Efficacy of a virtual assistance-based lifestyle intervention in reducing risk factors for Type 2 diabetes in young employees in the information technology industry in India: LIMIT, a randomized controlled trial.

PubMed

Limaye, T; Kumaran, K; Joglekar, C; Bhat, D; Kulkarni, R; Nanivadekar, A; Yajnik, C

2017-04-01

To investigate a virtual assistance-based lifestyle intervention to reduce risk factors for Type 2 diabetes in young employees in the information technology industry in India. LIMIT (Lifestyle Modification in Information Technology) was a parallel-group, partially blinded, randomized controlled trial. Employees in the information technology industry with ≥3 risk factors (family history of cardiometabolic disease, overweight/obesity, high blood pressure, impaired fasting glucose, hypertriglyceridaemia, high LDL cholesterol and low HDL cholesterol) from two industries were randomized to a control or an intervention (1:1) group. After initial lifestyle advice, the intervention group additionally received reinforcement through mobile phone messages (three per week) and e-mails (two per week) for 1 year. The primary outcome was change in prevalence of overweight/obesity, analysed by intention to treat. Of 437 employees screened (mean age 36.2 ± 9.3 years; 74.8% men), 265 (61.0%) were eligible and randomized into control (n=132) or intervention (n=133) group. After 1 year, the prevalence of overweight/obesity reduced by 6.0% in the intervention group and increased by 6.8% in the control group (risk difference 11.2%; 95% CI 1.2-21.1; P=0.042). There were also significant improvements in lifestyle measurements, waist circumference, and total and LDL cholesterol in the intervention group. The number-needed-to-treat to prevent one case of overweight/obesity in 1 year was 9 (95% CI 5-82), with an incremental cost of INR10665 (£112.30) per case treated/prevented. A total of 98% of participants found the intervention acceptable. A virtual assistance-based lifestyle intervention was effective, cost-effective and acceptable in reducing risk factors for diabetes in young employees in the information technology industry, and is potentially scalable. © 2016 Diabetes UK.

A surety engineering framework to reduce cognitive systems risks.

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

Caudell, Thomas P.; Peercy, David Eugene; Caldera, Eva O.

Cognitive science research investigates the advancement of human cognition and neuroscience capabilities. Addressing risks associated with these advancements can counter potential program failures, legal and ethical issues, constraints to scientific research, and product vulnerabilities. Survey results, focus group discussions, cognitive science experts, and surety researchers concur technical risks exist that could impact cognitive science research in areas such as medicine, privacy, human enhancement, law and policy, military applications, and national security (SAND2006-6895). This SAND report documents a surety engineering framework and a process for identifying cognitive system technical, ethical, legal and societal risks and applying appropriate surety methods to reducemore » such risks. The framework consists of several models: Specification, Design, Evaluation, Risk, and Maturity. Two detailed case studies are included to illustrate the use of the process and framework. Several Appendices provide detailed information on existing cognitive system architectures; ethical, legal, and societal risk research; surety methods and technologies; and educing information research with a case study vignette. The process and framework provide a model for how cognitive systems research and full-scale product development can apply surety engineering to reduce perceived and actual risks.« less

Conventional Reduced Risk Pesticide Program

EPA Pesticide Factsheets

Find out about the Conventional Reduced Risk Pesticide Program, which expedites the review and regulatory decision-making process of conventional pesticides that pose less risk to human health and the environment than existing conventional alternatives.

Reducing security risk using data loss prevention technology.

PubMed

Beeskow, John

2015-11-01

Data loss/leakage protection (DLP) technology seeks to improve data security by answering three fundamental questions: > Where are confidential data stored? > Who is accessing the information? > How are data being handled?

The HTA Risk Analysis Chart: Visualising the Need for and Potential Value of Managed Entry Agreements in Health Technology Assessment.

PubMed

Grimm, Sabine Elisabeth; Strong, Mark; Brennan, Alan; Wailoo, Allan J

2017-12-01

Recent changes to the regulatory landscape of pharmaceuticals may sometimes require reimbursement authorities to issue guidance on technologies that have a less mature evidence base. Decision makers need to be aware of risks associated with such health technology assessment (HTA) decisions and the potential to manage this risk through managed entry agreements (MEAs). This work develops methods for quantifying risk associated with specific MEAs and for clearly communicating this to decision makers. We develop the 'HTA risk analysis chart', in which we present the payer strategy and uncertainty burden (P-SUB) as a measure of overall risk. The P-SUB consists of the payer uncertainty burden (PUB), the risk stemming from decision uncertainty as to which is the truly optimal technology from the relevant set of technologies, and the payer strategy burden (PSB), the additional risk of approving a technology that is not expected to be optimal. We demonstrate the approach using three recent technology appraisals from the UK National Institute for Health and Clinical Excellence (NICE), each of which considered a price-based MEA. The HTA risk analysis chart was calculated using results from standard probabilistic sensitivity analyses. In all three HTAs, the new interventions were associated with substantial risk as measured by the P-SUB. For one of these technologies, the P-SUB was reduced to zero with the proposed price reduction, making this intervention cost effective with near complete certainty. For the other two, the risk reduced substantially with a much reduced PSB and a slightly increased PUB. The HTA risk analysis chart shows the risk that the healthcare payer incurs under unresolved decision uncertainty and when considering recommending a technology that is not expected to be optimal given current evidence. This allows the simultaneous consideration of financial and data-collection MEA schemes in an easily understood format. The use of HTA risk analysis charts will

2017 Emerging Technology Domains Risk Survey

DTIC Science & Technology

2017-10-01

REV-03.18.2016.0 2017 Emerging Technology Domains Risk Survey Daniel Klinedinst Joel Land Kyle O’Meara October 2017 TECHNICAL REPORT CMU/SEI...to the CERT/CC 2016 Emerging Technol- ogy Domains Risk Survey [King 2016]. This list does not supersede previous reports. Many of the previously... Survey [King 2016]. Table 1: New and Emerging Technologies Gartner’s 2015 List of New Technology CERT’s List of Emerging Domains Trust Boundary

A Risk Assessment Model for Reduced Aircraft Separation: A Quantitative Method to Evaluate the Safety of Free Flight

NASA Technical Reports Server (NTRS)

Cassell, Rick; Smith, Alex; Connors, Mary; Wojciech, Jack; Rosekind, Mark R. (Technical Monitor)

1996-01-01

As new technologies and procedures are introduced into the National Airspace System, whether they are intended to improve efficiency, capacity, or safety level, the quantification of potential changes in safety levels is of vital concern. Applications of technology can improve safety levels and allow the reduction of separation standards. An excellent example is the Precision Runway Monitor (PRM). By taking advantage of the surveillance and display advances of PRM, airports can run instrument parallel approaches to runways separated by 3400 feet with the same level of safety as parallel approaches to runways separated by 4300 feet using the standard technology. Despite a wealth of information from flight operations and testing programs, there is no readily quantifiable relationship between numerical safety levels and the separation standards that apply to aircraft on final approach. This paper presents a modeling approach to quantify the risk associated with reducing separation on final approach. Reducing aircraft separation, both laterally and longitudinally, has been the goal of several aviation R&D programs over the past several years. Many of these programs have focused on technological solutions to improve navigation accuracy, surveillance accuracy, aircraft situational awareness, controller situational awareness, and other technical and operational factors that are vital to maintaining flight safety. The risk assessment model relates different types of potential aircraft accidents and incidents and their contribution to overall accident risk. The framework links accident risks to a hierarchy of failsafe mechanisms characterized by procedures and interventions. The model will be used to assess the overall level of safety associated with reducing separation standards and the introduction of new technology and procedures, as envisaged under the Free Flight concept. The model framework can be applied to various aircraft scenarios, including parallel and in

Using Technology To Reduce Public School Violence.

ERIC Educational Resources Information Center

Brown, John A.; Brown, Robert C.; Ledford, Bruce R.

1996-01-01

Describes technology-driven strategies for reducing school violence: (1) commitment communicated by newsletters and cable television; (2) elimination of weapons using metal detectors, surveillance cameras, breathalyzers, student passes, alarm systems, and school emergency plans; (3) two-way communications and low technology; (4) educational…

Methodology for conceptual remote sensing spacecraft technology: insertion analysis balancing performance, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David A.; Duclos, Donald P.; Barrera, Mark J.; Mosher, Todd J.; Lao, Norman Y.

1997-12-01

Emerging technologies and micro-instrumentation are changing the way remote sensing spacecraft missions are developed and implemented. Government agencies responsible for procuring space systems are increasingly requesting analyses to estimate cost, performance and design impacts of advanced technology insertion for both state-of-the-art systems as well as systems to be built 5 to 10 years in the future. Numerous spacecraft technology development programs are being sponsored by Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) agencies with the goal of enhancing spacecraft performance, reducing mass, and reducing cost. However, it is often the case that technology studies, in the interest of maximizing subsystem-level performance and/or mass reduction, do not anticipate synergistic system-level effects. Furthermore, even though technical risks are often identified as one of the largest cost drivers for space systems, many cost/design processes and models ignore effects of cost risk in the interest of quick estimates. To address these issues, the Aerospace Corporation developed a concept analysis methodology and associated software tools. These tools, collectively referred to as the concept analysis and design evaluation toolkit (CADET), facilitate system architecture studies and space system conceptual designs focusing on design heritage, technology selection, and associated effects on cost, risk and performance at the system and subsystem level. CADET allows: (1) quick response to technical design and cost questions; (2) assessment of the cost and performance impacts of existing and new designs/technologies; and (3) estimation of cost uncertainties and risks. These capabilities aid mission designers in determining the configuration of remote sensing missions that meet essential requirements in a cost- effective manner. This paper discuses the development of CADET modules and their application to several remote sensing satellite

Got risk? risk-centric perspective for spacecraft technology decision-making

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Cornford, Steven L.; Moran, Kelly

2004-01-01

A risk-based decision-making methodology conceived and developed at JPL and NASA has been used to aid in decision making for spacecraft technology assessment, adoption, development and operation. It takes a risk-centric perspective, through which risks are used as a reasoning step to interpose between mission objectives and risk mitigation measures.

Reducing Disaster Vulnerability Through Science and Technology

DTIC Science & Technology

2003-07-01

engineering design. Source: “Massive Alaska Earthquake Rocks the Mainland,” Volcano Watch, Hawaiian Volcano Observatory, November 14, 2002, http... volcanoes , and landslides ■ Disease epidemics ■ Technological disasters, including critical infrastructure threats, oil and chemical spills, and building...risk reduction can enhance protection of buildings even in these high-risk areas. Volcanoes The United States is among the most volcanically active

Natural-technological risk assessment and management

NASA Astrophysics Data System (ADS)

Burova, Valentina; Frolova, Nina

2016-04-01

EM-DAT statistical data on human impact and economic damages in the 1st semester 2015 are the highest since 2011: 41% of disasters were floods, responsible for 39% of economic damage and 7% of events were earthquakes responsible for 59% of total death toll. This suggests that disaster risk assessment and management still need to be improved and stay the principle issue in national and international related programs. The paper investigates the risk assessment and management practice in the Russian Federation at different levels. The method is proposed to identify the territories characterized by integrated natural-technological hazard. The maps of the Russian Federation zoning according to the integrated natural-technological hazard level are presented, as well as the procedure of updating the integrated hazard level taking into account the activity of separate processes. Special attention is paid to data bases on past natural and technological processes consequences, which are used for verification of current hazard estimation. The examples of natural-technological risk zoning for the country and some regions territory are presented. Different output risk indexes: both social and economic, are estimated taking into account requirements of end-users. In order to increase the safety of population of the Russian Federation the trans-boundaries hazards are also taken into account.

Exemestane Reduces Breast Cancer Risk in High-Risk Postmenopausal Women

Cancer.gov

Clinical trial results presented at the 2011 ASCO annual meeting showed that the aromatase inhibitor exemestane—used to treat early and advanced breast cancer—substantially reduced the risk of invasive breast cancer in high-risk postmenopausal women.

Managing information technology security risk

NASA Technical Reports Server (NTRS)

Gilliam, David

2003-01-01

Information Technology (IT) Security Risk Management is a critical task for the organization to protect against the loss of confidentiality, integrity and availability of IT resources. As systems bgecome more complex and diverse and and attacks from intrusions and malicious content increase, it is becoming increasingly difficult to manage IT security risk. This paper describes a two-pronged approach in addressing IT security risk and risk management in the organization: 1) an institutional enterprise appraoch, and 2) a project life cycle approach.

Affect and Acceptability: Exploring Teachers' Technology-Related Risk Perceptions

ERIC Educational Resources Information Center

Howard, Sarah K.

2011-01-01

Educational change, such as technology integration, involves risk. Teachers are encouraged to "take risks", but what risks they are asked to take and how do they perceive these risks? Developing an understanding of teachers' technology-related risk perceptions can help explain their choices and behaviours. This paper presents a way to…

Diet components can suppress inflammation and reduce cancer risk.

PubMed

Hardman, W Elaine

2014-06-01

Epidemiology studies indicate that diet or specific dietary components can reduce the risk for cancer, cardiovascular disease and diabetes. An underlying cause of these diseases is chronic inflammation. Dietary components that are beneficial against disease seem to have multiple mechanisms of action and many also have a common mechanism of reducing inflammation, often via the NFκB pathway. Thus, a plant based diet can contain many components that reduce inflammation and can reduce the risk for developing all three of these chronic diseases. We summarize dietary components that have been shown to reduce cancer risk and two studies that show that dietary walnut can reduce cancer growth and development. Part of the mechanism for the anticancer benefit of walnut was by suppressing the activation of NFκB. In this brief review, we focus on reduction of cancer risk by dietary components and the relationship to suppression of inflammation. However, it should be remembered that most dietary components have multiple beneficial mechanisms of action that can be additive and that suppression of chronic inflammation should reduce the risk for all three chronic diseases.

Reducing Preconception Risks Among African American Women with Conversational Agent Technology.

PubMed

Jack, Brian; Bickmore, Timothy; Hempstead, Megan; Yinusa-Nyahkoon, Leanne; Sadikova, Ekaterina; Mitchell, Suzanne; Gardiner, Paula; Adigun, Fatima; Penti, Brian; Schulman, Daniel; Damus, Karla

2015-01-01

Systems and tools are needed to identify and mitigate preconception health (PCH) risks, particularly for African American (AA) women, given persistent health disparities. We developed and tested "Gabby," an online preconception conversational agent system. One hundred nongravid AA women 18-34 years of age were screened for over 100 PCH risks and randomized to the Gabby or control group. The Gabby group interacted with the system for up to six months; the control group received a letter indicating their health risks with a recommendation to talk with their clinician. The numbers, proportions, and types of risks were compared between groups. There were 23.7 (SD 5.9) risks identified per participant. Eighty-five percent (77 of 91) provided 6 month follow up data. The Gabby group had greater reductions in the number (8.3 vs. 5.5 risks, P < .05) and the proportion (27.8% vs 20.5%, P < 0.01) of risks compared to controls. The Gabby group averaged 63.7 minutes of interaction time. Seventy-eight percent reported that it "was easy to talk to Gabby" and 64% used information from Gabby to improve their health. Gabby was significantly associated with preconception risk reduction. More research is needed to determine if Gabby can benefit higher risk populations and if risk reduction is clinically significant. © Copyright 2015 by the American Board of Family Medicine.

Reducing the Risks of Military Aircrew Training through Simulation Technology.

ERIC Educational Resources Information Center

Farrow, Douglas R.

1982-01-01

This discussion of the types of risks associated with military aircrew training and the varieties of training devices and techniques currently utilized to minimize those risks includes an examination of flight trainer simulators and complex mission simulators for coping with military aviation hazards. Four references are listed. (Author/MER)

Diet components can suppress inflammation and reduce cancer risk

PubMed Central

2014-01-01

Epidemiology studies indicate that diet or specific dietary components can reduce the risk for cancer, cardiovascular disease and diabetes. An underlying cause of these diseases is chronic inflammation. Dietary components that are beneficial against disease seem to have multiple mechanisms of action and many also have a common mechanism of reducing inflammation, often via the NFκB pathway. Thus, a plant based diet can contain many components that reduce inflammation and can reduce the risk for developing all three of these chronic diseases. We summarize dietary components that have been shown to reduce cancer risk and two studies that show that dietary walnut can reduce cancer growth and development. Part of the mechanism for the anticancer benefit of walnut was by suppressing the activation of NFκB. In this brief review, we focus on reduction of cancer risk by dietary components and the relationship to suppression of inflammation. However, it should be remembered that most dietary components have multiple beneficial mechanisms of action that can be additive and that suppression of chronic inflammation should reduce the risk for all three chronic diseases. PMID:24944766

Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk.

PubMed

Blalock, Susan J; Gildner, Paula L; Jones, Jennifer L; Bowling, James M; Casteel, Carri H

2016-06-01

To better understand the relationship between perceived risk of falling and awareness and adoption of four specific precautions that older adults have taken to reduce this risk. Cross-sectional. Data were collected in in-person interviews conducted in the homes of study participants. Interviews conducted between March 2011 and September 2013 and lasted an average of 60-90 minutes. A stratified sampling strategy designed to enroll an equal number of homebound and nonhomebound participants was used. All participants (N = 164) were recruited from central North Carolina. Participants were asked about 1-year fall history, perceived risk of falling, restriction of activities because of fear of falling, awareness of four recommended fall prevention behaviors (exercise, annual medication review, bathroom grab bars, safe footwear), and current practice of these behaviors. In bivariate analyses, individuals who were aware of two behaviors recommended to reduce the risk of falling (exercise, use of safe footwear) and had adopted these behaviors perceived their risk of falling as lower than individuals who were aware of the recommended behaviors but had not adopted them. Moreover, in multivariate analyses, individuals who did not know that exercise is recommended to reduce the risk of falling perceived their risk of falling as lower than those who were aware of this recommendation and had adopted it. Individuals were least likely to be aware that medication reviews and exercise are recommended to reduce fall risk. Awareness of behaviors recommended to reduce fall risk appears necessary for adoption of these behaviors to reduce perceived risk. Fall-prevention campaigns should emphasize behaviors where awareness is low. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Does Metformin Reduce Cancer Risks? Methodologic Considerations.

PubMed

Golozar, Asieh; Liu, Shuiqing; Lin, Joeseph A; Peairs, Kimberly; Yeh, Hsin-Chieh

2016-01-01

The substantial burden of cancer and diabetes and the association between the two conditions has been a motivation for researchers to look for targeted strategies that can simultaneously affect both diseases and reduce their overlapping burden. In the absence of randomized clinical trials, researchers have taken advantage of the availability and richness of administrative databases and electronic medical records to investigate the effects of drugs on cancer risk among diabetic individuals. The majority of these studies suggest that metformin could potentially reduce cancer risk. However, the validity of this purported reduction in cancer risk is limited by several methodological flaws either in the study design or in the analysis. Whether metformin use decreases cancer risk relies heavily on the availability of valid data sources with complete information on confounders, accurate assessment of drug use, appropriate study design, and robust analytical techniques. The majority of the observational studies assessing the association between metformin and cancer risk suffer from methodological shortcomings and efforts to address these issues have been incomplete. Future investigations on the association between metformin and cancer risk should clearly address the methodological issues due to confounding by indication, prevalent user bias, and time-related biases. Although the proposed strategies do not guarantee a bias-free estimate for the association between metformin and cancer, they will reduce synthesis of and reporting of erroneous results.

Nanotechnology risk perceptions and communication: emerging technologies, emerging challenges.

PubMed

Pidgeon, Nick; Harthorn, Barbara; Satterfield, Terre

2011-11-01

Nanotechnology involves the fabrication, manipulation, and control of materials at the atomic level and may also bring novel uncertainties and risks. Potential parallels with other controversial technologies mean there is a need to develop a comprehensive understanding of processes of public perception of nanotechnology uncertainties, risks, and benefits, alongside related communication issues. Study of perceptions, at so early a stage in the development trajectory of a technology, is probably unique in the risk perception and communication field. As such it also brings new methodological and conceptual challenges. These include: dealing with the inherent diversity of the nanotechnology field itself; the unfamiliar and intangible nature of the concept, with few analogies to anchor mental models or risk perceptions; and the ethical and value questions underlying many nanotechnology debates. Utilizing the lens of social amplification of risk, and drawing upon the various contributions to this special issue of Risk Analysis on Nanotechnology Risk Perceptions and Communication, nanotechnology may at present be an attenuated hazard. The generic idea of "upstream public engagement" for emerging technologies such as nanotechnology is also discussed, alongside its importance for future work with emerging technologies in the risk communication field. © 2011 Society for Risk Analysis.

Engaging At-Risk Students with Technology.

ERIC Educational Resources Information Center

Duttweiler, Patricia Cloud

1992-01-01

Educational technology can be used to engage students in interesting activities through which teachers can present skills, concepts, and problems to be solved. At-risk students benefit from the investigation of relevant real world problems and the immediate feedback and privacy that technology affords. (EA)

Development of a Risk-Based Comparison Methodology of Carbon Capture Technologies

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

Engel, David W.; Dalton, Angela C.; Dale, Crystal

2014-06-01

Given the varying degrees of maturity among existing carbon capture (CC) technology alternatives, an understanding of the inherent technical and financial risk and uncertainty associated with these competing technologies is requisite to the success of carbon capture as a viable solution to the greenhouse gas emission challenge. The availability of tools and capabilities to conduct rigorous, risk–based technology comparisons is thus highly desirable for directing valuable resources toward the technology option(s) with a high return on investment, superior carbon capture performance, and minimum risk. To address this research need, we introduce a novel risk-based technology comparison method supported by anmore » integrated multi-domain risk model set to estimate risks related to technological maturity, technical performance, and profitability. Through a comparison between solid sorbent and liquid solvent systems, we illustrate the feasibility of estimating risk and quantifying uncertainty in a single domain (modular analytical capability) as well as across multiple risk dimensions (coupled analytical capability) for comparison. This method brings technological maturity and performance to bear on profitability projections, and carries risk and uncertainty modeling across domains via inter-model sharing of parameters, distributions, and input/output. The integration of the models facilitates multidimensional technology comparisons within a common probabilistic risk analysis framework. This approach and model set can equip potential technology adopters with the necessary computational capabilities to make risk-informed decisions about CC technology investment. The method and modeling effort can also be extended to other industries where robust tools and analytical capabilities are currently lacking for evaluating nascent technologies.« less

Screening Methodologies to Support Risk and Technology ...

EPA Pesticide Factsheets

The Clean Air Act establishes a two-stage regulatory process for addressing emissions of hazardous air pollutants (HAPs) from stationary sources. In the first stage, the Act requires the EPA to develop technology-based standards for categories of industrial sources. We have largely completed the required “Maximum Achievable Control Technology” (MACT) standards. In the second stage of the regulatory process, EPA must review each MACT standard at least every eight years and revise them as necessary, “taking into account developments in practices, processes and control technologies.” We call this requirement the “technology review.” EPA is also required to complete a one-time assessment of the health and environmental risks that remain after sources come into compliance with MACT. This residual risk review also must be done within 8 years of setting the initial MACT standard. If additional risk reductions are necessary to protect public health with an ample margin of safety or to prevent adverse environmental effects, EPA must develop standards to address these remaining risks. Because the risk review is an important component of the RTR process, EPA is seeking SAB input on the scientific credibility of specific enhancements made to our risk assessment methodologies, particularly with respect to screening methodologies, since the last SAB review was completed in 2010. These enhancements to our risk methodologies are outlined in the document title

Effective Strategies to Reduce High Risk Drinking among College Students and Residents in an Urban Environment

ERIC Educational Resources Information Center

Brinkley, Marsha; Zeigler, Donald W.

2007-01-01

An urban American university, Georgia Institute of Technology, established a campus-community coalition to reduce high risk drinking, its harms and second-hand effects among university students and residents of the Atlanta community. The Atlanta-based institution was part of a ten-year, ten-university project, A Matter of Degree (AMOD),…

Risk analysis and technology assessment in support of technology development: Putting responsible innovation in practice in a case study for nanotechnology.

PubMed

van Wezel, Annemarie P; van Lente, Harro; van de Sandt, Johannes Jm; Bouwmeester, Hans; Vandeberg, Rens Lj; Sips, Adrienne Jam

2018-01-01

Governments invest in "key enabling technologies," such as nanotechnology, to solve societal challenges and boost the economy. At the same time, governmental agencies demand risk reduction to prohibit any often unknown adverse effects, and industrial parties demand smart approaches to reduce uncertainties. Responsible research and innovation (RRI) is therefore a central theme in policy making. Risk analysis and technology assessment, together referred to as "RATA," can provide a basis to assess human, environmental, and societal risks of new technological developments during the various stages of technological development. This assessment can help both governmental authorities and innovative industry to move forward in a sustainable manner. Here we describe the developed procedures and products and our experiences to bring RATA in practice within a large Dutch nanotechnology consortium. This is an example of how to put responsible innovation in practice as an integrated part of a research program, how to increase awareness of RATA, and how to help technology developers perform and use RATA. Integr Environ Assess Manag 2018;14:9-16. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Reducing cancer risk in rural communities through supermarket interventions.

PubMed

McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M

2013-09-01

Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.

REDUCING CHILDREN'S RISK FROM LEAD IN SOIL

EPA Science Inventory

Traditional methods for reducing risk from elevated levels of soil Pb involves removal, covering, or dilution by mixing with uncontaminated soil. Believing that in situ remediation techniques are viable alternatives, the EPA=s National Risk Management Research Laboratory (NRMRL) ...

Comparative risk analysis of technological hazards (a review).

PubMed Central

Kates, R W; Kasperson, J X

1983-01-01

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

Reducing drinking water supply chemical contamination: risks from underground storage tanks.

PubMed

Enander, Richard T; Hanumara, R Choudary; Kobayashi, Hisanori; Gagnon, Ronald N; Park, Eugene; Vallot, Christopher; Genovesi, Richard

2012-12-01

Drinking water supplies are at risk of contamination from a variety of physical, chemical, and biological sources. Ranked among these threats are hazardous material releases from leaking or improperly managed underground storage tanks located at municipal, commercial, and industrial facilities. To reduce human health and environmental risks associated with the subsurface storage of hazardous materials, government agencies have taken a variety of legislative and regulatory actions--which date back more than 25 years and include the establishment of rigorous equipment/technology/operational requirements and facility-by-facility inspection and enforcement programs. Given a history of more than 470,000 underground storage tank releases nationwide, the U.S. Environmental Protection Agency continues to report that 7,300 new leaks were found in federal fiscal year 2008, while nearly 103,000 old leaks remain to be cleaned up. In this article, we report on an alternate evidence-based intervention approach for reducing potential releases from the storage of petroleum products (gasoline, diesel, kerosene, heating/fuel oil, and waste oil) in underground tanks at commercial facilities located in Rhode Island. The objective of this study was to evaluate whether a new regulatory model can be used as a cost-effective alternative to traditional facility-by-facility inspection and enforcement programs for underground storage tanks. We conclude that the alternative model, using an emphasis on technical assistance tools, can produce measurable improvements in compliance performance, is a cost-effective adjunct to traditional facility-by-facility inspection and enforcement programs, and has the potential to allow regulatory agencies to decrease their frequency of inspections among low risk facilities without sacrificing compliance performance or increasing public health risks. © 2012 Society for Risk Analysis.

Risk assessing study for Bio-CCS technology

NASA Astrophysics Data System (ADS)

Tanaka, A.; Sakamoto, Y.; Kano, Y.; Higashino, H.; Suzumura, M.; Tosha, T.; Nakao, S.; Komai, T.

2013-12-01

We have started a new R&D project titled 'Energy resources creation by geo-microbes and CCS'. It is new concept of a technology which cultivate methanogenic geo-microbes in reservoirs of geological CCS conditions to produce methane gas effectively and safely. As one of feasibility studies, we are evaluating risks around its new Bio-CCS technology. Our consideration involves risk scenarios about Bio-CCS in geological strata, marine environment, surface facilities, ambient air and injection sites. To cover risk scenarios in these areas, we are carrying out a sub-project with five sub-themes. Four sub-themes out of five are researches for identifying risk scenarios: A) Underground strata and injection well, B) Ambient air, C) Surface facilities and D) Seabed. We are developing risk assessment tool,named GERAS-CO2GS (Geo-environmental Risk Assessment System,CO2 Geological Storage Risk Assessment System. We are going to combine identified risk scenarios into GERAS-CO2GS accordingly. It is expected that new GERAS-CO2GS will contribute to risk assessment and management for not only Bio-CCS but also individual injection sites, and facilitate under standing of risks among legislators and concerned peoples around injection site.

Nutritional strategies to reduce falls risk in older people.

PubMed

Nash, Louise; Bergin, Nick

2018-03-23

A literature review found an association between increased falls risk and malnutrition, sarcopenia, vitamin D deficiency and dehydration. Strategies to identify, prevent and treat these conditions can help to reduce falls risk in at-risk groups such as frail, older people. Nurses can reduce falls risk in older people by raising awareness of risk factors and embedding nutritional strategies in local falls reduction strategies. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

New Technologies for Reducing Aviation Weather-Related Accidents

NASA Technical Reports Server (NTRS)

Stough, H. Paul, III; Watson, James F., III; Jarrell, Michael A.

2006-01-01

The National Aeronautics and Space Administration (NASA) has developed technologies to reduce aviation weather-related accidents. New technologies are presented for data-link and display of weather information to aircraft in flight, for detection of turbulence ahead of aircraft in flight, and for automated insitu reporting of atmospheric conditions from aircraft.

A methodology for spacecraft technology insertion analysis balancing benefit, cost, and risk

NASA Astrophysics Data System (ADS)

Bearden, David Allen

Emerging technologies are changing the way space missions are developed and implemented. Technology development programs are proceeding with the goal of enhancing spacecraft performance and reducing mass and cost. However, it is often the case that technology insertion assessment activities, in the interest of maximizing performance and/or mass reduction, do not consider synergistic system-level effects. Furthermore, even though technical risks are often identified as a large cost and schedule driver, many design processes ignore effects of cost and schedule uncertainty. This research is based on the hypothesis that technology selection is a problem of balancing interrelated (and potentially competing) objectives. Current spacecraft technology selection approaches are summarized, and a Methodology for Evaluating and Ranking Insertion of Technology (MERIT) that expands on these practices to attack otherwise unsolved problems is demonstrated. MERIT combines the modern techniques of technology maturity measures, parametric models, genetic algorithms, and risk assessment (cost and schedule) in a unique manner to resolve very difficult issues including: user-generated uncertainty, relationships between cost/schedule and complexity, and technology "portfolio" management. While the methodology is sufficiently generic that it may in theory be applied to a number of technology insertion problems, this research focuses on application to the specific case of small (<500 kg) satellite design. Small satellite missions are of particular interest because they are often developed under rigid programmatic (cost and schedule) constraints and are motivated to introduce advanced technologies into the design. MERIT is demonstrated for programs procured under varying conditions and constraints such as stringent performance goals, not-to-exceed costs, or hard schedule requirements. MERIT'S contributions to the engineering community are its: unique coupling of the aspects of performance

Technology Development Risk Assessment for Space Transportation Systems

NASA Technical Reports Server (NTRS)

Mathias, Donovan L.; Godsell, Aga M.; Go, Susie

2006-01-01

A new approach for assessing development risk associated with technology development projects is presented. The method represents technology evolution in terms of sector-specific discrete development stages. A Monte Carlo simulation is used to generate development probability distributions based on statistical models of the discrete transitions. Development risk is derived from the resulting probability distributions and specific program requirements. Two sample cases are discussed to illustrate the approach, a single rocket engine development and a three-technology space transportation portfolio.

Towards a Framework for Managing Risk Associated with Technology-Induced Error.

PubMed

Borycki, Elizabeth M; Kushniruk, Andre W

2017-01-01

Health information technologies (HIT) promised to streamline and modernize healthcare processes. However, a growing body of research has indicated that if such technologies are not designed, implemented or maintained properly this may lead to an increased incidence of new types of errors which the authors have referred to as "technology-induced errors". In this paper, framework is presented that can be used to manage HIT risk. The framework considers the reduction of technology-induced errors at different stages by managing risks associated with the implementation of HIT. Frameworks that allow health information technology managers to employ proactive and preventative approaches that can be used to manage the risks associated with technology-induced errors are critical to improving HIT safety and managing risk associated with implementing new technologies.

Using computer, mobile and wearable technology enhanced interventions to reduce sedentary behaviour: a systematic review and meta-analysis.

PubMed

Stephenson, Aoife; McDonough, Suzanne M; Murphy, Marie H; Nugent, Chris D; Mair, Jacqueline L

2017-08-11

High levels of sedentary behaviour (SB) are associated with negative health consequences. Technology enhanced solutions such as mobile applications, activity monitors, prompting software, texts, emails and websites are being harnessed to reduce SB. The aim of this paper is to evaluate the effectiveness of such technology enhanced interventions aimed at reducing SB in healthy adults and to examine the behaviour change techniques (BCTs) used. Five electronic databases were searched to identify randomised-controlled trials (RCTs), published up to June 2016. Interventions using computer, mobile or wearable technologies to facilitate a reduction in SB, using a measure of sedentary time as an outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Collaboration's tool and interventions were coded using the BCT Taxonomy (v1). Meta-analysis of 15/17 RCTs suggested that computer, mobile and wearable technology tools resulted in a mean reduction of -41.28 min per day (min/day) of sitting time (95% CI -60.99, -21.58, I2 = 77%, n = 1402), in favour of the intervention group at end point follow-up. The pooled effects showed mean reductions at short (≤ 3 months), medium (>3 to 6 months), and long-term follow-up (>6 months) of -42.42 min/day, -37.23 min/day and -1.65 min/day, respectively. Overall, 16/17 studies were deemed as having a high or unclear risk of bias, and 1/17 was judged to be at a low risk of bias. A total of 46 BCTs (14 unique) were coded for the computer, mobile and wearable components of the interventions. The most frequently coded were "prompts and cues", "self-monitoring of behaviour", "social support (unspecified)" and "goal setting (behaviour)". Interventions using computer, mobile and wearable technologies can be effective in reducing SB. Effectiveness appeared most prominent in the short-term and lessened over time. A range of BCTs have been implemented in these interventions. Future studies need to improve reporting

NASA Technology Evaluation for Environmental Risk Mitigation Remediation Technology Collaboration Development

NASA Technical Reports Server (NTRS)

Romeo, James

2013-01-01

NASA is committed to finding solutions to agency cleanup problems that are better, cheaper, and more effective than the status quo. Unfortunately, some potential solutions involve innovative technologies for which NASA remediation managers may not have a high level of understanding or confidence. Since 2004, NASA's Stennis Space Center (SSC) in Mississippi has been pumping groundwater contaminated with trichloroethylene (TCE) and other halogenated volatile organic compounds (HVOC) from their cleanup location designated "Area G" through extraction wells to an aboveground treatment system. Over time, however, the effectiveness of this treatment strategy has diminished and an alternative approach is needed. In 2012, professionals from NASA's Principal Center for Technology Evaluation for Environmental Risk Mitigation (TEERM) introduced SSC managers to an innovative technology for enhancing the performance of SSC's existing pump and treat system. The technology, generally referred to as in situ chemical oxidation (ISCO), involves slowly and continuously injecting a strong but safe chemical oxidant into the groundwater. Treatment is enhanced by a "surfactant-type effect" which causes residual contamination from saturated soil to be released into the dissolved-phase where it can be readily oxidized. Any dissolved-phase contamination that was not oxidized can be collected by the extraction well network and treated aboveground. SSC was not familiar with the technology so to increase their confidence, TEERM identified a contractor who was willing to demonstrate their product and process at a significantly reduced price. An initial, small-scale demonstration of ISCO began at sse in March 2012 and completed in August 2012. This successful demonstration was followed by three larger-scale ISCO demonstrations between August and December 2012. The contractor's innovative Continuous Injection System (CIS) incorporated "green" and sustainable technologies and practices. A slow

Colonoscopy Reduces Risk of Death from Colorectal Cancer in High-Risk Patients

Cancer.gov

Long-term results from the National Polyp Study confirm that removing precancerous adenomas not only reduces the risk of colorectal cancer but also reduces the number of deaths from the disease by more than half.

Breastfeeding Reduces Childhood Obesity Risks.

PubMed

Wang, Liang; Collins, Candice; Ratliff, Melanie; Xie, Bin; Wang, Youfa

2017-06-01

The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.

Model of areas for identifying risks influencing the compliance of technological processes and products

NASA Astrophysics Data System (ADS)

Misztal, A.; Belu, N.

2016-08-01

Operation of every company is associated with the risk of interfering with proper performance of its fundamental processes. This risk is associated with various internal areas of the company, as well as the environment in which it operates. From the point of view of ensuring compliance of the course of specific technological processes and, consequently, product conformity with requirements, it is important to identify these threats and eliminate or reduce the risk of their occurrence. The purpose of this article is to present a model of areas of identifying risk affecting the compliance of processes and products, which is based on multiregional targeted monitoring of typical places of interference and risk management methods. The model is based on the verification of risk analyses carried out in small and medium-sized manufacturing companies in various industries..

BBN-Based Portfolio Risk Assessment for NASA Technology R&D Outcome

NASA Technical Reports Server (NTRS)

Geuther, Steven C.; Shih, Ann T.

2016-01-01

The NASA Aeronautics Research Mission Directorate (ARMD) vision falls into six strategic thrusts that are aimed to support the challenges of the Next Generation Air Transportation System (NextGen). In order to achieve the goals of the ARMD vision, the Airspace Operations and Safety Program (AOSP) is committed to developing and delivering new technologies. To meet the dual challenges of constrained resources and timely technology delivery, program portfolio risk assessment is critical for communication and decision-making. This paper describes how Bayesian Belief Network (BBN) is applied to assess the probability of a technology meeting the expected outcome. The network takes into account the different risk factors of technology development and implementation phases. The use of BBNs allows for all technologies of projects in a program portfolio to be separately examined and compared. In addition, the technology interaction effects are modeled through the application of object-oriented BBNs. The paper discusses the development of simplified project risk BBNs and presents various risk results. The results presented include the probability of project risks not meeting success criteria, the risk drivers under uncertainty via sensitivity analysis, and what-if analysis. Finally, the paper shows how program portfolio risk can be assessed using risk results from BBNs of projects in the portfolio.

Technology Opportunities to Reduce U.S. Greenhouse Gas Emissions

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

National Lab Directors, . .

2001-04-05

The rise in greenhouse gas emissions from fossil fuel combustion and industrial and agricultural activities has aroused international concern about the possible impacts of these emissions on climate. Greenhouse gases--mostly carbon dioxide, some methane, nitrous oxide and other trace gases--are emitted to the atmosphere, enhancing an effect in which heat reflected from the earth's surface is kept from escaping into space, as in a greenhouse. Thus, there is concern that the earth's surface temperature may rise enough to cause global climate change. Approximately 90% of U.S. greenhouse gas emissions from anthropogenic sources come from energy production and use, most ofmore » which are a byproduct of the combustion of fossil fuels. On a per capita basis, the United States is one of the world's largest sources of greenhouse gas emissions, comprising 4% of the world's population, yet emitting 23% of the world's greenhouse gases. Emissions in the United States are increasing at around 1.2% annually, and the Energy Information Administration forecasts that emissions levels will continue to increase at this rate in the years ahead if we proceed down the business-as-usual path. President Clinton has presented a two-part challenge for the United States: reduce greenhouse gas emissions and grow the economy. Meeting the challenge will mean that in doing tomorrow's work, we must use energy more efficiently and emit less carbon for the energy expended than we do today. To accomplish these goals, President Clinton proposed on June 26, 1997, that the United States ''invest more in the technologies of the future''. In this report to Secretary of Energy Pena, 47 technology pathways are described that have significant potential to reduce carbon dioxide emissions. The present study was completed before the December 1997 United Nations Framework Convention on Climate Change and is intended to provide a basis to evaluate technology feasibility and options to reduce greenhouse gas

Distracted Walking, Bicycling, and Driving: Systematic Review and Meta-Analysis of Mobile Technology and Youth Crash Risk.

