policy/regulatory issues, although e-cigarette prevalence (21.0%) and health effects (21.7%) were common main topics. Concerns about youth were frequently mentioned, including the rise in youth e-cigarette use (45.4%), gateway to smoking potential (33.9%) and appeal of flavors (22.4%). Youth e-cigarette prevalence was more frequently mentioned than adult prevalence in articles discussing FDA regulation (61% vs. 13.5%, respectively). News articles more frequently discussed potential e-cigarette risks or concerns (80%) than benefits (45.4%), such as smoking harm-reduction. Quoted physicians, researchers, and government representatives were more likely to refer to e-cigarette risks than benefits. In 2015, rising rates of e-cigarette use among youth and policy strategies to address e-cigarettes dominated US e-cigarette news stories, leading up to their FDA regulation in 2016. Statements about e-cigarettes' potential risks were frequently attributed to trusted sources such as physicians, and outnumbered claims about their harm-reduction benefits. Such coverage may impact e-cigarette risk perceptions, use intentions and policy support. In the year leading up to the FDA's Deeming Rule, concerns about youth use or potential use were frequently discussed in e-cigarette news. News articles more frequently discussed potential e-cigarette risks/concerns compared to potential harm-reduction benefits relative to tobacco cigarettes. While such coverage may inform the public about potential e-cigarette risks, they may also contribute to increasing perceptions that e-cigarettes are as harmful as tobacco cigarettes. E-cigarette risk and benefit statements were most frequently made by or attributed to researchers and physicians in articles, which is significant given that they may be particularly trusted sources of e-cigarette risk information. © The Author 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.

Public health assessment for USAF Langley Air Force Base and NASA-Langley Research Center, Hampton, York County, Virginia, Region 3. CERCLIS Number VA4570024477 and CERCLIS Number VA2800005033; Final report

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

NONE

1998-12-29

Langley Air Force Base (Langley AFB) and the National Aeronautics and Space Administration Langley Research Center (NASA LaRC) are located adjacent to each other on a small coastal basin of the Back River, a tidal estuary of the Chesapeake Bay. The Agency for Toxic Substances and Disease Registry (ATSDR) visited the sites in 1994 and 1997. During the 1994 visit, several potential public health concerns were raised. (1) the potential for contaminants to migrate to fish and shellfish (which might be ingested by local residents) in the adjoining estuary, (2) surface soil contamination at a former playground at Langley AFBmore » Site OT-06, (3) surface soil contamination and physical hazards at Langley AFB Sites OT-25 and FT-41, where children or youths might trespass, (4) the use of Langley AFB Site LF-12 for storing fill material, and (5) lead-contaminated soil in the housing areas at Langley AFB. ATSDR made recommendations for several of these sites. During the 1997 visit, ATSDR identified one additional potential concern at NASA LaRC Site 4, an open storage site where surface soil has not been characterized.« less

EJSCREEN Version 1, Demographic Data

EPA Pesticide Factsheets

This map service displays demographic data used in EJSCREEN. All demographic data were derived from American Community Survey 2006-2010 estimates. EJSCREEN is an environmental justice screening tool that provides EPA with a nationally consistent approach to screening for potential areas of EJ concern that may warrant further investigation. The EJ indexes are block group level results that combine multiple demographic factors with a single environmental variable (such as proximity to traffic) that can be used to help identify communities living with the greatest potential for negative environmental and health effects. The EJSCREEN tool is currently for internal EPA use only. It is anticipated that as users become accustomed to this new tool, individual programs within the Agency will develop program use guidelines and a community of practice will develop around them within the EPA Geoplatform. Users should keep in mind that screening tools are subject to substantial uncertainty in their demographic and environmental data, particularly when looking at small geographic areas, such as Census block groups. Data on the full range of environmental impacts and demographic factors in any given location are almost certainly not available directly through this tool, and its initial results should be supplemented with additional information and local knowledge before making any judgments about potential areas of EJ concern.

Are chemicals in articles an obstacle for reaching environmental goals? - Missing links in EU chemical management.

PubMed

Molander, Linda; Breitholtz, Magnus; Andersson, Patrik L; Rybacka, Aleksandra; Rudén, Christina

2012-10-01

It is widely acknowledged that the management of risks associated with chemicals in articles needs to be improved. The EU environmental policy states that environmental damage should be rectified at source. It is therefore motivated that the risk management of substances in articles also takes particular consideration to those substances identified as posing a risk in different environmental compartments. The primary aim of the present study was to empirically analyze to what extent the regulation of chemicals in articles under REACH is coherent with the rules concerning chemicals in the Sewage Sludge Directive (SSD) and the Water Framework Directive (WFD). We also analyzed the chemical variation of the organic substances regulated under these legislations in relation to the most heavily used chemicals. The results show that 16 of 24 substances used in or potentially present in articles and regulated by the SSD or the WFD are also identified under REACH either as a substance of very high concern (SVHC) or subject to some restrictions. However, for these substances we conclude that there is limited coherence between the legislations, since the identification as an SVHC does not in itself encompass any use restrictions, and the restrictions in REACH are in many cases limited to a particular use, and thus all other uses are allowed. Only a minor part of chemicals in commerce is regulated and these show a chemical variation that deviates from classical legacy pollutants. This warrants new tools to identify potentially hazardous chemicals in articles. We also noted that chemicals monitored in the environment under the WFD deviate in their chemistry from the ones regulated by REACH. In summary, we argue that to obtain improved resource efficiency and a sustainable development it is necessary to minimize the input of chemicals identified as hazardous to health or the environment into articles. Copyright © 2012 Elsevier B.V. All rights reserved.

Groundwater contaminants in the deep benthic zone of urban streams in Canada (Invited)

NASA Astrophysics Data System (ADS)

Roy, J. W.; Bickerton, G.

2010-12-01

There is little information available on the potential threat that groundwater containing land-based contaminants poses to aquatic ecosystems in urban environments. In this study, a rapid screening approach was applied at the stream reach-scale for eight urban streams (reaches from 100 to < 1000 m). The objective was to determine what types of groundwater contaminants could be detected in the deeper benthic zone of these streams, if any, to start to address questions of whether such contaminants are a concern and which types are the most problematic. The benthic community may be especially at risk since it may experience higher contaminant concentrations than the stream itself due to fewer losses from sorption, degradation and volatilization processes. For each stream, groundwater samples from below the stream bed (typically 25-75 cm) were collected using a drive-point mini-profiler at intervals of 10-15 m along the stream and were subsequently analysed for general chemistry and a wide range of common and emerging urban contaminants. For a few test streams with known contamination, the area of contamination was identified with this technique. In addition, previously unknown contaminants or areas of contamination were identified at all nine streams. Identified contaminants included benzene and other petroleum hydrocarbons, fuel oxygenates (e.g. MTBE), perchlorate, pesticides, artificial sweeteners, and various chlorinated solvent compounds. In addition, elevated levels of nitrate, phosphate, some heavy metals, including cadmium and arsenic, and elevated chloride (likely indicating road salt) were detected. Most streams had many different types of contaminants, often overlapping over small stretches, and together often covering substantial portions of the monitored reach. The findings provide support for this screening approach for delineating areas of potential ecological concern and identifying possible sources of groundwater contamination, for urban settings. They also suggest that the presence of multiple groundwater contaminants may be a more common threat to the benthic community of urban streams than currently perceived.

mHealth: Don't Forget All the Stakeholders in the Business Case.

PubMed

Petersen, Carolyn; Adams, Samantha A; DeMuro, Paul R

2015-12-31

Mobile health (mHealth) facilitates linking patient-generated data with electronic health records with clinical decision support systems. mHealth can transform health care, but to realize this potential it is important to identify the relevant stakeholders and how they might be affected. Such stakeholders include primary stakeholders, such as patients, families and caregivers, clinicians, health care facilities, researchers, payors and purchasers, employer, and miscellaneous secondary stakeholders, such as vendors, suppliers, distributors, and consultants, policy makers and legislators. The breadth and depth of the mHealth market make it possible for mHealth to have a considerable effect on people's health. However, many concerns exist, including privacy, data security, funding, and the lack of case studies demonstrating efficacy and cost-effectiveness. Many American and European initiatives to address these concerns are afoot.

Assessment of the Probability of Autochthonous Transmission of Chikungunya Virus in Canada under Recent and Projected Climate Change

PubMed Central

Fazil, Aamir; Gachon, Philippe; Deuymes, Guillaume; Radojević, Milka; Mascarenhas, Mariola; Garasia, Sophiya; Johansson, Michael A.; Ogden, Nicholas H.

2017-01-01

Background: Chikungunya virus (CHIKV) is a reemerging pathogen transmitted by Aedes aegypti and Aedes albopictus mosquitoes. The ongoing Caribbean outbreak is of concern due to the potential for infected travelers to spread the virus to countries where vectors are present and the population is susceptible. Although there has been no autochthonous transmission of CHIKV in Canada, there is concern that both Ae. albopictus and CHIKV will become established, particularly under projected climate change. We developed risk maps for autochthonous CHIKV transmission in Canada under recent (1981–2010) and projected climate (2011–2040 and 2041–2070). Methods: The risk for CHIKV transmission was the combination of the climatic suitability for CHIKV transmission potential and the climatic suitability for the presence of Ae. albopictus; the former was assessed using a stochastic model to calculate R0 and the latter was assessed by deriving a suitability indicator (SIG) that captures a set of climatic conditions known to influence the ecology of Ae. albopictus. R0 and SIG were calculated for each grid cell in Canada south of 60°N, for each time period and for two emission scenarios, and combined to produce overall risk categories that were mapped to identify areas suitable for transmission and the duration of transmissibility. Findings: The risk for autochthonous CHIKV transmission under recent climate is very low with all of Canada classified as unsuitable or rather unsuitable for transmission. Small parts of southern coastal British Columbia become progressively suitable with short-term and long-term projected climate; the duration of potential transmission is limited to 1–2 months of the year. Interpretation: Although the current risk for autochthonous CHIKV transmission in Canada is very low, our study could be further supported by the routine surveillance of Ae. albopictus in areas identified as potentially suitable for transmission given our uncertainty on the current distribution of this species in Canada. https://doi.org/10.1289/EHP669 PMID:28731409

Areal distribution and concentrations of contaminants of concern in surficial streambed and lakebed sediments, Lake Erie-Lake Saint Clair Drainages, 1990-97

USGS Publications Warehouse

Rheaume, S.J.; Button, D.T.; Myers, Donna N.; Hubbell, D.L.

2001-01-01

Concerns about elevated concentrations of contaminants such as polychlorinated biphenyls and mercury in aquatic bed sediments throughout the Great Lakes Basin have resulted in a need for better understanding of the scope and severity of the problem. Various organochlorine pesticides, polychlorinated biphenyls, trace metals, and polycyclic aromatic hydrocarbons are a concern because of their ability to persist and accumulate in aquatic sediments and their association with adverse aquatic biological effects. The areal distribution and concentrations in surficial bed sediments of 20 contaminants of concern with established bed-sediment-toxicity guidelines were examined in relation to their potential effects on freshwater aquatic biota. Contaminants at more than 800 sampling locations are characterized in this report. Surficial bed-sediment-quality data collected from 1990 to 1997 in the Lake Erie?Lake Saint Clair Drainages were evaluated to reflect recent conditions. In descending order, concentrations of total polycyclic aromatic hydrocarbons, phenanthrene, total polychlorinated biphenyls, chrysene, benz[a]anthracene, benzo[a]pyrene, cadmium, lead, zinc, arsenic, and mercury were the contaminants that most commonly exceeded levels associated with probable adverse effects on aquatic benthic organisms. The highest concentrations of most of these contaminants in aquatic bed sediments are confined to the 12 specific geographic Areas of Concern identified in the 1987 Revisions to the Great Lakes Water Quality Agreement of 1972. An exception is arsenic, which was detected at concentrations exceeding threshold effect levels at many locations outside Areas of Concern.

The 'over-researched community': An ethics analysis of stakeholder views at two South African HIV prevention research sites.

PubMed

Koen, Jennifer; Wassenaar, Douglas; Mamotte, Nicole

2017-12-01

Health research in resource-limited, multi-cultural contexts raises complex ethical concerns. The term 'over-researched community' (ORC) has been raised as an ethical concern and potential barrier to community participation in research. However, the term lacks conceptual clarity and is absent from established ethics guidelines and academic literature. In light of the concern being raised in relation to research in low- and middle-income countries (LMICs), a critical and empirical exploration of the meaning of ORC was undertaken. Guided by Emanuel et al.'s (2004) eight principles for ethically sound research in LMICs, this study examines the relevance and meaning of the terms 'over-research' and 'over-researched community' through an analysis of key stakeholder perspectives at two South African research sites. Data were collected between August 2007 and October 2008. 'Over-research' was found to represent a conglomeration of ethical concerns often used as a proxy for standard research ethics concepts. 'Over-research' seemed fundamentally linked to disparate positions and perspectives between different stakeholders in the research interaction, arising from challenges in inter-stakeholder relationships. 'Over-research' might be interpreted to mean exploitation. However, exploitation itself could mean different things. Using the term may lead to obscured understanding of real or perceived ethical concerns, making it difficult to identify and address the underlying concerns. It is recommended that the term be carefully and critically interrogated for clarity when used in research ethics discourse. Because it represents other legitimate concerns, it should not be dismissed without careful exploration. Copyright © 2017 Elsevier Ltd. All rights reserved.

Organizational and physician perspectives about facilitating handheld computer use in clinical practice: results of a cross-site qualitative study.

PubMed

McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

2005-01-01

To describe strategies that organizations select to support physicians' use of handheld computers (HHCs) in clinical practice and to explore issues about facilitating HHC use. A multidisciplinary team used focus groups and interviews with clinical, administrative, and information technology (IT) staff to gather data from 161 informants at seven sites. Transcripts were coded using a combination of deductive and inductive approaches to both answer research questions and identify patterns and themes that emerged in the data. Answers to questions about strategies for HHC support and themes about (1) how to facilitate physician adoption and use and (2) organizational concerns. Three main organizational strategies for HHC support were characterized among sites: (1) active support for broad-based use, (2) active support for niche use, and (3) basic support for individual physician users. Three high-level themes emerged around how to best facilitate physician adoption and use of HHCs: (1) improving usability and usefulness, (2) promoting HHCs and device use, and (3) providing training and support. However, four major themes also emerged related to organizations' concerns about HHC use: (1) security-related concerns, (2) economic concerns, (3) technical concerns, and (4) strategic concerns. An organizational approach to HHC support that involves individualized attention to existing and potential physician users rather than one-size-fits-all, organization-wide implementation efforts was an important facilitator promoting physician use of HHCs. Health care organizations interested in supporting HHC use must consider issues related to security, economics, and IT strategy that may not be prominent concerns for physician users.

Deep brain stimulation for obsessive-compulsive disorder: Knowledge and concerns among psychiatrists, psychotherapists and patients

PubMed Central

Naesström, Matilda; Blomstedt, Patric; Hariz, Marwan; Bodlund, Owe

2017-01-01

Background: Deep brain stimulation (DBS) is under investigation for severe obsessive-compulsive disorder (OCD) resistant to other therapies. The number of implants worldwide is slowly increasing. Therefore, it is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. Especially, for future study designs and the creation of information targeting healthcare professionals and patients. The aim of this study was to explore the knowledge and concerns toward DBS among patients with OCD, psychiatrists, and cognitive behavioral therapists. Methods: The study was conducted through web-based surveys for the aimed target groups –psychiatrist, patients, and cognitive behavioral therapists. The surveys contained questions regarding previous knowledge of DBS, source of knowledge, attitudes, and concerns towards the therapy. Results: The main source of information was from scientific sources among psychiatrists and psychotherapists. The patient's main source of information was the media. Common concerns among the groups included complications from surgery, anesthesia, stimulation side effects, and the novelty of the treatment. Specific concerns for the groups included; personality changes mentioned by patients and psychotherapists, and ethical concerns among psychiatrists. Conclusion: There are challenges for DBS in OCD as identified by the participants of this study; source and quality of information, efficacy, potential adverse effects, and eligibility. In all of which the current evidence base still is limited. A broad research agenda is needed for studies going forward. PMID:29285414

Concerns and coping during cancer genetic risk assessment.

PubMed

Bennett, P; Phelps, C; Hilgart, J; Hood, K; Brain, K; Murray, A

2012-06-01

To gain an 'in-depth' understanding of patients' concerns and their related coping strategies during the genetic risk assessment process. Participants were the 'usual care' arm of a trial of a coping intervention targeted at men and women undergoing assessment of genetic risk for familial cancer. Participants completed questionnaires measuring the degree to which they experienced up to 11 concerns and which of 8 coping strategies they used to respond to each of them at entry into the programme and 1 month subsequently (before they received their risk information). A majority of participants were at least 'quite worried' about all the identified concerns, although the levels of concern fell over the waiting period. Participants used several strategies in response to their varying concerns - although a primary coping strategy for each concern was identifiable. The emotion-focused strategies of acceptance and positive appraisal were generally used in response to concerns they could not change, and seeking social support was used primarily to gain information, but not emotional support from their family. Cluster analysis identified three unique clusters of coping responses. Genetic risk assessment comprises a number of different stressors each of which is coped with using different strategies. Copyright © 2011 John Wiley & Sons, Ltd.

Presence of selected chemicals of emerging concern in water and bottom sediment from the St. Louis River, St. Louis Bay, and Superior Bay, Minnesota and Wisconsin, 2010

USGS Publications Warehouse

Christensen, Victoria G.; Lee, Kathy E.; Kieta, Kristen A.; Elliott, Sarah M.

2012-01-01

The St. Louis Bay of Lake Superior receives substantial urban runoff, wastewater treatment plant effluent, and industrial effluent. In 1987, the International Joint Commission designated the St. Louis Bay portion of the lower St. Louis River as one of the Great Lakes Areas of Concern. Concerns exist about the potential effects of chemicals of emerging concern on aquatic biota because many of these chemicals, including endocrine active chemicals, have been shown to affect the endocrine systems of fish. To determine the occurrence of chemicals of emerging concern in the St. Louis River, the St. Louis Bay, and Superior Bay, the U.S. Geological Survey in cooperation with the Minnesota Pollution Control Agency and the Wisconsin Department of Natural Resources collected water and bottom-sediment samples from 40 sites from August through October 2010. The objectives of this study were to (1) identify the extent to which chemicals of emerging concern, including pharmaceuticals, hormones, and other organic chemicals, occur in the St. Louis River, St. Louis Bay, and Superior Bay, and (2) identify the extent to which the chemicals may have accumulated in bottom sediment of the study area. Samples were analyzed for selected wastewater indicators, hormones, sterols, bisphenol A, and human-health pharmaceuticals. During this study, 33 of 89 chemicals of emerging concern were detected among all water samples collected and 56 of 104 chemicals of emerging concern were detected in bottom-sediment samples. The chemical N,N-diethyl-meta-toluamide (DEET) was the most commonly detected chemical in water samples and 2,6-dimethylnaphthalene was the most commonly detected chemical in bottom-sediment samples. In general, chemicals of emerging concern were detected at a higher frequency in bottom-sediment samples than in water samples. Estrone (a steroid hormone) and hexahydrohexamethyl cyclopentabensopyran (a synthetic fragrance) were the most commonly detected endocrine active chemicals in water samples; beta-sitosterol (a plant sterol), estrone, and 4-tert-octylphenol (an alkylphenol) were the most commonly detected endocrine active chemicals in bottom-sediment samples. The greater detection frequency of chemicals in bottom-sediment samples compared to the detection frequency in water samples indicates that bottom sediment is an important sink for chemicals of emerging concern. At least one polycyclic aromatic hydrocarbon was detected in every sample; and in most samples, all nine polycyclic aromatic hydrocarbons included in analyses were detected. Bottom sediment collected from Superior Bay had the most polycyclic aromatic hydrocarbon detections of the sediment sampling locations.

Bisphenol A (BPA) in China: a review of sources, environmental levels, and potential human health impacts.

PubMed

Huang, Y Q; Wong, C K C; Zheng, J S; Bouwman, H; Barra, R; Wahlström, B; Neretin, L; Wong, M H

2012-07-01

Bisphenol A (BPA), identified as an endocrine disruptor, is an industrially important chemical that is used as a raw material in the manufacture of many products such as engineering plastics (e.g., epoxy resins/polycarbonate plastics), food cans (i.e., lacquer coatings), and dental composites/sealants. The demand and production capacity of BPA in China have grown rapidly. This trend will lead to much more BPA contamination in the environmental media and in the general population in China. This paper reviews the current literature concerning the pollution status of BPA in China (the mainland, Hong Kong, and Taiwan) and its potential impact on human health. Due to potential human health risks from long-term exposure to BPA, body burden of the contaminant should be monitored. Copyright © 2011 Elsevier Ltd. All rights reserved.

Addressing the human factors issues associated with control room modifications

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

O`Hara, J.; Stubler, W.; Kramer, J.

1998-03-01

Advanced human-system interface (HSI) technology is being integrated into existing nuclear plants as part of plant modifications and upgrades. The result of this trend is that hybrid HSIs are created, i.e., HSIs containing a mixture of conventional (analog) and advanced (digital) technology. The purpose of the present research is to define the potential effects of hybrid HSIs on personnel performance and plant safety and to develop human factors guidance for safety reviews of them where necessary. In support of this objective, human factors issues associated with hybrid HSIs were identified. The issues were evaluated for their potential significance to plantmore » safety, i.e., their human performance concerns have the potential to compromise plant safety. The issues were then prioritized and a subset was selected for design review guidance development.« less

Antimicrobial activity and rutin identification of honey produced by the stingless bee Melipona compressipes manaosensis and commercial honey.