PubMed

Stavrinos, Despina; Pope, Caitlin N; Shen, Jiabin; Schwebel, David C

2018-01-01

This article examined the impact of mobile technology on young pedestrians, bicyclists, and drivers. A systematic search yielded 41 articles meeting inclusion criteria: peer-reviewed, published before February 1, 2016, behavioral outcome related to pedestrian, bicycling, or driving in the presence of mobile technology use, youth sample. Eleven studies were meta-analyzed to evaluate increased risk for crash/near-crash while distracted. Risk of bias and quality of research were assessed. Across methodologies, developmental stages, and type of distracting task, mobile technology use impairs youth safety on the road. Quality of evidence was low (pedestrian) to moderate (driving). Findings are discussed from the perspective of cognitive and visual distractions. Policy and behavioral efforts should continue to reduce mobile technology use in transportation settings. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

A lifestyle intervention supported by mobile health technologies to improve the cardiometabolic risk profile of individuals at risk for cardiovascular disease and type 2 diabetes: study rationale and protocol.

PubMed

Stuckey, Melanie I; Shapiro, Sheree; Gill, Dawn P; Petrella, Robert J

2013-11-07

Metabolic syndrome is a cluster of cardiovascular risk factors that greatly increase the risk of developing cardiovascular disease and type 2 diabetes. Regular exercise improves the risk profile, but most people do not successfully change their exercise habits to beneficially reduce risk. Tailored exercise prescribed by a family physician has shown promise as a means to increase fitness and reduce cardiometabolic risk, but optimal implementation practices remain unknown. Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes. These technologies may address the limited access to health interventions in rural and remote regions. However, the potential as a tool to support exercise-based prevention activities is not well understood. This study was undertaken to investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve metabolic syndrome and related cardiometabolic risk factors in rural community-dwelling adults at risk for cardiovascular disease and type 2 diabetes. Adults (n = 149) with at least two metabolic syndrome risk factors were recruited from rural communities and randomized to either: 1) an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application; or 2) an active control group receiving only an exercise prescription. All participants reported to the research centre at baseline, and at 12-, 24- and 52-week follow-up visits for measurement of anthropometrics and blood pressure and for a blood draw to test blood-borne markers of cardiometabolic health. Vascular and autonomic function were examined. Fitness was assessed and exercise prescribed according to the Step Test and Exercise Prescription protocol. This study tested the effects of a prescriptive exercise intervention alone, versus one supported

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

NASA Astrophysics Data System (ADS)

Jaster, Jeffrey F.

2006-05-01

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

The use of technology to address patterns of risk among teenage drivers.

PubMed

Brovold, Shawn; Ward, Nic; Donath, Max; Simon, Stephen; Shankwitz, Craig; Creaser, Janet

2007-01-01

The crash risk of teens is high, with fatal crash rates of teen drivers higher than any other age group. New approaches to reduce teen traffic fatalities are clearly needed. A possible approach to reduce the incidence of teen driver crashes and fatalities is through the use of vehicle-based intelligent driver support systems. To be most effective, the system should address the behaviors associated with an overwhelming number of teen fatal crashes: speed, low seatbelt use, and alcohol impairment. In-vehicle technology also offers an opportunity to address the issue of inexperience through enforcement of certain Graduated Driver's License provisions. To fully understand the capability of such technologies, there should be a concerted effort to further their development, and human factors testing should take place to understand their effects on the driver. If successfully implemented, a Teen Driver Support System (TDSS), such as the one described here, could significantly decrease the number of teens killed in traffic crashes.

Financial incentives for reducing proliferation risks

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

Weise, Rachel A.; Hund, Gretchen

This article submitted for publication to the Bulletin of Atomic Scientists explains the possible financial incentives for financial institutions and large integrators to reduce nuclear proliferation risks by including anti-proliferation measures in their due diligence and requiring their suppliers to meet heightened compliance standards. Because manufacturers of dual-use nuclear goods are diverse and numerous outreach is difficult. However, financial institutions and large integrators work with nearly all dual-use manufacturers, making financial institutions and integrators well-positioned to increase awareness of proliferation and trafficking risks throughout the nuclear supply chain

Minimal support technology and in situ resource utilization for risk management of planetary spaceflight missions

NASA Astrophysics Data System (ADS)

Murphy, K. L.; Rygalov, V. Ye.; Johnson, S. B.

2009-04-01

All artificial systems and components in space degrade at higher rates than on Earth, depending in part on environmental conditions, design approach, assembly technologies, and the materials used. This degradation involves not only the hardware and software systems but the humans that interact with those systems. All technological functions and systems can be expressed through functional dependence: [Function]˜[ERU]∗[RUIS]∗[ISR]/[DR];where [ERU]efficiency (rate) of environmental resource utilization[RUIS]resource utilization infrastructure[ISR]in situ resources[DR]degradation rateThe limited resources of spaceflight and open space for autonomous missions require a high reliability (maximum possible, approaching 100%) for system functioning and operation, and must minimize the rate of any system degradation. To date, only a continuous human presence with a system in the spaceflight environment can absolutely mitigate those degradations. This mitigation is based on environmental amelioration for both the technology systems, as repair of data and spare parts, and the humans, as exercise and psychological support. Such maintenance now requires huge infrastructures, including research and development complexes and management agencies, which currently cannot move beyond the Earth. When considering what is required to move manned spaceflight from near Earth stations to remote locations such as Mars, what are the minimal technologies and infrastructures necessary for autonomous restoration of a degrading system in space? In all of the known system factors of a mission to Mars that reduce the mass load, increase the reliability, and reduce the mission’s overall risk, the current common denominator is the use of undeveloped or untested technologies. None of the technologies required to significantly reduce the risk for critical systems are currently available at acceptable readiness levels. Long term interplanetary missions require that space programs produce a craft

Periodontal disease with treatment reduces subsequent cancer risks.

PubMed

Hwang, Ing-Ming; Sun, Li-Min; Lin, Cheng-Li; Lee, Chun-Feng; Kao, Chia-Hung

2014-10-01

The aim of our study was to evaluate the relationship between routine treatment of periodontal disease (PD) and the subsequent risks for cancers in Taiwan. Study participants were selected from the Taiwan National Health Insurance (NHI) system database. The PD with a routine treatment cohort contained 38 902 patients. For each treatment cohort participant, two age- and sex-matched comparison (control) cohort participants were randomly selected. Cox's proportional hazards regression analysis was used to estimate the effects of PD with treatment on the subsequent risk of cancer. The overall risk of developing cancer was significantly lower in the treatment cohort than in the patients without treatment (adjusted Hazard ratio = 0.72, 95% confidence interval = 0.68-0.76). The risks of developing most gastrointestinal tract, lung, gynecological and brain malignancies were significantly lower in the treatment cohort than in the comparison cohort. In contrast, the risks of prostate and thyroid cancers were significantly higher in the treatment cohort than in the comparison cohort. Our findings suggest that PD with treatment is associated with a significantly reduced overall risk of cancer and reduced risks of certain types of cancers. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reducing Pesticide Drift

EPA Pesticide Factsheets

Provides information about pesticide spray drift, including problems associated with drift, managing risks from drift and the voluntary Drift Reduction Technology program that seeks to reduce spray drift through improved spray equipment design.

Improving performance of HVAC systems to reduce exposure to aerosolized infectious agents in buildings; recommendations to reduce risks posed by biological attacks.

PubMed

Hitchcock, Penny J; Mair, Michael; Inglesby, Thomas V; Gross, Jonathan; Henderson, D A; O'Toole, Tara; Ahern-Seronde, Joa; Bahnfleth, William P; Brennan, Terry; Burroughs, H E Barney; Davidson, Cliff; Delp, William; Ensor, David S; Gomory, Ralph; Olsiewski, Paula; Samet, Jonathan M; Smith, William M; Streifel, Andrew J; White, Ronald H; Woods, James E

2006-01-01

The prospect of biological attacks is a growing strategic threat. Covert aerosol attacks inside a building are of particular concern. In the summer of 2005, the Center for Biosecurity of the University of Pittsburgh Medical Center convened a Working Group to determine what steps could be taken to reduce the risk of exposure of building occupants after an aerosol release of a biological weapon. The Working Group was composed of subject matter experts in air filtration, building ventilation and pressurization, air conditioning and air distribution, biosecurity, building design and operation, building decontamination and restoration, economics, medicine, public health, and public policy. The group focused on functions of the heating, ventilation, and air conditioning systems in commercial or public buildings that could reduce the risk of exposure to deleterious aerosols following biological attacks. The Working Group's recommendations for building owners are based on the use of currently available, off-the-shelf technologies. These recommendations are modest in expense and could be implemented immediately. It is also the Working Group's judgment that the commitment and stewardship of a lead government agency is essential to secure the necessary financial and human resources and to plan and build a comprehensive, effective program to reduce exposure to aerosolized infectious agents in buildings.

Risk-reducing Surgery in Women at Risk for Familial Breast or Ovarian Cancer

PubMed Central

Rhiem, K.; Pfeifer, K.; Schmutzler, R. K.; Kiechle, M.

2012-01-01

An estimated 5 % of breast cancers and 10 % of ovarian cancers may be due to inherited autosomal dominant breast and ovarian cancer alleles BRCA1 und BRCA2. According to population-based studies 1 or 2 women per 1000 carry such a risk allele. The cumulative cancer risk for healthy women with a BRCA-mutation is between 60 and 85 % for breast cancer and between 20 and 60 % for ovarian cancer. Recent studies have reported an increased risk for contralateral breast cancer in women after unilateral breast cancer. Since 1997 the German Cancer Aid has supported an interdisciplinary approach for high-risk women consisting of genetic testing, counselling and prevention in 12 specialised centres. Since 2005 this concept has received additional support from health insurance companies, and results have been assessed with regard to outcomes (e.g. reduced mortality due to more intensive early diagnosis). The number of centres has increased to 15 at various university hospitals. These interdisciplinary centres offer women the opportunity to participate in a structured screening programme for the early diagnosis of breast cancer and provide non-directive counselling on the options for risk-reducing surgery, e.g., prophylactic bilateral salpingo-oophorectomy, prophylactic bilateral mastectomy or contralateral prophylactic mastectomy after unilateral breast cancer. Such surgical interventions can significantly reduce the risk of disease, the respective disease-specific mortality and – particularly prophylactic bilateral salpingo-oophorectomy – total mortality in BRCA-mutation carriers. PMID:26640291

Technology for reducing aircraft engine pollution

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Kempke, E. E., Jr.

1975-01-01

Programs have been initiated by NASA to develop and demonstrate advanced technology for reducing aircraft gas turbine and piston engine pollutant emissions. These programs encompass engines currently in use for a wide variety of aircraft from widebody-jets to general aviation. Emission goals for these programs are consistent with the established EPA standards. Full-scale engine demonstrations of the most promising pollutant reduction techniques are planned within the next three years. Preliminary tests of advanced technology gas turbine engine combustors indicate that significant reductions in all major pollutant emissions should be attainable in present generation aircraft engines without adverse effects on fuel consumption. Fundamental-type programs are yielding results which indicate that future generation gas turbine aircraft engines may be able to utilize extremely low pollutant emission combustion systems.

The efficiency of asset management strategies to reduce urban flood risk.

PubMed

ten Veldhuis, J A E; Clemens, F H L R

2011-01-01

In this study, three asset management strategies were compared with respect to their efficiency to reduce flood risk. Data from call centres at two municipalities were used to quantify urban flood risks associated with three causes of urban flooding: gully pot blockage, sewer pipe blockage and sewer overloading. The efficiency of three flood reduction strategies was assessed based on their effect on the causes contributing to flood risk. The sensitivity of the results to uncertainty in the data source, citizens' calls, was analysed through incorporation of uncertainty ranges taken from customer complaint literature. Based on the available data it could be shown that increasing gully pot blockage is the most efficient action to reduce flood risk, given data uncertainty. If differences between cause incidences are large, as in the presented case study, call data are sufficient to decide how flood risk can be most efficiently reduced. According to the results of this analysis, enlargement of sewer pipes is not an efficient strategy to reduce flood risk, because flood risk associated with sewer overloading is small compared to other failure mechanisms.

Regulatory uncertainty and the associated business risk for emerging technologies

NASA Astrophysics Data System (ADS)

Hoerr, Robert A.

2011-04-01

An oversight system specifically concerned with nanomaterials should be flexible enough to take into account the unique aspects of individual novel materials and the settings in which they might be used, while recognizing that heretofore unrecognized safety issues may require future modifications. This article considers a question not explicitly considered by the project team: what is the risk that uncertainty over how regulatory oversight will be applied to nanomaterials will delay or block the development of this emerging technology, thereby depriving human health of potential and substantial benefits? An ambiguous regulatory environment could delay the availability of valuable new technology and therapeutics for human health by reducing access to investment capital. Venture capitalists list regulatory uncertainty as a major reason not to invest at all in certain areas. Uncertainty is far more difficult to evaluate than risk, which lends itself to quantitative models and can be factored into projections of return on possible investments. Loss of time has a large impact on investment return. An examination of regulatory case histories suggests that an increase in regulatory resting requirement, where the path is well-defined, is far less costly than a delay of a year or more in achieving product approval and market launch.

New technologies in the management of risk and violence in forensic settings.

PubMed

Tully, John; Larkin, Fintan; Fahy, Thomas

2015-06-01

Novel technological interventions are increasingly used in mental health settings. In this article, we describe 3 novel technological strategies in use for management of risk and violence in 2 forensic psychiatry settings in the United Kingdom: electronic monitoring by GPS-based tracking devices of patients on leave from a medium secure service in London, and closed circuit television (CCTV) monitoring and motion sensor technology at Broadmoor high secure hospital. A common theme is the use of these technologies to improve the completeness and accuracy of data used by clinicians to make clinical decisions. Another common thread is that each of these strategies supports and improves current clinical approaches rather than drastically changing them. The technologies offer a broad range of benefits. These include less restrictive options for patients, improved accountability of both staff and patients, less invasive testing, improved automated record-keeping, and better assurance reporting. Services utilizing technologies need also be aware of limitations. Technologies may be seen as unduly restrictive by patients and advocates, and technical issues may reduce effectiveness. It is vital that the types of technological innovations described in this article should be subject to thorough evaluation that addresses cost effectiveness, qualitative analysis of patients' attitudes, safety, and ethical considerations.

Risk disparities in the globalisation of assisted reproductive technology: the case of Asia.

PubMed

Ha, Jung-Ok

2013-01-01

This paper analyses the disparities in risks associated with biomedical technology focusing on the results of assisted reproductive technology (ART). ART among biomedical technologies transferred to Asia is a representative case that reveals in its clinical use and related scientific research the global politics of technology. This study notes the global politics at work in the recognition of and reaction to such risks. While many Asian countries aggressively pursue technological development, weak legislative and administrative regulations have created various problems and controversial cases. This study asserts that risks associated with technology are characterised as social facts not natural ones or mere 'side effects', since technological development and risk are closely intertwined.

Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy.

PubMed

Yu, Shui; Li, Hengjin

2016-01-01

The current study aimed to assess the value of microplasma radiofrequency technology combined with triamcinolone for the therapy of Chinese patients with hypertrophic scar. A total of 120 participants with hypertrophic scars were enrolled in the current study. Participants were divided into two groups based on sex, and then randomly and evenly divided into four groups (Groups A, B, C, and D). Participants in Group A received microplasma radiofrequency technology combined with triamcinolone. Participants in Group B received microplasma radiofrequency technology combined with normal saline. Participants in Groups C and D received triamcinolone (40 and 10 mg/mL) injected directly into scar. Experienced physicians evaluated the condition of scars according to the Vancouver Scar Scale 1 month before and after the therapy. There was no difference in age, sex, area, height and location of scars, and Vancouver Scar Scale scores before the therapy between any groups (P>0.05 for all). Vancouver Scar Scale scores after the therapy were significantly lower than those before the therapy in all groups (P<0.05 for all). Vancouver Scar Scale scores after the therapy in Group A were significantly lower than those after the therapy in Groups B and C (P<0.05 for all). Vancouver Scar Scale scores after the therapy in Group B were significantly higher than those after the therapy in Group C (P<0.05 for all) and similar to those after the therapy in Group D (P>0.05 for all). Incidences of tissue atrophy after the therapy were significantly lower in Groups A and B than in Group C (P<0.05 for all) and similar among Groups A, B, and D (P>0.05 for all). Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy compared with the use of either microplasma radiofrequency technology or triamcinolone injection alone.

INFLATE: INFlate Landing Apparatus Technology

NASA Astrophysics Data System (ADS)

Koryanov, V. V. K.; Da-Poian, V. D. P.

2018-02-01

Our project, named INFLATE (INFlatable Landing Apparatus Technology), aims at reducing space landing risks and constraints and so optimizing space missions (reducing cost, mass, and risk and in the same time improving performance).

Fighting Testing ACAT/FRRP: Automatic Collision Avoidance Technology/Fighter Risk Reduction Project

NASA Technical Reports Server (NTRS)

Skoog, Mark A.

2009-01-01

This slide presentation reviews the work of the Flight testing Automatic Collision Avoidance Technology/Fighter Risk Reduction Project (ACAT/FRRP). The goal of this project is to develop common modular architecture for all aircraft, and to enable the transition of technology from research to production as soon as possible to begin to reduce the rate of mishaps. The automated Ground Collision Avoidance System (GCAS) system is designed to prevent collision with the ground, by avionics that project the future trajectory over digital terrain, and request an evasion maneuver at the last instance. The flight controls are capable of automatically performing a recovery. The collision avoidance is described in the presentation. Also included in the presentation is a description of the flight test.

K-12 Teachers' Preparedness for Utilizing Technology to Reduce Classroom Administrative Workload

ERIC Educational Resources Information Center

Parizo, Daniel C.

2013-01-01

Research on technology in the K-12 classroom has focused on student learning initiatives. Few studies, however, have addressed whether technology is being used to reduce classroom administrative workload or whether teachers are prepared to utilize technology for reducing administrative workload. The problem this study addressed was the unclear…

Mine Waste Technology Program. Passive Treatment for Reducing Metal Loading

EPA Science Inventory

This report summarizes the results of Mine Waste Technology Program (MWTP) Activity III, Project 48, Passive Treatment Technology Evaluation for Reducing Metal Loading, funded by the U.S. Environmental Protection Agency (EPA) and jointly administered by EPA and the U.S. Departmen...

Risk-reducing mastectomy for the prevention of primary breast cancer.

PubMed

Carbine, Nora E; Lostumbo, Liz; Wallace, Judi; Ko, Henry

2018-04-05

Recent progress in understanding the genetic basis of breast cancer and widely publicized reports of celebrities undergoing risk-reducing mastectomy (RRM) have increased interest in RRM as a method of preventing breast cancer. This is an update of a Cochrane Review first published in 2004 and previously updated in 2006 and 2010. (i) To determine whether risk-reducing mastectomy reduces death rates from any cause in women who have never had breast cancer and in women who have a history of breast cancer in one breast, and (ii) to examine the effect of risk-reducing mastectomy on other endpoints, including breast cancer incidence, breast cancer mortality, disease-free survival, physical morbidity, and psychosocial outcomes. For this Review update, we searched Cochrane Breast Cancer's Specialized Register, MEDLINE, Embase and the WHO International Clinical Trials Registry Platform (ICTRP) on 9 July 2016. We included studies in English. Participants included women at risk for breast cancer in at least one breast. Interventions included all types of mastectomy performed for the purpose of preventing breast cancer. At least two review authors independently abstracted data from each report. We summarized data descriptively; quantitative meta-analysis was not feasible due to heterogeneity of study designs and insufficient reporting. We analyzed data separately for bilateral risk-reducing mastectomy (BRRM) and contralateral risk-reducing mastectomy (CRRM). Four review authors assessed the methodological quality to determine whether or not the methods used sufficiently minimized selection bias, performance bias, detection bias, and attrition bias. All 61 included studies were observational studies with some methodological limitations; randomized trials were absent. The studies presented data on 15,077 women with a wide range of risk factors for breast cancer, who underwent RRM.Twenty-one BRRM studies looking at the incidence of breast cancer or disease-specific mortality, or

Reducing uncertainty in risk modeling for methylmercury exposure

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

Ponce, R.; Egeland, G.; Middaugh, J.

The biomagnification and bioaccumulation of methylmercury in marine species represents a challenge for risk assessment related to the consumption of subsistence foods in Alaska. Because of the profound impact that food consumption advisories have on indigenous peoples seeking to preserve a way of life, there is a need to reduce uncertainty in risk assessment. Thus, research was initiated to reduce the uncertainty in assessing the health risks associated with the consumption of subsistence foods. Because marine subsistence foods typically contain elevated levels of methylmercury, preliminary research efforts have focused on methylmercury as the principal chemical of concern. Of particular interestmore » are the antagonistic effects of selenium on methylmercury toxicity. Because of this antagonism, methylmercury exposure through the consumption of marine mammal meat (with high selenium) may not be as toxic as comparable exposures through other sources of dietary intake, such as in the contaminated bread episode of Iraq (containing relatively low selenium). This hypothesis is supported by animal experiments showing reduced toxicity of methylmercury associated with marine mammal meat, by the antagonistic influence of selenium on methylmercury toxicity, and by negative clinical findings in adult populations exposed to methylmercury through a marine diet not subject to industrial contamination. Exploratory model development is underway to identify potential improvements and applications of current deterministic and probabilistic models, particularly by incorporating selenium as an antagonist in risk modeling methods.« less

[Strategies for reducing risks in smoking: opportunity or threat].

PubMed

Córdoba, Rodrigo; Nerín, Isabel

2009-12-01

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in the developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy (NRT)) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among those who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in our country are analysed. Tobacco control measures in Spain are recent and still insufficient. Therefore, the current priority in Spain is the development of policies of control that have shown to more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for the development of smoking control policies.

Waiting for Disasters: A Risk Reduction Assessment of Technological Disasters

NASA Astrophysics Data System (ADS)

Rovins, Jane; Winningham, Sam

2010-05-01

This session provides a risk reduction/mitigation assessment of natural hazards causation of technological disasters and possible solution. People use technology in an attempt to not only control their environment but nature itself in order to make them feel safe and productive. Most strategies for managing hazards followed a traditional planning model i.e. study the problem, identify and implement a solution, and move on to the next problem. This approach is often viewed as static model and risk reduction is more of an upward, positive, linear trend. However, technological disasters do not allow risk reduction action to neatly fit this upward, positive, linear trend with actual or potential threats to the environment and society. There are different types of technological disasters, including industrial accidents; pipeline ruptures; accidents at power, water and heat supply systems and other lines of communication; sudden collapse of buildings and mines; air crashes; shipwrecks; automobile and railway accidents to name a few. Natural factors can play an essential role in triggering or magnifying technological disasters. They can result from the direct destruction of given technical objects by a hazardous natural process such as the destruction of an atomic power plant or chemical plant due to an earthquake. Other examples would include the destruction of communications or infrastructure systems by heavy snowfalls, strong winds, avalanches. Events in the past ten years clearly demonstrate that natural disasters and the technological disasters that accompany them are not problems that can be solved in isolation and risk reduction can play an important part. Risk reduction was designed to head off the continuing rising financial and structural tolls from disasters. All Hazard Risk Reduction planning was supposed to include not only natural, but technological, and human-made disasters as well. The subsequent disaster risk reduction (DRR) indicators were to provide the

Evaluating Shielding Effectiveness for Reducing Space Radiation Cancer Risks

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Kim, Myung-Hee Y.; Ren, Lei

2007-01-01

We discuss calculations of probability distribution functions (PDF) representing uncertainties in projecting fatal cancer risk from galactic cosmic rays (GCR) and solar particle events (SPE). The PDF s are used in significance tests of the effectiveness of potential radiation shielding approaches. Uncertainties in risk coefficients determined from epidemiology data, dose and dose-rate reduction factors, quality factors, and physics models of radiation environments are considered in models of cancer risk PDF s. Competing mortality risks and functional correlations in radiation quality factor uncertainties are treated in the calculations. We show that the cancer risk uncertainty, defined as the ratio of the 95% confidence level (CL) to the point estimate is about 4-fold for lunar and Mars mission risk projections. For short-stay lunar missions (<180 d), SPE s present the most significant risk, however one that is mitigated effectively by shielding, especially for carbon composites structures with high hydrogen content. In contrast, for long duration lunar (>180 d) or Mars missions, GCR risks may exceed radiation risk limits, with 95% CL s exceeding 10% fatal risk for males and females on a Mars mission. For reducing GCR cancer risks, shielding materials are marginally effective because of the penetrating nature of GCR and secondary radiation produced in tissue by relativistic particles. At the present time, polyethylene or carbon composite shielding can not be shown to significantly reduce risk compared to aluminum shielding based on a significance test that accounts for radiobiology uncertainties in GCR risk projection.

Clinical engineering and risk management in healthcare technological process using architecture framework.

PubMed

Signori, Marcos R; Garcia, Renato

2010-01-01

This paper presents a model that aids the Clinical Engineering to deal with Risk Management in the Healthcare Technological Process. The healthcare technological setting is complex and supported by three basics entities: infrastructure (IS), healthcare technology (HT), and human resource (HR). Was used an Enterprise Architecture - MODAF (Ministry of Defence Architecture Framework) - to model this process for risk management. Thus, was created a new model to contribute to the risk management in the HT process, through the Clinical Engineering viewpoint. This architecture model can support and improve the decision making process of the Clinical Engineering to the Risk Management in the Healthcare Technological process.

Effects of communicating DNA-based disease risk estimates on risk-reducing behaviours.

PubMed

Marteau, Theresa M; French, David P; Griffin, Simon J; Prevost, A T; Sutton, Stephen; Watkinson, Clare; Attwood, Sophie; Hollands, Gareth J

2010-10-06

There are high expectations regarding the potential for the communication of DNA-based disease risk estimates to motivate behaviour change. To assess the effects of communicating DNA-based disease risk estimates on risk-reducing behaviours and motivation to undertake such behaviours. We searched the following databases using keywords and medical subject headings: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4 2010), MEDLINE (1950 to April 2010), EMBASE (1980 to April 2010), PsycINFO (1985 to April 2010) using OVID SP, and CINAHL (EBSCO) (1982 to April 2010). We also searched reference lists, conducted forward citation searches of potentially eligible articles and contacted authors of relevant studies for suggestions. There were no language restrictions. Unpublished or in press articles were eligible for inclusion. Randomised or quasi-randomised controlled trials involving adults (aged 18 years and over) in which one group received actual (clinical studies) or imagined (analogue studies) personalised DNA-based disease risk estimates for diseases for which the risk could plausibly be reduced by behavioural change. Eligible studies had to include a primary outcome measure of risk-reducing behaviour or motivation (e.g. intention) to alter such behaviour. Two review authors searched for studies and independently extracted data. We assessed risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. For continuous outcome measures, we report effect sizes as standardised mean differences (SMDs). For dichotomous outcome measures, we report effect sizes as odds ratios (ORs). We obtained pooled effect sizes with 95% confidence intervals (CIs) using the random effects model applied on the scale of standardised differences and log odds ratios. We examined 5384 abstracts and identified 21 studies as potentially eligible. Following a full text analysis, we included 14 papers reporting results of 7 clinical

Healthy eating and reduced risk of cognitive decline

PubMed Central

Dehghan, Mahshid; O'Donnell, Martin; Anderson, Craig; Teo, Koon; Gao, Peggy; Sleight, Peter; Dagenais, Gilles; Probstfield, Jeffrey L.; Mente, Andrew; Yusuf, Salim

2015-01-01

Objective: We sought to determine the association of dietary factors and risk of cognitive decline in a population at high risk of cardiovascular disease. Methods: Baseline dietary intake and measures of the Mini-Mental State Examination were recorded in 27,860 men and women who were enrolled in 2 international parallel trials of the ONTARGET (Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) studies. We measured diet quality using the modified Alternative Healthy Eating Index. Cox proportional hazards regression was used to determine the association between diet quality and risk of ≥3-point decline in Mini-Mental State Examination score, and reported as hazard ratio with 95% confidence intervals with adjustment for covariates. Results: During 56 months of follow-up, 4,699 cases of cognitive decline occurred. We observed lower risk of cognitive decline among those in the healthiest dietary quintile of modified Alternative Healthy Eating Index compared with lowest quintile (hazard ratio 0.76, 95% confidence interval 0.66–0.86, Q5 vs Q1). Lower risk of cognitive decline was consistent regardless of baseline cognitive level. Conclusion: We found that higher diet quality was associated with a reduced risk of cognitive decline. Improved diet quality represents an important potential target for reducing the global burden of cognitive decline. PMID:25948720

Decreasing the Risk of Adopting New Interactive Instructional Delivery Technologies.

ERIC Educational Resources Information Center

Dennis, Verl E.

1993-01-01

Discusses new interactive training technologies; considers risks of adopting a new technology; and presents the conceptual framework of technology life cycle analysis that provides timing information for the adoption of a new technology that should be used in addition to cost-benefit analysis and technical analysis. (LRW)

Reducing the Risks for Contrast-Induced Nephropathy

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

Stacul, Fulvio

2005-12-15

Contrast-induced nephropathy (CIN) is one of the most serious adverse events associated with the use of contrast media (CM). Patients who develop this complication can have increased morbidity, higher rates of mortality, lengthy hospital stays, and poor long-term outcomes. Although CIN cannot be eliminated, the chances of developing this condition can be reduced by using appropriate prevention strategies. An important first step to reduce the chance of CIN is to identify risk factors associated with this condition. Patients with a previously elevated serum creatinine level, especially when secondary to diabetic nephropathy, are at great risk for developing CIN. Other patient-relatedmore » risk factors include concurrent use of nephrotoxic medications, dehydration, congestive heart failure, age greater than 70 years, and probably the presence of diabetes mellitus even if serum creatinine is normal. Adequate hydration is widely accepted as an important prophylactic measure for preventing CIN, but the optimal hydration regimen is still debatable. The risk of CIN increases with greater doses of CM, as well as with the type of CM used. A high-osmolar CM poses a greater risk of CIN than does a low-osmolar CM and, as recent but limited data suggest, the use of an iso-osmolar CM is less nephrotoxic than a low-osmolar CM in patients with renal impairment following intra-arterial procedures, although this finding needs to be verified in future clinical studies. Pharmacologic agents such as calcium channel blockers, dopamine, atrial natriuretic peptide, fenoldopam, prostaglandin E1, and endothelin receptor antagonist have not been proven effective against CIN development. Controversies still exist on the possible effectiveness of theophylline and N-acetylcysteine. Simple strategies for the prevention of CIN in at-risk patients are reviewed and unproven interventions are discussed.« less

Risk assessment can be a game-changing information technology--but too often it isn't.

PubMed

Goble, Robert; Bier, Vicki M

2013-11-01

The printing press was a game-changing information technology. Risk assessment could be also. At present, risk assessments are commonly used as one-time decision aids: they provide justification for a particular decision, and afterwards usually sit on a shelf. However, when viewed as information technologies, their potential uses are much broader. Risk assessments: (1) are repositories of structured information and a medium for communication; (2) embody evaluative structures for setting priorities; (3) can preserve information over time and permit asynchronous communication, thus encouraging learning and adaptation; and (4) explicitly address uncertain futures. Moreover, because of their "what-if" capabilities, risk assessments can serve as a platform for constructive discussion among parties that hold different values. The evolution of risk assessment in the nuclear industry shows how such attributes have been used to lower core-melt risks substantially through improved templates for maintenance and more effective coordination with regulators (although risk assessment has been less commonly used in improving emergency-response capabilities). The end result of this evolution in the nuclear industry has been the development of "living" risk assessments that are updated more or less in real time to answer even routine operational questions. Similar but untapped opportunities abound for the use of living risk assessments to reduce risks in small operational decisions as well as large policy decisions in other areas of hazard management. They can also help improve understanding of and communication about risks, and future risk assessment and management. Realization of these opportunities will require significant changes in incentives and active promotion by the risk analytic community. © 2013 Society for Risk Analysis.

Mitigating flood exposure: Reducing disaster risk and trauma signature.

PubMed

Shultz, James M; McLean, Andrew; Herberman Mash, Holly B; Rosen, Alexa; Kelly, Fiona; Solo-Gabriele, Helena M; Youngs, Georgia A; Jensen, Jessica; Bernal, Oscar; Neria, Yuval

2013-01-01

Introduction. In 2011, following heavy winter snowfall, two cities bordering two rivers in North Dakota, USA faced major flood threats. Flooding was foreseeable and predictable although the extent of risk was uncertain. One community, Fargo, situated in a shallow river basin, successfully mitigated and prevented flooding. For the other community, Minot, located in a deep river valley, prevention was not possible and downtown businesses and one-quarter of the homes were inundated, in the city's worst flood on record. We aimed at contrasting the respective hazards, vulnerabilities, stressors, psychological risk factors, psychosocial consequences, and disaster risk reduction strategies under conditions where flood prevention was, and was not, possible. Methods . We applied the "trauma signature analysis" (TSIG) approach to compare the hazard profiles, identify salient disaster stressors, document the key components of disaster risk reduction response, and examine indicators of community resilience. Results . Two demographically-comparable communities, Fargo and Minot, faced challenging river flood threats and exhibited effective coordination across community sectors. We examined the implementation of disaster risk reduction strategies in situations where coordinated citizen action was able to prevent disaster impact (hazard avoidance) compared to the more common scenario when unpreventable disaster strikes, causing destruction, harm, and distress. Across a range of indicators, it is clear that successful mitigation diminishes both physical and psychological impact, thereby reducing the trauma signature of the event. Conclusion . In contrast to experience of historic flooding in Minot, the city of Fargo succeeded in reducing the trauma signature by way of reducing risk through mitigation.

Technology and At-Risk Young Readers and Their Classrooms

ERIC Educational Resources Information Center

Blachowicz, Camille L. Z.; Bates, Ann; Berne, Jennifer; Bridgman, Teresa; Chaney, Jeanne; Perney, Jan

2009-01-01

This study examined the ways in which 18 first-grade teachers and their students in 11 high-risk urban schools began to use literacy-focused technology. The goal of the study was to observe the technology in use by the students, to observe the classroom dynamics and teachers' instructional choices centered around technology use, to look at student…

Reducing the Risk of Human Space Missions with INTEGRITY

NASA Technical Reports Server (NTRS)

Jones, Harry W.; Dillon-Merill, Robin L.; Tri, Terry O.; Henninger, Donald L.

2003-01-01

The INTEGRITY Program will design and operate a test bed facility to help prepare for future beyond-LEO missions. The purpose of INTEGRITY is to enable future missions by developing, testing, and demonstrating advanced human space systems. INTEGRITY will also implement and validate advanced management techniques including risk analysis and mitigation. One important way INTEGRITY will help enable future missions is by reducing their risk. A risk analysis of human space missions is important in defining the steps that INTEGRITY should take to mitigate risk. This paper describes how a Probabilistic Risk Assessment (PRA) of human space missions will help support the planning and development of INTEGRITY to maximize its benefits to future missions. PRA is a systematic methodology to decompose the system into subsystems and components, to quantify the failure risk as a function of the design elements and their corresponding probability of failure. PRA provides a quantitative estimate of the probability of failure of the system, including an assessment and display of the degree of uncertainty surrounding the probability. PRA provides a basis for understanding the impacts of decisions that affect safety, reliability, performance, and cost. Risks with both high probability and high impact are identified as top priority. The PRA of human missions beyond Earth orbit will help indicate how the risk of future human space missions can be reduced by integrating and testing systems in INTEGRITY.

The Technology Implications of "A Nation at Risk"

ERIC Educational Resources Information Center

Allen, Lee

2008-01-01

In 1983, when "A Nation at Risk" appeared, it offered recommendations in the areas of content, standards and expectations, time, teaching, and leadership and fiscal support. The growing use of technology was addressed briefly in the section dealing with "indicators of risk," which listed examples of deficiencies in education as compared to the…

Risk assessment and risk management of mycotoxins.

PubMed

2012-01-01

Risk assessment is the process of quantifying the magnitude and exposure, or probability, of a harmful effect to individuals or populations from certain agents or activities. Here, we summarize the four steps of risk assessment: hazard identification, dose-response assessment, exposure assessment, and risk characterization. Risk assessments using these principles have been conducted on the major mycotoxins (aflatoxins, fumonisins, ochratoxin A, deoxynivalenol, and zearalenone) by various regulatory agencies for the purpose of setting food safety guidelines. We critically evaluate the impact of these risk assessment parameters on the estimated global burden of the associated diseases as well as the impact of regulatory measures on food supply and international trade. Apart from the well-established risk posed by aflatoxins, many uncertainties still exist about risk assessments for the other major mycotoxins, often reflecting a lack of epidemiological data. Differences exist in the risk management strategies and in the ways different governments impose regulations and technologies to reduce levels of mycotoxins in the food-chain. Regulatory measures have very little impact on remote rural and subsistence farming communities in developing countries, in contrast to developed countries, where regulations are strictly enforced to reduce and/or remove mycotoxin contamination. However, in the absence of the relevant technologies or the necessary infrastructure, we highlight simple intervention practices to reduce mycotoxin contamination in the field and/or prevent mycotoxin formation during storage.

When systems fail: improving care through technology can create risk.

PubMed

Bagalio, Sharon A

2007-01-01

Emerging medical technology is transforming the care of the modern-day patient. Hospital performance and patient safety is improving, lowering professional liability and medical malpractice costs. This advanced technology affects not only diagnosis and treatment but also hospital productivity and revenue. However, it also exposes hospitals and medical personnel to a number of unforeseeable risks. This article examines ongoing efforts to improve patient safety through the use of technology, automation and complex systems operations. It discusses the importance of skilled negotiation when vying for technology contracts and the value of maintaining a reliable data center to support it. Technology risk exposure is now a reality. A hospital needs to know how to protect itself from cyber liability, business interruption, and data loss and theft by ensuring that there is adequate coverage.

Proactive Motor Control Reduces Monetary Risk Taking in Gambling

PubMed Central

Adams, Rachel; Chambers, Christopher D.

2012-01-01

Less supervision by the executive system after disruption of the right prefrontal cortex leads to increased risk taking in gambling because superficially attractive—but risky—choices are not suppressed. Similarly, people might gamble more in multitask situations than in single-task situations because concurrent executive processes usually interfere with each other. In the study reported here, we used a novel monetary decision-making paradigm to investigate whether multitasking could reduce rather than increase risk taking in gambling. We found that performing a task that induced cautious motor responding reduced gambling in a multitask situation (Experiment 1). We then found that a short period of inhibitory training lessened risk taking in gambling at least 2 hr later (Experiments 2 and 3). Our findings indicate that proactive motor control strongly affects monetary risk taking in gambling. The link between control systems at different cognitive levels might be exploited to develop new methods for rehabilitation of addiction and impulse-control disorders. PMID:22692336

REDUCING CHILDREN'S RISK TO SOIL LEAD: SUMMARY OF A FIELD EXPERIMENT TO REDUCE SOIL LEAD BIOAVAILABILITY

EPA Science Inventory

Reducing risks associated with Pb in soil has typically been accomplished by soil removal, covering, or dilution by mixing with uncontaminated soil. EPA's National Risk Management Research Laboratory (NRMRL) and DuPont Corporation established a collaborative effort to evaluation...

Cost-effectiveness of risk-reducing surgeries in preventing hereditary breast and ovarian cancer.