PubMed

Pimentel, Renah Boanerges de Queiroz; da Costa, Cristovão Alves; Albuquerque, Patrícia Melchionna; Junior, Sergio Duvoisin

2013-07-01

Honey has been identified as a potential alternative to the widespread use of antibiotics, which are of significant concern considering the emergence of resistant bacteria. In this context, this study aimed to evaluate the antimicrobial activity of honey samples produced by a stingless bee species and by Apis sp. against pathogenic bacteria, as well as to identify the presence of phenolic compounds. Honey samples from the stingless bee M. compressipes manaosensis were collected twice, during the dry and rainy seasons. Three commercial honey samples from Apis sp. were also included in this study. Two different assays were performed to evaluate the antibacterial potential of the honey samples: agar-well diffusion and broth macrodilution. Liquid-liquid extraction was used to assess phenolic compounds from honey. HPLC analysis was performed in order to identify rutin and apigenin on honey samples. Chromatograms were recorded at 340 and 290 nm. Two honey samples were identified as having the highest antimicrobial activity using the agar diffusion method. Honey produced by Melipona compressipes manaosensis inhibited the growth of Staphylococcus aureus, Escherichia coli (0157: H7), Proteus vulgaris, Shigella sonnei and Klebsiella sp. A sample of honey produced by Apis sp. also inhibited the growth of Salmonella paratyphi. The macrodilution technique presented greater sensitivity for the antibacterial testing, since all honey samples showed activity. Flavonoid rutin was identified in the honey sample produced by the stingless bee. Honey samples tested in this work showed antibacterial activity against Gram-positive and Gram-negative bacteria. The results reported herein highlight the potential of using honey to control bacterial growth.

Assessing the Multidimensional Relationship Between Medication Beliefs and Adherence in Older Adults With Hypertension Using Polynomial Regression.

PubMed

Dillon, Paul; Phillips, L Alison; Gallagher, Paul; Smith, Susan M; Stewart, Derek; Cousins, Gráinne

2018-02-05

The Necessity-Concerns Framework (NCF) is a multidimensional theory describing the relationship between patients' positive and negative evaluations of their medication which interplay to influence adherence. Most studies evaluating the NCF have failed to account for the multidimensional nature of the theory, placing the separate dimensions of medication "necessity beliefs" and "concerns" onto a single dimension (e.g., the Beliefs about Medicines Questionnaire-difference score model). To assess the multidimensional effect of patient medication beliefs (concerns and necessity beliefs) on medication adherence using polynomial regression with response surface analysis. Community-dwelling older adults >65 years (n = 1,211) presenting their own prescription for antihypertensive medication to 106 community pharmacies in the Republic of Ireland rated their concerns and necessity beliefs to antihypertensive medications at baseline and their adherence to antihypertensive medication at 12 months via structured telephone interview. Confirmatory polynomial regression found the difference-score model to be inaccurate; subsequent exploratory analysis identified a quadratic model to be the best-fitting polynomial model. Adherence was lowest among those with strong medication concerns and weak necessity beliefs, and adherence was greatest for those with weak concerns and strong necessity beliefs (slope β = -0.77, p<.001; curvature β = -0.26, p = .004). However, novel nonreciprocal effects were also observed; patients with simultaneously high concerns and necessity beliefs had lower adherence than those with simultaneously low concerns and necessity beliefs (slope β = -0.36, p = .004; curvature β = -0.25, p = .003). The difference-score model fails to account for the potential nonreciprocal effects. Results extend evidence supporting the use of polynomial regression to assess the multidimensional effect of medication beliefs on adherence.

Aminomethyl-Derived Beta Secretase (BACE1) Inhibitors: Engaging Gly230 without an Anilide Functionality

PubMed Central

2016-01-01

A growing subset of β-secretase (BACE1) inhibitors for the treatment of Alzheimer’s disease (AD) utilizes an anilide chemotype that engages a key residue (Gly230) in the BACE1 binding site. Although the anilide moiety affords excellent potency, it simultaneously introduces a third hydrogen bond donor that limits brain availability and provides a potential metabolic site leading to the formation of an aniline, a structural motif of prospective safety concern. We report herein an alternative aminomethyl linker that delivers similar potency and improved brain penetration relative to the amide moiety. Optimization of this series identified analogues with an excellent balance of ADME properties and potency; however, potential drug–drug interactions (DDI) were predicted based on CYP 2D6 affinities. Generation and analysis of key BACE1 and CYP 2D6 crystal structures identified strategies to obviate the DDI liability, leading to compound 16, which exhibits robust in vivo efficacy as a BACE1 inhibitor. PMID:27997172

Ports and pests: Assessing the threat of aquatic invasive species introduced by maritime shipping activity in Cuba.

PubMed

O'Brien, Charleen E; Johnston, Matthew W; Kerstetter, David W

2017-12-15

Aquatic invasive species (AIS) are biological pollutants that cause detrimental ecological, economic, and human-health effects in their introduced communities. With increasing globalization through maritime trade, ports are vulnerable to AIS exposure via commercial vessels. The Cuban Port of Mariel is poised to become a competitive transshipment hub in the Caribbean and the intent of this study was to evaluate present and potential impacts AIS pose with the likely future increase in shipping activity. We utilized previous assessment frameworks and publicly accessible information to rank AIS by level of threat. Fifteen AIS were identified in Cuba and one, the Asian green mussel Perna viridis (Linnaeus, 1758), had repeated harmful economic impacts. Five species associated with trade partners of Port Mariel were considered potentially detrimental to Cuba if introduced through shipping routes. The results presented herein identify species of concern and emphasize the importance of prioritizing AIS prevention and management within Cuba. Copyright © 2017 Elsevier Ltd. All rights reserved.

A framework for implementing biodiversity offsets: selecting sites and determining scale

USGS Publications Warehouse

Kiesecker, Joseph M.; Copeland, Holly; Pocewicz, Amy; Nibbelink, Nate; McKenney, Bruce; Dahlke, John; Holloran, Matthew J.; Stroud, Dan

2009-01-01

Biodiversity offsets provide a mechanism for maintaining or enhancing environmental values in situations where development is sought despite detrimental environmental impacts. They seek to ensure that unavoidable negative environmental impacts of development are balanced by environmental gains, with the overall aim of achieving a net neutral or positive outcome. Once the decision has been made to offset, multiple issues arise regarding how to do so in practice. A key concern is site selection. In light of the general aim to locate offsets close to the affected sites to ensure that benefits accrue in the same area, what is the appropriate spatial scale for identifying potential offset sites (e.g., local, ecoregional)? We use the Marxan site-selection algorithm to address conceptual and methodological challenges associated with identifying a set of potential offset sites and determining an appropriate spatial scale for them. To demonstrate this process, we examined the design of offsets for impacts from development on the Jonah natural gas field in Wyoming.

Paired Exome Analysis Reveals Clonal Evolution and Potential Therapeutic Targets in Urothelial Carcinoma.

PubMed

Lamy, Philippe; Nordentoft, Iver; Birkenkamp-Demtröder, Karin; Thomsen, Mathilde Borg Houlberg; Villesen, Palle; Vang, Søren; Hedegaard, Jakob; Borre, Michael; Jensen, Jørgen Bjerggaard; Høyer, Søren; Pedersen, Jakob Skou; Ørntoft, Torben F; Dyrskjøt, Lars

2016-10-01

Greater knowledge concerning tumor heterogeneity and clonality is needed to determine the impact of targeted treatment in the setting of bladder cancer. In this study, we performed whole-exome, transcriptome, and deep-focused sequencing of metachronous tumors from 29 patients initially diagnosed with early-stage bladder tumors (14 with nonprogressive disease and 15 with progressive disease). Tumors from patients with progressive disease showed a higher variance of the intrapatient mutational spectrum and a higher frequency of APOBEC-related mutations. Allele-specific expression was also higher in these patients, particularly in tumor suppressor genes. Phylogenetic analysis revealed a common origin of the metachronous tumors, with a higher proportion of clonal mutations in the ancestral branch; however, 19 potential therapeutic targets were identified as both ancestral and tumor-specific alterations. Few subclones were present based on PyClone analysis. Our results illuminate tumor evolution and identify candidate therapeutic targets in bladder cancer. Cancer Res; 76(19); 5894-906. ©2016 AACR. ©2016 American Association for Cancer Research.

Landowner and practitioner perspectives on private land conservation programs

USGS Publications Warehouse

Lute, Michelle L.; Gillespie, Caitlyn R.; Fontaine, Joseph J.; Martin, Dustin R.

2018-01-01

Efforts to reverse declines in native grasslands benefit from agricultural policies that encourage private land conservation. The U.S. Department of Agriculture’s Conservation Reserve Program (CRP) improved conservation across landscapes but enrollment has declined. We used sequential exploratory mixed methods to compare landowner and conservation practitioners’ perceptions, evaluate perceived benefits, and identify potential improvements to CRP. Focus groups of practitioners informed a quantitative survey of landowners who had properties >160 total acres in Nebraska. Results suggest potential misalignment in perceptions between practitioners and landowners. Practitioners were concerned that conservation, especially of wildlife, was secondary to profit. But the majority of landowners valued CRP-related ecosystem services, including native pollinators. Practitioners posited that younger landowners were primarily profit motivated, but CRP enrollment did not differ by demographics. Practitioners and landowners identified rule complexity as a major challenge and practitioner–landowner relationships as critical to success. Findings suggest that practitioners may underestimate non-economic motivations and illuminate opportunities to encourage private land conservation.

Microplastic abundance, distribution and composition along a latitudinal gradient in the Atlantic Ocean.

PubMed

Kanhai, La Daana K; Officer, Rick; Lyashevska, Olga; Thompson, Richard C; O'Connor, Ian

2017-02-15

Microplastics in the world's oceans are a global concern due to the potential threat they pose to marine organisms. This study investigated microplastic abundance, distribution and composition in the Atlantic Ocean on a transect from the Bay of Biscay to Cape Town, South Africa. Microplastics were sampled from sub-surface waters using the underway system of the RV Polarstern. Potential microplastics were isolated from samples and FT-IR spectroscopy was used to identify polymer types. Of the particles analysed, 63% were rayon and 37% were synthetic polymers. The majority of microplastics were identified as polyesters (49%) and blends of polyamide or acrylic/polyester (43%). Overall, fibres (94%) were predominant. Average microplastic abundance in the Atlantic Ocean was 1.15±1.45particlesm -3 . Of the 76 samples, 14 were from the Benguela upwelling and there was no statistically significant difference in microplastic abundance between upwelled and non-upwelled sites. Copyright © 2016 Elsevier Ltd. All rights reserved.

Health care professionals' perspectives of advance care planning for people with dementia living in long-term care settings: A narrative review of the literature.

PubMed

Beck, Esther-Ruth; McIlfatrick, Sonja; Hasson, Felicity; Leavey, Gerry

2017-05-01

This paper provides an overview of the evidence on the perspective of health care professionals (HCPs) in relation to advance care planning (ACP) for people with dementia, residing in long-term care settings. A narrative approach was adopted to provide a comprehensive synthesis of previously published literature in the area. A systematic literature search identified 14 papers for inclusion. Following review of the studies four themes were identified for discussion; Early integration and planning for palliative care in dementia; HCPs ethical and moral concerns regarding ACP; Communication challenges when interacting with the person with dementia and their families and HCPs need for education and training. Despite evidence, that HCPs recognise the potential benefits of ACP, they struggle with its implementation in this setting. Greater understanding of dementia and the concept of ACP is required to improve consistency in practice. Synthesising the existing evidence will allow for further understanding of the key issues, potentially resulting in improved implementation in practice.

Evaluating Questionnaires Used to Assess Self-Reported Physical Activity and Psychosocial Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Cognitive Interview Study.

PubMed

Wurz, Amanda; Brunet, Jennifer

2017-09-01

Physical activity is increasingly being studied as a way to improve psychosocial outcomes (e.g., quality of life, self-efficacy, physical self-perceptions, self-esteem, body image, posttraumatic growth) among survivors of adolescent and young adult (AYA) cancer. Assessing levels of and associations between self-reported physical activity and psychosocial outcomes requires clear, appropriate, and relevant questionnaires. To explore how survivors of AYA cancer interpreted and responded to the following eight published questionnaires: Leisure Time Exercise Questionnaire, Exercise Self-Efficacy Scale, Physical Self-Description Questionnaire, Rosenberg Global Self-Esteem Scale, Multidimensional Body-Self Relations Questionnaire, Posttraumatic Growth Inventory, Functional Assessment of Cancer Therapy-General (FACT-G), RAND 36-Item Health Survey 1.0 (RAND-36), cognitive interviews were conducted with three men and four women age 18-36 years who were diagnosed with cancer at age 16-35 years. Initially, the first seven questionnaires listed above were assessed. Summaries of the interviews were prepared and compared across participants. Potential concerns were identified with the FACT-G; thus, a second interview was conducted with participants to explore the clarity, appropriateness, and relevance of the RAND-36. Concerns identified for the FACT-G related mostly to the lack of relevance of items pertaining to cancer-specific aspects of quality of life given that participants were posttreatment. No or few concerns related to comprehension and/or structure/logic were identified for the other questionnaires. In general, the questionnaires assessed were clear, appropriate, and relevant. Participants' feedback suggested they could be used to assess self-reported physical activity and varied psychosocial outcomes in studies with survivors of AYA cancer, either with or without slight modifications.

Load Disaggregation Technologies: Real World and Laboratory Performance

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

Mayhorn, Ebony T.; Sullivan, Greg P.; Petersen, Joseph M.

Low cost interval metering and communication technology improvements over the past ten years have enabled the maturity of load disaggregation (or non-intrusive load monitoring) technologies to better estimate and report energy consumption of individual end-use loads. With the appropriate performance characteristics, these technologies have the potential to enable many utility and customer facing applications such as billing transparency, itemized demand and energy consumption, appliance diagnostics, commissioning, energy efficiency savings verification, load shape research, and demand response measurement. However, there has been much skepticism concerning the ability of load disaggregation products to accurately identify and estimate energy consumption of end-uses; whichmore » has hindered wide-spread market adoption. A contributing factor is that common test methods and metrics are not available to evaluate performance without having to perform large scale field demonstrations and pilots, which can be costly when developing such products. Without common and cost-effective methods of evaluation, more developed disaggregation technologies will continue to be slow to market and potential users will remain uncertain about their capabilities. This paper reviews recent field studies and laboratory tests of disaggregation technologies. Several factors are identified that are important to consider in test protocols, so that the results reflect real world performance. Potential metrics are examined to highlight their effectiveness in quantifying disaggregation performance. This analysis is then used to suggest performance metrics that are meaningful and of value to potential users and that will enable researchers/developers to identify beneficial ways to improve their technologies.« less

The fruit and vegetable import pathway for potential invasive pest arrivals.

PubMed

Lichtenberg, Erik; Olson, Lars J

2018-01-01

The expansion of international trade in commodities increases the risk of alien species invasions. Invaders are difficult to detect on introduction, so prevention remains the preferred strategy for managing the threat of invasions. Propagule pressure has been shown to be a good predictor of invasion risk. Most studies to date, however, link potential invasive species arrivals with indirect measures of propagule pressure such as aggregate trade volumes. This paper estimates propagule pressure using data that measure actual arrivals. Specifically, it uses inspection data that covers almost all U.S. fruit and vegetable imports from 2005-2014 to estimate a logit model of the probability of potential invasive species arrival and expected propagule frequencies for 2,240 commodity/country of origin combinations. Clear patterns in the geographic origin and commodity pathways for potential pests are identified. The average probability of arrival is low, approximately 0.03, but is two to ten times higher for some commodities, most notably herbs. We identify commodities with a high number of expected arrivals due to either a large volume of trade, high interception rates, or a combination of both. Seven of the top ten countries of origin for propagule frequency are from the Western Hemisphere and further trade liberalization within the Western Hemisphere is likely to heighten challenges to enforcement of US phytosanitary standards. Patterns in the data can help identify the commodities and countries of origin in greatest need of technical assistance and guide targeting of surveillance for the pathways of greatest phytosanitary concern.

Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation.

PubMed

Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

2017-08-14

Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Using a mixed-method, qualitative approach, we observed training of service providers who were required to switch from telephone to video, and conducted pre- and post-training interviews with 15 service providers and their trainers on the challenges associated with transitioning to video. Two full days of simulation training were observed. Data were transcribed and analysed using an inductive approach; a modified constant comparative method was employed to identify common themes. We found three broad categories of issues likely to affect implementation of the video service: social, professional, and technical. Within these categories, eight sub-themes were identified; they were: enhanced delivery of the health service, improved health advice for people living in remote areas, safety concerns, professional risks, poor uptake of video service, system design issues, use of simulation for system testing, and use of simulation for system training. This study identified a number of unexpected potential barriers to successful transition from telephone to the video system. Most prominent were technical and training issues, and personal safety concerns about transitioning from telephone to video media. Addressing identified issues prior to implementation of a new video telehealth system is likely to improve effectiveness and uptake.

An Inquiry into Teacher Concerns in Taiwan.

ERIC Educational Resources Information Center

Chen, Yih-fen; Reeves, Carolyn

This study identified concerns of teachers in Taiwan and contrasted concerns of these teachers with the 56 concerns which comprise the Teacher Concerns Checklist (TCC), Form B, developed in the United States. A total of 294 teachers (155 preservice teachers and 139 inservice teachers) completed a Chinese version of the Survey of Teacher Concerns.…

Survey of bats on Columbia National Wildlife Refuge, Washington, December 2011-April 2012

USGS Publications Warehouse

Hagar, Joan C.; Manning, Tom; Barnett, Jenny

2013-01-01

Bats are diverse and abundant in many ecosystems worldwide. They perform important ecosystem functions, particularly by consuming large quantities of insects (Cleveland and others, 2006; Jones and others, 2009; Kuhn and others, 2011). The importance of bats to biodiversity and to ecosystem integrity has been overlooked in many regions, largely because the challenges of detecting and studying these small, nocturnal mammals have rendered a paucity of information on matters as basic as species distribution and natural history attributes. Recently, concern for bats has arisen in response to recognition of large-scale threats, such as white-nosed syndrome (WNS; Turner and others, 2009; Frick and others, 2010) and mortality at wind energy facilities (Arnett and others, 2008), factors that are causing unprecedented population declines of bats (Boyles and others, 2011). WNS is a fungal disease that has killed more than 1 million cave-hibernating bats in eastern North America since being discovered in New York State in 2006 (U.S. Fish and Wildlife Service, 2012). WNS has spread rapidly from northeastern U.S., and as of August 2012 has been confirmed as far west as eastern Missouri(U.S. Fish and Wildlife Service, 2013). Given the rapid spread of WNS, there is concern that the disease may soon affect western bat populations. Hibernating bats are particularly vulnerable to the effects of WNS (Blehert and others, 2009). Refuges in eastern Washington, including the Mid-Columbia River National Wildlife Refuge Complex (MCRNWRC) and Little Pend Oreille National Wildlife Refuge, support many potential hibernacula. Sixteen species of bats potentially occur on these refuges, including one federally listed species of concern (Townsend’s big-eared bat [Corynorhinus townsendii]; see table 1 for scientific names of bats), and 12 species that are of conservation concern in Washington and Oregon (table 1). However, little is known about bats on these refuges because few surveys have been done, and none have been done during winter. Refuge biologists are lacking even the most basic information, such as species presence, and location and status of hibernacula. In order to assess vulnerability and develop a strategy for management of WNS, refuge managers need to know where bats are hibernating, and which species are using each hibernaculum. The goal of this project was to provide information on the status of wintering bats to refuge biologists and managers in order to support decision-making that might minimize the threat of WNS in western bat populations. We conducted surveys of bat activity in winter and early spring as an initial step toward identifying bat species that may be over-wintering and locating potential hibernacula on these refuges. Our specific objectives were to identify bat species using the refuges, to identify areas of resident bat activity in autumn, winter, and early spring using acoustic bat detectors, and to try new methods for quick surveys of bat activity.

Androgen deprivation therapy of self-identifying, help-seeking pedophiles in the Dunkelfeld.

PubMed

Amelung, Till; Kuhle, Laura F; Konrad, Anna; Pauls, Alfred; Beier, Klaus M

2012-01-01

Androgen deprivation therapy (ADT) is considered an effective strategy in sexual offender treatment. However, the evidence base concerning its effects on sexual arousal control is limited. Past research has focused almost exclusively on men in forensic contexts. The present retrospective observational study provided data on ADT in a sample of self-identifying, help-seeking pedohebephilic men applying for a one-year group therapy program. Factors possibly influencing the readiness to take up or discontinue ADT were presented. Effects of a combination of ADT and group psychotherapy program on changes in paraphilic sexual behavior and associated psychological factors were examined. The proportion of men having taken up ADT was rather small (n=15). Greater awareness of potentially risky situations to commit child sexual offenses and self-rated uncontrollability of sexual urges were identified as characterizing men resorting to ADT. Additionally, these men were initially more open to include medical treatment. Examination of the effects of ADT and psychotherapy was limited to a sample of six men providing complete data sets. Descriptive data demonstrated a reduction of paraphilic sexual behaviors, an increase of risk-awareness and self-efficacy, and a decrease of offense-supportive cognitions and self-esteem. The present study underlined the importance of careful education and monitoring of self-identifying, help-seeking pedohebephilic patients interested in ADT concerning the effects and side effects of the treatment in a clinical context. Copyright © 2012 Elsevier Ltd. All rights reserved.

Online discourse on fibromyalgia: text-mining to identify clinical distinction and patient concerns.

PubMed

Park, Jungsik; Ryu, Young Uk

2014-10-07

The purpose of this study was to evaluate the possibility of using text-mining to identify clinical distinctions and patient concerns in online memoires posted by patients with fibromyalgia (FM). A total of 399 memoirs were collected from an FM group website. The unstructured data of memoirs associated with FM were collected through a crawling process and converted into structured data with a concordance, parts of speech tagging, and word frequency. We also conducted a lexical analysis and phrase pattern identification. After examining the data, a set of FM-related keywords were obtained and phrase net relationships were set through a web-based visualization tool. The clinical distinction of FM was verified. Pain is the biggest issue to the FM patients. The pains were affecting body parts including 'muscles,' 'leg,' 'neck,' 'back,' 'joints,' and 'shoulders' with accompanying symptoms such as 'spasms,' 'stiffness,' and 'aching,' and were described as 'sever,' 'chronic,' and 'constant.' This study also demonstrated that it was possible to understand the interests and concerns of FM patients through text-mining. FM patients wanted to escape from the pain and symptoms, so they were interested in medical treatment and help. Also, they seemed to have interest in their work and occupation, and hope to continue to live life through the relationships with the people around them. This research shows the potential for extracting keywords to confirm the clinical distinction of a certain disease, and text-mining can help objectively understand the concerns of patients by generalizing their large number of subjective illness experiences. However, it is believed that there are limitations to the processes and methods for organizing and classifying large amounts of text, so these limits have to be considered when analyzing the results. The development of research methodology to overcome these limitations is greatly needed.

Patient Understanding of the Risks and Benefits of Biologic Therapies in Inflammatory Bowel Disease: Insights from a Large-scale Analysis of Social Media Platforms.