PubMed

Schrauder, Michael G; Brunel-Geuder, Lisa; Häberle, Lothar; Wunderle, Marius; Hoyer, Juliane; Reis, André; Schulz-Wendtland, Rüdiger; Beckmann, Matthias W; Lux, Michael P

2017-04-01

Risk-reducing surgeries are a feasible option for mitigating the risk in individuals with inherited susceptibility to cancer, but are the procedures cost-effective in the current health-care system in Germany? This study compared the health-care costs for bilateral risk-reducing mastectomy (BRRM) and risk-reducing (bilateral) salpingo-oophorectomy (RRSO) with cancer treatment costs that could potentially be prevented. The analysis is based on interdisciplinary consultations with individuals with a high familial risk for breast and ovarian cancer at the University Breast Center for Franconia (Germany) between 2009 and 2013 (370 consultations; 44 patients with BRCA1 mutations and 26 with BRCA2 mutations). Health-care costs for risk-reducing surgeries in BRCA mutation carriers were calculated as reimbursements in the German diagnosis-related groups (DRG) hospital pricing system. These costs for the health-care system were compared with the potential cancer treatment costs that could possibly be prevented by risk-reducing surgeries. Long-term health-care costs can be reduced by risk-reducing surgeries after genetic testing in BRCA mutation carriers. The health-care system in Germany would have saved € 136,295 if BRRM had been performed and € 791,653 if RRSO had been performed before the development of cancer in only 50% of the 70 mutation carriers seen in our center. Moreover, in patients with combined RRSO and BRRM (without breast reconstruction), one further life-year for a 40-year-old BRCA mutation carrier would cost € 2,183. Intensive care, including risk-reducing surgeries in BRCA mutation carriers, is cost-effective from the point of view of the health-care system in Germany. Copyright © 2017 Elsevier Ltd. All rights reserved.

Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk

DTIC Science & Technology

2017-10-01

AWARD NUMBER: W81XWH-15-1-0632 TITLE: Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk PRINCIPAL INVESTIGATOR: Brian...CONTRACT NUMBER Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk 5b. GRANT NUMBER W81XWH-15-1-0632 5c. PROGRAM...Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The primary aim of the proposed project is to develop cognitive and

Reducing Communication Apprehension among At-Risk Children.

ERIC Educational Resources Information Center

Ayres, Debbie M.; And Others

1995-01-01

Investigates whether a videotape designed to reduce public speaking apprehension (PSA) could be used to help at-risk students cope with PSA. Finds that the videotape condition was associated with lower levels of trait communication apprehension, state communication apprehension, and negative thinking than the placebo and control conditions. (SR)

2016 Emerging Technology Domains Risk Survey

DTIC Science & Technology

2016-04-05

2016 Emerging Technology Domains Risk Survey Christopher King Dan Klinedinst Todd Lewellen Garret Wassermann April 2016 TECHNICAL REPORT...Unlimited [Checkoway 2011] Checkoway, Stephen; McCoy, Damon; Kantor, Brian; Anderson, Danny; Shacham, Hovav; Savage, Stefan. Comprehensive Experimental ...Koscher 2010] Koscher, Karl et al. “ Experimental Security Analysis of a Modern Automobile,” 447-462. IEEE Symposium on Security and Privacy

Risk-Informed Decision Making: Application to Technology Development Alternative Selection

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

2010-01-01

NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk

DTIC Science & Technology

2016-10-01

the annual conference of the Association for Behavioral and Cognitive Therapies in New York, NY October 27, 2016 – October 30, 2016. How were the...AWARD NUMBER: W81XWH-15-1-0632 TITLE: Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk PRINCIPAL INVESTIGATOR: Brian...CONTRACT NUMBER Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk 5b. GRANT NUMBER W81XWH-15-1-0632 5c. PROGRAM ELEMENT

We have the technology, but can we use it? Building flood risk capacity amongst property owners in England.

NASA Astrophysics Data System (ADS)

White, Iain; Connelly, Angela; O'Hare, Paul; Lawson, Nigel

2013-04-01

The UK's Meteorological Office has provisionally confirmed 2012 to be the second wettest recorded in the country (The Met Office, 2013). Volatile weather patterns resulted in much social and economic disruption and damage from floods. The UK's Flood and Water Management Act (2010) has placed responsibility for flood risk management primarily at local level. In reality, various agencies are responsible for managing flood risk resulting in a fragmented system that communities struggle to make sense of. Strengthening emergency response during a flood event is one strategy to build capacity. However, resilience has emerged as an operative policy, and points to a need for anticipatory approaches. These should extend beyond large-scale flood defenses or measures that reduce the vulnerability of infrastructures and buildings in order to incorporate social vulnerability through the establishment of warning systems and capacity building (White 2010). To this, small-scale, innovative technologies - from automatic door guards and 'smart' air bricks - hold the potential to manage the uncertainty around flood risk before an event occurs. However, innovative technologies are often resisted by institutions, technical systems, cultural preferences, and legislation, which require a multifaceted approach that addresses the social, cultural, economic and technical domains (De Graaf 2009). We present a case study that explores the barriers that inhibit the uptake of property level technologies in England by various actors: from property owners and manufacturers, to municipal authorities and built environment professionals. Through the case study, we demonstrate how these various stakeholders were involved in identifying the procedural principles to overcome these barriers and to integrate property level technologies more fully into an overall flood risk management system. Following this, best practice guidance was designed and we show the means by which such guidance can improve

Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer

PubMed Central

Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

2016-01-01

Abstract Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD). This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated. The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group. Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD. PMID:27977613

Risk factors, health risks, and risk management for aircraft personnel and frequent flyers.

PubMed

Kim, Jeoum Nam; Lee, Byung Mu

2007-01-01

Health risks associated with long periods of time in flight are of concern to astronauts, crew members, and passengers. Many epidemiological studies showed that occupational and frequent flyers may be susceptible to ocular, cardiovascular, neurological, pulmonary, gastrointestinal, sensory, immunological, physiological, and even developmental disorders. In addition, the incidences of cancer and food poisoning are expected to be higher in such individuals. This article reviews health risks and risk factors associated with air travel, and discusses risk management strategies. To reduce adverse health risks, risk factors such as radiation, infection, stress, temperature, pressure, and circadian rhythm need to be avoided or reduced to levels that are as low as technologically achievable to protect flight personnel and passengers.

Integrating Technology into the Curriculum for "At-Risk" Youth

ERIC Educational Resources Information Center

McCall, Denise

2009-01-01

This Independent Learning Project (ILP) discusses the best practices in educational technology to improve the behavior, instruction, and learning of at-risk youth, for whom technology offers unique opportunities. Research is compiled from numerous scholarly print and online sources. A guide for teachers provides detailed strategies, software…

Exploiting Science: Enhancing the Safety Training of Pilots to Reduce the Risk of Bird Strikes

NASA Astrophysics Data System (ADS)

Mendonca, Flavio A. C.

Analysis of bird strikes to aviation in the U.S. from 1990 to 2015 indicate that the successful mitigation efforts at airports, which must be sustained, have reduced incidents with damage and a negative effect-on-flight since 2000. However, such efforts have done little to reduce strikes outside the airport jurisdiction, such as occurred with US Airways Flight 1549 in 2009. There are basically three strategies to mitigate the risk of bird strikes: standards set by aviation authorities, technology, and actions by crewmembers. Pilots play an important role as stakeholders in the prevention of bird strikes, especially outside the airport environment. Thus, safety efforts require enhanced risk management and aeronautical decision-making training for flight crews. The purpose of this study was to determine if a safety training protocol could effectively enhance CFR Part 141 general aviation pilots' knowledge and skills to reduce the risk of bird strikes to aviation. Participants were recruited from the Purdue University professional flight program and from Purdue Aviation. The researcher of this study used a pretest posttest experimental design. Additionally, qualitative data were collected through open-ended questions in the pretest, posttest, and a follow-up survey questionnaire. The participants' pretest and posttest scores were analyzed using parametric and nonparametric tests. Results indicated a significant increase in the posttest scores of the experimental group. An investigation of qualitative data showed that the topic "safety management of bird hazards by pilots" is barely covered during the ground and flight training of pilots. Furthermore, qualitative data suggest a misperception of the safety culture tenets and a poor familiarity with the safety risk management process regarding bird hazards. Finally, the researcher presented recommendations for practice and future research.

Leveraging Technology to Reduce Patient Transaction Costs.

PubMed

Edlow, Richard C

2015-01-01

Medical practices are under significant pressure to provide superior customer service in an environment of declining or flat reimbursement. The solution for many practices involves the integration of a variety of third-party technologies that conveniently interface with one's electronic practice management and medical records systems. Typically, the applications allow the practice to reduce the cost of each patient interaction. Drilling down to quantify the cost of each individual patient interaction helps to determine the practicality of implementation.

Advanced technology for reducing aircraft engine pollution

NASA Technical Reports Server (NTRS)

Jones, R. E.

1973-01-01

Combustor research programs are described whose purpose is to demonstrate significantly lower exhaust emission levels. The proposed EPA regulations covering the allowable levels of emissions will require a major technological effort if these levels are to be met by 1979. Pollution reduction technology is being pursued by NASA through a combination of in-house research, contracted progams, and university grants. In-house research with the swirl-can modular combustor and the double-annular combustor has demonstrated significant reduction in the level of NO(x) emissions. The work is continuing in an attempt to further reduce these levels by improvements in module design and in air-fuel scheduling. Research on the reduction of idle emissions has included the conversion of conventional duplex fuel nozzles to air-assisted nozzles and exploration of the potential improvements possible with fuel staging and variable combustor geometry.

Supporting Technology at GRC to Mitigate Risk as Stirling Power Conversion Transitions to Flight

NASA Technical Reports Server (NTRS)

Schreiber, Jeffrey G.; Thieme, Lanny G.; Wong, Wayne A.

2009-01-01

Stirling power conversion technology has been reaching more advanced levels of maturity during its development for space power applications. The current effort is in support of the Advanced Stirling Radioisotope Generator (ASRG), which is being developed by the U.S. Department of Energy (DOE), Lockheed Martin Space Systems Company (LMSSC), Sunpower Inc., and the NASA Glenn Research Center (GRC). This generator would use two high-efficiency Advanced Stirling Convertors (ASCs) to convert thermal energy from a radioisotope heat source into electricity. Of paramount importance is the reliability of the power system and as a part of this, the Stirling power convertors. GRC has established a supporting technology effort with tasks in the areas of reliability, convertor testing, high-temperature materials, structures, advanced analysis, organics, and permanent magnets. The project utilizes the matrix system at GRC to make use of resident experts in each of the aforementioned fields. Each task is intended to reduce risk and enhance reliability of the convertor as this technology transitions toward flight status. This paper will provide an overview of each task, outline the recent efforts and accomplishments, and show how they mitigate risk and impact the reliability of the ASC s and ultimately, the ASRG.

Supporting Technology at GRC to Mitigate Risk as Stirling Power Conversion Transitions to Flight

NASA Technical Reports Server (NTRS)

Schreiber, Jeffrey G.; Thieme, Lanny G.; Wong, Wayne A.

2008-01-01

Stirling power conversion technology has been reaching more advanced levels of maturity during its development for space power applications. The current effort is in support of the Advanced Stirling Radioisotope Generator (ASRG), which is being developed by the U.S. Department of Energy (DOE), Lockheed Martin Space Systems Company (LMSSC), Sunpower Inc., and the NASA Glenn Research Center (GRC). This generator would use two high-efficiency Advanced Stirling Convertors (ASCs) to convert thermal energy from a radioisotope heat source into electricity. Of paramount importance is the reliability of the power system and as a part of this, the Stirling power convertors. GRC has established a supporting technology effort with tasks in the areas of reliability, convertor testing, high-temperature materials, structures, advanced analysis, organics, and permanent magnets. The project utilizes the matrix system at GRC to make use of resident experts in each of the aforementioned fields. Each task is intended to reduce risk and enhance reliability of the convertor as this technology transitions toward flight status. This paper will provide an overview of each task, outline the recent efforts and accomplishments, and show how they mitigate risk and impact the reliability of the ASC s and ultimately, the ASRG.

Reducing the risk of burns during electroconvulsive therapy.

PubMed

2011-10-01

Poor contact between electroconvulsive therapy (ECT) electrodes and the skin can result in patient burns during ECT treatment. Proper site preparation and electrode application are essential to ensure adequate contact and to reduce the risk of burns.

Public and stakeholder participation for managing and reducing the risks of shale gas development.

PubMed

North, D Warner; Stern, Paul C; Webler, Thomas; Field, Patrick

2014-01-01

Emerging technologies pose particularly strong challenges for risk governance when they have multidimensional and inequitable impacts, when there is scientific uncertainty about the technology and its risks, when there are strong value conflicts over the perceived benefits and risks, when decisions must be made urgently, and when the decision making environment is rife with mistrust. Shale gas development is one such emerging technology. Drawing on previous U.S. National Research Council committee reports that examined risk decision making for complex issues like these, we point to the benefits and challenges of applying the analytic-deliberative process recommended in those reports for stakeholder and public engagement in risk decision making about shale gas development in the United States. We discuss the different phases of such a process and conclude by noting the dangers of allowing controversy to ossify and the benefits of sound dialogue and learning among publics, stakeholders, industry, and regulatory decision makers.

Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk

PubMed Central

Briggs, Michelle A.; Petersen, Kristina S.; Kris-Etherton, Penny M.

2017-01-01

Dietary recommendations to decrease the risk of cardiovascular disease (CVD) have focused on reducing intake of saturated fatty acids (SFA) for more than 50 years. While the 2015–2020 Dietary Guidelines for Americans advise substituting both monounsaturated and polyunsaturated fatty acids for SFA, evidence supports other nutrient substitutions that will also reduce CVD risk. For example, replacing SFA with whole grains, but not refined carbohydrates, reduces CVD risk. Replacing SFA with protein, especially plant protein, may also reduce CVD risk. While dairy fat (milk, cheese) is associated with a slightly lower CVD risk compared to meat, dairy fat results in a significantly greater CVD risk relative to unsaturated fatty acids. As research continues, we will refine our understanding of dietary patterns associated with lower CVD risk. PMID:28635680

Reducing Stressful Aspects of Information Technology in Public Services.

ERIC Educational Resources Information Center

Quinn, Brian

1995-01-01

Identifies sources of technological stress for public services librarians and patrons and proposes ways to reduce stress, including communicating with staff, implementing a system gradually, providing adequate training, creating proper documentation, planning, considering ergonomics in hardware and software selection, selecting a good interface,…

Meta-analysis: Does garlic intake reduce risk of gastric cancer?

PubMed

Kodali, R T; Eslick, Guy D

2015-01-01

In the past 2 decades, various epidemiological studies investigated whether garlic can positively modify the risk of gastric cancer. Garlic contains numerous sulfide compounds, including diallyl trisulfide, which have anticarcinogenic properties. We conducted a meta-analysis to determine if garlic intake reduces the risk of gastric cancer. An electronic search of MEDLINE, PubMed, and EMBASE to June 2014 was completed. There were 14 case control studies, 2 randomized controlled studies, and 1 cohort study that fulfilled our inclusion criteria. We used a random effects model to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs) for risk of gastric cancer with garlic consumption. Meta-analysis of a total of 8,621 cases and 14,889 controls was conducted. Significant variability in duration of garlic intake and reference categories for amount of intake was noted. High, low, and any garlic intake were all associated with reduced risk of gastric cancer. High intake had the most significant risk reduction, OR = 0.49 (95% CI: 0.38-0.62). Heterogeneity was low (I² = 30.85, P = 0.17). A more modest risk reduction was associated with low intake, OR = 0.75 (95% CI: 0.58-0.97). Half of the studies did not separate garlic intake into high or low amounts, intake was only noted as consumption vs. non-consumption. Any amount of consumption still showed a risk reduction similar to low intake, OR = 0.77 (95% CI: 0.60-1.00). Low and any amount of consumption showed moderate heterogeneity (58% and 45%, respectively). Garlic intake appears to be associated with reduced risk of gastric cancer. Further high quality studies are required to confirm this finding and to assess the amount of garlic that needs to be consumed for protective effect.

REDUCING CHILDREN'S RISK TO SOIL LEAD: SUMMARY OF A FIELD EXPERIMENT TO REDUCE SOIL LEAD BIOAVAILABILITY (ABSTRACT)

EPA Science Inventory

Reducing risks associated with Pb in soil has typically been accomplished by soil removal, covering, or dilution by mixing with uncontaminated soil. EPA's National Risk Management Research Laboratory (NRMRL) and DuPont Corporation established a collaborative effort to evaluation...

Emerging technologies in healthcare: navigating risks, evaluating rewards.

PubMed

McGrady, Elizabeth; Conger, Sue; Blanke, Sandra; Landry, Brett J L

2010-01-01

The purpose of this prescriptive research is to help decision makers become better informed about three technologies emerging in the healthcare arena by providing a basic description of the technology and describing their current applications, future healthcare deployment, potential risks, and related managerial issues. Two of the technologies, radio frequency identification (RFID) and global positioning systems (GPS), are currently available to healthcare organizations and appear capable of decreasing cost but may require significant initial investment and have disruptive potential. The third technology, nanotechnology, has limited current use but may revolutionize both the delivery of medicine and hospital infrastructure management. With cautious attention to managerial issues and meticulous attention to implementation details, healthcare organizations that can successfully navigate the coming technologically driven paradigm shifts will emerge more resilient organizations.

Reducing software security risk through an integrated approach research initiative model based verification of the Secure Socket Layer (SSL) Protocol

NASA Technical Reports Server (NTRS)

Powell, John D.

2003-01-01

This document discusses the verification of the Secure Socket Layer (SSL) communication protocol as a demonstration of the Model Based Verification (MBV) portion of the verification instrument set being developed under the Reducing Software Security Risk (RSSR) Trough an Integrated Approach research initiative. Code Q of the National Aeronautics and Space Administration (NASA) funds this project. The NASA Goddard Independent Verification and Validation (IV&V) facility manages this research program at the NASA agency level and the Assurance Technology Program Office (ATPO) manages the research locally at the Jet Propulsion Laboratory (California institute of Technology) where the research is being carried out.

Information Technology Sector Baseline Risk Assessment

DTIC Science & Technology

2009-08-01

alternative root be economically advantageous , an actor’s ability to exploit market forces and create an alternative root would be significantly improved...conduct their operations. Therefore, a loss or disruption to Internet services would not be advantageous for the desired outcomes of these syndicates.26... eCommerce Service loss or disruption [C] Traffic Redirection [C] = Undesired consequence Information Technology Sector Baseline Risk Assessment

Recent innovation of geospatial information technology to support disaster risk management and responses

NASA Astrophysics Data System (ADS)

Une, Hiroshi; Nakano, Takayuki

2018-05-01

Geographic location is one of the most fundamental and indispensable information elements in the field of disaster response and prevention. For example, in the case of the Tohoku Earthquake in 2011, aerial photos taken immediately after the earthquake greatly improved information sharing among different government offices and facilitated rescue and recovery operations, and maps prepared after the disaster assisted in the rapid reconstruction of affected local communities. Thanks to the recent development of geospatial information technology, this information has become more essential for disaster response activities. Advancements in web mapping technology allows us to better understand the situation by overlaying various location-specific data on base maps on the web and specifying the areas on which activities should be focused. Through 3-D modelling technology, we can have a more realistic understanding of the relationship between disaster and topography. Geospatial information technology can sup-port proper preparation and emergency responses against disasters by individuals and local communities through hazard mapping and other information services using mobile devices. Thus, geospatial information technology is playing a more vital role on all stages of disaster risk management and responses. In acknowledging geospatial information's vital role in disaster risk reduction, the Sendai Framework for Disaster Risk Reduction 2015-2030, adopted at the Third United Nations World Conference on Disaster Risk Reduction, repeatedly reveals the importance of utilizing geospatial information technology for disaster risk reduction. This presentation aims to report the recent practical applications of geospatial information technology for disaster risk management and responses.

Assisted Reproductive Technology and Risk for Autism Spectrum Disorder

ERIC Educational Resources Information Center

Zachor, Ditza A.; Itzchak, E. Ben

2011-01-01

Epidemiologic studies on maternal and pregnancy risk factors for autism spectrum disorder (ASD), including use of assisted reproductive technology (ART), found conflicting results. This study included the following aims: to assess frequencies of ART in a large ASD group; to examine confounding birth and familial risk factors in the ASD with ART…

Technology to Reduce Hypoglycemia.

PubMed

Yeoh, Ester; Choudhary, Pratik

2015-07-01

Hypoglycemia is a major barrier toward achieving glycemic targets and is associated with significant morbidity (both psychological and physical) and mortality. This article reviews technological strategies, from simple to more advanced technologies, which may help prevent or mitigate exposure to hypoglycemia. More efficient insulin delivery systems, bolus advisor calculators, data downloads providing information on glucose trends, continuous glucose monitoring with alarms warning of hypoglycemia, predictive algorithms, and finally closed loop insulin delivery systems are reviewed. The building blocks to correct use and interpretation of this range of available technology require patient education and appropriate patient selection. © 2015 Diabetes Technology Society.

Cigarette smoking risk-reducing beliefs: Findings from the United States Health Information National Trends Survey.

PubMed

Kaufman, Annette R; Coa, Kisha I; Nguyen, Anh B

2017-09-01

Cigarette smoking risk-reducing beliefs are ideas that certain health promoting behaviors (e.g., exercise) may mitigate the risks associated with smoking. The objective of this study was to describe smoking risk-reducing beliefs and the belief that quitting can reduce the harmful effects of smoking among the U.S. adult population and the associations between these beliefs, current smoking status, and sociodemographics. Data were from the Health Information National Trends Survey 4 (HINTS 4) Cycles 3 and 4 (2013-2014; N=6862). Descriptive analyses were conducted to examine bivariate associations among the quit smoking belief, smoking risk-reducing beliefs, and covariates. Weighted ordinal logistic regression models examined the adjusted associations between smoking status and sociodemographics, with quit smoking belief and risk-reducing beliefs. Eighty-two percent of the population reported that quitting cigarette smoking can help reduce the harmful effects of smoking a lot: former smokers and individuals with higher educational attainment were more likely to endorse this belief than never smokers and those with lower educational attainment. Many people endorsed smoking risk-reducing beliefs about exercise (79.3%), fruits and vegetables (71.8%), vitamins (67.2%), and sleep (68.5%). Former smokers were less likely to subscribe to these beliefs than never smokers. Vulnerable populations who may be most at risk of smoking attributable morbidity and mortality were more likely to endorse risk-reducing beliefs. Future studies are needed to better understand how risk-reducing beliefs are formed and if modifying these beliefs may help to reduce cigarette smoking in the U.S. Published by Elsevier Inc.

Transforming Wartime Contracting: Controlling Costs, Reducing Risks

DTIC Science & Technology

2011-08-01

reduce the risk of awarding contracts to companies with questionable capability to perform. Expansion of investigative authority and jurisdiction ...A forcing function is needed to ensure widespread and effective adoption of contingency-contracting reform. Otherwise, agency inertia , resistance to...inflamed because jurisdiction over contractors is ambiguous, legal accountability is uncertain, and a clear command-and-control structure is absent. A

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

PubMed

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

2017-09-01

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

Parafricta Bootees and Undergarments to Reduce Skin Breakdown in People with or at Risk of Pressure Ulcers: A NICE Medical Technologies Guidance.

PubMed

Meads, Catherine; Glover, Matthew; Dimmock, Paul; Pokhrel, Subhash

2016-12-01

As part of the development of the National Institute for Health and Care Excellence (NICE) Medical Technologies Guidance on Parafricta Bootees and Undergarments to reduce skin breakdown in people with, or at risk of, pressure ulcers, the manufacturer (APA Parafricta Ltd) submitted clinical and economic evidence, which was critically appraised by an External Assessment Centre (EAC) and subsequently used by the Medical Technologies Advisory Committee (MTAC) to develop recommendations for further research. The University of Birmingham and Brunel University, acting as a consortium, were commissioned to act as the EAC, independently appraising the submission. This article is an overview of the original evidence submitted, the EAC's findings and the final NICE guidance. Very little comparative evidence was submitted to demonstrate the effectiveness of Parafricta Bootees or Undergarments. The sponsor submitted a simple cost analysis to estimate the costs of using Parafricta in addition to current practice-in comparison with current practice alone-in hospital and community settings separately. The analysis took a National Health Service (NHS) perspective. The basis of the analysis was a previously published comparative study, which showed no statistical difference in average lengths of stay between patients who wore Parafricta Undergarments and Bootees, and those who did not. The economic model incorporated the costs of Parafricta but assumed shorter lengths of stay with Parafricta. The sponsor concluded that Parafricta was cost saving relative to the comparators. The EAC made amendments to the sponsor's analysis to correct for errors and to reflect alternative assumptions. Parafricta remained cost saving in most analyses, and the savings per prevalent case ranged from £757 in the hospital model to £3455 in the community model. All analyses were severely limited by the available data on effectiveness-in particular, a lack of good-quality comparative studies.

Shear-reducing insoles to prevent foot ulceration in high-risk diabetic patients.

PubMed

Lavery, Lawrence A; LaFontaine, Javier; Higgins, Kevin R; Lanctot, Dan R; Constantinides, George

2012-11-01

To enhance the learner's competence with knowledge of the effectiveness of shear-reducing insoles for prevention of foot ulceration in patients with high-risk diabetes. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Demonstrate knowledge of foot ulceration risk, risk factors, incidence, and prevention.2. Apply knowledge gained from reviewing this study and a literature review about the use of shear-reducing insoles to patient scenarios. The objective of this study was to evaluate the effectiveness of a shear-reducing insole compared with a standard insole design to prevent foot ulceration in high-risk patients with diabetes. A total of 299 patients with diabetic neuropathy and loss of protective sensation, foot deformity, or history of foot ulceration were randomized into a standard therapy group (n = 150) or a shear-reducing insole group (n = 149). Patients were evaluated for 18 months. Standard therapy group consisted of therapeutic footwear, diabetic foot education, and regular foot evaluation by a podiatrist. The shear-reducing insole group included a novel insole designed to reduce both pressure and shear on the sole of the foot. Insoles were replaced every 4 months in both groups. The primary clinical outcome was foot ulceration. The authors used Cox proportional hazards regression to evaluate time to ulceration. There were 2 significant factors from the Cox regression model: insole treatment and history of a foot complication. The standard therapy group was about 3.5 times more likely to develop an ulcer compared with shear-reducing insole group (hazard ratio, 3.47; 95% confidence interval, 0.96-12.67). These results suggest that a shear-reducing insole is more effective than traditional insoles to prevent foot ulcers in high-risk persons with diabetes.

Emerging technologies to support independent living of older adults at risk.

PubMed

Hanson, Gregory J; Takahashi, Paul Y; Pecina, Jennifer L

2013-01-01

The aging of the population is expected to place an unprecedented strain on health care systems over the next two decades and beyond. Emerging electronic monitoring technologies provide opportunities to learn about the aging process, age-related diseases, and contribute to new, cost effective care models that preserve independence at home for older adults at risk. The goals of this article are to familiarize the reader with emerging technologies and potential applications to older adults' at-risk, review the current literature about the clinical and economic outcomes of emerging technologies, and to outline future directions and challenges.

Review of methods to prevent and reduce the risk of Lyme disease.

PubMed

Lindsay, L R; Ogden, N H; Schofield, S W

2015-06-04

Cases of Lyme disease and areas with self-sustaining populations of vector ticks are increasing in Canada. This trend is expected to continue. Preventing Lyme disease will therefore become relevant to an increasing number of Canadians. To summarize methods for reducing the risk of tick bites and preventing transmission once a tick is feeding. A literature search was conducted to identify methods to reduce the risk of tick bites and the abundance of vector ticks, as well as the risk of becoming infected with the Lyme disease pathogen, Borrelia burgdorferi (BB), if bitten by a vector tick. Current approaches to reducing the risk of tick bites or preventing infection with BB once bitten are largely reliant on the individual. They include use of topical repellents, use of protective clothing, avoidance of risk areas and removing ticks soon (ideally within a day) after they attach. These methods are efficacious, but constrained by user adherence. Other approaches such as landscape modification or the use of acaricides to control ticks, have shown promise in other countries, but have not been widely adopted in Canada. Lyme disease will continue to present a threat in Canada. In additional to the existing interventions for prevention of tick bites and Lyme disease, there is a need for new tools to help reduce the risk of Lyme disease to Canadians.

Reducing Risk in CO2 Sequestration: A Framework for Integrated Monitoring of Basin Scale Injection

NASA Astrophysics Data System (ADS)

Seto, C. J.; Haidari, A. S.; McRae, G. J.

2009-12-01

Geological sequestration of CO2 is an option for stabilization of atmospheric CO2 concentrations. Technical ability to safely store CO2 in the subsurface has been demonstrated through pilot projects and a long history of enhanced oil recovery and acid gas disposal operations. To address climate change, current injection operations must be scaled up by a factor of 100, raising issues of safety and security. Monitoring and verification is an essential component in ensuring safe operations and managing risk. Monitoring provides assurance that CO2 is securely stored in the subsurface, and the mechanisms governing transport and storage are well understood. It also provides an early warning mechanism for identification of anomalies in performance, and a means for intervention and remediation through the ability to locate the CO2. Through theoretical studies, bench scale experiments and pilot tests, a number of technologies have demonstrated their ability to monitor CO2 in the surface and subsurface. Because the focus of these studies has been to demonstrate feasibility, individual techniques have not been integrated to provide a more robust method for monitoring. Considering the large volumes required for injection, size of the potential footprint, length of time a project must be monitored and uncertainty, operational considerations of cost and risk must balance safety and security. Integration of multiple monitoring techniques will reduce uncertainty in monitoring injected CO2, thereby reducing risk. We present a framework for risk management of large scale injection through model based monitoring network design. This framework is applied to monitoring CO2 in a synthetic reservoir where there is uncertainty in the underlying permeability field controlling fluid migration. Deformation and seismic data are used to track plume migration. A modified Ensemble Kalman filter approach is used to estimate flow properties by jointly assimilating flow and geomechanical

Targeting high-risk employees may reduce cardiovascular racial disparities.

PubMed

Burke, James F; Vijan, Sandeep; Chekan, Lynette A; Makowiec, Ted M; Thomas, Laurita; Morgenstern, Lewis B

2014-09-01

A possible remedy for health disparities is for employers to promote cardiovascular health among minority employees. We sought to quantify the financial return to employers of interventions to improve minority health, and to determine whether a race- or risk-targeted strategy was better. Retrospective claims-based cohort analysis. Unconditional per-person costs attributable to stroke and myocardial infarction (MI) were estimated for University of Michigan employees from 2006 to 2009 using a 2-part model. The model was then used to predict the costs of cardiovascular disease to the University for 2 subgroups of employees-minorities and high-risk patients-and to calculate cost-savings thresholds: the point at which the costs of hypothetical interventions (eg, workplace fitness programs) would equal the cost savings from stroke/ MI prevention. Of the 38,314 enrollees, 10% were African American. Estimated unconditional payments for stroke/MI were almost the same in African Americans ($128 per employee per year; 95% CI, $79-$177) and whites ($128 per employee per year; 95% CI, $101- $156), including higher event rates and lower payments per event in African Americans. Targeting the highest risk decile with interventions to reduce stroke/MI would result in a substantially higher cost-savings threshold ($81) compared with targeting African Americans ($13). An unanticipated consequence of risk-based targeting is that African Americans would substantially benefit: an intervention targeted at the top risk decile would prevent 75% of the events in African Americans, just as would an intervention that exclusively targeted African Americans. Targeting all high-risk employees for cardiovascular risk reduction may be a win-win-win situation for employers: improving health, decreasing costs, and reducing disparities.

Engaging with residents' perceived risks and benefits about technologies as a way of resolving remediation dilemmas.

PubMed

Prior, Jason; Rai, Tapan

2017-12-01

In recent decades the diversity of remediation technologies has increased significantly, with the breadth of technologies ranging from dig and dump to emergent technologies like phytoremediation and nanoremediation. The benefits of these technologies to the environment and human health are believed to be substantial. However, they also potentially constitute risks. Whilst there is a growing body of knowledge about the risks and benefits of these technologies from the perspective of experts, little is known about how residents perceive the risks and benefits of the application of these technologies to address contaminants in their local environment. This absence of knowledge poses a challenge to remediation practitioners and policy makers who are increasingly seeking to engage these affected local residents in choosing technology applications. Building on broader research into the perceived benefits and risks of technologies, and data from a telephone survey of 2009 residents living near 13 contaminated sites in Australia, regression analysis of closed-ended survey questions and coding of open-ended questions are combined to identify the main predictors of resident's perceived levels of risk and benefit to resident's health and to their local environment from remediation technologies. This research identifies a range of factors associated with the residents' physical context, their engagement with institutions during remediation processes, and the technologies which are associated with residents' level of perceived risk and benefit for human health and the local environment. The analysis found that bioremediation technologies were perceived as less risky and more beneficial than chemical, thermal and physical technologies. The paper also supports broader technology research that reports an inverse correlation between levels of perceived risks and benefits. In addition, the paper reveals the types of risks and benefits to human health and the local environment that

Reducing health risk assigned to organic emissions from a chemical weapons incinerator.

PubMed

Laman, David M; Weiler, B Douglas; Skeen, Rodney S

2013-03-01

Organic emissions from a chemical weapons incinerator have been characterized with an improved set of analytical methods to reduce the human health risk assigned to operations of the facility. A gas chromatography/mass selective detection method with substantially reduced detection limits has been used in conjunction with scanning electron microscopy/energy dispersive X-ray spectrometry and Fourier transform infrared microscopy to improve the speciation of semi-volatile and non-volatile organics emitted from the incinerator. The reduced detection limits have allowed a significant reduction in the assumed polycyclic aromatic hydrocarbon (PAH) and aminobiphenyl (ABP) emission rates used as inputs to the human health risk assessment for the incinerator. A mean factor of 17 decrease in assigned human health risk is realized for six common local exposure scenarios as a result of the reduced PAH and ABP detection limits.

Space-based Networking Technology Developments in the Interplanetary Network Directorate Information Technology Program

NASA Technical Reports Server (NTRS)

Clare, Loren; Clement, B.; Gao, J.; Hutcherson, J.; Jennings, E.

2006-01-01

Described recent development of communications protocols, services, and associated tools targeted to reduce risk, reduce cost and increase efficiency of IND infrastructure and supported mission operations. Space-based networking technologies developed were: a) Provide differentiated quality of service (QoS) that will give precedence to traffic that users have selected as having the greatest importance and/or time-criticality; b) Improve the total value of information to users through the use of QoS prioritization techniques; c) Increase operational flexibility and improve command-response turnaround; d) Enable new class of networked and collaborative science missions; e) Simplify applications interfaces to communications services; and f) Reduce risk and cost from a common object model and automated scheduling and communications protocols. Technologies are described in three general areas: communications scheduling, middleware, and protocols. Additionally developed simulation environment, which provides comprehensive, quantitative understanding of the technologies performance within overall, evolving architecture, as well as ability to refine & optimize specific components.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Astrophysics Data System (ADS)

Drake, Bret G.

2007-07-01

order to put into context an updated Integrated Space Transportation Plan (post- Columbia) and guide Agency planning. NASA was on the verge of committing significant funding in programs that would be better served if longer term goals were better known including the Orbital Space Plane, research on the ISS, National Aerospace Initiative, Shuttle Life Extension Program, Project Prometheus, as well as a wide range of technology development throughout the Agency. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary viewgraph presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the Moon, can help reduce the risk for Mars missions.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Technical Reports Server (NTRS)

Drake, Bret G.

2007-01-01

order to put into context an updated Integrated Space Transportation Plan (post- Columbia) and guide Agency planning. NASA was on the verge of committing significant funding in programs that would be better served if longer term goals were better known including the Orbital Space Plane, research on the ISS, National Aerospace Initiative, Shuttle Life Extension Program, Project Prometheus, as well as a wide range of technology development throughout the Agency. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary viewgraph presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the Moon, can help reduce the risk for Mars missions.

Advanced technology for reducing aircraft engine pollution

NASA Technical Reports Server (NTRS)

Jones, R. E.

1973-01-01

The proposed EPA regulations covering emissions of gas turbine engines will require extensive combustor development. The NASA is working to develop technology to meet these goals through a wide variety of combustor research programs conducted in-house, by contract, and by university grant. In-house efforts using the swirl-can modular combustor have demonstrated sizable reduction in NO emission levels. Testing to reduce idle pollutants has included the modification of duplex fuel nozzles to air-assisted nozzles and an exploration of the potential improvements possible with combustors using fuel staging and variable geometry. The Experimental Clean Combustor Program, a large contracted effort, is devoted to the testing and development of combustor concepts designed to achieve a large reduction in the levels of all emissions. This effort is planned to be conducted in three phases with the final phase to be an engine demonstration of the best reduced emission concepts.

School-based programs to reduce sexual risk-taking behaviors.

PubMed

Kirby, D

1992-09-01

This article reviews the major approaches implemented during the last two decades to reduce sexual risk-taking behaviors, examines their evidence for success, and provides several recommendations for effective programs and program evaluations. This article does not discuss more broad-based sexuality education programs which address sexuality in a broader context. Instead, this article focuses primarily on programs that educators believed would reduce unprotected sexual intercourse.

Increased risk of eczema but reduced risk of early wheezy disorder from exclusive breast-feeding in high-risk infants.

PubMed

Giwercman, Charlotte; Halkjaer, Liselotte B; Jensen, Signe Marie; Bønnelykke, Klaus; Lauritzen, Lotte; Bisgaard, Hans

2010-04-01

Breast-feeding is recommended for the prevention of eczema, asthma, and allergy, particularly in high-risk families, but recent studies have raised concern that this may not protect children and may even increase the risk. However, disease risk, disease manifestation, lifestyle, and the choice to breast-feed are interrelated, and therefore, analyzing true causal effects presents a number of methodologic challenges. First, to assess the effect from duration of exclusive breast-feeding on the development of eczema and wheezy disorders during the first 2 years of life in a high-risk clinical birth cohort. Second, to assess any influence from the fatty acid composition of mother's milk on the risk from breast-feeding. We studied disease development during the first two years of life of the 411 infants from the Copenhagen Study on Asthma in Childhood (COPSAC) birth cohort, born to mothers with a history of asthma. We analyzed the effect from duration of breast-feeding before disease onset on the disease risk, avoiding the effect from disease-related modification of exposure (inverse causation). Polyunsaturated fatty acids were measured in breast milk. Breast-feeding significantly increased the risk of eczema adjusted for demographics, filaggrin variants, parents' eczema, and pets at home (N = 306; relative risk, 2.09; 95% CI 1.15-3.80; P = .016) but reduced the risk of wheezy episodes (relative risk, 0.67; 95% CI 0.48-0.96; P = .021) and of severe wheezy exacerbation (relative risk, 0.16; 95% CI 0.03-1.01; P = .051). There was no association between the fatty acid composition of mother's milk and the risk of eczema or wheeze. The risk of eczema was increased in infants with increasing duration of breast-feeding. In contrast, the risk of wheezy disorder and severe wheezy exacerbations was reduced. There were no significant effects from the fatty acid composition of the breast milk on risk of eczema or wheezy disorders. Copyright (c) 2010 American Academy of Allergy

Comparison of human exposure pathways in an urban brownfield: reduced risk from paving roads.