PubMed

Martinez, Bibiana; Dailey, Francis; Almario, Christopher V; Keller, Michelle S; Desai, Mansee; Dupuy, Taylor; Mosadeghi, Sasan; Whitman, Cynthia; Lasch, Karen; Ursos, Lyann; Spiegel, Brennan M R

2017-07-01

Few studies have examined inflammatory bowel disease (IBD) patients' knowledge and understanding of biologic therapies outside traditional surveys. Here, we used social media data to examine IBD patients' understanding of the risks and benefits associated with biologic therapies and how this affects decision-making. We collected posts from Twitter and e-forum discussions from >3000 social media sites posted between June 27, 2012 and June 27, 2015. Guided by natural language processing, we identified posts with specific IBD keywords that discussed the risks and/or benefits of biologics. We then manually coded the resulting posts and performed qualitative analysis using ATLAS.ti software. A hierarchical coding structure was developed based on the keyword list and relevant themes were identified through manual coding. We examined 1598 IBD-related posts, of which 452 (28.3%) centered on the risks and/or benefits of biologics. There were 5 main themes: negative experiences and concerns with biologics (n = 247; 54.6%), decision-making surrounding biologic use (n = 169; 37.4%), positive experiences with biologics (n = 168; 37.2%), information seeking from peers (n = 125; 27.7%), and cost (n = 38; 8.4%). Posts describing negative experiences primarily commented on side effects from biologics, concerns about potential side effects and increased cancer risk, and pregnancy safety concerns. Posts on decision-making focused on nonbiologic treatment options, hesitation to initiate biologics, and concerns about changing or discontinuing regimens. Social media reveals a wide range of themes governing patients' experience and choice with IBD biologics. The complexity of navigating their risk-benefit profiles suggests merit in creating online tailored decision tools to support IBD patients' decision-making with biologic therapies.

Air concentrations of volatile compounds near oil and gas production: a community-based exploratory study.

PubMed

Macey, Gregg P; Breech, Ruth; Chernaik, Mark; Cox, Caroline; Larson, Denny; Thomas, Deb; Carpenter, David O

2014-10-30

Horizontal drilling, hydraulic fracturing, and other drilling and well stimulation technologies are now used widely in the United States and increasingly in other countries. They enable increases in oil and gas production, but there has been inadequate attention to human health impacts. Air quality near oil and gas operations is an underexplored human health concern for five reasons: (1) prior focus on threats to water quality; (2) an evolving understanding of contributions of certain oil and gas production processes to air quality; (3) limited state air quality monitoring networks; (4) significant variability in air emissions and concentrations; and (5) air quality research that misses impacts important to residents. Preliminary research suggests that volatile compounds, including hazardous air pollutants, are of potential concern. This study differs from prior research in its use of a community-based process to identify sampling locations. Through this approach, we determine concentrations of volatile compounds in air near operations that reflect community concerns and point to the need for more fine-grained and frequent monitoring at points along the production life cycle. Grab and passive air samples were collected by trained volunteers at locations identified through systematic observation of industrial operations and air impacts over the course of resident daily routines. A total of 75 volatile organics were measured using EPA Method TO-15 or TO-3 by gas chromatography/mass spectrometry. Formaldehyde levels were determined using UMEx 100 Passive Samplers. Levels of eight volatile chemicals exceeded federal guidelines under several operational circumstances. Benzene, formaldehyde, and hydrogen sulfide were the most common compounds to exceed acute and other health-based risk levels. Air concentrations of potentially dangerous compounds and chemical mixtures are frequently present near oil and gas production sites. Community-based research can provide an important supplement to state air quality monitoring programs.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

PubMed

Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

2015-01-01

Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records

PubMed Central

Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.

2015-01-01

Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns. PMID:26604874

Health aspects of the curing of synthetic rubbers.

PubMed Central

Fraser, D A; Rappaport, S

1976-01-01

A commonly used tread rubber formulation was cured in the laboratory under conditions simulating vulcanization in the Bag-O-Matic press. Volatile emissions were collected on charcoal and analyzed by combined GC-mass spectrometry. The compounds identified were either contaminants present in the raw material or reaction products. Some of these compounds were also identified in charcoal tube samples collected in the atmosphere of the industrial operations. Estimates based on the loss of weight of rubber during curing were used to predict airborne concentrations and compared to the concentrations actually found. The literature of the toxicity of raw materials and effluents was reviewed, and no acute or chronic toxicological effects would be anticipated. Information concerning potential carcinogenicity was not available and could not be evaluated. PMID:1026417

Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community.

PubMed

Aiello, Allison E; Larson, Elaine

2003-08-01

Antibiotic resistance within the community setting is an emerging public-health concern. Infection with antibiotic-resistant organisms in the community among people lacking traditional risk factors has been reported. In addition, prevalence studies have identified individuals carrying antibiotic-resistant organisms in the absence of known risk factors. These studies strongly suggest the presence of contributing factors that have yet to be identified. In this paper we review the burden of antibiotic resistance and known risk factors within the community setting, assess the potential role of antibacterial cleaning and hygiene products containing triclosan in the emergence of resistance, and recommend future research on the assessment of household cleaning and hygiene products containing triclosan.

Supplemental Hazard Analysis and Risk Assessment - Hydrotreater

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

Lowry, Peter P.; Wagner, Katie A.

A supplemental hazard analysis was conducted and quantitative risk assessment performed in response to an independent review comment received by the Pacific Northwest National Laboratory (PNNL) from the U.S. Department of Energy Pacific Northwest Field Office (PNSO) against the Hydrotreater/Distillation Column Hazard Analysis Report issued in April 2013. The supplemental analysis used the hazardous conditions documented by the previous April 2013 report as a basis. The conditions were screened and grouped for the purpose of identifying whether additional prudent, practical hazard controls could be identified, using a quantitative risk evaluation to assess the adequacy of the controls and establish amore » lower level of concern for the likelihood of potential serious accidents. Calculations were performed to support conclusions where necessary.« less

Beyond expected utility: rethinking behavioral decision research.

PubMed

Frisch, D; Clemen, R T

1994-07-01

Much research in psychology has evaluated the quality of people's decisions by comparisons with subjective expected utility (SEU) theory. This article suggests that typical arguments made for the status of utility theory as normative do not justify its use by psychologists as a standard by which to evaluate decision quality. It is argued that to evaluate decision quality, researchers need to identify those decision processes that tend to lead to desirable outcomes. It is contended that a good decision-making process must be concerned with how (and whether) decision makers evaluate potential consequences of decisions, the extent to which they accurately identify all relevant consequences, and the way in which they make final choices. Research that bears on these issues is reviewed.

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

Gomez, Elaine; Kattel, Shyam; Yan, Binhang

In this paper, the inherent variability and insufficiencies in the co-production of propylene from steam crackers has raised concerns regarding the global propylene production gap and has directed industry to develop more on-purpose propylene technologies. The oxidative dehydrogenation of propane by CO 2 (CO 2-ODHP) can potentially fill this gap while consuming a greenhouse gas. Non-precious FeNi and precious NiPt catalysts supported on CeO 2 have been identified as promising catalysts for CO 2-ODHP and dry reforming, respectively, in flow reactor studies conducted at 823 K. In-situ X-ray absorption spectroscopy measurements revealed the oxidation states of metals under reaction conditionsmore » and density functional theory calculations were utilized to identify the most favorable reaction pathways over the two types of catalysts.« less

Masturbation among young women and associations with sexual health: an exploratory study.

PubMed

Hogarth, Harriet; Ingham, Roger

2009-01-01

Much research into young people's developing sexuality is concerned with risk avoidance and the reduction of negative outcomes. Little research has been conducted into sexual self-exploration and, in particular, masturbation among young people, and this has generally been concerned merely with its prevalence. Little is known about the potential role of masturbation in relation to young people's developing sexuality, especially among young women. This study aimed to explore, using a qualitative approach, how young women reported their experiences of masturbation and whether and how these related to other aspects of their sexual activity. Thematic analysis of interview transcripts was employed to identify the range of reported experiences across participants, as well as the relations between various aspects of sexual development and experiences within participants. The findings revealed a broad continuum of views and opinions on female masturbation, which had strong links with parent and partner communication and the young women's beliefs and values concerning their sexual selves. The article concludes by drawing attention to the apparent relation between positive early childhood communication, young women's positive views of their sexual self, and their subsequent sexual activity.

Acknowledging patient heterogeneity in economic evaluation : a systematic literature review.

PubMed

Grutters, Janneke P C; Sculpher, Mark; Briggs, Andrew H; Severens, Johan L; Candel, Math J; Stahl, James E; De Ruysscher, Dirk; Boer, Albert; Ramaekers, Bram L T; Joore, Manuela A

2013-02-01

Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic evaluations pay only limited attention to patient heterogeneity. The objective of the present paper is to provide a comprehensive overview of the current knowledge regarding patient heterogeneity within economic evaluation of healthcare programmes. A systematic literature review was performed to identify methodological papers on the topic of patient heterogeneity in economic evaluation. Data were obtained using a keyword search of the PubMed database and manual searches. Handbooks were also included. Relevant data were extracted regarding potential sources of patient heterogeneity, in which of the input parameters of an economic evaluation these occur, methods to acknowledge patient heterogeneity and specific concerns associated with this acknowledgement. A total of 20 articles and five handbooks were included. The relevant sources of patient heterogeneity (demographics, preferences and clinical characteristics) and the input parameters where they occurred (baseline risk, treatment effect, health state utility and resource utilization) were combined in a framework. Methods were derived for the design, analysis and presentation phases of an economic evaluation. Concerns related mainly to the danger of false-positive results and equity issues. By systematically reviewing current knowledge regarding patient heterogeneity within economic evaluations of healthcare programmes, we provide guidance for future economic evaluations. Guidance is provided on which sources of patient heterogeneity to consider, how to acknowledge them in economic evaluation and potential concerns. The improved acknowledgement of patient heterogeneity in future economic evaluations may well improve the efficiency of healthcare.

Gay and Bisexual Men’s Perceptions of the Donation and Use of Human Biological Samples for Research: A Qualitative Study

PubMed Central

Patterson, Chris

2015-01-01

Human biological samples (biosamples) are increasingly important in diagnosing, treating and measuring the prevalence of illnesses. For the gay and bisexual population, biosample research is particularly important for measuring the prevalence of human immunodeficiency virus (HIV). By determining people’s understandings of, and attitudes towards, the donation and use of biosamples, researchers can design studies to maximise acceptability and participation. In this study we examine gay and bisexual men’s attitudes towards donating biosamples for HIV research. Semi-structured telephone interviews were conducted with 46 gay and bisexual men aged between 18 and 63 recruited in commercial gay scene venues in two Scottish cities. Interview transcripts were analysed thematically using the framework approach. Most men interviewed seemed to have given little prior consideration to the issues. Participants were largely supportive of donating tissue for medical research purposes, and often favourable towards samples being stored, reused and shared. Support was often conditional, with common concerns related to: informed consent; the protection of anonymity and confidentiality; the right to withdraw from research; and ownership of samples. Many participants were in favour of the storage and reuse of samples, but expressed concerns related to data security and potential misuse of samples, particularly by commercial organisations. The sensitivity of tissue collection varied between tissue types and collection contexts. Blood, urine, semen and bowel tissue were commonly identified as sensitive, and donating saliva and as unlikely to cause discomfort. To our knowledge, this is the first in-depth study of gay and bisexual men’s attitudes towards donating biosamples for HIV research. While most men in this study were supportive of donating tissue for research, some clear areas of concern were identified. We suggest that these minority concerns should be accounted for to develop inclusive, evidence-informed research protocols that balance collective benefits with individual concerns. PMID:26053741

Understanding the Public's Reservations about Broad Consent and Study-By-Study Consent for Donations to a Biobank: Results of a National Survey.