PubMed

James, Kyle; Farrell, Richard E; Siciliano, Steven D

2012-10-01

Risk assessments often do not quantify the risk associated with soil inhalation. This pathway generally makes a negligible contribution to the cumulative risk, because soil ingestion is typically the dominant exposure pathway. Conditions in northern or rural centers in Canada characterized by large areas of exposed soil, including unpaved roads, favor the resuspension of soil particles, making soil inhalation a relevant risk pathway. The authors determined and compared human exposure to metals and polycyclic aromatic hydrocarbons (PAHs) from soil ingestion and inhalation and analyzed the carcinogenic and noncarcinogenic risks before and after roads were paved in a northern community. To determine the inhalation exposure, three size fractions of airborne particulate matter were collected (total suspended particulates [TSP], particulate matter with an aerodynamic diameter less than 10 µm [PM10], and particulate matter with an aerodynamic diameter less than 2.5 µm [PM2.5]) before and after roads were paved. Road paving reduced the concentration of many airborne contaminants by 25 to 75%, thus reducing risk. For example, before paving, the carcinogenic risk associated with inhalation of Cr was 3.4 excess cancers per 100,000 people exposed, whereas after paving, this risk was reduced to 1.6 in 100,000. Paving roads reduced the concentrations of total suspended particulates (TSP; p < 0.1) and PM10 (p < 0.05) but not PM25. Consequently, the ingestion of inhaled soil particles was substantially reduced. The authors conclude that resuspended soil is likely an important source of risk for many northern communities and that paving roads is an effective method of reducing risk from the inhalation of soil particles. Copyright © 2012 SETAC.

Reduced cancer risk in vegetarians: an analysis of recent reports.

PubMed

Lanou, Amy Joy; Svenson, Barbara

2010-12-20

This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%-12% reduction in overall cancer risk) although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer.

Reduced cancer risk in vegetarians: an analysis of recent reports

PubMed Central

Lanou, Amy Joy; Svenson, Barbara

2011-01-01

This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%–12% reduction in overall cancer risk) although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer. PMID:21407994

River Protection Project Technology and Innovation Roadmap.

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

Reid, D. S.; Wooley, T. A.; Kelly, S. E.

The Technology and Innovation Roadmap is a planning tool for WRPS management, DOE ORP, DOE EM, and others to understand the risks and technology gaps associated with the RPP mission. The roadmap identifies and prioritizes technical areas that require technology solutions and underscores where timely and appropriate technology development can have the greatest impact to reduce those risks and uncertainties. The roadmap also serves as a tool for determining allocation of resources.

Intervention of drudgery reducing technologies in agriculture and impact evaluation.

PubMed

Mehta, Manju; Gandhi, Sudesh; Dilbaghi, Mamta

2012-01-01

Agriculture is main source of livelihood for majority of the population in India. Agriculture has been established as one of the drudgery prone occupation of unorganized sector due to lack of access to improved agricultural technologies. The present study was planned to assess intervention of drudgery reducing technologies in agriculture and its impact evaluation. The drudgery areas/activities in agriculture were identified. Participatory field level skill training for proper use of the ergonomically improved farm technologies were given to men and women in separate groups. An intervention package consisting of improved sickle, wheel hand hoe, capron, cot bag and protective gloves was introduced in village Shahpur. Data were collected to quantify the impact of intervention on the level of drudgery of worker before and after the technology intervention from sample of 30 respondents (15 male and 15 female) selected randomly from village Shahpur. Gain in knowledge and change in awareness level were calculated after the training.Evaluation of field validation of technology on drudgery of men & women was done after its use in the field conditions. A significant gain in awareness was observed among both men(2.6) & women (3.0) whereas the gain in knowledge was more among men (6.6) than women (4.5). In evaluation of field validation of technology on drudgery it was found that all the five technologies reduced the drudgery of men as well as women. However wheel hand hoe was used successfully by men in comparison to women who preferred to use their conventional technology i.e improved long-handled hoe. Evaluation of validation trials of the technologies reported that improved sickle was used successfully by both men & women farmers. More than half of the men farmers (53.3%) & only 13.3 percent women farmers preferred the wheel hand hoe over the traditional one as they found it four times more efficient in terms of time, energy & money saving. Cot bag was preferred by the

Identifying postpartum intervention approaches to reduce cardiometabolic risk among American Indian women with prior gestational diabetes, Oklahoma, 2012-2013.

PubMed

Jones, Emily J; Peercy, Michael; Woods, J Cedric; Parker, Stephany P; Jackson, Teresa; Mata, Sara A; McCage, Shondra; Levkoff, Sue E; Nicklas, Jacinda M; Seely, Ellen W

2015-04-02

Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women's cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women's competing priorities. Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population.

Dairy food supplementation may reduce malnutrition risk in institutionalised elderly.

PubMed

Iuliano, Sandra; Poon, Shirley; Wang, Xiaofang; Bui, Minh; Seeman, Ego

2017-01-01

Malnutrition in institutionalised elderly increases morbidity and care costs. Meat and dairy foods are high-quality protein sources so adequate intakes may reduce malnutrition risk. We aimed to determine whether inadequate intakes of meat and dairy foods contribute to malnutrition in institutionalised elderly. This cross-sectional study involved 215 elderly residents (70·2 % females, mean age 85·8 years) from twenty-one aged-care facilities in Melbourne, Australia. Dietary intake was assessed using observed plate waste. Food groups and serving sizes were based on the Australian Guide to Healthy Eating. Nutrient content was analysed using a computerised nutrient analysis software (Xyris). Malnutrition risk was assessed using the Mini Nutrition Assessment (MNA) tool; a score between 24 and 30 indicates normal nutritional status. Data were analysed using robust regression. Mean MNA score was 21·6 (sd 2·7). In total, 68 % of residents were malnourished or at risk of malnutrition (MNA score≤23·5). Protein intake was 87 (sd 28) % of the Australian recommended dietary intake (RDI). Consumption averaged 1 serving each of dairy foods and meat daily. Number of dairy and meat servings related to proportion of protein RDI (both P24 points). Provision of meat and dairy foods did not meet recommended levels. On the basis of current dietary intakes in aged-care residents, increasing consumption of dairy foods to the recommended four servings daily ensures protein adequacy and may reduce malnutrition risk in institutionalised elderly, and so reduce risk of comorbidities and costs associated with malnutrition.

Policies for Reducing Coastal Risk on the East and Gulf Coasts

NASA Astrophysics Data System (ADS)

Glickson, D.; Johnson, S.

2014-12-01

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

Reducing mortality risk by targeting specific air pollution sources: Suva, Fiji.

PubMed

Isley, C F; Nelson, P F; Taylor, M P; Stelcer, E; Atanacio, A J; Cohen, D D; Mani, F S; Maata, M

2018-01-15

Health implications of air pollution vary dependent upon pollutant sources. This work determines the value, in terms of reduced mortality, of reducing ambient particulate matter (PM 2.5 : effective aerodynamic diameter 2.5μm or less) concentration due to different emission sources. Suva, a Pacific Island city with substantial input from combustion sources, is used as a case-study. Elemental concentration was determined, by ion beam analysis, for PM 2.5 samples from Suva, spanning one year. Sources of PM 2.5 have been quantified by positive matrix factorisation. A review of recent literature has been carried out to delineate the mortality risk associated with these sources. Risk factors have then been applied for Suva, to calculate the possible mortality reduction that may be achieved through reduction in pollutant levels. Higher risk ratios for black carbon and sulphur resulted in mortality predictions for PM 2.5 from fossil fuel combustion, road vehicle emissions and waste burning that surpass predictions for these sources based on health risk of PM 2.5 mass alone. Predicted mortality for Suva from fossil fuel smoke exceeds the national toll from road accidents in Fiji. The greatest benefit for Suva, in terms of reduced mortality, is likely to be accomplished by reducing emissions from fossil fuel combustion (diesel), vehicles and waste burning. Copyright © 2017. Published by Elsevier B.V.

Breast-feeding reduces the risk for childhood eczema.

PubMed

Kull, Inger; Böhme, Maria; Wahlgren, Carl-Fredrik; Nordvall, Lennart; Pershagen, Göran; Wickman, Magnus

2005-09-01

The evidence for a preventive effect of breast-feeding on the development of eczema in childhood remains controversial. To investigate the effect of breast-feeding in various phenotypes of eczema to 4 years. A birth cohort of 4089 children made up the study base. Data on breast-feeding, allergic symptoms, and potential confounders were obtained from questionnaires when the children were 2 months and 1, 2, and 4 years old. At 4 years, blood specific IgE was analyzed. Children with symptoms of eczema and asthma during the period of breast-feeding were excluded in most analyses on risk assessment of eczema and asthma, respectively, to avoid disease-related modification of exposure. Exclusive breast-feeding for >or=4 months reduced the risk for eczema at the age of 4 years (odds ratio [OR], 0.78; 95% CI, 0.63--0.96) irrespective of combination with asthma, sensitization to common allergens, or parental allergic disease. This decreased risk was most evident for children with onset of eczema during the first 2 years persisting to 4 years (OR, 0.59; 95% CI, 0.45--0.77). Among children with early-onset eczema, irrespective of persistency, followed by late onset of asthma or early-onset asthma irrespective of persistency, followed by late-onset eczema to 4 years, a protective effect of breast-feeding was also seen (OR, 0.48; 95% CI, 0.30--0.76). Breast-feeding 4 months or more reduces the risk for eczema and onset of the allergy march to age 4.

Managing Risk on a Technology Development Project/Advanced Mirror System Demonstrator

NASA Technical Reports Server (NTRS)

Byberg, Alicia; Russell, J. Kevin; Stahl, Phil (Technical Monitor)

2002-01-01

The risk management study applied to the Advanced Mirror System Demonstrator (AMSD), a precursor mirror technology development for the Next Generation Space Telescope (NGST) is documented. The AMSD will be developed as a segment of a lightweight primary mirror system that can be produced at a low cost and with a short manufacturing schedule. The technology gained from the program will support the risk mitigation strategy for the NGST, as well as other government agency space mirror programs.

Reducing the risk of surgical site infections: did we really think SCIP was going to lead us to the promised land?

PubMed

Edmiston, Charles E; Spencer, Maureen; Lewis, Brian D; Brown, Kellie R; Rossi, Peter J; Henen, Cindy R; Smith, Heidi W; Seabrook, Gary R

2011-06-01

Surgical site infections (SSIs) are associated with substantial patient morbidity and death. It is estimated that 750,000-1 million SSIs occur in the U.S. each year, utilizing 3.7 million extra hospital days and costing more than $1.6 billion in excess hospital charges. Review of pertinent English-language literature. The Surgical Care Improvement Project (SCIP) was embraced as a "one-size-fits-all" strategy to reduce postoperative infectious morbidity 25% by 2010. Unfortunately, the evidence suggests that SCIP by itself has had little efficacy in reducing the overall risk of SSI. Whereas the SCIP initiative represents a first national effort to focus on reducing postoperative infectious morbidity and deaths, it fails to consider salient risk factors such as body mass index and selected surgical practices, including tourniquet application prior to incision. Rather than focus on a single risk-reduction strategy, future efforts to improve surgical outcomes should embrace a "SCIP-plus" multi-faceted, tiered interventional strategy that includes pre-admission antiseptic showering, state-of-the-art skin antisepsis, innovative antimicrobial technology, active staphylococcal surveillance, and pharmacologic-physiologic considerations unique to selective patient populations.

Study Shows Aspirin Reduces Colorectal Cancer in Those at High Risk

Cancer.gov

Findings from the first large clinical trial of its kind indicate that taking high doses of aspirin daily for at least 2 years substantially reduces the risk of colorectal cancer among people at increased risk of the disease.

Novel sensing technology in fall risk assessment in older adults: a systematic review.

PubMed

Sun, Ruopeng; Sosnoff, Jacob J

2018-01-16

Falls are a major health problem for older adults with significant physical and psychological consequences. A first step of successful fall prevention is to identify those at risk of falling. Recent advancement in sensing technology offers the possibility of objective, low-cost and easy-to-implement fall risk assessment. The objective of this systematic review is to assess the current state of sensing technology on providing objective fall risk assessment in older adults. A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Twenty-two studies out of 855 articles were systematically identified and included in this review. Pertinent methodological features (sensing technique, assessment activities, outcome variables, and fall discrimination/prediction models) were extracted from each article. Four major sensing technologies (inertial sensors, video/depth camera, pressure sensing platform and laser sensing) were reported to provide accurate fall risk diagnostic in older adults. Steady state walking, static/dynamic balance, and functional mobility were used as the assessment activity. A diverse range of diagnostic accuracy across studies (47.9% - 100%) were reported, due to variation in measured kinematic/kinetic parameters and modelling techniques. A wide range of sensor technologies have been utilized in fall risk assessment in older adults. Overall, these devices have the potential to provide an accurate, inexpensive, and easy-to-implement fall risk assessment. However, the variation in measured parameters, assessment tools, sensor sites, movement tasks, and modelling techniques, precludes a firm conclusion on their ability to predict future falls. Future work is needed to determine a clinical meaningful and easy to interpret fall risk diagnosis utilizing sensing technology. Additionally, the gap between functional evaluation and user experience to technology should be addressed.

Natural disturbance reduces disease risk in endangered rainforest frog populations

PubMed Central

Roznik, Elizabeth A.; Sapsford, Sarah J.; Pike, David A.; Schwarzkopf, Lin; Alford, Ross A.

2015-01-01

Natural disturbances can drive disease dynamics in animal populations by altering the microclimates experienced by hosts and their pathogens. Many pathogens are highly sensitive to temperature and moisture, and therefore small changes in habitat structure can alter the microclimate in ways that increase or decrease infection prevalence and intensity in host populations. Here we show that a reduction of rainforest canopy cover caused by a severe tropical cyclone decreased the risk of endangered rainforest frogs (Litoria rheocola) becoming infected by a fungal pathogen (Batrachochytrium dendrobatidis). Reductions in canopy cover increased the temperatures and rates of evaporative water loss in frog microhabitats, which reduced B. dendrobatidis infection risk in frogs by an average of 11–28% in cyclone-damaged areas, relative to unaffected areas. Natural disturbances to the rainforest canopy can therefore provide an immediate benefit to frogs by altering the microclimate in ways that reduce infection risk. This could increase host survival and reduce the probability of epidemic disease outbreaks. For amphibian populations under immediate threat from this pathogen, targeted manipulation of canopy cover could increase the availability of warmer, drier microclimates and therefore tip the balance from host extinction to coexistence. PMID:26294048

Natural disturbance reduces disease risk in endangered rainforest frog populations.

PubMed

Roznik, Elizabeth A; Sapsford, Sarah J; Pike, David A; Schwarzkopf, Lin; Alford, Ross A

2015-08-21

Natural disturbances can drive disease dynamics in animal populations by altering the microclimates experienced by hosts and their pathogens. Many pathogens are highly sensitive to temperature and moisture, and therefore small changes in habitat structure can alter the microclimate in ways that increase or decrease infection prevalence and intensity in host populations. Here we show that a reduction of rainforest canopy cover caused by a severe tropical cyclone decreased the risk of endangered rainforest frogs (Litoria rheocola) becoming infected by a fungal pathogen (Batrachochytrium dendrobatidis). Reductions in canopy cover increased the temperatures and rates of evaporative water loss in frog microhabitats, which reduced B. dendrobatidis infection risk in frogs by an average of 11-28% in cyclone-damaged areas, relative to unaffected areas. Natural disturbances to the rainforest canopy can therefore provide an immediate benefit to frogs by altering the microclimate in ways that reduce infection risk. This could increase host survival and reduce the probability of epidemic disease outbreaks. For amphibian populations under immediate threat from this pathogen, targeted manipulation of canopy cover could increase the availability of warmer, drier microclimates and therefore tip the balance from host extinction to coexistence.

Limitations of self-care in reducing the risk of lymphedema: supportive-educative systems.

PubMed

Armer, Jane M; Brooks, Constance W; Stewart, Bob R

2011-01-01

The purpose of this study was to examine patient perceptions of limitations related to self-care measures to reduce lymphedema risk following breast cancer surgery. Secondary analysis of survey data from a companion study to a study piloting a behavioral-educational intervention was conducted to examine the specific limitations in performing lymphedema risk-reduction self-care measures. Findings suggest a more comprehensive approach is needed if patients are to engage in self-care actions to reduce lymphedema risk. Understanding the concepts of self-care and personal support interventions that include motivational interviewing can help nurses design supportive-educative care systems that assist patients in overcoming limitations in the estimative, transitional, and productive phases of self-care necessary to reduce lymphedema risk.

Exposure to indoor air pollution from household energy use in rural China: the interactions of technology, behavior, and knowledge in health risk management.

PubMed

Jin, Yinlong; Ma, Xiao; Chen, Xining; Cheng, Yibin; Baris, Enis; Ezzati, Majid

2006-06-01

Indoor air pollution (IAP) from household use of biomass and coal is a leading environmental health risk in many developing nations. Much of the initial research on household energy technology overlooked the complex interactions of technological, behavioral, economic, and infrastructural factors that determine the success of environmental health interventions. Consequently, despite enormous interest in reducing the large and inequitable risks associated with household energy use in international development and global health, there is limited empirical research to form the basis for design and delivery of effective interventions. We used data from four poor provinces in China (Gansu, Guizhou, Inner Mongolia, and Shaanxi) to examine the linkages among technology, user knowledge and behavior, and access and infrastructure in exposure to IAP from household energy use. We conclude that broad health risk education is insufficient for successful risk mitigation when exposure behaviors are closely linked to day-to-day activities of households such as cooking and heating, or have other welfare implications, and hence cannot be simply stopped. Rather, there should be emphasis on the economic and infrastructure determinants of access to technology, as well as the details of behaviors that affect exposure. Better understanding of technology-behavior interface would also allow designing technological interventions that account for, and are robust to, behavioral factors or to provide individuals and households with alternative behaviors. Based on the analysis, we present technological and behavioral interventions for these four Chinese provinces.

Phenology Information Contributes to Reduce Temporal Basis Risk in Agricultural Weather Index Insurance.

PubMed

Dalhaus, Tobias; Musshoff, Oliver; Finger, Robert

2018-01-08

Weather risks are an essential and increasingly important driver of agricultural income volatility. Agricultural insurances contribute to support farmers to cope with these risks. Among these insurances, weather index insurances (WII) are an innovative tool to cope with climatic risks in agriculture. Using WII, farmers receive an indemnification not based on actual yield reductions but are compensated based on a measured weather index, such as rainfall at a nearby weather station. The discrepancy between experienced losses and actual indemnification, basis risk, is a key challenge. In particular, specifications of WII used so far do not capture critical plant growth phases adequately. Here, we contribute to reduce basis risk by proposing novel procedures how occurrence dates and shifts of growth phases over time and space can be considered and test for their risk reducing potential. Our empirical example addresses drought risks in the critical growth phase around the anthesis stage in winter wheat production in Germany. We find spatially explicit, public and open databases of phenology reports to contribute to reduce basis risk and thus improve the attractiveness of WII. In contrast, we find growth stage modelling based on growing degree days (thermal time) not to result in significant improvements.

Effects of a Family Intervention in Reducing HIV Risk Behaviors Among High-Risk Hispanic Adolescents

PubMed Central

Prado, Guillermo; Pantin, Hilda; Huang, Shi; Cordova, David; Tapia, Maria I.; Velazquez, Maria-Rosa; Calfee, Meghan; Malcolm, Shandey; Arzon, Margaret; Villamar, Juan; Jimenez, Giselle Leon; Cano, Nicole; Brown, C. Hendricks; Estrada, Yannine

2013-01-01

Objective To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents. Design Randomized controlled trial. Setting Miami–Dade County Public School System and Miami–Dade County’s Department of Juvenile Services, Florida. Participants A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention. Intervention Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants). Main Outcome Measures Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures. Results Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting. Conclusion These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents. Trial Registration clinicaltrials.gov Identifier: NCT01257022 PMID:21969363

Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: a systematic literature review.

PubMed

Meiser, B; Wong, W K T; Peate, M; Julian-Reynier, C; Kirk, J; Mitchell, G

2017-01-01

Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen's well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use 's amongst high-risk women. Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women's decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies. A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism. Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological.

A Framework for Integrating Knowledge Management with Risk Management for Information Technology Projects (RiskManiT)

ERIC Educational Resources Information Center

Karadsheh, Louay A.

2010-01-01

This research focused on the challenges experienced when executing risk management activities for information technology projects. The lack of adequate knowledge management support of risk management activities has caused many project failures in the past. The research objective was to propose a conceptual framework of the Knowledge-Based Risk…

Technology to Reduce Hypoglycemia

PubMed Central

Yeoh, Ester; Choudhary, Pratik

2015-01-01

Hypoglycemia is a major barrier toward achieving glycemic targets and is associated with significant morbidity (both psychological and physical) and mortality. This article reviews technological strategies, from simple to more advanced technologies, which may help prevent or mitigate exposure to hypoglycemia. More efficient insulin delivery systems, bolus advisor calculators, data downloads providing information on glucose trends, continuous glucose monitoring with alarms warning of hypoglycemia, predictive algorithms, and finally closed loop insulin delivery systems are reviewed. The building blocks to correct use and interpretation of this range of available technology require patient education and appropriate patient selection. PMID:25883167

The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis.

PubMed

Hollands, Gareth J; French, David P; Griffin, Simon J; Prevost, A Toby; Sutton, Stephen; King, Sarah; Marteau, Theresa M

2016-03-15

To assess the impact of communicating DNA based disease risk estimates on risk-reducing health behaviours and motivation to engage in such behaviours. Systematic review with meta-analysis, using Cochrane methods. Medline, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials up to 25 February 2015. Backward and forward citation searches were also conducted. Randomised and quasi-randomised controlled trials involving adults in which one group received personalised DNA based estimates of disease risk for conditions where risk could be reduced by behaviour change. Eligible studies included a measure of risk-reducing behaviour. We examined 10,515 abstracts and included 18 studies that reported on seven behavioural outcomes, including smoking cessation (six studies; n=2663), diet (seven studies; n=1784), and physical activity (six studies; n=1704). Meta-analysis revealed no significant effects of communicating DNA based risk estimates on smoking cessation (odds ratio 0.92, 95% confidence interval 0.63 to 1.35, P=0.67), diet (standardised mean difference 0.12, 95% confidence interval -0.00 to 0.24, P=0.05), or physical activity (standardised mean difference -0.03, 95% confidence interval -0.13 to 0.08, P=0.62). There were also no effects on any other behaviours (alcohol use, medication use, sun protection behaviours, and attendance at screening or behavioural support programmes) or on motivation to change behaviour, and no adverse effects, such as depression and anxiety. Subgroup analyses provided no clear evidence that communication of a risk-conferring genotype affected behaviour more than communication of the absence of such a genotype. However, studies were predominantly at high or unclear risk of bias, and evidence was typically of low quality. Expectations that communicating DNA based risk estimates changes behaviour is not supported by existing evidence. These results do not support use of genetic testing or the search for risk

Aircraft Engine Technology for Green Aviation to Reduce Fuel Burn

NASA Technical Reports Server (NTRS)

Hughes, Christopher E.; VanZante, Dale E.; Heidmann, James D.

2013-01-01

The NASA Fundamental Aeronautics Program Subsonic Fixed Wing Project and Integrated Systems Research Program Environmentally Responsible Aviation Project in the Aeronautics Research Mission Directorate are conducting research on advanced aircraft technology to address the environmental goals of reducing fuel burn, noise and NOx emissions for aircraft in 2020 and beyond. Both Projects, in collaborative partnerships with U.S. Industry, Academia, and other Government Agencies, have made significant progress toward reaching the N+2 (2020) and N+3 (beyond 2025) installed fuel burn goals by fundamental aircraft engine technology development, subscale component experimental investigations, full scale integrated systems validation testing, and development validation of state of the art computation design and analysis codes. Specific areas of propulsion technology research are discussed and progress to date.

Reducing risk where tectonic plates collide

USGS Publications Warehouse

Gomberg, Joan S.; Ludwig, Kristin A.

2017-06-19

Most of the world’s earthquakes, tsunamis, landslides, and volcanic eruptions are caused by the continuous motions of the many tectonic plates that make up the Earth’s outer shell. The most powerful of these natural hazards occur in subduction zones, where two plates collide and one is thrust beneath another. The U.S. Geological Survey’s (USGS) “Reducing Risk Where Tectonic Plates Collide—A USGS Plan to Advance Subduction Zone Science” is a blueprint for building the crucial scientific foundation needed to inform the policies and practices that can make our Nation more resilient to subduction zone-related hazards.

What can individuals do to reduce personal health risks from air pollution?

PubMed Central

Laumbach, Robert; Meng, Qingyu

2015-01-01

In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure and health risks. Personal exposure to ambient air pollution can be reduced on high air pollution days by staying indoors, reducing outdoor air infiltration to indoors, cleaning indoor air with air filters, and limiting physical exertion, especially outdoors and near air pollution sources. Limited evidence suggests that the use of respirators may be effective in some circumstances. Awareness of air pollution levels is facilitated by a growing number of public air quality alert systems. Avoiding exposure to air pollutants is especially important for susceptible individuals with chronic cardiovascular or pulmonary disease, children, and the elderly. Research on mechanisms underlying the adverse health effects of air pollution have suggested potential pharmaceutical or chemopreventive interventions, such as antioxidant or antithrombotic agents, but in the absence of data on health outcomes, no sound recommendations can be made for primary prevention. Health care providers and their patients should carefully consider individual circumstances related to outdoor and indoor air pollutant exposure levels and susceptibility to those air pollutants when deciding on a course of action to reduce personal exposure and health risks from ambient air pollutants. Careful consideration is especially warranted when interventions may have unintended negative consequences, such as when efforts to avoid exposure to air pollutants lead to reduced physical activity or when there is evidence that dietary supplements, such as antioxidants, have potential adverse health effects. These potential complications of partially effective personal interventions to reduce exposure or

What can individuals do to reduce personal health risks from air pollution?

PubMed

Laumbach, Robert; Meng, Qingyu; Kipen, Howard

2015-01-01

In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure and health risks. Personal exposure to ambient air pollution can be reduced on high air pollution days by staying indoors, reducing outdoor air infiltration to indoors, cleaning indoor air with air filters, and limiting physical exertion, especially outdoors and near air pollution sources. Limited evidence suggests that the use of respirators may be effective in some circumstances. Awareness of air pollution levels is facilitated by a growing number of public air quality alert systems. Avoiding exposure to air pollutants is especially important for susceptible individuals with chronic cardiovascular or pulmonary disease, children, and the elderly. Research on mechanisms underlying the adverse health effects of air pollution have suggested potential pharmaceutical or chemopreventive interventions, such as antioxidant or antithrombotic agents, but in the absence of data on health outcomes, no sound recommendations can be made for primary prevention. Health care providers and their patients should carefully consider individual circumstances related to outdoor and indoor air pollutant exposure levels and susceptibility to those air pollutants when deciding on a course of action to reduce personal exposure and health risks from ambient air pollutants. Careful consideration is especially warranted when interventions may have unintended negative consequences, such as when efforts to avoid exposure to air pollutants lead to reduced physical activity or when there is evidence that dietary supplements, such as antioxidants, have potential adverse health effects. These potential complications of partially effective personal interventions to reduce exposure or

Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

NASA Astrophysics Data System (ADS)

Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

2013-04-01

Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific

Reducing Risk Behaviors Linked to Noncommunicable Diseases in Mongolia: A Randomized Controlled Trial

PubMed Central

Wang, Wei; Riedel, Marion; Witte, Susan S.

2013-01-01

Objectives. We tested the efficacy of a 6-session, evidence-based health promotion intervention aimed at reducing noncommunicable disease (NCD) risk behaviors. Methods. Two hundred male and female factory workers in Ulaanbaatar, Mongolia were randomly assigned to groups receiving either the health promotion intervention or a time-matched financial literacy control intervention. Results. The health promotion intervention increased daily fruit and vegetable intake and physical activity, increased readiness for NCD risk behavior reduction and health promotion knowledge, and reduced the number of daily alcoholic drinks and diabetes symptoms 3 months after the intervention. Conclusions. The findings support the efficacy of the intervention to reduce risk behaviors associated with NCDs. Dissemination of the intervention may improve productivity, reduce costs of health services, and better the quality of life for Mongolians. PMID:23865647

Damage-reducing measures to manage flood risks in a changing climate

NASA Astrophysics Data System (ADS)

Kreibich, Heidi; Bubeck, Philip; Van Vliet, Mathijs; De Moel, Hans

2014-05-01

Damage due to floods has increased during the last few decades, and further increases are expected in several regions due to climate change and a growing vulnerability. To address the projected increase in flood risk, a combination of structural and non-structural flood risk mitigation measures is considered as a promising adaptation strategy. Such a combination takes into account that flood defence systems may fail, and prepare for unexpected crisis situations via land-use planning, building construction, evacuation and disaster response. Non-structural flood risk mitigation measures like shielding with water shutters or sand bags, building fortification or safeguarding of hazardous substances are often voluntary: they demand self-dependent action by the population at risk (Bubeck et al. 2012; 2013). It is believed that these measures are especially effective in areas with frequent flood events and low flood water levels, but some types of measures showed a significant damage-reducing effect also during extreme flood events, such as the Elbe River flood in August 2002 in Germany (Kreibich et al. 2005; 2011). Despite the growing importance of damage-reducing measures, information is still scarce about factors that motivate people to undertake such measures, the state of implementation of various non-structural measures in different countries and their damage reducing effects. Thus, we collected information and undertook an international review about this topic in the framework of the Dutch KfC project "Climate proof flood risk management". The contribution will present an overview about the available information on damage-reducing measures and draw conclusions for practical flood risk management in a changing climate. References: Bubeck, P., Botzen, W. J. W., Suu, L. T. T., Aerts, J. C. J. H. (2012): Do flood risk perceptions provide useful insights for flood risk management? Findings from central Vietnam. Journal of Flood Risk Management, 5, 4, 295-302 Bubeck, P

Identification of technology options for reducing nitrogen pollution in cropping systems of Pujiang.

PubMed

Fang, Bin; Wang, Guang-Huo; Van, Den Berg Marrit; Roetter, Reimund

2005-10-01

This work analyses the potential role of nitrogen pollution technology of crop systems of Pujiang, County in Eastern China's Zhejiang Province, rice and vegetables are important cropping systems. We used a case study approach involving comparison of farmer practices and improved technologies. This approach allows assessing the impact of technology on pollution, is forward looking, and can yield information on the potential of on-the-shelf technology and provide opportunities for technology development. The approach particularly suits newly developed rice technologies with large potential of reducing nitrogen pollution and for future rice and vegetables technologies. The results showed that substantial reductions in nitrogen pollution are feasible for both types of crops.

Reduced cost alternatives to premise wiring using ATM and microcellular technologies

NASA Technical Reports Server (NTRS)

Gejji, Raghvendra R.

1993-01-01

The cost of premises wiring keeps increasing due to personnel moves, new equipment, capacity upgrades etc. It would be desirable to have a wireless interface from the workstations to the fixed network, so as to minimize the wiring changes needed. New technologies such as microcellular personal communication systems are promising to bring down the cost of wireless communication. Another promising technology is Code Division Multiple Access (CDMA), which could dramatically increase the bandwidth available for wireless connections. In addition, Asynchronous Transfer Mode (ATM) technology is emerging as a technique for integrated management of voice, data, and video traffic on a single network. The focus of this investigation will be to assess the future utility of these new technologies for reducing the premise wiring cost at KSC. One of the issues to be studied is the cost comparison of 'old' versus 'new,' especially as time and technology progress. An additional issue for closer study is a feasible time-line for progress in technological capability.

Pharmacist intervention reduces gastropathy risk in patients using NSAIDs.

PubMed

Ibañez-Cuevas, Victoria; Lopez-Briz, Eduardo; Guardiola-Chorro, M Teresa

2008-12-01

To establish a detection and intervention strategy in order to reduce the number of non-steroidal anti-inflammatory drug (NSAIDs) users at risk of gastropathy from receiving either inadequate or no gastroprotection. Community Pharmacies in Valencia, Spain. Prospective longitudinal intervention study without control group carried out by 79 Community Pharmacies. Patients over 18 who asked for any systemic NSAID were interviewed according to standard procedure. Pharmacist intervention was carried out when a patient at risk of serious NSAID-induced gastrointestinal complications due to inadequate or no gastric protection was identified. The doctor responsible was informed in order to then be able to assess the need to prescribe gastroprotection or change it if inadequate. In the case of over-the-counter (OTC) drugs, pharmacist intervention mainly involved replacing NSAIDs for safer medications. Firstly, the number of patients who had no prescribed gastroprotection or inadequate gastroprotection was determined. Pharmacist intervention then brought about changes in pharmacotherapy in this situation. Of the 6,965 patients who asked for NSAIDs during the study period, 3,054 (43.9%) presented NSAID gastropathy risk factors. 35.6% of the latter (1,089) were not prescribed gastroprotection or were prescribed inadequate gastroprotection. Pharmacist intervention was carried out in 1,075 of these cases. On 391 occasions such risk situations were reported to doctors, who accepted pharmacist intervention on 309 occasions (79.0%) and then either prescribed gastroprotection (77% of cases); changed it (13.9%); withdrew the NSAID (5.8%) or substituted it (3.2%). 235 Pharmacist interventions took place when dispensing OTC NSAIDs. Our strategy allowed us to identify a large number of patients who asked for NSAIDs in Community Pharmacies and who were at risk of NSAID gastropathy, as they received either inadequate gastroprotection or no gastroprotection whatsoever. Moreover, the

Risk and benefit perceptions of mobile phone and base station technology in Bangladesh.

PubMed

van Kleef, Ellen; Fischer, Arnout R H; Khan, Moin; Frewer, Lynn J

2010-06-01

Research in developed countries showed that many citizens perceive that radio signals transmitted by mobile phones and base stations represent potential health risks. Less research has been conducted in developing countries focused on citizen perceptions of risks and benefits, despite the recent and rapid introduction of mobile communication technologies. This study aims to identify factors that are influential in determining the tradeoffs that Bangladeshi citizens make between risks and benefits in terms of mobile phone technology acceptance and health concerns associated with the technology. Bangladesh was selected as representative of many developing countries inasmuch as terrestrial telephone infrastructure is insubstantial, and mobile phone use has expanded rapidly over the last decade, even among the poor. Issues of importance were identified in a small-scale qualitative study among Bangladeshi citizens (n = 13), followed by a survey within a sample of Bangladeshi citizens (n = 500). The results demonstrate that, in general, the perceived benefits of mobile phone technology outweigh the risks. The perceived benefits are primarily related to the social and personal advantages of mobile phone use, including the ability to receive emergency news about floods, cyclones, and other natural disasters. Base stations were seen as a symbol of societal advance. The results furthermore suggest that overall risk perceptions are relatively low, in particular health risks, and are primarily driven by perceptions that related to crime and social inconvenience. Perceived health risks are relatively small. These findings show that risk communication and management may be particularly effective when contextual factors of the society where the system is implemented are taken into consideration.

Observations Concerning the National Task Force on Educational Technology Report: "Reducing the Risk to the Nation."

ERIC Educational Resources Information Center

Salser, Carl

1987-01-01

Presents one educator's reaction to the National Task Force on Educational Technology's report. Provides responses to certain passages from the report's eight sections. Emphasizes that educators should look for ways to implement existing information-age technology in addition to more traditional forms of education technologies. (TW)

The prefabricated building risk decision research of DM technology on the basis of Rough Set

NASA Astrophysics Data System (ADS)

Guo, Z. L.; Zhang, W. B.; Ma, L. H.

2017-08-01

With the resources crises and more serious pollution, the green building has been strongly advocated by most countries and become a new building style in the construction field. Compared with traditional building, the prefabricated building has its own irreplaceable advantages but is influenced by many uncertainties. So far, a majority of scholars have been studying based on qualitative researches from all of the word. This paper profoundly expounds its significance about the prefabricated building. On the premise of the existing research methods, combined with rough set theory, this paper redefines the factors which affect the prefabricated building risk. Moreover, it quantifies risk factors and establish an expert knowledge base through assessing. And then reduced risk factors about the redundant attributes and attribute values, finally form the simplest decision rule. This simplest decision rule, which is based on the DM technology of rough set theory, provides prefabricated building with a controllable new decision-making method.

Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

NASA Astrophysics Data System (ADS)

Evans, J. D.; Hao, W.; Chettri, S. R.

2014-12-01

Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.

High-speed running and sprinting as an injury risk factor in soccer: Can well-developed physical qualities reduce the risk?

PubMed

Malone, Shane; Owen, Adam; Mendes, Bruno; Hughes, Brian; Collins, Kieran; Gabbett, Tim J

2018-03-01

This study investigated the association between high-speed running (HSR) and sprint running (SR) and injuries within elite soccer players. The impact of intermittent aerobic fitness as measured by the end speed of the 30-15 intermittent fitness test (30-15V IFT ) and high chronic workloads (average 21-day) as potential mediators of injury risk were also investigated. Observational Cohort Study. 37 elite soccer players from one elite squad were involved in a one-season study. Training and game workloads (session-RPE×duration) were recorded in conjunction with external training loads (using global positioning system technology) to measure the HSR (>14.4kmh -1 ) and SR (>19.8kmh -1 ) distance covered across weekly periods during the season. Lower limb injuries were also recorded. Training load and GPS data were modelled against injury data using logistic regression. Odds ratios (OR) were calculated with 90% confidence intervals based on 21-day chronic training load status (sRPE), aerobic fitness, HSR and SR distance with these reported against a reference group. Players who completed moderate HSR (701-750-m: OR: 0.12, 90%CI: 0.08-0.94) and SR distances (201-350-m: OR: 0.54, 90%CI: 0.41-0.85) were at reduced injury risk compared to low HSR (≤674-m) and SR (≤165-m) reference groups. Injury risk was higher for players who experienced large weekly changes in HSR (351-455-m; OR: 3.02; 90%CI: 2.03-5.18) and SR distances (between 75-105-m; OR: 6.12, 90%CI: 4.66-8.29). Players who exerted higher chronic training loads (≥2584 AU) were at significantly reduced risk of injury when they covered 1-weekly HSR distances of 701-750m compared to the reference group of <674m (OR=0.65, 90% CI 0.27-0.89). When intermittent aerobic fitness was considered based on 30-15V IFT performance, players with poor aerobic fitness had a greater risk of injury than players with better-developed aerobic fitness. Exposing players to large and rapid increases in HSR and SR distances increased the

Active fans and grizzly bears: Reducing risks for wilderness campers

NASA Astrophysics Data System (ADS)

Sakals, M. E.; Wilford, D. J.; Wellwood, D. W.; MacDougall, S. A.

2010-03-01

Active geomorphic fans experience debris flows, debris floods and/or floods (hydrogeomorphic processes) that can be hazards to humans. Grizzly bears ( Ursus arctos) can also be a hazard to humans. This paper presents the results of a cross-disciplinary study that analyzed both hydrogeomorphic and grizzly bear hazards to wilderness campers on geomorphic fans along a popular hiking trail in Kluane National Park and Reserve in southwestern Yukon Territory, Canada. Based on the results, a method is proposed to reduce the risks to campers associated with camping on fans. The method includes both landscape and site scales and is based on easily understood and readily available information regarding weather, vegetation, stream bank conditions, and bear ecology and behaviour. Educating wilderness campers and providing a method of decision-making to reduce risk supports Parks Canada's public safety program; a program based on the principle of user self-sufficiency. Reducing grizzly bear-human conflicts complements the efforts of Parks Canada to ensure a healthy grizzly bear population.

Reducing Metabolic Syndrome Risk Using a Personalized Wellness Program.

PubMed

Steinberg, Gregory; Scott, Adam; Honcz, Joseph; Spettell, Claire; Pradhan, Susil

2015-12-01

The aim of this study was to determine the impact of a targeted, personalized wellness program on reducing employees' future risk of metabolic syndrome. Aetna piloted a year-long program that included a limited genetic profile, a traditional psychosocial assessment, and high-intensity coaching in a randomized controlled study of Aetna employees with an increased risk for metabolic syndrome. Sustained employee engagement of 50% over the course of 1 year; 76% of participating employees lost an average of 10 pounds (4.5 kg) (P < 0.001 vs baseline weight), and there were trends in improved clinical outcomes relative to three of five metabolic factors. Average health care costs were reduced by $122 per participant per month, resulting in a positive return on investment in the program's first year. At scale, such programs would be expected to lead to significant downstream reduction in major clinical events and costs.

Sediment Management Methods to Reduce Dredging: Part 2, Sediment Collector Technology

DTIC Science & Technology

2017-04-01

Approved for public release; distribution is unlimited. ERDC TN-DOER-T13 April 2017 Sediment Management Methods to Reduce Dredging: Part 2...DOER) Program technical note (TN) is the second in a series evaluating sediment management methods to reduce dredging through a research task (RT...in the DOER Program.1 This TN presents an evaluation of sediment collector technology, one promising new device that may help better manage

Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia.

PubMed

Seeman, Ego; Devogelaer, Jean-Pierre; Lorenc, Roman; Spector, Timothy; Brixen, Kim; Balogh, Adam; Stucki, Gerold; Reginster, Jean-Yves

2008-03-01

Many fractures occur in women with moderate fracture risk caused by osteopenia. Strontium ranelate was studied in 1431 postmenopausal women with osteopenia. Vertebral fracture risk reduction of 41-59% was shown depending on the site and fracture status at baseline. This is the first report of antivertebral fracture efficacy in women with vertebral osteopenia. Women with osteoporosis are at high risk for fracture. However, more than one half of all fractures in the community originate from the larger population at more moderate risk of fracture caused by osteopenia. Despite this, evidence for antifracture efficacy in these persons is limited. The aim of this study was to determine whether strontium ranelate, a new drug that reduces fracture risk in women with osteoporosis, is also effective in women with osteopenia. Data from the Spinal Osteoporosis Therapeutic Intervention study (SOTI; n = 1649) and the TReatment Of Peripheral OSteoporosis (TROPOS; n = 5091) were pooled to evaluate the antivertebral fracture efficacy of strontium ranelate in women with lumbar spine (LS) osteopenia with any BMD value at the femoral neck (FN; N = 1166) and in 265 women with osteopenia at both sites (intention-to-treat analysis). The women were randomized to strontium ranelate 2 g/d orally or placebo for 3 yr. No group differences were present in baseline characteristics that may influence fracture outcome independent of therapy. In women with LS osteopenia, treatment reduced the risk of vertebral fracture by 41% (RR = 0.59; 95% CI, 0.43-0.82), by 59% (RR = 0.41; 95% CI, 0.17-0.99) in the 447 patients with no prevalent fractures, and by 38% (RR = 0.62; 95% CI, 0.44-0.88) in the 719 patients with prevalent fractures. In women with osteopenia at both sites, treatment reduced the risk of fracture by 52% (RR = 0.48; 95% CI, 0.24-0.96). Strontium ranelate safely reduces the risk of vertebral fractures in women with osteopenia with or without a prevalent fracture.

Use of advanced treatment technologies among men at low risk of dying from prostate cancer.

PubMed

Jacobs, Bruce L; Zhang, Yun; Schroeck, Florian R; Skolarus, Ted A; Wei, John T; Montie, James E; Gilbert, Scott M; Strope, Seth A; Dunn, Rodney L; Miller, David C; Hollenbeck, Brent K

2013-06-26

The use of advanced treatment technologies (ie, intensity-modulated radiotherapy [IMRT] and robotic prostatectomy) for prostate cancer is increasing. The extent to which these advanced treatment technologies have disseminated among patients at low risk of dying from prostate cancer is uncertain. To assess the use of advanced treatment technologies, compared with prior standards (ie, traditional external beam radiation treatment [EBRT] and open radical prostatectomy) and observation, among men with a low risk of dying from prostate cancer. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified a retrospective cohort of men diagnosed with prostate cancer between 2004 and 2009 who underwent IMRT (n = 23,633), EBRT (n = 3926), robotic prostatectomy (n = 5881), open radical prostatectomy (n = 6123), or observation (n = 16,384). Follow-up data were available through December 31, 2010. The use of advanced treatment technologies among men unlikely to die from prostate cancer, as assessed by low-risk disease (clinical stage ≤T2a, biopsy Gleason score ≤6, and prostate-specific antigen level ≤10 ng/mL), high risk of noncancer mortality (based on the predicted probability of death within 10 years in the absence of a cancer diagnosis), or both. In our cohort, the use of advanced treatment technologies increased from 32% (95% CI, 30%-33%) to 44% (95% CI, 43%-46%) among men with low-risk disease (P < .001) and from 36% (95% CI, 35%-38%) to 57% (95% CI, 55%-59%) among men with high risk of noncancer mortality (P < .001). The use of these advanced treatment technologies among men with both low-risk disease and high risk of noncancer mortality increased from 25% (95% CI, 23%-28%) to 34% (95% CI, 31%-37%) (P < .001). Among all patients diagnosed in SEER, the use of advanced treatment technologies for men unlikely to die from prostate cancer increased from 13% (95% CI, 12%-14%), or 129.2 per 1000 patients diagnosed with prostate cancer, to 24% (95

Healthcare technology: physician collaboration in reducing the surgical cost.

PubMed

Olson, Steven A; Obremskey, William T; Bozic, Kevin J

2013-06-01

The increasing cost of providing health care is a national concern. Healthcare spending related to providing hospital care is one of the primary drivers of healthcare spending in the United States. Adoption of advanced medical technologies accounts for the largest percentage of growth in healthcare spending in the United States when compared with other developed countries. Within the specialty of orthopaedic surgery, a variety of implants can result in similar outcomes for patients in several areas of clinical care. However, surgeons often do not know the cost of implants used in a specific procedure or how the use of an implant or technology affects the overall cost of the episode of care. The purposes of this study were (1) to describe physician-led processes for introduction of new surgical products and technologies; and (2) to inform physicians of potential cost savings of physician-led product contract negotiations and approval of new technology. We performed a detailed review of the steps taken by two centers that have implemented surgeon-led programs to demonstrate responsibility in technology acquisition and product procurement decision-making. Each program has developed a physician peer review process in technology and new product acquisition that has resulted in a substantial reduction in spending for the respective hospitals in regard to surgical implants. Implant costs have decreased between 3% and 38% using different negotiating strategies. At the same time, new product requests by physicians have been approved in greater than 90% of instances. Hospitals need physicians to be engaged and informed in discussions concerning current and new technology and products. Surgeons can provide leadership for these efforts to reduce the cost of high-quality care.

Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines.

PubMed

Zhou, Lu-Jie; Cao, Qing-Gui; Yu, Kai; Wang, Lin-Lin; Wang, Hai-Bin

2018-04-26

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines.

Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines

PubMed Central

Zhou, Lu-jie; Cao, Qing-gui; Yu, Kai; Wang, Lin-lin; Wang, Hai-bin

2018-01-01

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines. PMID:29701715

Identification of technology options for reducing nitrogen pollution in cropping systems of Pujiang*

PubMed Central

Fang, Bin; Wang, Guang-huo; Van den berg, Marrit; Roetter, Reimund

2005-01-01

This work analyses the potential role of nitrogen pollution technology of crop systems of Pujiang, County in Eastern China’s Zhejiang Province, rice and vegetables are important cropping systems. We used a case study approach involving comparison of farmer practices and improved technologies. This approach allows assessing the impact of technology on pollution, is forward looking, and can yield information on the potential of on-the-shelf technology and provide opportunities for technology development. The approach particularly suits newly developed rice technologies with large potential of reducing nitrogen pollution and for future rice and vegetables technologies. The results showed that substantial reductions in nitrogen pollution are feasible for both types of crops. PMID:16187411

An Approach to Reducing Risk through School System Intervention.

ERIC Educational Resources Information Center

Gottfredson, Gary D.; Gottfredson, Denise C.

This paper provides school district administrators with a structured method for developing school programs aimed at reducing the risk of adolescent dropout. The methodology encompasses problem definition, fact finding, mission management, overcoming inertia, cohering programs tied to theory, feasible goal-setting, and normative personnel…

Measuring Profitability Impacts of Information Technology: Use of Risk Adjusted Measures.

ERIC Educational Resources Information Center

Singh, Anil; Harmon, Glynn

2003-01-01

Focuses on understanding how investments in information technology are reflected in the income statements and balance sheets of firms. Shows that the relationship between information technology investments and corporate profitability is much better explained by using risk-adjusted measures of corporate profitability than using the same measures…

From dinner table to digital tablet: technology's potential for reducing loneliness in older adults.

PubMed

McCausland, Lauren; Falk, Nancy L

2012-05-01

Statistics estimate that close to 35% of our nation's older individuals experience loneliness. Feelings of loneliness have been associated with physical and psychological illness in several research studies. As technology advances and connectivity through tablet devices becomes increasingly user friendly, the potential for tablets to reduce loneliness among older adults is substantial. This article discusses the issue of loneliness among older adults and suggests tablet technology as a tool to improve connectivity and reduce loneliness in the older adult population. As nurses, we have the opportunity to help enhance the quality of life for our clients. Tablet technology offers a new option that should be fully explored. Copyright 2012, SLACK Incorporated.

Status of ERA Vehicle System Integration Technology Demonstrators

NASA Technical Reports Server (NTRS)

Flamm, Jeffrey D.; Fernandez, Hamilton; Khorrami, Mehdi; James, Kevin D.; Thomas, Russell

2015-01-01

The Environmentally Responsible Aviation (ERA) Project within the Integrated Systems Research Program (ISRP) of the NASA Aeronautics Research Mission Directorate (ARMD) has the responsibility to explore and document the feasibility, benefits, and technical risk of air vehicle concepts and enabling technologies that will reduce the impact of aviation on the environment. The primary goal of the ERA Project is to select air vehicle concepts and technologies that can simultaneously reduce fuel burn, noise, and emissions. In addition, the ERA Project will identify and mitigate technical risk and transfer knowledge to the aeronautics community at large so that new technologies and vehicle concepts can be incorporated into the future design of aircraft.

Computer Security: Improvements Needed to Reduce Risk to Critical Federal Operations and Assets

DTIC Science & Technology

2001-11-09

COMPUTER SECURITY Improvements Needed to Reduce Risk to Critical Federal Operations and Assets Statement of Robert F. Dacey Director, Information...Improvements Needed to Reduce Risk to Critical Federal Operations and Assets Contract Number Grant Number Program Element Number Author(s...The benefits have been enormous. Vast amounts of information are now literally at our fingertips, facilitating research on virtually every topic

The Potential Role of Tree Diversity in Reducing Shallow Landslide Risk.

PubMed

Kobayashi, Yuta; Mori, Akira S

2017-05-01

Recently, interest in utilizing ecosystems for disaster risk reduction has increased, even though there remains considerable uncertainty regarding the role of ecosystems in buffering against natural hazards. This ecosystem role can be considered an ecosystem service. Although a strong body of evidence shows that biodiversity enhances ecosystem services, there are only a few studies of the relationship between biodiversity and the role of the ecosystem in reducing the risk of natural disasters. To explore the desired state of an ecosystem for disaster risk reduction we applied the finding that biodiversity enhances ecosystem services to evaluate the role of woody vegetation in reducing the frequency and severity of shallow landslides. Using information related to shallow landslides and woody vegetation in Japan as a case study, we compared the severity of shallow landslides (i.e., landslide volume) with tree species richness. Although we provide no direct evidence that tree species richness reduces shallow landslide volume, we found that the predictability of the model, which evaluated relationships between landslide volume and environmental variables in watersheds throughout the Japanese Archipelago, increased with tree species richness. This finding suggests that biodiversity is likely associated with shallow landslide risk reduction, emphasizing a possible reduction of spatial and temporal uncertainty in the roles of woody vegetation. Our study identifies a need for socioecological systems to build new approaches found on the functionality of such ecosystems.

Combining novel technologies with improved logistics to reduce hemodialysis vascular access dysfunction.

PubMed

Roy-Chaudhury, P; Lee, T; Duncan, H; El-Khatib, M

2009-01-01

Hemodialysis (HD) vascular access dysfunction is currently a huge clinical problem for which there are no effective therapies. There are, however, a number of promising technologies that are currently at the experimental or clinical trial stage. We believe that the application of these novel technologies in combination with better clinical protocols for vascular access care could significantly reduce the current problems associated with HD vascular access.

Information technologies for taking into account risks in business development programme

NASA Astrophysics Data System (ADS)

Kalach, A. V.; Khasianov, R. R.; Rossikhina, L. V.; Zybin, D. G.; Melnik, A. A.

2018-05-01

The paper describes the information technologies for taking into account risks in business development programme, which rely on the algorithm for assessment of programme project risks and the algorithm of programme forming with constrained financing of high-risk projects taken into account. A method of lower-bound estimate is suggested for subsets of solutions. The corresponding theorem and lemma and their proofs are given.

PGD to reduce reproductive risk: the case of mitochondrial DNA disorders.

PubMed

Bredenoord, A L; Dondorp, W; Pennings, G; De Die-Smulders, C E M; De Wert, G

2008-11-01

This paper discusses the pros and cons of introducing PGD for mitochondrial DNA (mtDNA) disorders such as NARP (Neurogenic muscle weakness, Ataxia, Retinis Pigmentosa)/Leigh, MELAS (Mitochondrial myopathy, Encephalopathy, Lactic acidosis, and Stroke-like episodes), private mtDNA mutations and LHON (Leber Hereditary Optic Neuropathy). Although there is little experience with PGD for mtDNA disorders, it is reasonable to assume that in many cases, the best one can achieve is the selection of the 'least' affected embryos for transfer. So instead of 'promising' parents a healthy child, PGD in these cases can only aim at reducing reproductive risk. From an ethical point of view, this raises challenging questions about parental and medical responsibilities. The main argument in favour of PGD is that it offers couples at risk the opportunity of reducing their chances of having a severely affected child. Potential objections are manifold, but we conclude that none of them supplies convincing moral arguments to regard risk-reducing PGD as unacceptable. Nevertheless, introducing this new application of PGD in clinical practice will raise further complex issues of determining conditions for its responsible use.

Outcome after reduced chemotherapy for intermediate-risk neuroblastoma.

PubMed

Baker, David L; Schmidt, Mary L; Cohn, Susan L; Maris, John M; London, Wendy B; Buxton, Allen; Stram, Daniel; Castleberry, Robert P; Shimada, Hiroyuki; Sandler, Anthony; Shamberger, Robert C; Look, A Thomas; Reynolds, C Patrick; Seeger, Robert C; Matthay, Katherine K

2010-09-30

The survival rate among patients with intermediate-risk neuroblastoma who receive dose-intensive chemotherapy is excellent, but the survival rate among patients who receive reduced doses of chemotherapy for shorter periods of time is not known. We conducted a prospective, phase 3, nonrandomized trial to determine whether a 3-year estimated overall survival of more than 90% could be maintained with reductions in the duration of therapy and drug doses, using a tumor biology-based therapy assignment. Eligible patients had newly diagnosed, intermediate-risk neuroblastoma without MYCN amplification; these patients included infants (<365 days of age) who had stage 3 or 4 disease, children (≥365 days of age) who had stage 3 tumors with favorable histopathological features, and infants who had stage 4S disease with a diploid DNA index or unfavorable histopathological features. Patients who had disease with favorable histopathological features and hyperdiploidy were assigned to four cycles of chemotherapy, and those with an incomplete response or either unfavorable feature were assigned to eight cycles. Between 1997 and 2005, a total of 479 eligible patients were enrolled in this trial (270 patients with stage 3 disease, 178 with stage 4 disease, and 31 with stage 4S disease). A total of 323 patients had tumors with favorable biologic features, and 141 had tumors with unfavorable biologic features. Ploidy, but not histopathological features, was significantly predictive of the outcome. Severe adverse events without disease progression occurred in 10 patients (2.1%), including secondary leukemia (in 3 patients), death from infection (in 3 patients), and death at surgery (in 4 patients). The 3-year estimate (±SE) of overall survival for the entire group was 96±1%, with an overall survival rate of 98±1% among patients who had tumors with favorable biologic features and 93±2% among patients who had tumors with unfavorable biologic features. A very high rate of survival

Reduced Incidence of Invasive Breast Cancer With Raloxifene Among Women at Increased Coronary Risk

PubMed Central

Grady, Deborah; Cauley, Jane A.; Geiger, Mary Jane; Kornitzer, Marcel; Mosca, Lori; Collins, Peter; Wenger, Nanette K.; Song, Jingli; Mershon, John; Barrett-Connor, Elizabeth

2013-01-01

Background In the Raloxifene Use for The Heart trial, 10 101 postmenopausal women with coronary heart disease (CHD) or multiple CHD risk factors were randomly assigned to 60 mg/d raloxifene or to placebo and followed for a median of 5.6 years. Raloxifene, a selective estrogen receptor modulator, was found to reduce the risk of invasive breast cancer and vertebral fractures but not the risk of cardiovascular events. Here, we provide further details about breast cancer incidence by tumor characteristics, duration of treatment, and subgroup. Methods Reported breast cancer was adjudicated by an independent committee based on medical records and pathology reports. The primary analyses used Cox proportional hazards models with time to first breast cancer as the outcome. Subgroup effects were analyzed using similar models with terms for treatment by subgroup. All statistical tests were two-sided. Results As previously reported, raloxifene reduced the incidence of invasive breast cancer by 44% (hazard ratio [HR] = 0.56; 95% confidence interval [CI] = 0.38 to 0.83; absolute risk reduction = 1.2 invasive breast cancers per 1000 women treated for 1 year). The lower incidence of invasive breast cancer reflected a 55% lower incidence of invasive estrogen receptor (ER)–positive tumors (HR = 0.45; 95% CI = 0.28 to 0.72). However, raloxifene treatment did not reduce the incidence of noninvasive breast cancer or of invasive ER-negative breast cancer. The reduced incidence of invasive breast cancer was similar across subgroups, including those defined by age, body mass index, family history of breast cancer, prior use of postmenopausal hormones, and 5-year estimated risk of invasive breast cancer. Conclusion Raloxifene reduces risk of invasive ER-positive breast cancer regardless of a woman's baseline breast cancer risk but does not reduce risk of noninvasive or ER-negative breast cancers. These results confirm those of the Multiple Outcomes of Raloxifene Evaluation, a previous

Identifying Postpartum Intervention Approaches to Reduce Cardiometabolic Risk Among American Indian Women With Prior Gestational Diabetes, Oklahoma, 2012–2013

PubMed Central

Peercy, Michael; Woods, J. Cedric; Parker, Stephany P.; Jackson, Teresa; Mata, Sara A.; McCage, Shondra; Levkoff, Sue E.; Nicklas, Jacinda M.; Seely, Ellen W.

2015-01-01

Introduction Innovative approaches are needed to reduce cardiometabolic risk among American Indian women with a history of gestational diabetes. We assessed beliefs of Oklahoma American Indian women about preventing type 2 diabetes and cardiovascular disease after having gestational diabetes. We also assessed barriers and facilitators to healthy lifestyle changes postpartum and intervention approaches that facilitate participation in a postpartum lifestyle program. Methods In partnership with a tribal health system, we conducted a mixed-method study with American Indian women aged 19 to 45 years who had prior gestational diabetes, using questionnaires, focus groups, and individual interviews. Questionnaires were used to identify women’s cardiometabolic risk perceptions and feasibility and acceptability of Internet or mobile phone technology for delivery of a postpartum lifestyle modification program. Focus groups and individual interviews were conducted to identify key perspectives and preferences related to a potential program. Results Participants were 26 women, all of whom completed surveys; 11 women participated in focus group sessions, and 15 participated in individual interviews. Most women believed they would inevitably develop diabetes, cardiovascular disease, or both; however, they were optimistic that they could delay onset with lifestyle change. Most women expressed enthusiasm for a family focused, technology-based intervention that emphasizes the importance of delaying disease onset, provides motivation, and promotes accountability while accommodating women’s competing priorities. Conclusions Our findings suggest that an intervention that uses the Internet, text messaging, or both and that emphasizes the benefits of delaying disease onset should be tested as a novel, culturally relevant approach to reducing rates of diabetes and cardiovascular disease in this high-risk population. PMID:25837258

Coffee consumption and reduced risk of hepatocellular carcinoma: findings from the Singapore Chinese Health Study

PubMed Central

Johnson, Shane; Koh, Woon-Puay; Wang, Renwei; Govindarajan, Sugantha; Yu, Mimi C.

2012-01-01

Background Coffee consumption has been associated with reduced markers of hepatic cell damage, reduced risk of chronic liver disease, and cirrhosis across a variety of populations. Data on the association between coffee consumption and risk of hepatocellular carcinoma (HCC), especially in high-risk populations, are sparse. Methods This study examines the relationship between coffee and caffeine consumption, and the risk of developing HCC within the Singapore Chinese Health Study, a prospective cohort of 63,257 middle-aged and older Chinese men and women, a relatively high-risk population for HCC. Baseline data on coffee consumption and other dietary and lifestyle factors were collected through inperson interviews at enrollment between 1993 and 1998. Results As of 31 December 2006, 362 cohort participants had developed HCC. High levels of coffee or caffeine consumption were associated with reduced risk of HCC (p for trend < 0.05). Compared with non-drinkers of coffee, individuals who consumed three or more cups of coffee per day experienced a statistically significant 44% reduction in risk of HCC (hazard ratio 0.56, 95% confidence interval, 0.31–1.00, p = .049) after adjustment for potential confounders and tea consumption. Conclusion These data suggest that coffee consumption may reduce the risk of developing HCC in Chinese in Singapore. PMID:21258859

Coffee consumption and reduced risk of hepatocellular carcinoma: findings from the Singapore Chinese Health Study.

PubMed

Johnson, Shane; Koh, Woon-Puay; Wang, Renwei; Govindarajan, Sugantha; Yu, Mimi C; Yuan, Jian-Min

2011-03-01

Coffee consumption has been associated with reduced markers of hepatic cell damage, reduced risk of chronic liver disease, and cirrhosis across a variety of populations. Data on the association between coffee consumption and risk of hepatocellular carcinoma (HCC), especially in high-risk populations, are sparse. This study examines the relationship between coffee and caffeine consumption, and the risk of developing HCC within the Singapore Chinese Health Study, a prospective cohort of 63,257 middle-aged and older Chinese men and women, a relatively high-risk population for HCC. Baseline data on coffee consumption and other dietary and lifestyle factors were collected through in-person interviews at enrollment between 1993 and 1998. As of 31 December 2006, 362 cohort participants had developed HCC. High levels of coffee or caffeine consumption were associated with reduced risk of HCC (p for trend < 0.05). Compared with non-drinkers of coffee, individuals who consumed three or more cups of coffee per day experienced a statistically significant 44% reduction in risk of HCC (hazard ratio 0.56, 95% confidence interval, 0.31-1.00, p = .049) after adjustment for potential confounders and tea consumption. These data suggest that coffee consumption may reduce the risk of developing HCC in Chinese in Singapore.

The Role of Hedonic Behavior in Reducing Perceived Risk

PubMed Central

Jia, Jayson S.; Jia, Jianmin; Hsee, Christopher K.; Shiv, Baba

2016-01-01

Understanding how human populations naturally respond to and cope with risk is important for fields ranging from psychology to public health. We used geophysical and individual-level mobile-phone data (mobile-apps, telecommunications, and Web usage) of 157,358 victims of the 2013 Ya’an earthquake to diagnose the effects of the disaster and investigate how experiencing real risk (at different levels of intensity) changes behavior. Rather than limiting human activity, higher earthquake intensity resulted in graded increases in usage of communications apps (e.g., social networking, messaging), functional apps (e.g., informational tools), and hedonic apps (e.g., music, videos, games). Combining mobile data with a field survey (N = 2,000) completed 1 week after the earthquake, we use an instrumental-variable approach to show that only increases in hedonic behavior reduced perceived risk. Thus, hedonic behavior could potentially serve as a population-scale coping and recovery strategy that is often missing in risk management and policy considerations. PMID:27881710

The Role of Hedonic Behavior in Reducing Perceived Risk.

PubMed

Jia, Jayson S; Jia, Jianmin; Hsee, Christopher K; Shiv, Baba

2017-01-01

Understanding how human populations naturally respond to and cope with risk is important for fields ranging from psychology to public health. We used geophysical and individual-level mobile-phone data (mobile-apps, telecommunications, and Web usage) of 157,358 victims of the 2013 Ya'an earthquake to diagnose the effects of the disaster and investigate how experiencing real risk (at different levels of intensity) changes behavior. Rather than limiting human activity, higher earthquake intensity resulted in graded increases in usage of communications apps (e.g., social networking, messaging), functional apps (e.g., informational tools), and hedonic apps (e.g., music, videos, games). Combining mobile data with a field survey ( N = 2,000) completed 1 week after the earthquake, we use an instrumental-variable approach to show that only increases in hedonic behavior reduced perceived risk. Thus, hedonic behavior could potentially serve as a population-scale coping and recovery strategy that is often missing in risk management and policy considerations.

Reducing Homicide Risk in Indianapolis between 1997 and 2000

PubMed Central

McGarrell, Edmund F.

2010-01-01

Rates of homicide risk are not evenly distributed across the US population. Prior research indicates that young males in disadvantaged urban neighborhoods are particularly vulnerable to lethal violence. The traditional criminal justice response to violent crime in the urban context has the potential to exacerbate problems, particularly when broad-based arrest sweeps and general deterrence initiatives are the standard models used by law enforcement. Recent studies suggest that alternative intervention approaches that use both specific deterrence combined with improving pro-social opportunities has shown promise in reducing violent crime in these high-risk contexts. This paper examines the changes in homicide patterns for the highest-risk populations in Indianapolis after a “pulling levers” intervention was implemented in the late 1990s to address youth, gang, and gun violence. Multilevel growth curve regression models controlling for a linear trend over time, important structural correlates of homicide across urban neighborhoods, and between-neighborhood variance estimates showed that homicide rates involving the highest-risk populations (i.e., actors 15 to 24 years old) were most likely to experience a statistically significant and substantive reduction after the intervention was implemented (IRR = 0.48, 95% CI = 0.29 – 0.78). Among male actors in this age range, Black male homicide rates (IRR = 0.41, 95% CI = 0.25 – 0.70) and White male rates (IRR = 0.38, 95% CI = 0.15 – 0.79) declined substantially more than homicide rates involving actors outside the 15 to 24 years age range (IRR = 0.95, 95% CI = 0.54 – 1.69). In addition, neighborhoods where specific, community-level strategies were implemented had statistically significant and substantive high-risk homicide rate declines. We conclude that further extension of the pulling levers framework appears warranted in light of the recent findings. Alternative

Change IS Possible: Reducing High-Risk Drinking Using a Collaborative Improvement Model.

PubMed

Lanter, Patricia L; Wolff, Kristina B; Johnson, Lisa C; Ercolano, Ellyn M; Kilmer, Jason R; Provost, Lloyd

2015-01-01

To describe the adoption of public health and improvement methodologies to address college students' high-risk drinking behaviors and to aid in prevention efforts. Members of 32 colleges and universities, content experts, and staff members of the National College Health Improvement Program (NCHIP). A 2-year learning collaborative developed by NCHIP trained individuals from 32 different college and universities in using the Plan-Do-Study-Act cycle as a method to create and implement initiatives aimed at reducing students' high-risk drinking behaviors and related harms. Participants experienced success ranging from noteworthy increases in type and amount of interventions directed at reducing high-risk drinking, to creating collaboratives across campus, the local community, and stakeholders. Challenges related to data collection and creating lasting cultural change remain. The use of quality improvement methodologies and creation of a national collaborative successfully effected meaningful change in high-risk drinking behaviors on college campuses.

Urinary tract infections and reduced risk of bladder cancer in Los Angeles.

PubMed

Jiang, X; Castelao, J E; Groshen, S; Cortessis, V K; Shibata, D; Conti, D V; Yuan, J-M; Pike, M C; Gago-Dominguez, M

2009-03-10

We investigated the association between urinary tract infections (UTIs) and transitional cell carcinoma of the bladder in a population-based case-control study in Los Angeles covering 1586 cases and age-, gender-, and race-matched neighbourhood controls. A history of bladder infection was associated with a reduced risk of bladder cancer among women (odds ratio (OR), 0.66; 95% confidence interval (CI), 0.46-0.96). No effect was found in men, perhaps due to power limitations. A greater reduction in bladder cancer risk was observed among women with multiple infections (OR, 0.37; 95% CI, 0.18-0.78). Exclusion of subjects with a history of diabetes, kidney or bladder stones did not change the inverse association. A history of kidney infections was not associated with bladder cancer risk, but there was a weak association between a history of other UTIs and slightly increased risk among men. Our results suggest that a history of bladder infection is associated with a reduced risk of bladder cancer among women. Cytotoxicity from antibiotics commonly used to treat bladder infections is proposed as one possible explanation.

Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer: An Asian population study.

PubMed

Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

2016-12-01

Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD).This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated.The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group.Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD.

Reducing Weight for Transportation Applications: Technology Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Taub, Alan I.

Today's land, sea and air transportation industries — as a business necessity — are focused on technology solutions that will make vehicles more sustainable in terms of energy, the environment, safety and affordability. Reducing vehicle weight is a key enabler for meeting these challenges as well as increasing payload and improving performance. The potential weight reductions from substituting lightweight metals (advanced high-strength steels, aluminum, magnesium and titanium alloys) are well established. For magnesium castings, weight savings of 60% have been reported [1]. The value of weight reduction depends on the transportation sector and ranges from about 5/kg saved for automobiles to over 500/kg saved for aircraft [2]. The challenge is to optimize the material properties and develop robust, high volume, manufacturing technologies and the associated supply chain to fabricate components and subsystems at the appropriate cost for each application.

Maternal HIV-1 envelope–specific antibody responses and reduced risk of perinatal transmission

PubMed Central

Permar, Sallie R.; Fong, Youyi; Vandergrift, Nathan; Fouda, Genevieve G.; Gilbert, Peter; Parks, Robert; Jaeger, Frederick H.; Pollara, Justin; Martelli, Amanda; Liebl, Brooke E.; Lloyd, Krissey; Yates, Nicole L.; Overman, R. Glenn; Shen, Xiaoying; Whitaker, Kaylan; Chen, Haiyan; Pritchett, Jamie; Solomon, Erika; Friberg, Emma; Marshall, Dawn J.; Whitesides, John F.; Gurley, Thaddeus C.; Von Holle, Tarra; Martinez, David R.; Cai, Fangping; Kumar, Amit; Xia, Shi-Mao; Lu, Xiaozhi; Louzao, Raul; Wilkes, Samantha; Datta, Saheli; Sarzotti-Kelsoe, Marcella; Liao, Hua-Xin; Ferrari, Guido; Alam, S. Munir; Montefiori, David C.; Denny, Thomas N.; Moody, M. Anthony; Tomaras, Georgia D.; Gao, Feng; Haynes, Barton F.

2015-01-01

Despite the wide availability of antiretroviral drugs, more than 250,000 infants are vertically infected with HIV-1 annually, emphasizing the need for additional interventions to eliminate pediatric HIV-1 infections. Here, we aimed to define humoral immune correlates of risk of mother-to-child transmission (MTCT) of HIV-1, including responses associated with protection in the RV144 vaccine trial. Eighty-three untreated, HIV-1–transmitting mothers and 165 propensity score–matched nontransmitting mothers were selected from the Women and Infants Transmission Study (WITS) of US nonbreastfeeding, HIV-1–infected mothers. In a multivariable logistic regression model, the magnitude of the maternal IgG responses specific for the third variable loop (V3) of the HIV-1 envelope was predictive of a reduced risk of MTCT. Neutralizing Ab responses against easy-to-neutralize (tier 1) HIV-1 strains also predicted a reduced risk of peripartum transmission in secondary analyses. Moreover, recombinant maternal V3–specific IgG mAbs mediated neutralization of autologous HIV-1 isolates. Thus, common V3-specific Ab responses in maternal plasma predicted a reduced risk of MTCT and mediated autologous virus neutralization, suggesting that boosting these maternal Ab responses may further reduce HIV-1 MTCT. PMID:26053661

Utilization of UV Curing Technology to Significantly Reduce the Manufacturing Cost of LIB Electrodes

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

Voelker, Gary; Arnold, John

2015-11-30

Previously identified novel binders and associated UV curing technology have been shown to reduce the time required to apply and finish electrode coatings from tens of minutes to less than one second. This revolutionary approach can result in dramatic increases in process speeds, significantly reduced capital (a factor of 10 to 20) and operating costs, reduced energy requirements, and reduced environmental concerns and costs due to the virtual elimination of harmful volatile organic solvents and associated solvent dryers and recovery systems. The accumulated advantages of higher speed, lower capital and operating costs, reduced footprint, lack of VOC recovery, and reducedmore » energy cost is a reduction of 90% in the manufacturing cost of cathodes. When commercialized, the resulting cost reduction in Lithium batteries will allow storage device manufacturers to expand their sales in the market and thereby accrue the energy savings of broader utilization of HEVs, PHEVs and EVs in the U.S., and a broad technology export market is also envisioned.« less

Motor Behavior Reflects Reduced Hemispheric Asymmetry in the Psychosis Risk Period

PubMed Central

Dean, Derek J.; Orr, Joseph M.; Newberry, Raeana E.; Mittal, Vijay A.

2015-01-01

Background A body of work focusing on brain connectivity, language dominance, and motor laterality research suggests reduced hemispheric asymmetry is a core feature in schizophrenia. However, there is little consensus about whether reduced dominance is present in those at ultrahigh risk (UHR) for psychosis. Methods A total of 94 demonstrated right-handed neuroleptic free participants (38 UHR and 56 matched healthy controls) were assessed with structured clinical interviews and completed an innovative handwriting task using a digital tablet computer. A laterality quotient (LQ) was calculated using kinematic variables from the participant’s left and right hands. A subset of the sample (26 UHR and 29 controls) returned after 12-months to complete clinical interviews in order to examine relationships between handwriting laterality and progression of psychosis risk symptoms. Results The UHR group showed decreased dextrality compared to healthy controls. At the 12-month follow-up, decreased dextrality accounted for 8% of the variance in worsened positive symptoms within the UHR group. Conclusion The current results suggest that disrupted cerebral dominance is also present in the ultrahigh risk period and that decreased dextrality may serve as a novel biomarker for the progression of psychosis risk. PMID:26492987

EPA Recognized for Research on Reducing Risks to Drinking ...

EPA Pesticide Factsheets

Technical Brief Threat Ensemble Vulnerability Assessment (TEVA) among finalists for Edelman Award On February 7, 2008, the Institute for Operations Research and the Management Sciences (INFORMS ® of Hanover, MD) announced that a TEVA Research project is one of six finalists vying for this year’s prestigious Franz Edelman Award. The project is called “Reducing Security Risks in American Drinking Water Systems.” Edelman Award Information This is the thirty-seventh year of the Edelman competition. Every year, the competition recognizes outstanding operations research-based projects that transform companies, entire industries, and people’s lives. Operations research uses advanced analytical methods to make optimal decisions in order to solve complex problems. The winner of the award will be announced in mid-April 2008. Past Edelman Award finalists include Travelocity; IBM; Merrill Lynch; the Memorial Sloan-Kettering Cancer Center; and Georgia Tech. The winning team for 2007 reduced both patient suffering and health care costs from the treatment of prostate and breast cancer. The Edelman competition attests to the contributions of operations research in the profit and nonprofit sectors. It is estimated that the cumulative dollar benefits from Edelman finalist projects between 1984 and 2006 reached the $100 billion mark. TEVA Research Program The TEVA research program has focused on reducing the security risks to drinking water systems. Ad

Go Grrrls: A Randomized Controlled Trial of a Gender-Specific Intervention to Reduce Sexual Risk Factors in Middle School Females.

PubMed

LeCroy, Craig Winston; McCullough Cosgrove, Jenny; Cotter, Katie; Fordney, Marie

2018-04-01

Adolescent females continue to face health consequences associated with risky sexual behaviors such as unintended pregnancies and sexually transmitted diseases. The purpose of this study was to investigate the efficacy of a gender-specific intervention targeted to early adolescent females. This study used an intent to treat randomized clinical trial comparing a broad-based female empowerment curriculum with a dose-matched science and technology female leadership curriculum. The sample ( N = 801) was recruited from schools and was implemented in community-based settings mostly in an after school context. Assessments were conducted at baseline, postintervention, 6-, and 18-month follow-up time periods. Both groups in the study obtained good implementation and engagement. The average attendance rate was 81% of program sessions. There were significant differences between the two groups favoring the intervention group on measures of sexually transmitted disease knowledge and condom technical skills. On a measure of condom self-efficacy, there was a significant trend. At the postassessment, there was a significant difference on the intentions to reduce sexual risk behaviors. Both the intervention and control groups made gains on the self-assertive behavior scale. Gender-specific programs for early adolescent females can help reduce indicators that are related to sexual risk reduction. More long-term follow-up is needed to assess impact on sexual behaviors. Efforts directed at a younger population of females should continue to be researched for potential in reducing sexual risks.

Predicting 30- to 120-Day Readmission Risk among Medicare Fee-for-Service Patients Using Nonmedical Workers and Mobile Technology.

PubMed

Ostrovsky, Andrey; O'Connor, Lori; Marshall, Olivia; Angelo, Amanda; Barrett, Kelsy; Majeski, Emily; Handrus, Maxwell; Levy, Jeffrey

2016-01-01

Hospital readmissions are a large source of wasteful healthcare spending, and current care transition models are too expensive to be sustainable. One way to circumvent cost-prohibitive care transition programs is complement nurse-staffed care transition programs with those staffed by less expensive nonmedical workers. A major barrier to utilizing nonmedical workers is determining the appropriate time to escalate care to a clinician with a wider scope of practice. The objective of this study is to show how mobile technology can use the observations of nonmedical workers to stratify patients on the basis of their hospital readmission risk. An area agency on aging in Massachusetts implemented a quality improvement project with the aim of reducing 30-day hospital readmission rates using a modified care transition intervention supported by mobile predictive analytics technology. Proprietary readmission risk prediction algorithms were used to predict 30-, 60-, 90-, and 120-day readmission risk. The risk score derived from the nonmedical workers' observations had a significant association with 30-day readmission rate with an odds ratio (OR) of 1.12 (95 percent confidence interval [CI], 1 .09-1.15) compared to an OR of 1.25 (95 percent CI, 1.19-1.32) for the risk score using nurse observations. Risk scores using nurse interpretation of nonmedical workers' observations show that patients in the high-risk category had significantly higher readmission rates than patients in the baseline-risk and mild-risk categories at 30, 60, 90, and 120 days after discharge. Of the 1,064 elevated-risk alerts that were triaged, 1,049 (98.6 percent) involved the nurse care manager, 804 (75.6 percent) involved the patient, 768 (72.2 percent) involved the health coach, 461 (43.3 percent) involved skilled nursing, and 235 (22.1 percent) involved the outpatient physician in the coordination of care in response to the alert. The predictive nature of the 30-day readmission risk scores is influenced

Risk assessment of technologies for detecting illicit drugs in containers

NASA Astrophysics Data System (ADS)

Brandenstein, Albert E.