PubMed

De Vries, Raymond Gene; Tomlinson, Tom; Kim, Hyungjin Myra; Krenz, Chris; Haggerty, Diana; Ryan, Kerry A; Kim, Scott Y H

2016-01-01

Researchers and policymakers do not agree about the most appropriate way to get consent for the use of donations to a biobank. The most commonly used method is blanket-or broad-consent where donors allow their donation to be used for any future research approved by the biobank. This approach does not account for the fact that some donors may have moral concerns about the uses of their biospecimens. This problem can be avoided using "real-time"-or study-by-study-consent, but this policy places a significant burden on biobanks. In order to better understand the public's preferences regarding biobank consent policy, we surveyed a sample that was representative of the population of the United States. Respondents were presented with 5 biobank consent policies and were asked to indicate which policies were acceptable/unacceptable and to identify the best/worst policies. They were also given 7 research scenarios that could create moral concern (e.g. research intending to make abortions safer and more effective) and asked how likely they would be to provide broad consent knowing that their donation might be used in that research. Substantial minorities found both broad and study-by-study consent to be unacceptable and identified those two options as the worst policies. Furthermore, while the type of moral concern (e.g., regarding abortion, the commercial use of donations, or stem cell research) had no effect on policy preferences, an increase in the number of research scenarios generating moral concerns was related to an increased likelihood of finding broad consent to be the worst policy. The rejection of these ethically problematic and costly extremes is good news for biobanks. The challenge now is to design a policy that combines consent with access to information in a way that assures potential donors that their interests and moral concerns are being respected.

Gay and Bisexual Men's Perceptions of the Donation and Use of Human Biological Samples for Research: A Qualitative Study.

PubMed

Patterson, Chris; McDaid, Lisa M; Hilton, Shona

2015-01-01

Human biological samples (biosamples) are increasingly important in diagnosing, treating and measuring the prevalence of illnesses. For the gay and bisexual population, biosample research is particularly important for measuring the prevalence of human immunodeficiency virus (HIV). By determining people's understandings of, and attitudes towards, the donation and use of biosamples, researchers can design studies to maximise acceptability and participation. In this study we examine gay and bisexual men's attitudes towards donating biosamples for HIV research. Semi-structured telephone interviews were conducted with 46 gay and bisexual men aged between 18 and 63 recruited in commercial gay scene venues in two Scottish cities. Interview transcripts were analysed thematically using the framework approach. Most men interviewed seemed to have given little prior consideration to the issues. Participants were largely supportive of donating tissue for medical research purposes, and often favourable towards samples being stored, reused and shared. Support was often conditional, with common concerns related to: informed consent; the protection of anonymity and confidentiality; the right to withdraw from research; and ownership of samples. Many participants were in favour of the storage and reuse of samples, but expressed concerns related to data security and potential misuse of samples, particularly by commercial organisations. The sensitivity of tissue collection varied between tissue types and collection contexts. Blood, urine, semen and bowel tissue were commonly identified as sensitive, and donating saliva and as unlikely to cause discomfort. To our knowledge, this is the first in-depth study of gay and bisexual men's attitudes towards donating biosamples for HIV research. While most men in this study were supportive of donating tissue for research, some clear areas of concern were identified. We suggest that these minority concerns should be accounted for to develop inclusive, evidence-informed research protocols that balance collective benefits with individual concerns.

Framing health for land-use planning legislation: A qualitative descriptive content analysis.

PubMed

Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Thow, Anne Marie

2016-01-01

Framing health as a relevant policy issue for other sectors is not well understood. A recent review of the New South Wales (Australia) land-use planning system resulted in the drafting of legislation with an internationally unprecedented focus on human health. We apply a political science approach to investigate the question 'how and to what extent were health and wider issues framed in submissions to the review?' We investigated a range of stakeholder submissions including health focussed agencies (n = 31), purposively identified key stakeholders with influence on the review (n = 24), and a random sample of other agencies and individuals (n = 47). Using qualitative descriptive analysis we inductively coded for the term 'health' and sub-categories. We deductively coded for 'wider concerns' using a locally endorsed 'Healthy Urban Development Checklist'. Additional inductive analysis uncovered further 'wider concerns'. Health was explicitly identified as a relevant issue for planning policy only in submissions by health-focussed agencies. This framing concerned the new planning system promoting and protecting health as well as connecting health to wider planning concerns including economic issues, transport, public open space and, to a slightly lesser extent, environmental sustainability. Key stakeholder and other agency submissions focussed on these and other wider planning concerns but did not mention health in detail. Health agency submissions did not emphasise infrastructure, density or housing as explicitly as others. Framing health as a relevant policy issue has the potential to influence legislative change governing the business of other sectors. Without submissions from health agencies arguing the importance of having health as an objective in the proposed legislation it is unlikely health considerations would have gained prominence in the draft bill. The findings have implications for health agency engagement with legislative change processes and beyond in land use planning. Copyright © 2015 Elsevier Ltd. All rights reserved.

Concerns with AED conversion: comparison of patient and physician perspectives.

PubMed

Smith, Brien J; St Louis, Erik K; Stern, John M; Green, Chad; Bramley, Thomas

2009-06-01

When discussing AED conversion in the clinic, both the patient and physician perspectives on the goals and risks of this change are important to consider. To identify patient-reported and clinician-perceived concerns, a panel of epilepsy specialists was questioned about the topics discussed with patients and the clinician's perspective of patient concerns. Findings of a literature review of articles that report patient-expressed concerns regarding their epilepsy and treatment were also reviewed. Results showed that the specialist panel appropriately identified patient-reported concerns of driving ability, medication cost, seizure control, and medication side effects. Additionally, patient-reported concerns of independence, employment issues, social stigma, medication dependence, and undesirable cognitive effects are important to address when considering and initiating AED conversion.

Neuromodulation research and application in the U.S. Department of Defense.

PubMed

Nelson, Jeremy T; Tepe, Victoria

2015-01-01

Modern neuromodulatory techniques for military applications have been explored for the past decade, with an intent to optimize operator performance and, ultimately, to improve overall military effectiveness. In light of potential military applications, some researchers have voiced concern about national security agency involvement in this area of research, and possible exploitation of research findings to support military objectives. The aim of this article is to examine the U.S. Department of Defense's interest in and application of neuromodulation. We explored articles, cases, and historical context to identify critical considerations of debate concerning dual use (i.e., national security and civilian) technologies, specifically focusing on non-invasive brain stimulation (NIBS). We review the background and recent examples of DoD-sponsored neuromodulation research, framed in the more general context of research that aims to optimize and/or rehabilitate human performance. We propose that concerns about military exploitation of neuromodulatory science and technology are not unique, but rather are part of a larger philosophic debate pertaining to military application of human performance science and technology. We consider unique aspects of the Department of Defense research enterprise--which includes programs crucial to the advancement of military medicine--and why it is well-situated to fund and perform such research. We conclude that debate concerning DoD investment in human performance research must recognize the significant potential for dual use (civilian, medical) benefit as well as the need for civilian scientific insight and influence. Military interests in the health and performance of service members provide research funding and impetus to dual use applications that will benefit the civilian community. Copyright © 2015 Elsevier Inc. All rights reserved.

Research Lasers and Air Traffic Safety: Issues, Concerns and Responsibilities of the Research Community

NASA Technical Reports Server (NTRS)

Nessler, Phillip J., Jr.

1998-01-01

The subject of outdoor use of lasers relative to air traffic has become a diverse and dynamic topic. During the past several decades, the use of lasers in outdoor research activities have increased significantly. Increases in the outdoor use of lasers and increases in air traffic densities have changed the levels of risk involved. To date there have been no documented incidents of air traffic interference from research lasers; however, incidents involving display lasers have shown a marked increase. As a result of the national response to these incidents, new concerns over lasers have arisen. Through the efforts of the SAE G-10T Laser Safety Hazards Subcommittee and the ANSI Z136.6 development committee, potential detrimental effects to air traffic beyond the traditional eye damage concerns have been identified. An increased emphasis from the Federal Aviation Administration (FAA), the Center for Devices and Radiological Hazards (CDRH), and the National Transportation Safety Board (NTSB) along with increased concern by the public have resulted in focused scrutiny of potential hazards presented by lasers. The research community needs to rethink the traditional methods of risk evaluation and application of protective measures. The best current approach to assure adequate protection of air traffic is the application of viable hazard and risk analysis and the use of validated protective measures. Standards making efforts and regulatory development must be supported by the research community to assure that reasonable measures are developed. Without input, standards and regulations can be developed that are not compatible with the needs of the research community. Finally, support is needed for the continued development and validation of protective measures.

Earth based approaches to enhancing the health and safety of space operations

NASA Technical Reports Server (NTRS)

Koller, A. M., Jr.

1985-01-01

This paper provides an overview of the current state of our earth based knowledge of space safety hazards; identification of several key areas of concern for space operations; and proposed approaches to providing technology enhancement and information needed to improve the health and safety to those conducting space operations. Included are a review of the identified hazards for space oeprations by hazard classification; a summarization of the information currently available on space experiences and an assessment of potential hazards for long duration spaceflight; a discussion of potential failure modes and their significance for Space Station work: and an assessment of current work which indicates additional research and experimentation which can only be accomplished in actual space missions.

Food poisoning potential of Bacillus cereus strains from Norwegian dairies.

PubMed

Stenfors Arnesen, Lotte P; O'sullivan, Kristin; Granum, Per Einar

2007-05-10

Characteristics concerning diarrhoeal potential were investigated in B. cereus dairy strains. The thirty-nine strains, isolated from whipping cream, were tested for cytotoxicity after culturing at human body temperature as well as 25 degrees C and 32 degrees C. At 37 degrees C, none of the strains were highly cytotoxic. This observation suggests that those strains should be considered to pose a minor risk with regard to diarrhoeal food poisoning. However, some strains were moderately or highly cytotoxic when grown at 25 degrees C and 32 degrees C. While the majority of the strains were able to grow at refrigeration temperatures, only four B. weihenstephanensis strains were identified among them when subjected to discriminative PCR assays and growth temperatures which delimit this species.

Potential effects of energy development on environmental resources of the Williston Basin in Montana, North Dakota, and South Dakota

USGS Publications Warehouse

Post van der Burg, Max; Vining, Kevin C.; Frankforter, Jill D.

2017-09-28

The Williston Basin, which includes parts of Montana, North Dakota, and South Dakota in the United States, has been a leading domestic oil and gas producing area. To better understand the potential effects of energy development on environmental resources in the Williston Basin, the U.S. Geological Survey, in cooperation with the Bureau of Land Management, and in support of the needs identified by the Bakken Federal Executive Group (consisting of representatives from 13 Federal agencies and Tribal groups), began work to synthesize existing information on science topics to support management decisions related to energy development. This report is divided into four chapters (A–D). Chapter A provides an executive summary of the report and principal findings from chapters B–D. Chapter B provides a brief compilation of information regarding the history of energy development, physiography, climate, land use, demographics, and related studies in the Williston Basin. Chapter C synthesizes current information about water resources, identifies potential effects from energy development, and summarizes water resources research and information needs in the Williston Basin. Chapter D summarizes information about ecosystems, species of conservation concern, and potential effects to those species from energy development in the Williston Basin.