1995-03-01

This paper provides the highlights of the role risk assessment plays in the United States technology program for nonintrusive inspection of cargo containers for illicit drugs. The Counterdrug Technology Assessment Center is coordinating the national effort to develop prototype technologies for an advanced generation, nonintrusive cargo inspection system. In the future, the U.S. Customs Service could configure advanced technologies for finding not only drugs and other contraband hidden in cargo, but for a wide variety of commodities for customs duty verification purposes. The overall nonintrusive inspection system is envisioned to consist primarily of two classes of subsystems: (1) shipment document examination subsystems to prescreen exporter and importer documents; and (2) chemical and physics-based subsystems to detect and characterize illicit substances. The document examination subsystems would use software algorithms, artificial intelligence, and neural net technology to perform an initial prescreening of the information on the shipping manifest for suspicious patterns. This would be accomplished by creating a `profile' from the shipping information and matching it to trends known to be used by traffickers. The chemical and physics-based subsystems would apply nuclear physics, x-ray, gas chromatography and spectrometry technologies to locate and identify contraband in containers and other conveyances without the need for manual searches. The approach taken includes using technology testbeds to assist in evaluating technology prototypes and testing system concepts in a fully instrumented but realistic operational environment. This approach coupled with a substance signature phenomenology program to characterize those detectable elements of benign, as well as target substances lends itself particularly well to the topics of risk assessment and elemental characterization of substances. A technology testbed established in Tacoma, Washington provides a national

Angular Impact Mitigation System for Bicycle Helmets to Reduce Head Acceleration and Risk of Traumatic Brain Injury

PubMed Central

Hansen, Kirk; Dau, Nathan; Feist, Florian; Deck, Caroline; Willinger, Rémy; Madey, Steven M.; Bottlang, Michael

2013-01-01

Angular acceleration of the head is a known cause of traumatic brain injury (TBI), but contemporary bicycle helmets lack dedicated mechanisms to mitigate angular acceleration. A novel Angular Impact Mitigation (AIM) system for bicycle helmets has been developed that employs an elastically suspended aluminum honeycomb liner to absorb linear acceleration in normal impacts as well as angular acceleration in oblique impacts. This study tested bicycle helmets with and without AIM technology to comparatively assess impact mitigation. Normal impact tests were performed to measure linear head acceleration. Oblique impact tests were performed to measure angular head acceleration and neck loading. Furthermore, acceleration histories of oblique impacts were analyzed in a computational head model to predict the resulting risk of TBI in the form of concussion and diffuse axonal injury (DAI). Compared to standard helmets, AIM helmets resulted in a 14% reduction in peak linear acceleration (p < 0.001), a 34% reduction in peak angular acceleration (p < 0.001), and a 22% to 32% reduction in neck loading (p < 0.001). Computational results predicted that AIM helmets reduced the risk of concussion and DAI by 27% and 44%, respectively. In conclusion, these results demonstrated that AIM technology could effectively improve impact mitigation compared to a contemporary expanded polystyrene-based bicycle helmet, and may enhance prevention of bicycle-related TBI. Further research is required. PMID:23770518

Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

PubMed

Ingersoll, Karen S; Ceperich, Sherry D; Hettema, Jennifer E; Farrell-Carnahan, Leah; Penberthy, J Kim

2013-04-01

Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs. Participants at risk for AEP (N=217) were randomized to motivational interviewing+assessment feedback (EARLY), informational video, or informational brochure conditions. Outcomes were drinks per drinking day (DDD), ineffective contraception rate, and AEP risk at 3 and 6 months. All interventions were associated with decreased DDD, ineffective contraception rate, and AEP risk. Participants who received EARLY had larger absolute risk reductions in ineffective contraception and AEP risk, but not DDD. Effect sizes were compared to previous RCTs. The one-session EARLY intervention had less powerful effects than multi-session AEP prevention interventions among community women, but may provide a new option in a continuum of preventive care. Copyright © 2013 Elsevier Inc. All rights reserved.

AIDS and behavioral change to reduce risk: a review.

PubMed Central

Becker, M H; Joseph, J G

1988-01-01

Published reports describing behavioral changes in response to the threat of AIDS (acquired immunodeficiency syndrome) are reviewed. These studies demonstrate rapid, profound, but expectably incomplete alterations in the behavior of both homosexual/bisexual males and intravenous drug users. This is true in the highest risk metropolitan areas such as New York City and in areas with lower AIDS incidence. Risk reduction is occurring more frequently through the modification of sexual or drug-use behavior than through its elimination. In contrast to aggregate data, longitudinal descriptions of individual behavior demonstrate considerable instability or recidivism. Behavioral change in the potentially vulnerable heterosexual adolescent and young adult populations is less common, as is risk reduction among urban minorities. Reports of AIDS-related knowledge and attitudes generally parallel the pattern of behavioral changes. Nonetheless, few studies investigate the relationship of knowledge and attitudes to risk reduction. Future studies should provide much-needed information about the determinants as well as the magnitude of behavioral changes required to reduce the further spread of AIDS. PMID:3279837

Reduced risk of sudden death from chest wall blows (commotio cordis) with safety baseballs.

PubMed

Link, Mark S; Maron, Barry J; Wang, Paul J; Pandian, Natesa G; VanderBrink, Brian A; Estes, N A Mark

2002-05-01

In an experimental model of sudden death from baseball chest wall impact (commotio cordis), we sought to determine if sudden death by baseball impact could be reduced with safety baseballs. Sudden cardiac death can occur after chest wall impact with a baseball (commotio cordis). Whether softer-than-standard (safety) baseballs reduce the risk of sudden death is unresolved from the available human data. In a juvenile swine model, ventricular fibrillation (VF) has been shown to be induced reproducibly by precordial impact with a 30-mph baseball 10 to 30 ms before the T-wave peak, and this likelihood was reduced with the softest safety baseballs (T-balls). To further test whether safety baseballs would reduce the risk of sudden death at velocities more relevant to youth sports competition, we used our swine model of commotio cordis to test baseballs propelled at the 40-mph velocity commonly attained in that sport. Forty animals received up to 3 chest wall impacts at 40 mph during the vulnerable period of repolarization for VF with 1 of 3 different safety baseballs of varying hardness, and also by a standard baseball. Safety baseballs propelled at 40 mph significantly reduced the risk for VF. The softest safety baseballs triggered VF in only 11% of impacts, compared with 19% and 22% with safety baseballs of intermediate hardness, and 69% with standard baseballs. In this experimental model of low-energy chest wall impact, safety baseballs reduced (but did not abolish) the risk of sudden cardiac death. More universal use of these safety baseballs may decrease the risk of sudden death on the playing field for young athletes.

Reducing environmental damage through the use of unmanned aerial vehicles as the best available technology

NASA Astrophysics Data System (ADS)

Fedulova, E. A.; Akulov, A. O.; Rada, A. O.; Alabina, T. A.; Savina, Ju Ju

2018-01-01

The article examines the possibilities of using unmanned aerial vehicles as the best available technologies in the field of agriculture and mining. The object of the study is the use of unmanned aerial vehicles as the best available technology. The main areas of application of this technology are identified: agro technical operations, aerial photography of mining operations. The technology of unmanned aerial vehicles is compared with the technologies of ground agricultural machinery. The research methodology includes an expert evaluation of the unmanned aerial vehicle technology belonging to the class of the best available technologies by the criteria: the level of environmental impact, resource saving, the use of low-waste, non-waste processes, the existence of at least two objects, economic efficiency. Expert evaluations were processed using the apparatus of fuzzy sets, which make it possible to construct membership functions. This allowed us to prove that the technology of unmanned aerial vehicles belongs to a fuzzy set of the best available technologies. The results of the research show that the use of unmanned aerial vehicles provides a saving of resources, especially non-renewable combustible minerals, reduces emissions and discharges of pollutants into the atmosphere, and also reduces soil erosion. Unmanned aerial vehicles should be included in the national directories of the best available technologies for the mining industry and agriculture.

Pneumococcal vaccination reduces the risk of community-acquired pneumonia in children.

PubMed

Hasegawa, Junko; Mori, Mitsuru; Ohnishi, Hirofumi; Tsugawa, Takeshi; Hori, Tsukasa; Yoto, Yuko; Tsutsumi, Hiroyuki

2017-03-01

The seven-valent pneumococcal conjugate vaccine (PCV7) was introduced to Japan in 2009, after which there was a rapid decline in invasive pneumococcal disease. There are few data, however, on the effectiveness of PCV7 against community-acquired pneumonia (CAP). We conducted an ambispective cohort study among children aged 0-6 years old who attended day-care centers. A total of 624 children at 10 day-care centers in Sapporo, Japan participated in the study. The parents reported whether their child had received PCV7 one or more times, as well as the exact dates of vaccination from records in maternal and child health handbooks marked by pediatricians. Each CAP event was reported by parents according to doctor diagnosis. A Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95%CI of CAP incidence reduced by PCV7 inoculation. During the observational period, 94 subjects contracted CAP. After adjusting for potentially confounding variables, inoculation with PCV7 was significantly associated with a reduced risk of CAP (HR, 0.22; 95%CI: 0.13-0.34). On stratified analysis by age, PCV7 was significantly associated with a reduced risk of CAP in both children aged <3 years (HR, 0.31; 95%CI: 0.14-0.71), and those ≥3 years (HR, 0.20; 95%CI: 0.09-0.43). PCV7 is highly effective in reducing the risk of CAP in children attending day-care centers. © 2016 Japan Pediatric Society.

Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana.

PubMed

Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S-N; Kirby, Ryan

2016-02-01

Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders.

Bridge Scour Technology Transfer

DOT National Transportation Integrated Search

2018-01-24

Scour and flooding are the leading causes of bridge failures in the United States and therefore should be monitored. New applications of tools and technologies are being developed, tested, and implemented to reduce bridge scour risk. The National Coo...

Reducing The Risk Of Fires In Conveyor Transport

NASA Astrophysics Data System (ADS)

Cheremushkina, M. S.; Poddubniy, D. A.

2017-01-01

The paper deals with the actual problem of increasing the safety of operation of belt conveyors in mines. Was developed the control algorithm that meets the technical requirements of the mine belt conveyors, reduces the risk of fires of conveyors belt, and enables energy and resource savings taking into account random sort of traffic. The most effective method of decision such tasks is the construction of control systems with the use of variable speed drives for asynchronous motors. Was designed the mathematical model of the system "variable speed multiengine drive - conveyor - control system of conveyors", that takes into account the dynamic processes occurring in the elements of the transport system, provides an assessment of the energy efficiency of application the developed algorithms, which allows to reduce the dynamic overload in the belt to (15-20)%.

Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk

PubMed Central

Lee, Duck-chul; Pate, Russell R.; Lavie, Carl J.; Sui, Xuemei; Church, Timothy S.; Blair, Steven N.

2014-01-01

Background Although running is a popular leisure-time physical activity, little is known about the long-term effects of running on mortality. The dose-response relations between running, as well as the change in running behaviors over time and mortality remain uncertain. Objectives We examined the associations of running with all-cause and cardiovascular mortality risks in 55,137 adults, aged 18 to 100 years (mean age, 44). Methods Running was assessed on the medical history questionnaire by leisure-time activity. Results During a mean follow-up of 15 years, 3,413 all-cause and 1,217 cardiovascular deaths occurred. Approximately, 24% of adults participated in running in this population. Compared with non-runners, runners had 30% and 45% lower adjusted risks of all-cause and cardiovascular mortality, respectively, with a 3-year life expectancy benefit. In dose-response analyses, the mortality benefits in runners were similar across quintiles of running time, distance, frequency, amount, and speed, compared with non-runners. Weekly running even <51 minutes, <6 miles, 1-2 times, <506 metabolic equivalent-minutes, or <6 mph was sufficient to reduce risk of mortality, compared with not running. In the analyses of change in running behaviors and mortality, persistent runners had the most significant benefits with 29% and 50% lower risks of all-cause and cardiovascular mortality, respectively, compared with never-runners. Conclusions Running, even 5-10 minutes per day and slow speeds <6 mph, is associated with markedly reduced risks of death from all causes and cardiovascular disease. This study may motivate healthy but sedentary individuals to begin and continue running for substantial and attainable mortality benefits. PMID:25082581

Advantages and disadvantages of nonfusion technology in spine surgery.

PubMed

Huang, Russel C; Girardi, Federico P; Lim, Moe R; Cammisa, Frank P

2005-07-01

Nonfusion technology in spine surgery may improve outcomes by reducing surgical morbidity and the incidence of adjacent level degeneration; however, new technologies also introduce new short- and long-term complications. There is currently no evidence that nonfusion implants are superior to fusion in mid- to long-term follow-up. Understanding the potential risks and benefits of nonfusion technology is essential for spine surgeons and their patients. This article reviews the current evidence relating to the potential risks and benefits of nonfusion technology in spine surgery.

Perceptions of Risk of Developing Skin Cancer for Diverse Audiences: Enhancing Relevance of Sun Protection to Reduce the Risk.

PubMed

Robinson, June K; Friedewald, John; Gordon, Elisa J

2016-03-01

Sixty-five percent of kidney transplant recipients (KTRs) develop squamous cell carcinoma (SCC). Perceptions of risk of developing skin cancer, amelioration of this risk with sun protection, and having choices among sun protection strategies may enhance sun protection use by KTRS, who are at greater risk than the general population. Thirty KTRs stratified among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic/Latinos evaluated three versions of the interactive, web-based, electronic sun protection program and suggested refinements. The sequence of content presentation prepared the participant to accept the credibility, accuracy, and relevance of the message. Beginning with informing participants that using sun protection reduces the chance of developing skin cancer made the information credible to KTRs. Showing skin cancer on all skin types and patient testimonials enhanced participants' awareness of their susceptibility to develop skin cancer and primed patients to receive their personal risk of developing skin cancer. Coupling presentation of knowledge about the benefits of sun protection in reducing the risk of developing skin cancer with the personal risk of getting the disease was essential to KTRs believing that they could influence their health outcome.

The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk?

PubMed Central

Segev-Jacubovski, Orit; Herman, Talia; Yogev-Seligmann, Galit; Mirelman, Anat; Giladi, Nir; Hausdorff, Jeffrey M

2011-01-01

In this article, we briefly summarize the incidence and significant consequences of falls among older adults, the insufficient effectiveness of commonly used multifactorial interventions and the evidence linking falls and cognitive function. Recent pharmacologic and nonpharmacologic studies that evaluated the effects of cognitive therapy on fall risk are reviewed. The results of this article illustrate the potential utility of multiple, diverse forms of cognitive therapy for reducing fall risk. The article also indicates that large-scale, randomized controlled trials are warranted and that additional research is needed to better understand the pathophysiologic mechanisms underlying the interplay between human mobility, fall risk and cognitive function. Nonetheless, we suggest that multimodality interventions that combine motor and cognitive therapy should, eventually, be incorporated into clinical practice to enable older adults and patients to move safer and with a reduced fall risk. PMID:21721921

Hypotheses and fundamental study design characteristics for evaluating potential reduced-risk tobacco products. Part I: Heuristic.

PubMed

Murrelle, Lenn; Coggins, Christopher R E; Gennings, Chris; Carchman, Richard A; Carter, Walter H; Davies, Bruce D; Krauss, Marc R; Lee, Peter N; Schleef, Raymond R; Zedler, Barbara K; Heidbreder, Christian

2010-06-01

The risk-reducing effect of a potential reduced-risk tobacco product (PRRP) can be investigated conceptually in a long-term, prospective study of disease risks among cigarette smokers who switch to a PRRP and in appropriate comparison groups. Our objective was to provide guidance for establishing the fundamental design characteristics of a study intended to (1) determine if switching to a PRRP reduces the risk of lung cancer (LC) compared with continued cigarette smoking, and (2) compare, using a non-inferiority approach, the reduction in LC risk among smokers who switched to a PRRP to the reduction in risk among smokers who quit smoking entirely. Using standard statistical methods applied to published data on LC incidence after smoking cessation, we show that the sample size and duration required for a study designed to evaluate the potential for LC risk reduction for an already marketed PRRP, compared with continued smoking, varies depending on the LC risk-reducing effectiveness of the PRRP, from a 5-year study with 8000-30,000 subjects to a 15-year study with <5000 to 10,000 subjects. To assess non-inferiority to quitting, the required sample size tends to be about 10 times greater, again depending on the effectiveness of the PRRP. (c) 2009 Elsevier Inc. All rights reserved.

Does non-pharmacological therapy for antenatal depression reduce risks for the infant?

PubMed

Jarde, A; Morais, M; Kingston, D; Giallo, R; Giglia, L; MacQueen, G; Wang, Y; Beyene, J; McDonald, S D

2016-06-01

Depression during pregnancy has been associated with an increased risk of adverse outcomes for the infant such as preterm birth. These risks are not reduced with pharmacological treatment, but the effect of non-pharmacological therapies is unknown. We performed a systematic review to assess the risk of adverse perinatal outcomes in non-pharmacologically treated depressed women compared to non-depressed women. We found no studies that met our inclusion criteria, highlighting a critical need for research on this topic.

Using technology to assess and intervene with illicit drug-using persons at risk for HIV.

PubMed

Horvath, Keith J; Lammert, Sara; LeGrand, Sara; Muessig, Kathryn E; Bauermeister, José A

2017-09-01

This review describes recent literature on novel ways technology is used for assessment of illicit drug use and HIV risk behaviours, suggestions for optimizing intervention acceptability, and recently completed and ongoing technology-based interventions for drug-using persons at risk for HIV and others with high rates of drug use and HIV risk behaviour. Among studies (n = 5) comparing technology-based to traditional assessment methods, those using Ecological Momentary Assessment (EMA) had high rates of reported drug use and high concordance with traditional assessment methods. The two recent studies assessing the acceptability of mHealth approaches overall demonstrate high interest in these approaches. Current or in-progress technology-based interventions (n = 8) are delivered using mobile apps (n = 5), text messaging (n = 2) and computers (n = 1). Most intervention studies are in progress or do not report intervention outcomes; the results from one efficacy trial showed significantly higher HIV testing rates among persons in need of drug treatment. Studies are needed to continually assess technology adoption and intervention preferences among drug-using populations to ensure that interventions are appropriately matched to users. Large-scale technology-based intervention trials to assess the efficacy of these approaches, as well as the impact of individual intervention components, on drug use and other high-risk behaviours are recommended.

Work stress and subsequent risk of internet addiction among information technology engineers in Taiwan.

PubMed

Chen, Sung-Wei; Gau, Susan Shur-Fen; Pikhart, Hynek; Peasey, Anne; Chen, Shih-Tse; Tsai, Ming-Chen

2014-08-01

Work stress, as defined by the Demand-Control-Support (DCS) model and the Effort-Reward Imbalance (ERI) model, has been found to predict risks for depression, anxiety, and substance addictions, but little research is available on work stress and Internet addiction. The aims of this study are to assess whether the DCS and ERI models predict subsequent risks of Internet addiction, and to examine whether these associations might be mediated by depression and anxiety. A longitudinal study was conducted in a sample (N=2,550) of 21-55 year old information technology engineers without Internet addiction. Data collection included questionnaires covering work stress, demographic factors, psychosocial factors, substance addictions, Internet-related factors, depression and anxiety at wave 1, and the Internet Addiction Test (IAT) at wave 2. Ordinal logistic regression was used to assess the associations between work stress and IAT; path analysis was adopted to evaluate potentially mediating roles of depression and anxiety. After 6.2 months of follow-up, 14.0% of subjects became problematic Internet users (IAT 40-69) and 4.1% pathological Internet users (IAT 70-100). Job strain was associated with an increased risk of Internet addiction (odds ratio [OR] of having a higher IAT outcome vs. a lower outcome was 1.53); high work social support reduced the risk of Internet addiction (OR=0.62). High ER ratio (OR=1.61) and high overcommitment (OR=1.68) were associated with increased risks of Internet addiction. Work stress defined by the DCS and ERI models predicted subsequent risks of Internet addiction.

Robotics crosscutting program: Technology summary

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

NONE

The Office of Environmental Management (EM) is responsible for cleaning up the legacy of radioactive and chemically hazardous waste at contaminated sites and facilities throughout the U.S. Department of Energy (DOE) nuclear weapons complex, preventing further environmental contamination, and instituting responsible environmental management. Initial efforts to achieve this mission resulted in the establishment of environmental restoration and waste management programs. However, as EM began to execute its responsibilities, decision makers became aware that the complexity and magnitude of this mission could not be achieved efficiently, affordably, safely, or reasonably with existing technology. Once the need for advanced cleanup technologies becamemore » evident, EM established an aggressive, innovative program of applied research and technology development. The Office of Technology Development (OTD) was established in November 1989 to advance new and improved environmental restoration and waste management technologies that would reduce risks to workers, the public, and the environment; reduce cleanup costs; and devise methods to correct cleanup problems that currently have no solutions. In 1996, OTD added two new responsibilities - management of a Congressionally mandated environmental science program and development of risk policy, requirements, and guidance. OTD was renamed the Office of Science and Technology (OST). This documents presents information concerning robotics tank waste retrieval overview, robotic chemical analysis automation, robotics decontamination and dismantlement, and robotics crosscutting and advanced technology.« less

Risk, mobility or population size? Drivers of technological richness among contact-period western North American hunter-gatherers.

PubMed

Collard, Mark; Buchanan, Briggs; O'Brien, Michael J; Scholnick, Jonathan

2013-11-19

Identifying factors that influence technological evolution in small-scale societies is important for understanding human evolution. There have been a number of attempts to identify factors that influence the evolution of food-getting technology, but little work has examined the factors that affect the evolution of other technologies. Here, we focus on variation in technological richness (total number of material items and techniques) among recent hunter-gatherers from western North America and test three hypotheses: (i) technological richness is affected by environmental risk, (ii) population size is the primary determinant of technological richness, and (iii) technological richness is constrained by residential mobility. We found technological richness to be correlated with a proxy for environmental risk-mean rainfall for the driest month-in the manner predicted by the risk hypothesis. Support for the hypothesis persisted when we controlled for shared history and intergroup contact. We found no evidence that technological richness is affected by population size or residential mobility. These results have important implications for unravelling the complexities of technological evolution.

Leisure-time running reduces all-cause and cardiovascular mortality risk.

PubMed

Lee, Duck-Chul; Pate, Russell R; Lavie, Carl J; Sui, Xuemei; Church, Timothy S; Blair, Steven N

2014-08-05

Although running is a popular leisure-time physical activity, little is known about the long-term effects of running on mortality. The dose-response relations between running, as well as the change in running behaviors over time, and mortality remain uncertain. We examined the associations of running with all-cause and cardiovascular mortality risks in 55,137 adults, 18 to 100 years of age (mean age 44 years). Running was assessed on a medical history questionnaire by leisure-time activity. During a mean follow-up of 15 years, 3,413 all-cause and 1,217 cardiovascular deaths occurred. Approximately 24% of adults participated in running in this population. Compared with nonrunners, runners had 30% and 45% lower adjusted risks of all-cause and cardiovascular mortality, respectively, with a 3-year life expectancy benefit. In dose-response analyses, the mortality benefits in runners were similar across quintiles of running time, distance, frequency, amount, and speed, compared with nonrunners. Weekly running even <51 min, <6 miles, 1 to 2 times, <506 metabolic equivalent-minutes, or <6 miles/h was sufficient to reduce risk of mortality, compared with not running. In the analyses of change in running behaviors and mortality, persistent runners had the most significant benefits, with 29% and 50% lower risks of all-cause and cardiovascular mortality, respectively, compared with never-runners. Running, even 5 to 10 min/day and at slow speeds <6 miles/h, is associated with markedly reduced risks of death from all causes and cardiovascular disease. This study may motivate healthy but sedentary individuals to begin and continue running for substantial and attainable mortality benefits. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana

PubMed Central

Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S.-N.; Kirby, Ryan

2016-01-01

Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders. PMID:27330828

The Term Risk: Etymology, Legal Definition and Various Traits

PubMed Central

Liuzzo, Gaetano; Bentley, Stefano; Giacometti, Federica; Bonfante, Elena

2014-01-01

The etymology of the term risk and its legal qualification and definitions are reported in this article; decription of the various traits of the term risk used in food safety management (acceptable risk, current risk, emerging risk, crude risk, unrestricted risk, perceived risk, real risk, residual risk, reduced risk, baseline risk, serious risk, major technological risk, etc.) are presented and discussed. PMID:27800325

Regulating the unknown: Managing the occupational health risks of nanomedical technologies and nanopharmaceuticals in the research laboratory

NASA Astrophysics Data System (ADS)

Ersin, Ozlem Hacer

Novel technologies and their resultant products demand fresh ways of thinking about pre-market risk analysis and post-market surveillance. A regulatory framework that is responsive to emerging knowledge about the hazards of novel technologies offers repeatable and transparent processes and remains economically and socially feasible. Workers are an especially vulnerable population who are exposed to unknown hazards of novel technologies and serve often as unwitting sentinels of impending risks. This Grounded Theory-based case study identifies gaps in our current ability to regulate novel technologies so as to minimize occupational health risks and offers necessary modifications for an environment that is conducive to proper regulation. Nanopharmaceuticals and the nano-based technologies at their base are used by way of exemplar technologies that are currently taxing the ability of the regulatory system to provide adequate oversight. Ambiguities of definition, absence of a tracking system (of who is doing nanotechnology research), and the paucity of scientific evidence to support risk management efforts are among the findings of the study and need to be addressed as ameliorative steps toward an effective regulatory structure.

Managing overweight and obesity in adults to reduce cardiovascular disease risk.

PubMed

Ebbert, Jon O; Elrashidi, Muhamad Y; Jensen, Michael D

2014-10-01

Obesity is a leading preventable cause of death and disability worldwide. Obesity increases the risk for clinically identifiable risk factors for cardiovascular disease (CVD) as well as a host of other metabolic, sleep, and orthopedic disorders. Coordinated and systematic interventions are needed to manage obesity and reduce these risks. The Obesity 2 Expert Panel updated the previous guidelines and produced the "Guideline for the Management of Overweight and Obesity in Adults." The Panel used data from publications from years 1999 to 2011 to address five critical questions, provide evidence statements, and recommend creation of a treatment algorithm to guide decision making about clinical care. The current review discusses the evidence statements pertaining to CVD risk in the assessment and management of patients who are overweight and obese. We summarize the FDA-approved medications for the treatment of overweight and obesity and their impact on CVD risk and risk factors, as well as ongoing clinical trials which will further inform clinical practice.

Foresight Study on the Risk Governance of New Technologies: The Case of Nanotechnology.

PubMed

Read, Sheona A K; Kass, Gary S; Sutcliffe, Hilary R; Hankin, Steven M

2016-05-01

Technology-led innovation represents an important driver of European economic and industrial competitiveness and offers solutions to societal challenges. In order to facilitate responsible innovation and public acceptance, a need exists to identify and implement oversight approaches focused on the effective risk governance of emerging technologies. This article describes a foresight study on the governance of new technologies, using nanotechnology as a case example. Following a mapping of the governance landscape, four plausible foresight scenarios were developed, capturing critical uncertainties for nanotechnology governance. Key governance elements were then stress tested within these scenarios to see how well they might perform in a range of possible futures and to inform identification of the strengths, weaknesses, opportunities, and threats for nanotechnology governance in Europe. Based on the study outcomes, recommendations are proposed regarding the development of governance associated with the responsible development of new technologies. © 2015 Society for Risk Analysis.

Reducing OR Traffic Using Education, Policy Development, and Communication Technology.

PubMed

Esser, Jennifer; Shrinski, Keonemana; Cady, Rhonda; Belew, John

2016-01-01

A bundled approach to surgical site infection (SSI) prevention strategies includes reducing OR traffic. A nurse-led quality improvement (QI) team sought to reduce OR traffic through education and a process change that included wireless communication technology and policy development. The team measured OR traffic by counting the frequency of door openings per hour in seven surgical suites during 305 surgical procedures conducted during similar 22-week periods before and after the QI project intervention. Door openings decreased significantly (P < 0.05) from an average of 37.8 per hour to 32.8 per hour after the QI project intervention. This suggests that our multifaceted approach reduces OR traffic. The next steps of this project include analyzing automatically captured video to understand OR traffic patterns and expanding education to departments and external personnel frequently present in our surgical suites. Future research evaluating the effectiveness of this OR traffic initiative on SSI incidence is recommended. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Cost, Time, and Risk Assessment of Different Wave Energy Converter Technology Development Trajectories: Preprint

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

Weber, Jochem W; Laird, Daniel; Costello, Ronan

This paper presents a comparative assessment of three fundamentally different wave energy converter technology development trajectories. The three technology development trajectories are expressed and visualised as a function of technology readiness levels and technology performance levels. The assessment shows that development trajectories that initially prioritize technology readiness over technology performance are likely to require twice the development time, consume a threefold of the development cost, and are prone to a risk of technical or commercial failure of one order of magnitude higher than those development trajectories that initially prioritize technology performance over technology readiness.

The holy grail of soil metal contamination site assessment: reducing risk and increasing confidence of decision making using infield portable X-ray Fluorescence (pXRF) technology

NASA Astrophysics Data System (ADS)

Rouillon, M.; Taylor, M. P.; Dong, C.

2016-12-01

This research assesses the advantages of integrating field portable X-ray Fluorescence (pXRF) technology for reducing the risk and increase confidence of decision making for metal-contaminated site assessments. Metal-contaminated sites are often highly heterogeneous and require a high sampling density to accurately characterize the distribution and concentration of contaminants. The current regulatory assessment approaches rely on a small number of samples processed using standard wet-chemistry methods. In New South Wales (NSW), Australia, the current notification trigger for characterizing metal-contaminated sites require the upper 95% confidence interval of the site mean to equal or exceed the relevant guidelines. The method's low `minimum' sampling requirements can misclassify sites due to the heterogeneous nature of soil contamination, leading to inaccurate decision making. To address this issue, we propose integrating infield pXRF analysis with the established sampling method to overcome sampling limitations. This approach increases the minimum sampling resolution and reduces the 95% CI of the site mean. Infield pXRF analysis at contamination hotspots enhances sample resolution efficiently and without the need to return to the site. In this study, the current and proposed pXRF site assessment methods are compared at five heterogeneous metal-contaminated sites by analysing the spatial distribution of contaminants, 95% confidence intervals of site means, and the sampling and analysis uncertainty associated with each method. Finally, an analysis of costs associated with both the current and proposed methods is presented to demonstrate the advantages of incorporating pXRF into metal-contaminated site assessments. The data shows that pXRF integrated site assessments allows for faster, cost-efficient, characterisation of metal-contaminated sites with greater confidence for decision making.

Methodology Development for Assessment of Spaceport Technology Returns and Risks

NASA Technical Reports Server (NTRS)

Joglekar, Prafulla; Zapata, Edgar

2001-01-01

As part of Kennedy Space Center's (KSC's) challenge to open the space frontier, new spaceport technologies must be developed, matured and successfully transitioned to operational systems. R&D investment decisions can be considered from multiple perspectives. Near mid and far term technology horizons must be understood. Because a multitude of technology investment opportunities are available, we must identify choices that promise the greatest likelihood of significant lifecycle At the same time, the costs and risks of any choice must be well understood and balanced against its potential returns The problem is not one of simply rank- ordering projects in terms of their desirability. KSC wants to determine a portfolio of projects that simultaneously satisfies multiple goals, such as getting the biggest bang for the buck, supporting projects that may be too risky for private funding, staying within annual budget cycles without foregoing the requirements of a long term technology vision, and ensuring the development of a diversity of technologies that, support the variety of operational functions involved in space transportation. This work aims to assist in the development of in methods and techniques that support strategic technology investment decisions and ease the process of determining an optimal portfolio of spaceport R&D investments. Available literature on risks and returns to R&D is reviewed and most useful pieces are brought to the attention of the Spaceport Technology Development Office (STDO). KSC's current project management procedures are reviewed. It is found that the "one size fits all" nature of KSC's existing procedures and project selection criteria is not conducive to prudent decision-making. Directions for improving KSC's - procedures and criteria are outlined. With help of a contractor, STDO is currently developing a tool, named Change Management Analysis Tool (CMAT)/ Portfolio Analysis Tool (PAT), to assist KSC's R&D portfolio determination. A

Publicly Owned Treatment Works (POTW): NESHAP Risk and Technology Review Final

EPA Pesticide Factsheets

These proposed amendments to the National Emission Standards for Hazardous Air Pollutants (NESHAP) for Publicly Owned Treatment Works (POTW) result from the results of the residual risk and technology review of that source category.

Publicly Owned Treatment Works (POTW): NESHAP Risk and Technology Review Proposal

EPA Pesticide Factsheets

These proposed amendments to the National Emission Standards for Hazardous Air Pollutants (NESHAP) for Publicly Owned Treatment Works (POTW) result from the results of the residual risk and technology review of that source category.

Effects of radon mitigation vs smoking cessation in reducing radon-related risk of lung cancer.

PubMed Central

Mendez, D; Warner, K E; Courant, P N

1998-01-01

OBJECTIVES: The purpose of this paper is to provide smokers with information on the relative benefits of mitigating radon and quitting smoking in reducing radon-related lung cancer risk. METHODS: The standard radon risk model, linked with models characterizing residential radon exposure and patterns of moving to new homes, was used to estimate the risk reduction produced by remediating high-radon homes, quitting smoking, or both. RESULTS: Quitting smoking reduces lung cancer risk from radon more than does reduction of radon exposure itself. CONCLUSIONS: Smokers should understand that, in addition to producing other health benefits, quitting smoking dominates strategies to deal with the problem posed by radon. PMID:9585753

Does the Use of Diagnostic Technology Reduce Fetal Mortality?

PubMed

Grytten, Jostein; Skau, Irene; Sørensen, Rune; Eskild, Anne

2018-01-19

To examine the effect that the introduction of new diagnostic technology in obstetric care has had on fetal death. The Medical Birth Registry of Norway provided detailed medical information for approximately 1.2 million deliveries from 1967 to 1995. Information about diagnostic technology was collected directly from the maternity units, using a questionnaire. The data were analyzed using a hospital fixed-effects regression with fetal mortality as the outcome measure. The key independent variables were the introduction of ultrasound and electronic fetal monitoring at each maternity ward. Hospital-specific trends and risk factors of the mother were included as control variables. The richness of the data allowed us to perform several robustness tests. The introduction of ultrasound caused a significant drop in fetal mortality rate, while the introduction of electronic fetal monitoring had no effect on the rate. In the population as a whole, ultrasound contributed to a reduction in fetal deaths of nearly 20 percent. For post-term deliveries, the reduction was well over 50 percent. The introduction of ultrasound made a major contribution to the decline in fetal mortality at the end of the last century. © Health Research and Educational Trust.

Psychosocial factors and uptake of risk-reducing salpingo-oophorectomy in women at high risk for ovarian cancer.

PubMed

Meiser, Bettina; Price, Melanie A; Butow, Phyllis N; Karatas, Janan; Wilson, Judy; Heiniger, Louise; Baylock, Brandi; Charles, Margaret; McLachlan, Sue-Anne; Phillips, Kelly-Anne

2013-03-01

Bilateral risk-reducing salpingo-oophorectomy (RRSO) has been shown to significantly reduce the risk of ovarian cancer. This study assessed factors predicting uptake of RRSO. Women participating in a large multiple-case breast cancer family cohort study who were at increased risk for ovarian and fallopian tube cancer (i.e. BRCA1 or BRCA2 mutation carrier or family history including at least one first- or second-degree relative with ovarian or fallopian tube cancer), with no personal history of cancer and with at least one ovary in situ at cohort enrolment, were eligible for this study. Women who knew they did not carry the BRCA1 or BRCA2 mutation segregating in their family (true negatives) were excluded. Sociodemographic, biological and psychosocial factors, including cancer-specific anxiety, perceived ovarian cancer risk, optimism and social support, were assessed using self-administered questionnaires and interviews at cohort enrolment. RRSO uptake was self-reported every three years during systematic follow-up. Of 2,859 women, 571 were eligible. Mean age was 43.3 years; 62 women (10.9 %) had RRSO a median of two years after cohort entry. Factors predicting RRSO were: being parous (OR 3.3, p = 0.015); knowing one's mutation positive status (OR 2.9, p < 0.001) and having a mother and/or sister who died from ovarian cancer (OR 2.5, p = 0.013). Psychological variables measured at cohort entry were not associated with RRSO. These results suggest that women at high risk for ovarian cancer make decisions about RRSO based on risk and individual socio-demographic characteristics, rather than in response to psychological factors such as anxiety.

Identifying and reducing risk factors related to trainee-client sexual misconduct.

PubMed

Hamilton, J C; Spruill, J

1999-06-01

Sexual misconduct involving therapists-in-training and their clients is addressed. Personal and situational factors that may constitute risk factors for the development of inappropriate sexual activity between trainees and their clients are identified. Although there may be certain characteristics that put particular students at risk for such involvement, the authors believe this risk is more strongly related to systemic, programmatic, and pedagogic characteristics of the environments in which students train. Examples include, respectively, the decline of concern over transference and countertransference, failure to include education about client-therapist sexual attraction and the consequences of sexual misconduct in graduate psychology curricula, and the reluctance of supervisors to deal straightforwardly with trainees' sexual feelings. Suggestions for reducing risks for client-therapist sexual misconduct are directed toward these situational factors.

Bringing Business Intelligence to Health Information Technology Curriculum

ERIC Educational Resources Information Center

Zheng, Guangzhi; Zhang, Chi; Li, Lei

2015-01-01

Business intelligence (BI) and healthcare analytics are the emerging technologies that provide analytical capability to help healthcare industry improve service quality, reduce cost, and manage risks. However, such component on analytical healthcare data processing is largely missed from current healthcare information technology (HIT) or health…

Multisite Parent-Centered Risk Assessment to Reduce Pediatric Oral Chemotherapy Errors

PubMed Central

Walsh, Kathleen E.; Mazor, Kathleen M.; Roblin, Douglas; Biggins, Colleen; Wagner, Joann L.; Houlahan, Kathleen; Li, Justin W.; Keuker, Christopher; Wasilewski-Masker, Karen; Donovan, Jennifer; Kanaan, Abir; Weingart, Saul N.

2013-01-01

Purpose: Observational studies describe high rates of errors in home oral chemotherapy use in children. In hospitals, proactive risk assessment methods help front-line health care workers develop error prevention strategies. Our objective was to engage parents of children with cancer in a multisite study using proactive risk assessment methods to identify how errors occur at home and propose risk reduction strategies. Methods: We recruited parents from three outpatient pediatric oncology clinics in the northeast and southeast United States to participate in failure mode and effects analyses (FMEA). An FMEA is a systematic team-based proactive risk assessment approach in understanding ways a process can fail and develop prevention strategies. Steps included diagram the process, brainstorm and prioritize failure modes (places where things go wrong), and propose risk reduction strategies. We focused on home oral chemotherapy administration after a change in dose because prior studies identified this area as high risk. Results: Parent teams consisted of four parents at two of the sites and 10 at the third. Parents developed a 13-step process map, with two to 19 failure modes per step. The highest priority failure modes included miscommunication when receiving instructions from the clinician (caused by conflicting instructions or parent lapses) and unsafe chemotherapy handling at home. Recommended risk assessment strategies included novel uses of technology to improve parent access to information, clinicians, and other parents while at home. Conclusion: Parents of pediatric oncology patients readily participated in a proactive risk assessment method, identifying processes that pose a risk for medication errors involving home oral chemotherapy. PMID:23633976

Status of Technological Advancements for Reducing Aircraft Gas Turbine Engine Pollutant Emissions

NASA Technical Reports Server (NTRS)

Rudey, R. A.

1975-01-01

Combustor test rig results indicate that substantial reductions from current emission levels of carbon monoxide (CO), total unburned hydrocarbons (THC), oxides of nitrogen (NOx), and smoke are achievable by employing varying degrees of technological advancements in combustion systems. Minor to moderate modifications to existing conventional combustors produced significant reductions in CO and THC emissions at engine low power (idle/taxi) operating conditions but did not effectively reduce NOx at engine full power (takeoff) operating conditions. Staged combusiton techniques were needed to simultaneously reduce the levels of all the emissions over the entire engine operating range (from idle to takeoff). Emission levels that approached or were below the requirements of the 1979 EPA standards were achieved with the staged combustion systems and in some cases with the minor to moderate modifications to existing conventional combustion systems. Results from research programs indicate that an entire new generation of combustor technology with extremely low emission levels may be possible in the future.

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk

PubMed Central

Thorndike, Anne N.

2012-01-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees’ nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs. PMID:22708000

Workplace Interventions to Reduce Obesity and Cardiometabolic Risk.

PubMed

Thorndike, Anne N

2011-02-01

The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees' nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs.

The Effectiveness of Different Diet Strategies to Reduce Type 2 Diabetes Risk in Youth

PubMed Central

Gow, Megan L.; Garnett, Sarah P.; Baur, Louise A.; Lister, Natalie B.

2016-01-01

Type 2 diabetes in children and adolescents has become a prominent clinical issue in recent decades. Increasing numbers of young people have risk factors for type 2 diabetes, particularly obesity, indicating the need for effective type 2 diabetes prevention strategies. The aim of this review was to identify specific dietary strategies that optimize improvements in risk factors for type 2 diabetes in youth and hence reduce the risk of type 2 diabetes development. Our review of the current literature indicates that dietary interventions lead to weight loss when intervention adherence is high. However, in addition to weight loss, a diet that is reduced in carbohydrates may optimize improvements in other type 2 diabetes risk factors, including insulin resistance and hyperglycemia. While further research is needed to confirm this finding, reduced carbohydrate diets may include a very low-carbohydrate diet, a very low-energy diet, a lower-glycemic-index diet, and/or an intermittent fasting diet. This array of dietary strategies provides a suite of intervention options for clinicians to recommend to young people at risk of type 2 diabetes. However, these findings are in contrast to current guidelines for the prevention of type 2 diabetes in adults which recommends a low-fat, high-carbohydrate diet. PMID:27517953

Can helmet design reduce the risk of concussion in football?

PubMed

Rowson, Steven; Duma, Stefan M; Greenwald, Richard M; Beckwith, Jonathan G; Chu, Jeffrey J; Guskiewicz, Kevin M; Mihalik, Jason P; Crisco, Joseph J; Wilcox, Bethany J; McAllister, Thomas W; Maerlender, Arthur C; Broglio, Steven P; Schnebel, Brock; Anderson, Scott; Brolinson, P Gunnar

2014-04-01

Of all sports, football accounts for the highest incidence of concussion in the US due to the large number of athletes participating and the nature of the sport. While there is general agreement that concussion incidence can be reduced through rule changes and teaching proper tackling technique, there remains debate as to whether helmet design may also reduce the incidence of concussion. A retrospective analysis was performed of head impact data collected from 1833 collegiate football players who were instrumented with helmet-mounted accelerometer arrays for games and practices. Data were collected between 2005 and 2010 from 8 collegiate football teams: Virginia Tech, University of North Carolina, University of Oklahoma, Dartmouth College, Brown University, University of Minnesota, Indiana University, and University of Illinois. Concussion rates were compared between players wearing Riddell VSR4 and Riddell Revolution helmets while controlling for the head impact exposure of each player. A total of 1,281,444 head impacts were recorded, from which 64 concussions were diagnosed. The relative risk of sustaining a concussion in a Revolution helmet compared with a VSR4 helmet was 46.1% (95% CI 28.1%-75.8%). When controlling for each player's exposure to head impact, a significant difference was found between concussion rates for players in VSR4 and Revolution helmets (χ(2) = 4.68, p = 0.0305). This study illustrates that differences in the ability to reduce concussion risk exist between helmet models in football. Although helmet design may never prevent all concussions from occurring in football, evidence illustrates that it can reduce the incidence of this injury.

Risk factors associated with reduced work productivity among people with chronic knee pain.

PubMed

Agaliotis, M; Fransen, M; Bridgett, L; Nairn, L; Votrubec, M; Jan, S; Heard, R; Mackey, M

2013-09-01

To determine the burden and risk factors associated with reduced work productivity among people with chronic knee pain. A longitudinal study, nested within a randomised controlled trial (RCT) evaluating the long-term effects of dietary supplements, was conducted among people with chronic knee pain in paid employment (n = 360). Participants recorded days off work (absenteeism) and reduced productivity while at work (presenteeism) for seven days every two months over a 12-month period in a study specific diary. Examined risk factors included knee pain severity, occupational group, radiographic disease severity, physical activity, body mass index (BMI), health-related quality of life (SF-12) and co-morbidity. Over the 12-month follow up period, 50 (14%) participants reported one or more days off work due to knee problems, while 283 (79%) reported reduced productivity while at work (presenteeism <100%). In multivariate analysis, the only significant risk factor for absenteeism was having an SF-12 Mental Component Summary (MCS) score <40 (OR: 2.49 [95% CI: 1.03-5.98]). Significant risk factors for presenteeism included; reporting an; SF-12 Physical Component Summary (PCS) score <50 (OR: 1.99 [95% CI: 1.05-3.76]), semi-manual labour (OR: 2.23 [1.09-4.59]) or manual labour (OR: 6.40 [1.44-28.35]) or a high maximum knee pain (4-6 out of 10) (OR: 2.29 [1.17-4.46]). This longitudinal study found that among this cohort of people with chronic knee pain, the burden of reduced work productivity is mainly attributable to presenteeism rather absenteeism. This study demonstrated that effective strategies to increase work productivity should focus on reducing knee pain or physical disability especially among workers in manual or semi-manual labour. © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Reducing the Risk of Internalizing Symptoms among High-risk Hispanic Youth through a Family Intervention: A Randomized Controlled Trial.

PubMed

Perrino, Tatiana; Pantin, Hilda; Huang, Shi; Brincks, Ahnalee; Brown, C Hendricks; Prado, Guillermo

2016-03-01

Familias Unidas is an intervention that has been found to be efficacious in preventing and reducing substance use, sexual risk, and problem behaviors among Hispanic youth. While it does not specifically target youth internalizing symptoms, the intervention works to strengthen parenting and family factors associated with reduced risk of internalizing symptoms (i.e., depression, anxiety symptoms). This study examines the effects of Familias Unidas on internalizing symptoms among high-risk youth, as well as the role of family level factors in the intervention's effects. A total of 242 12-17-year-old Hispanic youth with a history of delinquency and their primary caregivers were recruited from the school and juvenile justice systems, and randomly assigned to the Familias Unidas intervention or community practice control. A linear latent growth model was used to examine intervention effects on the trajectory of adolescent internalizing symptoms from baseline to 6 and 12 months post-baseline. Results show that the Familias Unidas intervention was more efficacious than control in reducing youth internalizing symptoms. Baseline youth externalizing and internalizing symptoms did not moderate the intervention's effects on the trajectory of youth internalizing symptoms. While parent-adolescent communication did not significantly moderate the intervention's effects, changes in parent-adolescent communication mediated the intervention's effects on internalizing symptoms, showing stronger intervention effects for youth starting with poorer communication. Findings indicate that the Familias Unidas intervention can reduce internalizing symptoms among high-risk Hispanic youth, and that improving parent-youth communication, a protective family factor, may be one of the mechanisms by which the intervention influences youth internalizing symptoms. © 2015 Family Process Institute.

Risk reducing mastectomy, breast reconstruction and patient satisfaction in Norwegian BRCA1/2 mutation carriers.

PubMed

Hagen, Anne Irene; Mæhle, Lovise; Vedå, Nina; Vetti, Hildegunn Høberg; Stormorken, Astrid; Ludvigsen, Trond; Guntvedt, Bente; Isern, Anne Elisabeth; Schlichting, Ellen; Kleppe, Geir; Bofin, Anna; Gullestad, Hans Petter; Møller, Pål

2014-02-01

The aim of this study was to evaluate the outcome of risk-reducing mastectomy in BRCA1/2 mutation carriers with and without breast cancer. Uptake, methods of operation and reconstruction, complications, patient satisfaction and histopathological findings were registered at all five departments of genetics in Norway. Data from 267 affected and unaffected BRCA1/2 mutation carriers were analyzed, including a study-specific questionnaire returned by 178 mutation carriers. There was a steady increase in the uptake of risk-reducing mastectomies during the study period. Complications were observed in 106/266 (39.7%) women. Patient satisfaction was high. The majority of women expressed great relief after risk-reducing mastectomy and would have chosen the same option again. Copyright © 2013 Elsevier Ltd. All rights reserved.

Does a too risk-averse approach to the implementation of new radiotherapy technologies delay their clinical use?

PubMed

Garcia, R; Nyström, H; Fiorino, C; Thwaites, D

2015-07-01

Radiotherapy is a generally safe treatment modality in practice; nevertheless, recent well-reported accidents also confirm its potential risks. However, this may obstruct or delay the introduction of new technologies and treatment strategies/techniques into clinical practice. Risks must be addressed and judged in a realistic context: risks must be assessed realistically. Introducing new technology may introduce new possibilities of errors. However, delaying the introduction of such new technology therefore means that patients are denied the potentially better treatment opportunities. Despite the difficulty in quantitatively assessing the risks on both sides of the possible choice of actions, including the "lost opportunity", the best estimates should be included in the overall risk-benefit and cost-benefit analysis. Radiotherapy requires a sufficiently high level of support for the safety, precision and accuracy required: radiotherapy development and implementation is exciting. However, it has been anxious with a constant awareness of the consequences of mistakes or misunderstandings. Recent history can be used to show that for introduction of advanced radiotherapy, the risk-averse medical physicist can act as an electrical fuse in a complex circuit. The lack of sufficient medical physics resource or expertise can short out this fuse and leave systems unsafe. Future technological developments will continue to present further safety and risk challenges. The important evolution of radiotherapy brings different management opinions and strategies. Advanced radiotherapy technologies can and should be safely implemented in as timely a manner as possible for the patient groups where clinical benefit is indicated.

Two-scale evaluation of remediation technologies for a contaminated site by applying economic input-output life cycle assessment: risk-cost, risk-energy consumption and risk-CO2 emission.

PubMed

Inoue, Yasushi; Katayama, Arata

2011-09-15

A two-scale evaluation concept of remediation technologies for a contaminated site was expanded by introducing life cycle costing (LCC) and economic input-output life cycle assessment (EIO-LCA). The expanded evaluation index, the rescue number for soil (RN(SOIL)) with LCC and EIO-LCA, comprises two scales, such as risk-cost, risk-energy consumption or risk-CO(2) emission of a remediation. The effectiveness of RN(SOIL) with LCC and EIO-LCA was examined in a typical contamination and remediation scenario in which dieldrin contaminated an agricultural field. Remediation was simulated using four technologies: disposal, high temperature thermal desorption, biopile and landfarming. Energy consumption and CO(2) emission were determined from a life cycle inventory analysis using monetary-based intensity based on an input-output table. The values of RN(SOIL) based on risk-cost, risk-energy consumption and risk-CO(2) emission were calculated, and then rankings of the candidates were compiled according to RN(SOIL) values. A comparison between three rankings showed the different ranking orders. The existence of differences in ranking order indicates that the scales would not have reciprocal compatibility for two-scale evaluation and that each scale should be used independently. The RN(SOIL) with LCA will be helpful in selecting a technology, provided an appropriate scale is determined. Copyright © 2011 Elsevier B.V. All rights reserved.

Development of air conditioning technologies to reduce CO2 emissions in the commercial sector

PubMed Central

Yoshida, Yukiko

2006-01-01

Background Architectural methods that take into account global environmental conservation generally concentrate on mitigating the heat load of buildings. Here, we evaluate the reduction of carbon dioxide (CO2) emissions that can be achieved by improving heating, ventilating, and air conditioning (HVAC) technologies. Results The Climate Change Research Hall (CCRH) of the National Institute for Environmental Studies (NIES) is used as a case study. CCRH was built in line with the "Green Government Buildings" program of the Government Buildings Department at the Ministry of Land, Infrastructure and Transport in Japan. We have assessed the technology used in this building, and found that there is a possibility to reduce energy consumption in the HVAC system by 30%. Conclusion Saving energy reduces CO2 emissions in the commercial sector, although emission factors depend on the country or region. Consequently, energy savings potential may serve as a criterion in selecting HVAC technologies with respect to emission reduction targets. PMID:17062161

Design of Work Facilities for Reducing Musculoskeletal Disorders Risk in Paper Pallet Assembly Station

NASA Astrophysics Data System (ADS)

Mardi Safitri, Dian; Arfi Nabila, Zahra; Azmi, Nora

2018-03-01

Musculoskeletal Disorders (MSD) is one of the ergonomic risks due to manual activity, non-neutral posture and repetitive motion. The purpose of this study is to measure risk and implement ergonomic interventions to reduce the risk of MSD on the paper pallet assembly work station. Measurements to work posture are done by Ovako Working Posture Analysis (OWAS) methods and Rapid Entire Body Assessment (REBA) method, while the measurement of work repetitiveness was using Strain Index (SI) method. Assembly processes operators are identified has the highest risk level. OWAS score, Strain Index, and REBA values are 4, 20.25, and 11. Ergonomic improvements are needed to reduce that level of risk. Proposed improvements will be developed using the Quality Function Deployment (QFD) method applied with Axiomatic House of Quality (AHOQ) and Morphological Chart. As the result, risk level based on OWAS score & REBA score turn out from 4 & 11 to be 1 & 2. Biomechanics analysis of the operator also shows the decreasing values for L4-L5 moment, compression, joint shear, and joint moment strength.

Improving Learning Processes in Institutions of Higher Education by Incorporating High-Risk Web Technologies.

ERIC Educational Resources Information Center

Hinga, Sophia W.; Chen, Linlin Irene

With the assistance of learning technology consultants in the Technology Teaching and Learning Center (TTLC) at the University of Houston-Downtown (Texas), professors have shifted their paradigms and are taking the leap to use more high-risk World Wide Web technologies in their courses. One that has become a hallmark is delivering exams via the…

The Residual Risk Reduction Initiative: a call to action to reduce residual vascular risk in patients with dyslipidemia.

PubMed

Fruchart, Jean-Charles; Sacks, Frank; Hermans, Michel P; Assmann, Gerd; Brown, W Virgil; Ceska, Richard; Chapman, M John; Dodson, Paul M; Fioretto, Paola; Ginsberg, Henry N; Kadowaki, Takashi; Lablanche, Jean-Marc; Marx, Nikolaus; Plutzky, Jorge; Reiner, Zeljko; Rosenson, Robert S; Staels, Bart; Stock, Jane K; Sy, Rody; Wanner, Christoph; Zambon, Alberto; Zimmet, Paul

2008-11-17

Despite achieving targets for low-density lipoprotein (LDL) cholesterol, blood pressure, and glycemia in accordance with current standards of care, patients with dyslipidemia remain at high residual risk of vascular events. Atherogenic dyslipidemia, characterized by elevated triglycerides and low levels of high-density lipoprotein (HDL) cholesterol, often with elevated apolipoprotein B and non-HDL cholesterol, is common in patients with established cardiovascular disease (CVD), type 2 diabetes mellitus, or metabolic syndrome and contributes to both macrovascular and microvascular residual risk. However, atherogenic dyslipidemia is largely underdiagnosed and undertreated in clinical practice. The Residual Risk Reduction Initiative (R3i) was established to address this highly relevant clinical issue. The aims of this position paper are (1) to highlight evidence that atherogenic dyslipidemia is associated with residual macrovascular and microvascular risk in patients at high risk for CVD, despite current standards of care for dyslipidemia and diabetes; and (2) to recommend therapeutic intervention for reducing this residual vascular risk supported by evidence and expert consensus. Lifestyle modification with nutrition and exercise is an important, effective, and underutilized first step in reducing residual vascular risk. Therapeutic intervention aimed at achievement of all lipid targets is also often required. Combination lipid-modifying therapy, with the addition of niacin, a fibrate, or omega-3 fatty acids to statin therapy, increases the probability of achieving all lipid goals. Outcomes studies are in progress to evaluate whether these combination treatment strategies translate to a clinical benefit greater than that achieved with statins alone. The R3i highlights the need to address with lifestyle and/or pharmacotherapy the high level of residual risk of CVD events and microvascular complications among patients with dyslipidemia receiving therapy for high levels

Emerging Technologies for Environmental Remediation: Integrating Data and Judgment.

PubMed

Bates, Matthew E; Grieger, Khara D; Trump, Benjamin D; Keisler, Jeffrey M; Plourde, Kenton J; Linkov, Igor

2016-01-05

Emerging technologies present significant challenges to researchers, decision-makers, industry professionals, and other stakeholder groups due to the lack of quantitative risk, benefit, and cost data associated with their use. Multi-criteria decision analysis (MCDA) can support early decisions for emerging technologies when data is too sparse or uncertain for traditional risk assessment. It does this by integrating expert judgment with available quantitative and qualitative inputs across multiple criteria to provide relative technology scores. Here, an MCDA framework provides preliminary insights on the suitability of emerging technologies for environmental remediation by comparing nanotechnology and synthetic biology to conventional remediation methods. Subject matter experts provided judgments regarding the importance of criteria used in the evaluations and scored the technologies with respect to those criteria. The results indicate that synthetic biology may be preferred over nanotechnology and conventional methods for high expected benefits and low deployment costs but that conventional technology may be preferred over emerging technologies for reduced risks and development costs. In the absence of field data regarding the risks, benefits, and costs of emerging technologies, structuring evidence-based expert judgment through a weighted hierarchy of topical questions may be helpful to inform preliminary risk governance and guide emerging technology development and policy.

NIH study finds regular aspirin use may reduce ovarian cancer risk

Cancer.gov

Women who take aspirin daily may reduce their risk of ovarian cancer by 20 percent, according to a study by scientists at the National Cancer Institute (NCI), part of the National Institutes of Health. However, further research is needed before clinical r

Risk-reducing surgery on the uterine adnexa: timing and type of surgical treatment, and pathology report.

PubMed

Signorelli, Mauro; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco

2016-10-01

Inherited mutations in BRCA1 and BRCA2 increase significantly the risk of developing breast and ovarian cancers, and they have been associated with increased risks of developing other types of cancer. Although screening programs have been implemented in order to detect cancers at the early stage, they resulted ineffective. To date, risk-reducing bilateral salpingo-oophorectomy represents the only procedure allowing reducing the incidence of ovarian cancer and increasing survival among BRCA1 and -2 mutation carriers. In the present review we will discuss the advantages and disadvantages related to the execution of prophylactic surgery, thus underlying possible beneficial and detrimental effects of this kind of surgery in premenopausal women. Additionally, we will investigate further therapeutic strategies aimed to reduce the risk of developing ovarian cancer, without affected patients' hormonal status.

Environmental equity: Reducing risk for all communities. Volume 2. Supporting document

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

NONE

1992-06-01

In targeting its protection efforts to reduce the most serious risks, the Agency has begun to examine how the patterns of environmental problems converge on different places, how the people who live in those places are affected, and how environmental programs should be refined to address identified differences. A community surrounded by Multiple sources of air pollution, ringed by waste treatment facilities and landfills, and whose residences contain lead-based paint clearly faces higher than average potential environmental risks. It is in this context that concerns have been raised about the relative risk burden borne by low-income and racial minority communities.more » Examination of these differences in risk burden and how government agencies respond is known as environmental equity. Although there are many types of equity, this report focuses on racial and socioeconomic equity.« less

A Multifaceted School-based Intervention to Reduce Risk for Type 2 Diabetes in At-Risk Youth

PubMed Central

Grey, Margaret; Jaser, Sarah S.; Holl, Marita G.; Jefferson, Vanessa; Dziura, James; Northrup, Veronika

2009-01-01

Objective To evaluate the impact of a multifaceted, school-based intervention on inner city youth at high risk for type 2 diabetes mellitus (T2DM) and to determine whether the addition of coping skills training (CST) and health coaching improves outcomes. Method 198 students in New Haven, CT at risk for T2DM (BMI > 85th percentile and family history of diabetes) were randomized by school to an educational intervention with or without the addition of CST and health coaching. Students were enrolled from 2004–2007 and followed for 12 months. Results Students in both groups showed some improvement in anthropometric measures, lipids, and depressive symptoms over 12 months. BMI was not improved by the intervention. Students who received CST showed greater improvement on some indicators of metabolic risk than students who received education only. Conclusion A multifaceted, school-based intervention may hold promise for reducing metabolic risk in urban, minority youth. PMID:19643125

Fact Sheet for Friction Materials Manufacturing Facilities Residual Risk and Technology Review

EPA Pesticide Factsheets

proposed amendments to the National Emission Standards for Hazardous Air Pollutants (NESHAP) for Friction Materials Manufacturing Facilities to address the results of the residual risk and technology review

[Application of risk-based approach for determination of critical factors in technology transfer of production of medicinal products].

PubMed

Beregovykh, V V; Spitskiy, O R

2014-01-01

Risk-based approach is used for examination of impact of different factors on quality of medicinal products in technology transfer. A general diagram is offered for risk analysis execution in technology transfer from pharmaceutical development to production. When transferring technology to full- scale commercial production it is necessary to investigate and simulate production process application beforehand in new real conditions. The manufacturing process is the core factorfor risk analysis having the most impact on quality attributes of a medicinal product. Further importantfactors are linked to materials and products to be handled and manufacturing environmental conditions such as premises, equipment and personnel. Usage of risk-based approach in designing of multipurpose production facility of medicinal products is shown where quantitative risk analysis tool RAMM (Risk Analysis and Mitigation Matrix) was applied.

Concurrent and Subsequent Associations between Daily Digital Technology Use and High-Risk Adolescents' Mental Health Symptoms

ERIC Educational Resources Information Center

George, Madeleine J.; Russell, Michael A.; Piontak, Joy R.; Odgers, Candice L.

2018-01-01

Adolescents are spending an unprecedented amount of time using digital technologies (especially mobile technologies), and there are concerns that adolescents' constant connectivity is associated with poor mental health, particularly among at-risk adolescents. Participants included 151 adolescents at risk for mental health problems (M[subscript…

Assessing the Risk of Occult Cancer and 30-day Morbidity in Women Undergoing Risk-reducing Surgery: A Prospective Experience.

PubMed

Bogani, Giorgio; Tagliabue, Elena; Signorelli, Mauro; Chiappa, Valentina; Carcangiu, Maria Luisa; Paolini, Biagio; Casarin, Jvan; Scaffa, Cono; Gennaro, Massimiliano; Martinelli, Fabio; Borghi, Chiara; Ditto, Antonino; Lorusso, Domenica; Raspagliesi, Francesco

To investigate the incidence and predictive factors of 30-day surgery-related morbidity and occult precancerous and cancerous conditions for women undergoing risk-reducing surgery. A prospective study (Canadian Task Force classification II-1). A gynecologic oncology referral center. Breast-related cancer antigen (BRCA) mutation carriers and BRCAX patients (those with a significant family history of breast and ovarian cancer). Minimally invasive risk-reduction surgery. Overall, 85 women underwent risk-reducing surgery: 30 (35%) and 55 (65%) had hysterectomy plus bilateral salpingo-oophorectomy (BSO) and BSO alone, respectively. Overall, in 6 (7%) patients, the final pathology revealed unexpected cancer: 3 early-stage ovarian/fallopian tube cancers, 2 advanced-stage ovarian cancers (stage IIIA and IIIB), and 1 serous endometrial carcinoma. Additionally, 3 (3.6%) patients had incidental finding of serous tubal intraepithelial carcinoma. Four (4.7%) postoperative complications within 30 days from surgery were registered, including fever (n = 3) and postoperative ileus (n = 1); no severe (grade 3 or more) complications were observed. All complications were managed conservatively. The presence of occult cancer was the only factor predicting the development of postoperative complications (p = .02). Minimally invasive risk-reducing surgery is a safe and effective strategy to manage BRCA mutation carriers. Patients should benefit from an appropriate counseling about the high prevalence of undiagnosed cancers observed at the time of surgery. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

Reducing safety risk among underserved caregivers with an Alzheimer's home safety program.

PubMed

Levy-Storms, Lené; Cherry, Debra L; Lee, Linda J; Wolf, Sheldon M

2017-09-01

Older adults living with Alzheimer's disease (AD) experience more of the types of accidents and injuries prevalent among older adults. Relatively few studies specifically on safety risks have included older adults of color and tested interventions. This pilot study tested the feasibility and evaluability of educating Hispanic and African American caregivers of patients living with AD about reducing safety risks in their homes. This outpatient memory clinic-based intervention study included a pre-/post-test survey design with two nonequivalent groups and predominately serves Hispanic and African Americans. Of 60 eligible caregivers, 67% participated in a tailored, safety training class with an optional follow-up call. The results indicate a reduction in some safety risks compared to baseline and/or a no intervention group, respectively, including leaving patients at home alone part-time (p < .01 and p < .01), getting lost (p < .05 and p < .05), going outdoors alone less often (p < .05 and p < .01), and giving themselves medicine (p < .05 and p < .01). At post-test, 47 clinically significant instances occurred, in which caregivers who participated in the intervention self-reported patients living with AD to be 'completely safe' in one or more of the safety risk items compared to 8 instances among those who did not. This pilot pre/post design with non-equivalent groups study needs refinement in a future randomized control trial. Despite limitations, this pilot study demonstrates the first feasible and evaluable intervention with both statistically and clinically significant results that suggest potential for reducing safety risks among at-risk minority patients living with AD in future research.

Interventions to reduce zoonotic and pandemic risks from avian influenza in Asia

PubMed Central

Peiris, Malik; Cowling, Benjamin J.; Wu, Joseph T.; Feng, Luzhao; Guan, Yi; Yu, Hongjie; Leung, Gabriel M.

2017-01-01

Summary Novel influenza viruses continue to emerge posing zoonotic and potentially pandemic threats, avian influenza A/H7N9 being the most recent example. While closure of live poultry markets in mainland China was effective at aborting A/H7N9 outbreaks temporarily, they are difficult to sustain, given the current poultry production and marketing systems in China. We summarise interventions taken in mainland China to date. We provide evidence for other more sustainable but effective interventions in the live poultry market (LPM) systems that reduce risk of zoonotic influenza including “rest days” in LPM and banning live poultry in markets overnight. On the longer term, separation of live ducks and geese from terrestrial poultry in LPM systems can reduce the risk of emergence of zoonotic, epizootic (and potentially pandemic) viruses at source. Given evidence that A/H7N9 is now endemic in over half of the provinces in mainland China, and will continue to cause recurrent zoonotic disease in the winter months, such interventions should receive high priority in China as well as other Asian countries which are at risk of introduction of A/H7N9 through cross-border poultry movements. Such generic measures are likely to reduce current as well as future threats from zoonotic influenza. PMID:26654122

Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care.

PubMed

Potter, Patricia; Allen, Kelly; Costantinou, Eileen; Klinkenberg, William Dean; Malen, Jill; Norris, Traci; O'Connor, Elizabeth; Roney, Wilhemina; Tymkew, Heidi Hahn; Wolf, Laurie

2017-08-01

Sensor technology that dynamically identifies hospitalized patients' fall risk and detects and alerts nurses of high-risk patients' early exits out of bed has potential for reducing fall rates and preventing patient harm. During Phase 1 (August 2014-January 2015) of a previously reported performance improvement project, an innovative depth sensor was evaluated on two inpatient medical units to study fall characteristics. In Phase 2 (April 2015-January 2016), a combined depth and bed sensor system designed to assign patient fall probability, detect patient bed exits, and subsequently prevent falls was evaluated. Fall detection depth sensors remained in place on two medicine units; bed sensors used to detect patient bed exits were added on only one of the medicine units. Fall rates and fall with injury rates were evaluated on both units. During Phase 2, the designated evaluation unit had 14 falls, for a fall rate of 2.22 per 1,000 patient-days-a 54.1% reduction compared with the Phase 1 fall rate. The difference in rates from Phase 1 to Phase 2 was statistically significant (z = 2.20; p = 0.0297). The comparison medicine unit had 30 falls-a fall rate of 4.69 per 1,000 patient-days, representing a 57.9% increase as compared with Phase 1. A fall detection sensor system affords a level of surveillance that standard fall alert systems do not have. Fall prevention remains a complex issue, but sensor technology is a viable fall prevention option. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Webinar Presentation: EPA Actions to Reduce Children's Health Risks from Environmental Factors

EPA Pesticide Factsheets

This presentation, EPA Actions to Reduce Children's Health Risks from Environmental Factors, was given at the NIEHS/EPA Children's Centers 2015 Webinar Series: The Significance of Children’s Environmental Health Research Through Collaboration.

Different Patterns of Risk Reducing Decisions in Affected or Unaffected BRCA Pathogenic Variant Carriers.

PubMed

Lee, Eun-Gyeong; Kang, Hyok Jo; Lim, Myong Cheol; Park, Boyoung; Park, Soo Jin; Jung, So-Youn; Lee, Seeyoun; Kang, Han-Sung; Park, Sang-Yoon; Park, Boram; Joo, Jungnam; Han, Jai Hong; Kong, Sun-Young; Lee, Eun Sook

2018-05-04

The purpose of this study was to investigate decision patterns to reduce the risks of BRCA-related breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and risk-reducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers. The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management. Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC, which significantly differed between BRCA1 and BRCA2 carriers (p<0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 (71.1%) of the 83 carriers with BC and the 39 (49.4%) of 79 unaffected carriers underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of risk-reducing surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p<0.001). RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness.

Risk dishabituation: in repeated gambling, risk is reduced following low-probability "surprising" events (wins or losses).

PubMed

Demaree, Heath A; Burns, Kevin J; Dedonno, Michael A; Agarwala, Edward K; Everhart, D Erik

2012-06-01

In path-dependent risk taking, like playing a slot machine, the wager on one trial may be affected by the outcome of the preceding trial. Previous studies have shown that a person's risk-taking preferences may change as a result of the preceding trial (win or loss). For example, the "house money effect" suggests that risk taking may increase after a win, whereas the "break even effect" posits that risk taking increases after a loss. Independent of those findings, a person's emotional state has been found to influence risk taking. For example, the "mood maintenance hypothesis" supports the notion that positive affect decreases risk taking, and related research finds that increased negative affect increases risk taking. Because winning and losing may influence one's emotional state, we sought to investigate how both previous outcomes, as well as a person's emotional responses to those outcomes, independently influence subsequent risk taking. To do this, data were collected using three simplified slot machines where the chance of winning each trial was set to 13%, 50%, and 87%, respectively. Evidence for the break even and house money effects were found on the 13% and 87% games, respectively. Likewise, emotional valence was found to predict risk taking on these two tasks, with emotional valence fully explaining the break even effect observed on the 13% game. In addition to these results, the present research revealed that risk taking is reduced following low-probability ("surprising") events (i.e., a win in the 13% condition or loss in the 87% condition). Dubbed "risk dishabituation," this phenomenon is discussed, along with its likely corresponding emotional experience--surprise.

Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions

PubMed Central

Ooi, Adrian SH; Song, David H

2016-01-01

Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections. PMID:27621667

Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness analysis.

PubMed

Manchanda, Ranjit; Legood, Rosa; Antoniou, Antonis C; Gordeev, Vladimir S; Menon, Usha

2016-09-01

Risk-reducing salpingo-oophorectomy (RRSO) is the most effective intervention to prevent ovarian cancer (OC). It is only available to high-risk women with >10% lifetime OC risk. This threshold has not been formally tested for cost-effectiveness. To specify the OC risk thresholds for RRSO being cost-effective for preventing OC in premenopausal women. The costs as well as effects of surgical prevention ('RRSO') were compared over a lifetime with 'no RRSO' using a decision analysis model. RRSO was undertaken in premenopausal women >40 years. The model was evaluated at lifetime OC risk levels: 2%, 4%, 5%, 6%, 8% and 10%. Costs and outcomes are discounted at 3.5%. Uncertainty in the model was assessed using both deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA). Outcomes included in the analyses were OC, breast cancer (BC) and additional deaths from coronary heart disease. Total costs and effects were estimated in terms of quality-adjusted life-years (QALYs); incidence of OC and BC; as well as incremental cost-effectiveness ratio (ICER). Published literature, Nurses Health Study, British National Formulary, Cancer Research UK, National Institute for Health and Care Excellence guidelines and National Health Service reference costs. The time horizon is lifetime and perspective: payer. Premenopausal RRSO is cost-effective at 4% OC risk (life expectancy gained=42.7 days, ICER=£19 536/QALY) with benefits largely driven by reduction in BC risk. RRSO remains cost-effective at >8.2% OC risk without hormone replacement therapy (ICER=£29 071/QALY, life expectancy gained=21.8 days) or 6%if BC risk reduction=0 (ICER=£27 212/QALY, life expectancy gained=35.3 days). Sensitivity analysis indicated results are not impacted much by costs of surgical prevention or treatment of OC/ BC or cardiovascular disease. However, results were sensitive to RRSO utility scores. Additionally, 37%, 61%, 74%, 84%, 96% and 99.5% simulations on PSA are cost

The Benefits of Social Technology Use Among Older Adults Are Mediated by Reduced Loneliness.

PubMed

Chopik, William J

2016-09-01

Technology has the ability to enhance and enrich the lives of older adults by facilitating better interpersonal relationships. However, few studies have directly examined associations between technology use for social reasons and physical and psychological health among older adults. The current study examines the benefits of technology use in 591 older adults from the 2012 wave of the Health and Retirement Study (Mage = 68.18, SD = 10.75; 55.5% female). Social technology use was assessed through five technology-based behaviors (i.e., using e-mail, social networking sites, online video/phone calls, online chatting/instant messaging, using a smartphone). Attitudes toward the usability and benefits of technology use were also assessed. Older adults had generally positive attitudes toward technology. Higher social technology use was associated with better self-rated health, fewer chronic illnesses, higher subjective well-being, and fewer depressive symptoms. Furthermore, each of the links between social technology use and physical and psychological health was mediated by reduced loneliness. Close relationships are a large determinant of physical health and well-being, and technology has the potential to cultivate successful relationships among older adults.

The Benefits of Social Technology Use Among Older Adults Are Mediated by Reduced Loneliness

PubMed Central

2016-01-01

Abstract Technology has the ability to enhance and enrich the lives of older adults by facilitating better interpersonal relationships. However, few studies have directly examined associations between technology use for social reasons and physical and psychological health among older adults. The current study examines the benefits of technology use in 591 older adults from the 2012 wave of the Health and Retirement Study (Mage = 68.18, SD = 10.75; 55.5% female). Social technology use was assessed through five technology-based behaviors (i.e., using e-mail, social networking sites, online video/phone calls, online chatting/instant messaging, using a smartphone). Attitudes toward the usability and benefits of technology use were also assessed. Older adults had generally positive attitudes toward technology. Higher social technology use was associated with better self-rated health, fewer chronic illnesses, higher subjective well-being, and fewer depressive symptoms. Furthermore, each of the links between social technology use and physical and psychological health was mediated by reduced loneliness. Close relationships are a large determinant of physical health and well-being, and technology has the potential to cultivate successful relationships among older adults. PMID:27541746

Adequate nutrient intake can reduce cardiovascular disease risk in African Americans.

PubMed

Reusser, Molly E; DiRienzo, Douglas B; Miller, Gregory D; McCarron, David A

2003-03-01

Cardiovascular disease kills nearly as many Americans each year as the next seven leading causes of death combined. The prevalence of cardiovascular disease and most of its associated risk factors is markedly higher and increasing more rapidly among African Americans than in any other racial or ethnic group. Improving these statistics may be simply a matter of improving diet quality. In recent years, a substantial and growing body of evidence has revealed that dietary patterns complete in all food groups, including nutrient-rich dairy products, are essential for preventing and reducing cardiovascular disease and the conditions that contribute to it. Several cardiovascular risk factors, including hypertension, insulin resistance syndrome, and obesity, have been shown to be positively influenced by dietary patterns that include adequate intake of dairy products. The benefits of nutrient-rich dietary patterns have been specifically tested in randomized, controlled trials emphasizing African American populations. These studies demonstrated proportionally greater benefits for African Americans without evidence of adverse effects such as symptoms of lactose intolerance. As currently promoted for the prevention of certain cancers and osteoporosis, regular consumption of diets that meet recommended nutrient intake levels might also be the most effective approach for reducing cardiovascular disease risk in African Americans.

Having a Go: Looking at Teachers' Experience of Risk-Taking in Technology Integration

ERIC Educational Resources Information Center

Howard, Sarah K.; Gigliotti, Amanda

2016-01-01

Risk is an integral part of change. Technology-related change in teachers' practice is guided by confidence engaging in and beliefs about integration. However, it is also affected by how teachers feel about taking risks, experimenting and change. This paper presents a theoretical framework of affect and emotion to understand how teachers…

Integrating mHealth Mobile Applications to Reduce High Risk Drinking among Underage Students

ERIC Educational Resources Information Center

Kazemi, Donna M.; Cochran, Allyson R.; Kelly, John F.; Cornelius, Judith B.; Belk, Catherine

2014-01-01

Objective: College students embrace mobile cell phones (MCPs) as a primary communication and entertainment device. The aim of this study was to investigate college students' perceptions toward using mHealth technology to deliver interventions to prevent high-risk drinking and associated consequences. Design/setting: Four focus group interviews…

Hemodialysis patients receiving a greater Kt dose than recommended have reduced mortality and hospitalization risk.

PubMed

Maduell, Francisco; Ramos, Rosa; Varas, Javier; Martin-Malo, Alejandro; Molina, Manuel; Pérez-Garcia, Rafael; Marcelli, Daniele; Moreso, Francesc; Aljama, Pedro; Merello, Jose Ignacio

2016-12-01

Achieving an adequate dialysis dose is one of the key goals for dialysis treatments. Here we assessed whether patients receiving the current cleared plasma volume (Kt), individualized for body surface area per recommendations, had improved survival and reduced hospitalizations at 2 years of follow-up. Additionally, we assessed whether patients receiving a greater dose gained more benefit. This prospective, observational, multicenter study included 6129 patients in 65 Fresenius Medical Care Spanish facilities. Patients were classified monthly into 1 of 10 risk groups based on the difference between achieved and target Kt. Patient groups with a more negative relationship were significantly older with a higher percentage of diabetes mellitus and catheter access. Treatment dialysis time, effective blood flow, and percentage of on-line hemodiafiltration were significantly higher in groups with a higher dose. The mortality risk profile showed a progressive increase when achieved minus target Kt became more negative but was significantly lower in the group with 1 to 3 L clearance above target Kt and in groups with greater increases above target Kt. Additionally, hospitalization risk appeared significantly reduced in groups receiving 9 L or more above the minimum target. Thus, prescribing an additional 3 L or more above the minimum Kt dose could potentially reduce mortality risk, and 9 L or more reduce hospitalization risk. As such, future prospective studies are required to confirm these dose effect findings. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Do risk assessment tools help manage and reduce risk of violence and reoffending? A systematic review.

PubMed

Viljoen, Jodi L; Cochrane, Dana M; Jonnson, Melissa R

2018-06-01

Although it is widely believed that risk assessment tools can help manage risk of violence and offending, it is unclear what evidence exists to support this view. As such, we conducted a systematic review and narrative synthesis. To identify studies, we searched 13 databases, reviewed reference lists, and contacted experts. Through this review, we identified 73 published and unpublished studies (N = 31,551 psychiatric patients and offenders, N = 10,002 professionals) that examined either professionals' risk management efforts following the use of a tool, or rates of violence or offending following the implementation of a tool. These studies included a variety of populations (e.g., adults, adolescents), tools, and study designs. The primary findings were as follows: (a) despite some promising findings, professionals do not consistently adhere to tools or apply them to guide their risk management efforts; (b) following the use of a tool, match to the risk principle is moderate and match to the needs principle is limited, as many needs remained unaddressed; (c) there is insufficient evidence to conclude that tools directly reduce violence or reoffending, as findings are mixed; and (d) tools appear to have a more beneficial impact on risk management when agencies use careful implementation procedures and provide staff with training and guidelines related to risk management. In sum, although risk assessment tools may be an important starting point, they do not guarantee effective treatment or risk management. However, certain strategies may bolster their utility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

CT Dose Optimization in Pediatric Radiology: A Multiyear Effort to Preserve the Benefits of Imaging While Reducing the Risks.