Sex similarities and differences in risk factors for recurrence of major depression.

PubMed

van Loo, Hanna M; Aggen, Steven H; Gardner, Charles O; Kendler, Kenneth S

2017-11-27

Major depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms. We used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences. Recurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems. No prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.

Bond Testing for Effects of Silicone Contamination

NASA Technical Reports Server (NTRS)

Plaia, James; Evans, Kurt

2005-01-01

In 2003 ATK Thiokol discovered that the smocks and coveralls worn by its operations personnel for safety and contamination control were themselves contaminated with a silicone defoamer and a silicone oil. As a growing list of items have been identified as having this form of contamination, it was desirable to devise a test method to determine if the contamination level detected could cause subsequent processing concerns. The smocks and coveralls could potentially contact bonding surfaces during processing so the test method focused on dry transfer of the silicone from the clothing to the bonding surface.

A review of the economic implications of the National Academy of Engineering 1974 study of the potential application of space systems

NASA Technical Reports Server (NTRS)

1975-01-01

User benefits resulting from the application of space systems to previously described application areas were identified, and methods to assign priorities to application areas and to quantify the benefits were described. The following areas were selected for in-depth review: communications, materials processing in space, weather and climate, and institutional arrangements for space applications. Recommendations concerning studies that should be undertaken to develop a more precise understanding of the source and magnitude of the realizable economic benefits were also presented.

A spatial model of potential jaguar habitat in Arizona

USGS Publications Warehouse

Hatten, J.R.; Averill-Murray, A.; van Pelt, W.E.

2005-01-01

The jaguar (Panthera onca) is an endangered species that occasionally visits the southwestern United States from Mexico. The number of jaguar sightings per decade has declined over the last 100 years in Arizona, USA, raising conservation concerns for the species at a local and national level. In 1997, state, federal, and local governments with land-management responsibilities agreed to characterize and identify potential jaguar habitat in Arizona and New Mexico. Specifically, the objectives of our analysis were 2-fold: (1) characterize potential jaguar habitat in Arizona from historic sighting records and (2) create a statewide habitat suitability map. We used a Geographic Information System (GIS) to characterize potential jaguar habitat by overlaying historic jaguar sightings (25) on landscape and habitat features believed important (e.g., vegetation biomes and series, elevation, terrain ruggedness, proximity to perennial or intermittent water sources, human density). The amount of Arizona (%) identified as potential jaguar habitat ranged from 21% to 30% depending on the input variables. Most jaguar sightings were in scrub grasslands between 1,220 and 1,829-m elevation in southeastern Arizona, in intermediately to extremely rugged terrain, and within 10 km of a water source. Conservation efforts should focus on protecting the most suitable jaguar habitat in southeastern Arizona (i.e., Santa Cruz, Pima, Cochise, Pinal, Graham counties), travel corridors within and outside Arizona, and jaguar habitat in the Sierra Madres of Sonora, Mexico.

Updated indicators of Swedish national human toxicity and ecotoxicity footprints using USEtox 2.01

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

Nordborg, Maria, E-mail: maria.nordborg@chalmers.se; Arvidsson, Rickard; Finnveden, Göran

In a recent paper, Sörme et al. (Environ. Impact Assess. Rev., 56, 2016), took a first step towards an indicator of a national chemical footprint, and applied it to Sweden. Using USEtox 1.01, they calculated national impact potentials for human toxicity and ecotoxicity. The results showed that zinc dominated impacts, both for human toxicity and ecotoxicity. We calculated updated indicators of the Swedish national human toxicity and ecotoxicity footprint using USEtox 2.01. We also compared impact potentials based on USEtox with the mass of chemical emissions. The two model versions produced relatively consistent results. Zinc is still a major contributormore » to the human toxicity and ecotoxicity impact potentials when characterized with USEtox 2.01. The mass-based indicator pinpoints somewhat different substances than the impact-based indicators. - Highlights: • USEtox 1.01 and 2.01 are relatively consistent in identifying the substances with largest impact potentials. • Metals were identified as a priority group of substances for both human toxicity and ecotoxicity. • Zinc is a major contributor to the human toxicity impact potential, in both model versions. • Zinc’s dominance concerning human toxicity sharply contrasts results from other studies: this is somewhat of a paradox. • Using the mass of chemical emissions as a simplified indicator pinpoints somewhat different substances.« less

Bilateral childhood visual impairment: child and parent concerns.

PubMed

Liebermann, Laura; Leske, David A; Hatt, Sarah R; Castañeda, Yolanda S; Wernimont, Suzanne M; Cheng-Patel, Christina S; Birch, Eileen E; Holmes, Jonathan M

2017-06-01

To identify specific health-related quality of life and visual function concerns affecting children with bilateral visual impairment as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. A total of 37 children <16 years of age with visual impairment (visual acuity worse than 20/70 in the better eye) and one parent for each child were prospectively enrolled. Semistructured individual interviews were performed with children 5-15 years of age (n = 16) and with one parent for each child (ages 0-15 years, N = 37). Interview transcripts were analyzed using NVivo software. Categories of concern were identified from both child and parent interviews, from which broad themes were identified. The frequencies of the themes and specific categories of concerns were calculated. Regarding the child's experience, categories of concern were grouped into 6 themes: visual function (expressed by 13 of 16 children [81%] and 33 of 37 parents [89%]), treatment (63% and 54%), emotions (50% and 68%), social (50% and 70%), physical discomfort (50% and 22%), and worry (38% and 8%). Concerns expressed regarding the parents' own experience were grouped into 5 themes: worry (100%), compensate-adjust for condition (89%), treatment (84%), emotions (81%), and affects family (46%). Individual interviews identified a wide spectrum of concerns in children with visual impairment and their parents, affecting functional, emotional, social and physical domains. Specific concerns will be used to develop patient-derived questionnaires for quantifying the effects of visual impairment on children and parents in everyday life. Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

MALDI-TOF MS for the Identification of Cultivable Organic-Degrading Bacteria in Contaminated Groundwater near Unconventional Natural Gas Extraction Sites.

PubMed

Santos, Inês C; Martin, Misty S; Carlton, Doug D; Amorim, Catarina L; Castro, Paula M L; Hildenbrand, Zacariah L; Schug, Kevin A

2017-08-10

Groundwater quality and quantity is of extreme importance as it is a source of drinking water in the United States. One major concern has emerged due to the possible contamination of groundwater from unconventional oil and natural gas extraction activities. Recent studies have been performed to understand if these activities are causing groundwater contamination, particularly with respect to exogenous hydrocarbons and volatile organic compounds. The impact of contaminants on microbial ecology is an area to be explored as alternatives for water treatment are necessary. In this work, we identified cultivable organic-degrading bacteria in groundwater in close proximity to unconventional natural gas extraction. Pseudomonas stutzeri and Acinetobacter haemolyticus were identified using matrix-assisted laser desorption/ionization-time-of-flight-mass spectrometry (MALDI-TOF MS), which proved to be a simple, fast, and reliable method. Additionally, the potential use of the identified bacteria in water and/or wastewater bioremediation was studied by determining the ability of these microorganisms to degrade toluene and chloroform. In fact, these bacteria can be potentially applied for in situ bioremediation of contaminated water and wastewater treatment, as they were able to degrade both compounds.

MALDI-TOF MS for the Identification of Cultivable Organic-Degrading Bacteria in Contaminated Groundwater near Unconventional Natural Gas Extraction Sites

PubMed Central

Martin, Misty S.; Carlton, Doug D.; Castro, Paula M. L.; Hildenbrand, Zacariah L.; Schug, Kevin A.

2017-01-01

Groundwater quality and quantity is of extreme importance as it is a source of drinking water in the United States. One major concern has emerged due to the possible contamination of groundwater from unconventional oil and natural gas extraction activities. Recent studies have been performed to understand if these activities are causing groundwater contamination, particularly with respect to exogenous hydrocarbons and volatile organic compounds. The impact of contaminants on microbial ecology is an area to be explored as alternatives for water treatment are necessary. In this work, we identified cultivable organic-degrading bacteria in groundwater in close proximity to unconventional natural gas extraction. Pseudomonas stutzeri and Acinetobacter haemolyticus were identified using matrix-assisted laser desorption/ionization-time-of-flight-mass spectrometry (MALDI-TOF MS), which proved to be a simple, fast, and reliable method. Additionally, the potential use of the identified bacteria in water and/or wastewater bioremediation was studied by determining the ability of these microorganisms to degrade toluene and chloroform. In fact, these bacteria can be potentially applied for in situ bioremediation of contaminated water and wastewater treatment, as they were able to degrade both compounds. PMID:28796186

Prostate: techniques, results, and potential applications of color Doppler US scanning.

PubMed

Rifkin, M D; Sudakoff, G S; Alexander, A A

1993-02-01

Color Doppler ultrasound (US) scanning and conventional endorectal gray-scale US of the prostate were performed in 619 patients. Pathologic correlation was available in all cases after US-guided transrectal biopsy. There were 132 cancers in 121 men, 13 foci of atypia in 10 men, 33 foci of inflammation in 31 men, and 469 benign lesions in 457 men. Two hundred seventy patients with abnormal areas of flow identified at color Doppler scanning also underwent spectral waveform analysis of the area of potential concern. No statistical difference in the mean resistive indexes was identified in any patient (P = .25; Scheffe F test, analysis of variance). All malignant lesions had abnormalities demonstrated at gray-scale US and/or focal or diffuse abnormal flow demonstrated at color Doppler scanning. Of the 132 cancers, 123 (93%) had corresponding gray-scale abnormalities and 114 (86%) demonstrated abnormal flow at color Doppler imaging. Nine of the 132 cancers (7%) had no obviously identifiable abnormality at gray-scale scanning but had distinctly abnormal flow at color Doppler scanning. Abnormal findings at color scanning without abnormal findings at gray-scale scanning occurred in eight of the 33 cases of inflammatory foci (24%) and in 24 of the 469 (5%) benign lesions.

Integrating Public Perspectives in Sample Return Planning

NASA Technical Reports Server (NTRS)

Race, Margaret S.; MacGregor, G.

2001-01-01

Planning for extraterrestrial sample returns, whether from Mars or other solar system bodies, must be done in a way that integrates planetary protection concerns with the usual mission technical and scientific considerations. Understanding and addressing legitimate societal concerns about the possible risks of sample return will be a critical part of the public decision making process ahead. This paper presents the results of two studies, one with lay audiences, the other with expert microbiologists, designed to gather information, on attitudes and concerns about sample return risks and planetary protection. Focus group interviews with lay subjects, using generic information about Mars sample return and a preliminary environmental impact assessment, were designed to obtain an indication of how the factual content is perceived and understood by the public. A research survey of microbiologists gathered information on experts' views and attitudes about sample return, risk management approaches and space exploration risks. These findings, combined with earlier research results on risk perception, will be useful in identifying levels of concern and potential conflicts in understanding between experts and the public about sample return risks. The information will be helpful in guiding development of the environmental impact statement and also has applicability to proposals for sample return from other solar system bodies where scientific uncertainty about extraterrestrial life may persist at the time of mission planning.

Sexual Counseling in Patients With Heart Failure: A Silent Phenomenon: Results From a Convergent Parallel Mixed Method Study.

PubMed

Kolbe, Nina; Kugler, Christiane; Schnepp, Wilfried; Jaarsma, Tiny

2016-01-01

Patients with heart failure (HF) often worry about resuming sexual activity and may need information. Nurses have a role in helping patients to live with the consequences of HF and can be expected to discuss patients' sexual concerns. The aims of this study were to identify whether nurses discuss consequences of HF on sexuality with patients and to explore their perceived role and barriers regarding this topic. A cross-sectional research design with a convergent parallel mixed method approach was used combining qualitative and quantitative data collected with a self-reported questionnaire. Nurses in this study rarely addressed sexual issues with their patients. The nurses did not feel that discussing sexual concerns with their patients was their responsibility, and only 8% of the nurses expressed confidence to do so. The main phenomenon in discussing sexual concerns seems to be "one of silence": Neither patients nor nurses talk about sexual concerns. Factors influencing this include structural barriers, lack of knowledge and communication skills, as well as relevance of the topic and relationship to patients. Cardiac nurses in Germany rarely practice sexual counseling. It is a phenomenon that is silent. Education and skill-based training might hold potential to "break the silence."

Association between congenital toxoplasmosis and parent-reported developmental outcomes, concerns, and impairments, in 3 year old children

PubMed Central

Freeman, Katherine; Salt, Alison; Prusa, Andrea; Malm, Gunilla; Ferret, Nicole; Buffolano, Wilma; Schmidt, Dorthe; Tan, Hooi Kuan; Gilbert, Ruth E

2005-01-01

Background Information is lacking on the effects of congenital toxoplasmosis on development, behavior, and impairment in later childhood, as well as on parental concerns and anxiety. This information is important for counselling parents about the prognosis for an infected child and for policy decisions on screening. Methods We prospectively studied a cohort of children identified by screening for toxoplasmosis in pregnant women or neonates between 1996 and 2000 in ten European centers. At 3 years of age, parents of children with and without congenital toxoplasmosis were surveyed about their child's development, behavior, and impairment, and about parental concerns and anxiety, using a postal questionnaire. Results Parents of 178/223 (80%) infected, and 527/821 (64%) uninfected children responded. We found no evidence that impaired development or behavior were more common in infected children, or that any potential effect of congenital toxoplasmosis was masked by prenatal treatment. Parents of infected children were significantly more anxious and reported more visual problems in their children. Conclusion On average, children aged three to four years with congenital toxoplasmosis identified by screening and treated during infancy in this European setting had risks of abnormal development and behavior similar to uninfected children. Parental anxiety about infected children needs to be addressed by clinicians. Future studies with longer follow up and clinician-administered assessments may be better able to detect any subtle differences in child outcomes. PMID:16014166

A multi-scale spatial approach to address environmental effects of small hydropower development.

PubMed

McManamay, Ryan A; Samu, Nicole; Kao, Shih-Chieh; Bevelhimer, Mark S; Hetrick, Shelaine C

2015-01-01

Hydropower development continues to grow worldwide in developed and developing countries. While the ecological and physical responses to dam construction have been well documented, translating this information into planning for hydropower development is extremely difficult. Very few studies have conducted environmental assessments to guide site-specific or widespread hydropower development. Herein, we propose a spatial approach for estimating environmental effects of hydropower development at multiple scales, as opposed to individual site-by-site assessments (e.g., environmental impact assessment). Because the complex, process-driven effects of future hydropower development may be uncertain or, at best, limited by available information, we invested considerable effort in describing novel approaches to represent environmental concerns using spatial data and in developing the spatial footprint of hydropower infrastructure. We then use two case studies in the US, one at the scale of the conterminous US and another within two adjoining rivers basins, to examine how environmental concerns can be identified and related to areas of varying energy capacity. We use combinations of reserve-design planning and multi-metric ranking to visualize tradeoffs among environmental concerns and potential energy capacity. Spatial frameworks, like the one presented, are not meant to replace more in-depth environmental assessments, but to identify information gaps and measure the sustainability of multi-development scenarios as to inform policy decisions at the basin or national level. Most importantly, the approach should foster discussions among environmental scientists and stakeholders regarding solutions to optimize energy development and environmental sustainability.

Wheelchair cleaning and disinfection in Canadian health care facilities: "That's wheelie gross!".

PubMed

Gardner, Paula; Muller, Matthew P; Prior, Betty; So, Ken; Tooze, Jane; Eum, Linda; Kachur, Oksana

2014-11-01

Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care-associated infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Assessment and application of national environmental databases and mapping tools at the local level to two community case studies.

PubMed

Hammond, Davyda; Conlon, Kathryn; Barzyk, Timothy; Chahine, Teresa; Zartarian, Valerie; Schultz, Brad

2011-03-01

Communities are concerned over pollution levels and seek methods to systematically identify and prioritize the environmental stressors in their communities. Geographic information system (GIS) maps of environmental information can be useful tools for communities in their assessment of environmental-pollution-related risks. Databases and mapping tools that supply community-level estimates of ambient concentrations of hazardous pollutants, risk, and potential health impacts can provide relevant information for communities to understand, identify, and prioritize potential exposures and risk from multiple sources. An assessment of existing databases and mapping tools was conducted as part of this study to explore the utility of publicly available databases, and three of these databases were selected for use in a community-level GIS mapping application. Queried data from the U.S. EPA's National-Scale Air Toxics Assessment, Air Quality System, and National Emissions Inventory were mapped at the appropriate spatial and temporal resolutions for identifying risks of exposure to air pollutants in two communities. The maps combine monitored and model-simulated pollutant and health risk estimates, along with local survey results, to assist communities with the identification of potential exposure sources and pollution hot spots. Findings from this case study analysis will provide information to advance the development of new tools to assist communities with environmental risk assessments and hazard prioritization. © 2010 Society for Risk Analysis.

Monitoring potential adverse event rate differences using data from blinded trials: the canary in the coal mine.

PubMed

Gould, A Lawrence; Wang, William B

2017-01-15

The development of drugs and biologicals whose mechanisms of action may extend beyond their target indications has led to a need to identify unexpected potential toxicities promptly even while blinded clinical trials are under way. One component of recently issued FDA rules regarding safety reporting requirements raises the possibility of breaking the blind for pre-identified serious adverse events that are not the clinical endpoints of a blinded study. Concern has been expressed that unblinding individual cases of frequently occurring adverse events could compromise the overall validity of the study. However, if external information is available about adverse event rates among patients not receiving the test product in populations similar to the study population, then it may be possible to address the potential for elevated risk without unblinding the trial. This article describes a Bayesian approach for determining the likelihood of elevated risk suitable binomial or Poisson likelihoods that applies regardless of the metric used to express the difference. The method appears to be particularly appropriate for routine monitoring of safety information for project development programs that include large blinded trials. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

"I don't want to be Henrietta Lacks": diverse patient perspectives on donating biospecimens for precision medicine research.

PubMed

Lee, Sandra S-J; Cho, Mildred K; Kraft, Stephanie A; Varsava, Nina; Gillespie, Katie; Ormond, Kelly E; Wilfond, Benjamin S; Magnus, David

2018-06-11

To determine whether patients distinguish between biospecimens and electronic health records (EHRs) when considering research participation to inform research protections. We conducted 20 focus groups with individuals who identified as African American, Hispanic, Chinese, South Asian, and non-Hispanic white on the collection of biospecimens and EHR data for research. Our study found that many participants did not distinguish between biospecimens and EHR data. However, some participants identified specific concerns about biospecimens. These included the need for special care and respect for biospecimens due to enduring connections between the body and identity; the potential for unacceptable future research, specifically the prospect of human cloning; heightened privacy risks; and the potential for unjust corporate profiteering. Among those who distinguished biospecimens from EHR data, many supported separate consent processes and would limit their own participation to EHR data. Considering that the potential misuse of EHR data is as great as, if not greater than, for biospecimens, more research is needed to understand how attitudes differ between biospecimens and EHR data across diverse populations. Such research should explore mechanisms beyond consent that can address diverse values, perspectives, and misconceptions about sources of patient information to build trust in research relationships.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Current decision making involves numerous possible combinations of technology elements, safety and health issues, operational aspects and process considerations to satisfy program goals. Identifying potential risk considerations as part of the management decision making process provides additional tools to make more informed management decision. Adapting and using risk assessment methodologies can generate new perspectives on various risk and safety concerns that are not immediately apparent. Safety and operational risks can be identified and final decisions can balance these considerations with cost and schedule risks. Additional assessments can also show likelihood of event occurrence and event consequence to provide a more informed basis for decision making, as well as cost effective mitigation strategies. Methodologies available to perform Risk Assessments range from qualitative identification of risk potential, to detailed assessments where quantitative probabilities are calculated. Methodology used should be based on factors that include: 1) type of industry and industry standards, 2) tasks, tools, and environment 3) type and availability of data and 4) industry views and requirements regarding risk & reliability. Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures.

A needs assessment of unused and expired medication disposal practices: A study from the Medication Safety Research Network of Indiana.

PubMed

Kozak, Mary Ann; Melton, Johnna R; Gernant, Stephanie A; Snyder, Margie E

2016-01-01

Access and availability of unused and expired medication (UEM) due to improper disposal and storage is a serious issue, potentially leading to abuse and environmental concerns. To describe the extent of the UEM issue in Indiana (U.S. State), identify patient beliefs about UEM, and determine any association between those beliefs and various personal/demographic characteristics. A needs assessment was conducted among community pharmacy patients. A convenience sample of 200 patients from 15 community pharmacies that are part of a practice-based research network (PBRN) in Indiana completed a survey concerning UEM beliefs and behaviors from Feb-March, 2014. Approximately 40% of patients were aware of a UEM take-back location in their community, although only 15% had utilized a UEM take-back location. Seventy-seven percent of patients were willing to drive to a take-back location to return UEM. Particularly vulnerable populations lacking knowledge regarding UEM and access to proper disposal were identified. While states have made efforts to increase accessibility for UEM return, there remains a need for more disposal locations for both non-controlled and controlled medication. Copyright © 2016 Elsevier Inc. All rights reserved.

Using Decision Tree Analysis to Understand Foundation Science Student Performance. Insight Gained at One South African University

NASA Astrophysics Data System (ADS)

Kirby, Nicola Frances; Dempster, Edith Roslyn

2014-11-01

The Foundation Programme of the Centre for Science Access at the University of KwaZulu-Natal, South Africa provides access to tertiary science studies to educationally disadvantaged students who do not meet formal faculty entrance requirements. The low number of students proceeding from the programme into mainstream is of concern, particularly given the national imperative to increase participation and levels of performance in tertiary-level science. An attempt was made to understand foundation student performance in a campus of this university, with the view to identifying challenges and opportunities for remediation in the curriculum and processes of selection into the programme. A classification and regression tree analysis was used to identify which variables best described student performance. The explanatory variables included biographical and school-history data, performance in selection tests, and socio-economic data pertaining to their year in the programme. The results illustrate the prognostic reliability of the model used to select students, raise concerns about the inefficiency of school performance indicators as a measure of students' academic potential in the Foundation Programme, and highlight the importance of accommodation arrangements and financial support for student success in their access year.