PubMed

Greenwood, Taylor J; Lopez-Costa, Rodrigo I; Rhoades, Patrick D; Ramírez-Giraldo, Juan C; Starr, Matthew; Street, Mandie; Duncan, James; McKinstry, Robert C

2015-01-01

The marked increase in radiation exposure from medical imaging, especially in children, has caused considerable alarm and spurred efforts to preserve the benefits but reduce the risks of imaging. Applying the principles of the Image Gently campaign, data-driven process and quality improvement techniques such as process mapping and flowcharting, cause-and-effect diagrams, Pareto analysis, statistical process control (control charts), failure mode and effects analysis, "lean" or Six Sigma methodology, and closed feedback loops led to a multiyear program that has reduced overall computed tomographic (CT) examination volume by more than fourfold and concurrently decreased radiation exposure per CT study without compromising diagnostic utility. This systematic approach involving education, streamlining access to magnetic resonance imaging and ultrasonography, auditing with comparison with benchmarks, applying modern CT technology, and revising CT protocols has led to a more than twofold reduction in CT radiation exposure between 2005 and 2012 for patients at the authors' institution while maintaining diagnostic utility. (©)RSNA, 2015.

The estimated risk for coronary heart disease and prevalence of dyslipidemia among workers of information technology industries in Taiwan.

PubMed

Yang, Shao-Chi; Chien, Kuo-Liong; Tsai, Wei-I; Ho, Yi-Lwun; Chen, Ming-Fong

2011-03-18

Individuals working in information technology (IT) industries suffer from high work stress, possibly causing adverse impacts on their health. However, studies of cardiovascular risk factors among these workers are lacking. The aims of this study were to evaluate the estimated risk for coronary heart disease (CHD) and prevalence of dyslipidemia among IT workers. A total of 941 employees from 11 IT companies were enrolled and the anthropometrics and serum lipid profiles were measured. The 10-year risk for CHD was calculated based on the Framingham risk score. Compared with lipid profiles in a representative sample (n=6589), IT workers had a significantly higher prevalence of obesity, hypercholesterolemia, low level of HDL-C, and high level of LDL-C in each age group. Their overall estimated 10-year risk for CHD was higher than the average risk of an age- and gender-matched population (2.91% vs. 2.79%, p=0.027). Working for more than 10h/day was associated with a higher estimated CHD risk (3.62% vs. 2.54%, p<0.01). A higher prevalence of hyperlipidemia was noted among IT workers. Their estimated 10-year CHD risk was also higher than average. More aggressive interventions to reduce the risk of CHD in this population are needed. Copyright © 2010 Elsevier B.V. All rights reserved.

Reducing drug–herb interaction risk with a computerized reminder system

PubMed Central

Lin, Sheng-Shing; Tsai, Chiu-Lin; Tu, Ching-Yeh; Hsieh, Ching-Liang

2015-01-01

Background Traditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions. Methods Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient. Results During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL). Conclusion Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions. PMID:25733840

VOCs elimination and health risk reduction in e-waste dismantling workshop using integrated techniques of electrostatic precipitation with advanced oxidation technologies.

PubMed

Chen, Jiangyao; Huang, Yong; Li, Guiying; An, Taicheng; Hu, Yunkun; Li, Yunlu

2016-01-25

Volatile organic compounds (VOCs) emitted during the electronic waste dismantling process (EWDP) were treated at a pilot scale, using integrated electrostatic precipitation (EP)-advanced oxidation technologies (AOTs, subsequent photocatalysis (PC) and ozonation). Although no obvious alteration was seen in VOC concentration and composition, EP technology removed 47.2% of total suspended particles, greatly reducing the negative effect of particles on subsequent AOTs. After the AOT treatment, average removal efficiencies of 95.7%, 95.4%, 87.4%, and 97.5% were achieved for aromatic hydrocarbons, aliphatic hydrocarbons, halogenated hydrocarbons, as well as nitrogen- and oxygen-containing compounds, respectively, over 60-day treatment period. Furthermore, high elimination capacities were also seen using hybrid technique of PC with ozonation; this was due to the PC unit's high loading rates and excellent pre-treatment abilities, and the ozonation unit's high elimination capacity. In addition, the non-cancer and cancer risks, as well as the occupational exposure cancer risk, for workers exposed to emitted VOCs in workshop were reduced dramatically after the integrated technique treatment. Results demonstrated that the integrated technique led to highly efficient and stable VOC removal from EWDP emissions at a pilot scale. This study points to an efficient approach for atmospheric purification and improving human health in e-waste recycling regions. Copyright © 2015 Elsevier B.V. All rights reserved.

Missed Opportunity? Leveraging Mobile Technology to Reduce Racial Health Disparities.

PubMed

Ray, Rashawn; Sewell, Abigail A; Gilbert, Keon L; Roberts, Jennifer D

2017-10-01

Blacks and Latinos are less likely than whites to access health insurance and utilize health care. One way to overcome some of these racial barriers to health equity may be through advances in technology that allow people to access and utilize health care in innovative ways. Yet, little research has focused on whether the racial gap that exists for health care utilization also exists for accessing health information online and through mobile technologies. Using data from the Health Information National Trends Survey (HINTS), we examine racial differences in obtaining health information online via mobile devices. We find that blacks and Latinos are more likely to trust online newspapers to get health information than whites. Minorities who have access to a mobile device are more likely to rely on the Internet for health information in a time of strong need. Federally insured individuals who are connected to mobile devices have the highest probability of reliance on the Internet as a go-to source of health information. We conclude by discussing the importance of mobile technologies for health policy, particularly related to developing health literacy, improving health outcomes, and contributing to reducing health disparities by race and health insurance status. Copyright © 2017 by Duke University Press.

Does Chocolate Intake During Pregnancy Reduce the Risks of Preeclampsia and Gestational Hypertension?

PubMed Central

Saftlas, Audrey F.; Triche, Elizabeth W.; Beydoun, Hind; Bracken, Michael B.

2010-01-01

Purpose Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine if regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Methods Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at <16 weeks gestation to ascertain risk factors for adverse pregnancy outcomes. Hospital delivery and prenatal records were abstracted to classify preeclampsia (n=58), GH (n=158), and normotensive pregnancies (n=2351). Chocolate consumption (servings/week) during the 1st and 3rd trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of <1 serving/week comprised the referent group. Adjusted odds ratios (aOR) were estimated using logistic regression. Results Chocolate intake was more frequent among normotensives (80.7%) than preeclamptics (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (1st trimester: aOR=0.55, 95% CI: 0.32-0.95; 3rd trimester: aOR=0.56, 95% CI: 0.32-0.97). Only 1st trimester intake was associated with reduced odds of GH (aOR=0.65, 95% CI: 0.45-0.87). Conclusions These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. PMID:20609337

Does chocolate intake during pregnancy reduce the risks of preeclampsia and gestational hypertension?

PubMed

Saftlas, Audrey F; Triche, Elizabeth W; Beydoun, Hind; Bracken, Michael B

2010-08-01

Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine whether regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at <16 weeks' gestation to ascertain risk factors for adverse pregnancy outcomes. Hospital delivery and prenatal records were abstracted to classify preeclampsia (n = 58), GH (n = 158), and normotensive pregnancies (n = 2351). Chocolate consumption (servings/week) during the first and third trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of less than 1 serving/week comprised the referent group. Adjusted odds ratios (aORs) were estimated by the use of logistic regression. Chocolate intake was more frequent among normotensive (80.7%) than preeclamptic (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (first trimester: aOR, 0.55; 95% confidence interval [95% CI], 0.32-0.95; third trimester: aOR, 0.56; 95% CI, 0.32-0.97). Only first trimester intake was associated with reduced odds of GH (aOR,0.65; 95% CI, 0.45-0.87). These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. 2010 Elsevier Inc. All rights reserved.

Using a Sound Field to Reduce the Risks of Bird-Strike: An Experimental Approach.

PubMed

Swaddle, John P; Ingrassia, Nicole M

2017-07-01

Each year, billions of birds collide with large human-made structures, such as building, towers, and turbines, causing substantial mortality. Such bird-strike, which is projected to increase, poses risks to populations of birds and causes significant economic costs to many industries. Mitigation technologies have been deployed in an attempt to reduce bird-strike, but have been met with limited success. One reason for bird-strike may be that birds fail to pay adequate attention to the space directly in front of them when in level, cruising flight. A warning signal projected in front of a potential strike surface might attract visual attention and reduce the risks of collision. We tested this idea in captive zebra finches (Taeniopygia guttata) that were trained to fly down a long corridor and through an open wooden frame. Once birds were trained, they each experienced three treatments at unpredictable times and in a randomized order: a loud sound field projected immediately in front of the open wooden frame; a mist net (i.e., a benign strike surface) placed inside the wooden frame; and both the loud sound and the mist net. We found that birds slowed their flight approximately 20% more when the sound field was projected in front of the mist net compared with when the mist net was presented alone. This reduction in velocity would equate to a substantial reduction in the force of any collision. In addition to slowing down, birds increased the angle of attack of their body and tail, potentially allowing for more maneuverable flight. Concomitantly, the only cases where birds avoided the mist net occurred in the sound-augmented treatment. Interestingly, the sound field by itself did not demonstrably alter flight. Although our study was conducted in a limited setting, the alterations of flight associated with our sound field has implications for reducing bird-strike in nature and we encourage researchers to test our ideas in field trials. © The Author 2017. Published by

Artistic occupations are associated with a reduced risk of Parkinson's disease.

PubMed

Haaxma, Charlotte A; Borm, George F; van der Linden, Dimitri; Kappelle, Arnoud C; Bloem, Bastiaan R

2015-09-01

Parkinson's disease (PD) is preceded by a premotor phase of unknown duration. Dopaminergic degeneration during this phase may lead to subtle cognitive and behavioural changes, such as decreased novelty seeking. Consequently, premotor subjects might be most comfortable in jobs that do not require optimal dopamine levels, leading to an overrepresentation in structured and predictable occupations, or an underrepresentation in artistic occupations. In a case-control study, 750 men with PD (onset ≥40 years) and 1300 healthy men completed a validated questionnaire about their lifetime occupational status. Occupations were classified using the RIASEC model. Odds ratios (ORs) were calculated for the conventional and artistic categories, both for the most recent occupation before symptom onset, and for the very first occupation. Because farming has been associated with a PD risk, ORs were calculated separately for farming. A reduced risk of PD was found for men with an artistic occupation late in life (OR 0.14, 95% CI 0.04-0.53), while an artistic first occupation did not prevent PD (OR 0.72, CI 0.32-1.59). Conventional occupations showed no increased risk (recent: OR 1.07, CI 0.70-1.64; first: OR 1.14, CI 0.77-1.71). In support of previous reports, farming was associated with an increased risk of PD (recent: OR 2.6, CI 1.4-4.6; first: OR 2.7, CI 1.6-4.5). PD patients were older than controls, but various statistical corrections for age all lead to similar results. Artistic occupations late in life are associated with a reduced risk of subsequent PD, perhaps because this reflects a better preserved dopaminergic state. No initial occupation predicted PD, suggesting that the premotor phase starts later in life.

Advancing Technologies for Climate Observation

NASA Technical Reports Server (NTRS)

Wu, D.; Esper, J.; Ehsan, N.; Johnson, T.; Mast, W.; Piepmeier, J.; Racette, P.

2014-01-01

Climate research needs Accurate global cloud ice measurements Cloud ice properties are fundamental controlling variables of radiative transfer and precipitation Cost-effective, sensitive instruments for diurnal and wide-swath coverage Mature technology for space remote sensing IceCube objectivesDevelop and validate a flight-qualified 883 GHz receiver for future use in ice cloud radiometer missions Raise TRL (57) of 883 GHz receiver technology Reduce instrument cost and risk by developing path to space for COTS sub-mm-wave receiver systems Enable remote sensing of global cloud ice with advanced technologies and techniques

Safe system approach to reducing serious injury risk in motorcyclist collisions with fixed hazards.

PubMed

Bambach, M R; Mitchell, R J

2015-01-01

Collisions with fixed objects in the roadway environment account for a substantial proportion of motorcyclist fatalities. Many studies have identified individual roadway environment and/or motorcyclist characteristics that are associated with the severity of the injury outcome, including the presence of roadside barriers, helmet use, alcohol use and speeding. However, no studies have reported the cumulative benefit of such characteristics on motorcycling safety. The safe system approach recognises that the system must work as a whole to reduce the net injury risk to road users to an acceptable level, including the four system cornerstone areas of roadways, speeds, vehicles and people. The aim of the present paper is to consider these cornerstone areas concomitantly, and quantitatively assess the serious injury risk of motorcyclists in fixed object collisions using this holistic approach. A total of 1006 Australian and 15,727 (weighted) United States motorcyclist-fixed object collisions were collected retrospectively, and the serious injury risks associated with roadside barriers, helmet use, alcohol use and speeding were assessed both individually and concomitantly. The results indicate that if safety efforts are made in each of the safe system cornerstone areas, the combined effect is to substantially reduce the serious injury risk of fixed hazards to motorcyclists. The holistic approach is shown to reduce the serious injury risk considerably more than each of the safety efforts considered individually. These results promote the use of a safe system approach to motorcycling safety. Copyright © 2014 Elsevier Ltd. All rights reserved.

ATDRS payload technology R & D

NASA Technical Reports Server (NTRS)

Anzic, G.; Connolly, D. J.; Fujikawa, G.; Andro, M.; Kunath, R. R.; Sharp, G. R.

1990-01-01

Four technology development tasks were chosen to reduce (or at least better understand) the technology risks associated with proposed approaches to Advanced Tracking and Data Relay Satellite (ATDRS). The four tasks relate to a Tri-Band Antenna feed system, a Digital Beamforming System for the S Band Multiple-Access System (SMA), an SMA Phased Array Antenna, and a Configuration Thermal/Mechanical Analysis task. The objective, approach, and status of each are discussed.

ATDRS payload technology R & D

NASA Astrophysics Data System (ADS)

Anzic, G.; Connolly, D. J.; Fujikawa, G.; Andro, M.; Kunath, R. R.; Sharp, G. R.

Four technology development tasks were chosen to reduce (or at least better understand) the technology risks associated with proposed approaches to Advanced Tracking and Data Relay Satellite (ATDRS). The four tasks relate to a Tri-Band Antenna feed system, a Digital Beamforming System for the S Band Multiple-Access System (SMA), an SMA Phased Array Antenna, and a Configuration Thermal/Mechanical Analysis task. The objective, approach, and status of each are discussed.

Does opioid substitution treatment in prisons reduce injecting-related HIV risk behaviours? A systematic review.

PubMed

Larney, Sarah

2010-02-01

To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours. Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs. Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55-75% and risk of needle and syringe sharing was reduced by 47-73%. No study reported a direct effect of prison OST on HIV incidence. There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment.

Reducing risk of spinal haematoma from spinal and epidural pain procedures.

PubMed

Breivik, Harald; Norum, Hilde; Fenger-Eriksen, Christian; Alahuhta, Seppo; Vigfússon, Gísli; Thomas, Owain; Lagerkranser, Michael

2018-04-25

Central neuraxial blocks (CNB: epidural, spinal and their combinations) and other spinal pain procedures can cause serious harm to the spinal cord in patients on antihaemostatic drugs or who have other risk-factors for bleeding in the spinal canal. The purpose of this narrative review is to provide a practise advisory on how to reduce risk of spinal cord injury from spinal haematoma (SH) during CNBs and other spinal pain procedures. Scandinavian guidelines from 2010 are part of the background for this practise advisory. We searched recent guidelines, PubMed (MEDLINE), SCOPUS and EMBASE for new and relevant randomised controlled trials (RCT), case-reports and original articles concerning benefits of neuraxial blocks, risks of SH due to anti-haemostatic drugs, patient-related risk factors, especially renal impairment with delayed excretion of antihaemostatic drugs, and specific risk factors related to the neuraxial pain procedures. Epidural and spinal analgesic techniques, as well as their combination provide superior analgesia and reduce the risk of postoperative and obstetric morbidity and mortality. Spinal pain procedure can be highly effective for cancer patients, less so for chronic non-cancer patients. We did not identify any RCT with SH as outcome. We evaluated risks and recommend precautions for SH when patients are treated with antiplatelet, anticoagulant, or fibrinolytic drugs, when patients' comorbidities may increase risks, and when procedure-specific risk factors are present. Inserting and withdrawing epidural catheters appear to have similar risks for initiating a SH. Invasive neuraxial pain procedures, e.g. spinal cord stimulation, have higher risks of bleeding than traditional neuraxial blocks. We recommend robust monitoring routines and treatment protocol to ensure early diagnosis and effective treatment of SH should this rare but potentially serious complication occur. When neuraxial analgesia is considered for a patient on anti

Prevalence and work-related risk factors for reduced activities and absenteeism due to low back symptoms.

PubMed

Widanarko, Baiduri; Legg, Stephen; Stevenson, Mark; Devereux, Jason; Eng, Amanda; 't Mannetje, Andrea; Cheng, Soo; Pearce, Neil

2012-07-01

Although quite a lot is known about the risk factors for low back symptoms (LBS), less is known about the risk factors for the consequences of LBS. A sample of 3003 men and women randomly selected from the New Zealand Electoral Roll, were interviewed by telephone about self reported physical, psychosocial, organizational, environmental factors and the consequences of LBS (i.e. self-reported reduced activities and absenteeism). The 12-month period prevalence of reduced activities and absenteeism were 18% and 9%, respectively. Lifting (OR 1.79 95% CI 1.16-2.77) increased the risk of reduced activities. Working in awkward/tiring positions (OR 2.11 95% CI 1.20-3.70) and in a cold/damp environment (OR 2.18 95% CI 1.11-4.28) increased the risk of absenteeism. Among those with LBS, reduced activities increased with working in a hot/warm environment (OR 2.14 95% CI 1.22-3.76) and absenteeism was increased with work in awkward/tiring positions (OR 2.06 95% CI 1.13-3.77), tight deadlines (OR 1.89 95% CI 1.02-3.50), and a hot/warm environment (OR 3.35 95% CI 1.68-6.68). Interventions to reduce the consequences of LBS should aim to reduce awkward/tiring positions, lifting and work in a cold/damp environment. For individuals with LBS, additional focus should be to reduce tight deadlines, and work in hot/warm environments. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

TREATMENT TECHNOLOGIES FOR ARSENIC REMOVAL

EPA Science Inventory

The United States Environmental Protection Agency (US EPA) recently reduced the arsenic maximum contaminant level (MCL) from 0.050 mg/L to 0.010 mg/L. In order to increase arsenic outreach efforts, a summary of the new rule, related health risks, treatment technologies, and desig...

A Framework to Reduce Infectious Disease Risk from Urban Poultry in the United States

PubMed Central

Tobin, Molly R.; Goldshear, Jesse L.; Price, Lance B.; Graham, Jay P.

2015-01-01

Objectives Backyard poultry ownership is increasingly common in U.S. cities and is regulated at the local level. Human contact with live poultry is a well-known risk for infection with zoonotic pathogens, notably Salmonella, yet the ability of local jurisdictions to reduce the risk of infectious disease transmission from poultry to humans is unstudied. We reviewed urban poultry ordinances in the United States and reported Salmonella outbreaks from backyard poultry to identify regulatory gaps in preventing zoonotic pathogen transmission. Based on this analysis, we propose regulatory guidelines for U.S. cities to reduce infectious disease risk from backyard poultry ownership. Methods We assessed local ordinances in the 150 most populous U.S. jurisdictions for content related to noncommercial poultry ownership using online resources and communications with government officials. We also performed a literature review using publicly available data sources to identify human infectious disease outbreaks caused by contact with backyard poultry. Results Of the cities reviewed, 93% (n=139) permit poultry in some capacity. Most urban poultry ordinances share common characteristics focused on reducing nuisance to neighbors. Ordinances do not address many pathways of transmission relevant to poultry-to-human transmission of pathogens, such as manure management. Conclusions To reduce the risk of pathogen exposure from backyard poultry, urban ordinances should incorporate the following seven components: limited flock size, composting of manure in sealed containers, prohibition of slaughter, required veterinary care to sick birds, appropriate disposal of dead birds, annual permits linked to consumer education, and a registry of poultry owners. PMID:26346104

Dietary Cholesterol Increases the Risk whereas PUFAs Reduce the Risk of Active Tuberculosis in Singapore Chinese12

PubMed Central

Soh, Avril Z; Chee, Cynthia BE; Wang, Yee-Tang; Yuan, Jian-Min; Koh, Woon-Puay

2016-01-01

Background: Experimental studies suggest that cholesterol enhances the intracellular survival of Mycobacterium tuberculosis, whereas marine ω-3 (n–3) and ω-6 (n–6) fatty acids (FAs) may modulate responses to M. tuberculosis in macrophage and animal models. However, there are no epidemiologic data from prospective studies of the relation between dietary cholesterol and FAs and the risk of developing active tuberculosis. Objective: We aimed to investigate the relation between dietary intake of cholesterol and FAs and the risk of active tuberculosis in a prospective cohort in Singapore. Methods: We analyzed data from the Singapore Chinese Health Study, a cohort of 63,257 Chinese men and women aged 45–74 y recruited between 1993 and 1998. Dietary intake of cholesterol and FAs was determined with the use of a validated food-frequency questionnaire. Incident cases of active tuberculosis were identified via linkage with the nationwide tuberculosis registry. Analysis was performed with the use of Cox proportional hazards models. Results: As of 31 December 2013, 1136 incident cases of active tuberculosis were identified. Dietary cholesterol was positively associated with an increased risk of active tuberculosis in a dose-dependent manner. Compared with the lowest intake quartile, the HR was 1.22 (95% CI: 1.00, 1.47) for the highest quartile (P-trend = 0.04). Conversely, dietary marine n–3 and n–6 FAs were associated with a reduced risk of active tuberculosis in a dose-dependent manner. Compared with the lowest quartile, the HR for the highest intake quartile was 0.77 (95% CI: 0.62, 0.95) for marine n–3 FAs (P-trend = 0.01) and 0.82 (95% CI: 0.68, 0.98) for n–6 FAs (P-trend = 0.03). There was no association with saturated, monounsaturated, or plant-based n–3 FA intake. Conclusion: Dietary intake of cholesterol may increase the risk of active tuberculosis, whereas marine n–3 and n–6 FAs may reduce the risk of active tuberculosis in the Chinese population

Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial.

PubMed

Lappe, Joan M; Travers-Gustafson, Dianne; Davies, K Michael; Recker, Robert R; Heaney, Robert P

2007-06-01

Numerous observational studies have found supplemental calcium and vitamin D to be associated with reduced risk of common cancers. However, interventional studies to test this effect are lacking. The purpose of this analysis was to determine the efficacy of calcium alone and calcium plus vitamin D in reducing incident cancer risk of all types. This was a 4-y, population-based, double-blind, randomized placebo-controlled trial. The primary outcome was fracture incidence, and the principal secondary outcome was cancer incidence. The subjects were 1179 community-dwelling women randomly selected from the population of healthy postmenopausal women aged >55 y in a 9-county rural area of Nebraska centered at latitude 41.4 degrees N. Subjects were randomly assigned to receive 1400-1500 mg supplemental calcium/d alone (Ca-only), supplemental calcium plus 1100 IU vitamin D3/d (Ca + D), or placebo. When analyzed by intention to treat, cancer incidence was lower in the Ca + D women than in the placebo control subjects (P < 0.03). With the use of logistic regression, the unadjusted relative risks (RR) of incident cancer in the Ca + D and Ca-only groups were 0.402 (P = 0.01) and 0.532 (P = 0.06), respectively. When analysis was confined to cancers diagnosed after the first 12 mo, RR for the Ca + D group fell to 0.232 (CI: 0.09, 0.60; P < 0.005) but did not change significantly for the Ca-only group. In multiple logistic regression models, both treatment and serum 25-hydroxyvitamin D concentrations were significant, independent predictors of cancer risk. Improving calcium and vitamin D nutritional status substantially reduces all-cancer risk in postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00352170.

Strontium ranelate reduces the risk of vertebral and nonvertebral fractures in women eighty years of age and older.

PubMed

Seeman, Ego; Vellas, Bruno; Benhamou, Claude; Aquino, Jean Pierre; Semler, Jutta; Kaufman, Jean Marc; Hoszowski, Krzysztof; Varela, Alfredo Roces; Fiore, Carmelo; Brixen, Kim; Reginster, Jean Yves; Boonen, Steven

2006-07-01

Strontium ranelate produces an early and sustained reduction of both vertebral and nonvertebral fractures in patients > or = 80 years of age. About 25-30% of the population burden of all fragility fractures in the community arise from women > or = 80 years of age, because this population is at high risk for all types of fracture, particularly nonvertebral fractures. Despite this, evidence that therapies reduce the risk of both vertebral and nonvertebral fractures in this group is lacking. The aim of this study was to determine whether strontium ranelate, an agent that reduces the risk of vertebral and nonvertebral fractures in postmenopausal women >50 years of age, also reduces fractures in the elderly. An analysis based on preplanned pooling of data from two international, phase III, randomized, placebo-controlled, double-blind studies (the Spinal Osteoporosis Therapeutic Intervention [SOTI] and TReatment Of Peripheral OSteoporosis [TROPOS]) included 1488 women between 80 and 100 years of age followed for 3 years. Yearly spinal X-rays were performed in 895 patients. Only radiographically confirmed nonvertebral fractures were included. Baseline characteristics did not differ in placebo and treatment arms. In the intent-to-treat analysis, the risk of vertebral, nonvertebral, and clinical (symptomatic vertebral and nonvertebral) fractures was reduced within 1 year by 59% (p = 0.002), 41% (p = 0.027), and 37% (p = 0.012), respectively. At the end of 3 years, vertebral, nonvertebral, and clinical fracture risks were reduced by 32% (p = 0.013), 31% (p = 0.011), and 22% (p = 0.040), respectively. The medication was well tolerated, and the safety profile was similar to that in younger patients. Treatment with strontium ranelate safely reduces the risk of vertebral and nonvertebral fractures in women with osteoporosis > or = 80 years of age. Even in the oldest old, it is not too late to reduce fracture risk.

Reduced Risk of Disease During Postsecondary Dengue Virus Infections

PubMed Central

Olkowski, Sandra; Forshey, Brett M.; Morrison, Amy C.; Rocha, Claudio; Vilcarromero, Stalin; Halsey, Eric S.; Kochel, Tadeusz J.; Scott, Thomas W.; Stoddard, Steven T.

2013-01-01

Background. Antibodies induced by infection with any 1 of 4 dengue virus (DENV) serotypes (DENV-1–4) may influence the clinical outcome of subsequent heterologous infections. To quantify potential cross-protective effects, we estimated disease risk as a function of DENV infection, using data from longitudinal studies performed from September 2006 through February 2011 in Iquitos, Peru, during periods of DENV-3 and DENV-4 transmission. Methods. DENV infections before and during the study period were determined by analysis of serial serum samples with virus neutralization tests. Third and fourth infections were classified as postsecondary infections. Dengue fever cases were detected by door-to-door surveillance for acute febrile illness. Results. Among susceptible participants, 39% (420/1077) and 53% (1595/2997) seroconverted to DENV-3 and DENV-4, respectively. Disease was detected in 7% of DENV-3 infections and 10% of DENV-4 infections. Disease during postsecondary infections was reduced by 93% for DENV-3 and 64% for DENV-4, compared with primary and secondary infections. Despite lower disease rates, postsecondary infections constituted a significant proportion of apparent infections (14% [for DENV-3 infections], 45% [for DENV-4 infections]). Conclusions. Preexisting heterotypic antibodies markedly reduced but did not eliminate the risk of disease in this study population. These results improve understanding of how preinfection history can be associated with dengue outcomes and DENV transmission dynamics. PMID:23776195

The role of technology in reducing health care costs. Final project report

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

Sill, A.E.; Warren, S.; Dillinger, J.D.

1997-08-01

Sandia National Laboratories applied a systems approach to identifying innovative biomedical technologies with the potential to reduce U.S. health care delivery costs while maintaining care quality. This study was conducted by implementing both top-down and bottom-up strategies. The top-down approach used prosperity gaming methodology to identify future health care delivery needs. This effort provided roadmaps for the development and integration of technology to meet perceived care delivery requirements. The bottom-up approach identified and ranked interventional therapies employed in existing care delivery systems for a host of health-related conditions. Economic analysis formed the basis for development of care pathway interaction modelsmore » for two of the most pervasive, chronic disease/disability conditions: coronary artery disease (CAD) and benign prostatic hypertrophy (BPH). Societal cost-benefit relationships based on these analyses were used to evaluate the effect of emerging technology in these treatment areas. 17 figs., 48 tabs.« less

Opening a New Lipid “Apo-thecary”: Incorporating Apolipoproteins as Potential Risk Factors and Treatment Targets to Reduce Cardiovascular Risk

PubMed Central

Jacobson, Terry A.

2011-01-01

Statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors) represent the cornerstone of drug therapy to reduce low-density lipoprotein (LDL) cholesterol and cardiovascular risk. However, even optimal statin management of LDL cholesterol leaves many patients with residual cardiovascular risk, in part because statins are more effective in reducing LDL cholesterol than apolipoprotein B (Apo B). Apo B may be a better marker of atherogenic risk than LDL cholesterol because Apo B measures the total number of all atherogenic particles (total atherosclerotic burden), including LDL, very low-density lipoprotein, intermediate-density lipoprotein, remnant lipoproteins, and lipoprotein(a). To determine whether Apo B is a better indicator of baseline cardiovascular risk and residual risk after lipid therapy compared with LDL cholesterol, a MEDLINE search of the literature published in English from January 1, 1975, through December 1, 2010, was conducted. On the basis of data from most population studies, elevated Apo B was more strongly associated with incident coronary heart disease than similarly elevated LDL cholesterol. Apo B was also a superior benchmark (vs LDL cholesterol) of statins' cardioprotective efficacy in both primary-prevention and secondary-prevention trials. To minimize cardiovascular risk among persons with hypercholesterolemia or dyslipidemia, the best available evidence suggests that intensive therapy with statins should be initiated to achieve the lowest possible Apo B level (with adequate drug toleration) and then other therapies (eg, niacin, bile acid resins, ezetimibe) added to potentiate these Apo B–lowering effects. In future consensus lipid-lowering treatment guidelines, Apo B should be considered as an index of residual risk, a potential parameter of treatment efficacy, and a treatment target to minimize risk of coronary heart disease. PMID:21803958

A systems approach to purchasing and implementing new technology.

PubMed

Kinney, Kristin

2007-01-01

There are many risks associated with purchasing and implementing new technology. The challenge is to reduce these risks to gain maximum benefit from the new technology purchased. In the high-cost world of healthcare, there is little room for wasting time and money related to technology implementation. If the workflow of the current system is not adequately understood before purchasing and implementing a new technology, that technology may mask underlying problems and/or create new ones. The purpose of this article is to present a framework for analyzing the current process or system, identifying the strengths and the areas in need of improvement. A thorough understanding of the problems with the current system and the barriers to change is necessary to ensure the selection of the "right" technology and promote its implementation.

Use of Mobile Health Technology in the Prevention and Management of Diabetes Mellitus.

PubMed

Hartz, Jacob; Yingling, Leah; Powell-Wiley, Tiffany M

2016-12-01

Cardiovascular disease is the leading cause of morbidity and mortality globally, with diabetes being an independent risk factor. Adequate diabetes management has proven to be resource-intensive, requiring frequent lab work, primary care and specialist visits, and time-consuming record-keeping by the patient and care team. New mobile health (mHealth) technologies have enhanced how diabetes is managed and care is delivered. While more recent work has investigated mHealth devices as complementary tools in behavioral interventions for diabetes prevention and management, little is still known about the effectiveness of mHealth technology as stand-alone intervention tools for reducing diabetes risk. In addition, more work is needed to identify the role of mHealth technology in treating vulnerable populations to ameliorate cardiovascular health disparities. With advances in mobile health technology development for diabetes prevention and management, these modalities will likely play an increasingly prominent role in reducing cardiometabolic risk for the US population.

Balance training reduces falls risk in older individuals with type 2 diabetes.

PubMed

Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

2010-04-01

This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

Balance Training Reduces Falls Risk in Older Individuals With Type 2 Diabetes

PubMed Central

Morrison, Steven; Colberg, Sheri R.; Mariano, Mira; Parson, Henri K.; Vinik, Arthur I.

2010-01-01

OBJECTIVE This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50–75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. RESULTS Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. CONCLUSIONS Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes. PMID:20097781

Objective fall risk detection in stroke survivors using wearable sensor technology: a feasibility study.

PubMed

Taylor-Piliae, Ruth E; Mohler, M Jane; Najafi, Bijan; Coull, Bruce M

2016-12-01

Stroke survivors often have persistent neural deficits related to motor function and sensation, which increase their risk of falling, most of which occurs at home or in community settings. The use of wearable technology to monitor fall risk and gait in stroke survivors may prove useful in enhancing recovery and/or preventing injuries. Determine the feasibility of using wearable technology (PAMSys™) to objectively monitor fall risk and gait in home and community settings in stroke survivors. In this feasibility study, we used the PAMSys to identify fall risk indicators (postural transitions: duration in seconds, and number of unsuccessful attempts), and gait (steps, speed, duration) for 48 hours during usual daily activities in stroke survivors (n = 10) compared to age-matched controls (n = 10). A questionnaire assessed device acceptability. Stroke survivors mean age was 70 ± 8 years old, were mainly Caucasian (60%) women (70%), and not significantly different than the age-matched controls (all P-values >0.20). Stroke survivors (100%) reported that the device was comfortable to wear, didn't interfere with everyday activities, and were willing to wear it for another 48 hours. None reported any difficulty with the device while sleeping, removing/putting back on for showering or changing clothes. When compared to controls, stroke survivors had significantly worse fall risk indicators and walked less (P < 0.05). Stroke survivors reported high acceptability of 48 hours of continuous PAMSys monitoring. The use of in-home wearable technology may prove useful in monitoring fall risk and gait in stroke survivors, potentially enhancing recovery.

A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among Housing First residents.

PubMed

Kennedy, David P; Hunter, Sarah B; Chan Osilla, Karen; Maksabedian, Ervant; Golinelli, Daniela; Tucker, Joan S

2016-03-15

Individuals transitioning from homelessness to housing face challenges to reducing alcohol, drug and HIV risk behaviors. To aid in this transition, this study developed and will test a computer-assisted intervention that delivers personalized social network feedback by an intervention facilitator trained in motivational interviewing (MI). The intervention goal is to enhance motivation to reduce high risk alcohol and other drug (AOD) use and reduce HIV risk behaviors. In this Stage 1b pilot trial, 60 individuals that are transitioning from homelessness to housing will be randomly assigned to the intervention or control condition. The intervention condition consists of four biweekly social network sessions conducted using MI. AOD use and HIV risk behaviors will be monitored prior to and immediately following the intervention and compared to control participants' behaviors to explore whether the intervention was associated with any systematic changes in AOD use or HIV risk behaviors. Social network health interventions are an innovative approach for reducing future AOD use and HIV risk problems, but little is known about their feasibility, acceptability, and efficacy. The current study develops and pilot-tests a computer-assisted intervention that incorporates social network visualizations and MI techniques to reduce high risk AOD use and HIV behaviors among the formerly homeless. CLINICALTRIALS. NCT02140359.

Pokémon Go: digital health interventions to reduce cardiovascular risk.

PubMed

Krittanawong, Chayakrit; Aydar, Mehmet; Kitai, Takeshi

2017-10-01

Physical activity is associated with a lower risk of coronary heart disease/cardiovascular disease mortality, and current guidelines recommend physical activity for primary prevention in healthy individuals and secondary prevention in patients with coronary heart disease/cardiovascular disease. Over the last decade, playing classic video games has become one of the most popular leisure activities in the world, but is associated with a sedentary lifestyle. In the new era of rapidly evolving augmented reality technology, Pokémon Go, a well-known augmented reality game, may promote physical activity and prevent cardiovascular disease risks - that is, diabetes, obesity, and hypertension. Pokémon Go makes players willing to be physically active for regular and long periods of time. We report on an assessment of regular walking and playing Pokémon Go by performing data mining in Twitter.

[Conditions of effective correctional treatment for reducing recidivism: Focusing on risk principle].

PubMed

Mori, Takemi; Takahashi, Masaru; Ohbuchi, Ken-ichi

2016-10-01

Research on correctional treatment based on the risk principle (Andrews & Bonta, 2010) has found that the intensity of intervention matched with the risk level of offenders’ recidivism is successful to reduce recidivism. However, there is no research dealing with this issue in a non-Western context. The purpose of this study was to examine the validity of the risk principle in rehabilitation for Japanese juvenile delinquents. The sample was 321 Japanese male inmates of the juvenile detention and assessment centers. They were followed for an average of 573 days after discharge to assess recidivism. Among high-risk juvenile delinquents, those who were treated in the juvenile training school showed significantly lower rates of recidivism than those who were placed under community supervision, while among low risk juveniles, there was no significant difference in recidivism between the two treatment conditions. The results indicate that the risk principle is valid for the correctional treatment of Japanese juvenile delinquents, suggesting its cross-cultural universality. Implications for juvenile justice policies and directions for future research are discussed.

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review.

PubMed

Palomba, Stefano; Homburg, Roy; Santagni, Susanna; La Sala, Giovanni Battista; Orvieto, Raoul

2016-11-04

In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

Risk, mobility or population size? Drivers of technological richness among contact-period western North American hunter–gatherers

PubMed Central

Collard, Mark; Buchanan, Briggs; O'Brien, Michael J.; Scholnick, Jonathan

2013-01-01

Identifying factors that influence technological evolution in small-scale societies is important for understanding human evolution. There have been a number of attempts to identify factors that influence the evolution of food-getting technology, but little work has examined the factors that affect the evolution of other technologies. Here, we focus on variation in technological richness (total number of material items and techniques) among recent hunter–gatherers from western North America and test three hypotheses: (i) technological richness is affected by environmental risk, (ii) population size is the primary determinant of technological richness, and (iii) technological richness is constrained by residential mobility. We found technological richness to be correlated with a proxy for environmental risk—mean rainfall for the driest month—in the manner predicted by the risk hypothesis. Support for the hypothesis persisted when we controlled for shared history and intergroup contact. We found no evidence that technological richness is affected by population size or residential mobility. These results have important implications for unravelling the complexities of technological evolution. PMID:24101622

School-based programs to reduce sexual risk behaviors: a review of effectiveness.

PubMed Central

Kirby, D; Short, L; Collins, J; Rugg, D; Kolbe, L; Howard, M; Miller, B; Sonenstein, F; Zabin, L S

1994-01-01

This review was undertaken in recognition of the mounting public health and social problems associated with adolescent sexual behavior and the importance of basing school-affiliated programs designed to reduce sexual risk-taking behavior on sound research. The authors were commissioned by the Division of Adolescent and School Health within the Centers for Disease Control and Prevention, Public Health Service, to review carefully the research on these programs and to assess their impact on behavior. The authors identified 23 studies of school-based programs that were published in professional journals and measured program impact on behavior. They then summarized the results of those studies, identifying the distinguishing characteristics of effective programs, and citing important research questions to be addressed in the future. Not all sex and AIDS education programs had significant effects on adolescent sexual risk-taking behavior, but specific programs did delay the initiation of intercourse, reduce the frequency of intercourse, reduce the number of sexual partners, or increase the use of condoms or other contraceptives. These effective programs have the potential to reduce exposure to unintended pregnancy and sexually transmitted disease, including HIV infection. These programs should be replicated widely in U.S. schools. Additional research is needed to improve the effectiveness of programs and to clarify the most important characteristics of effective programs. PMID:8190857

Status of ERA Airframe Technology Demonstrators

NASA Technical Reports Server (NTRS)

Davis, Pamela; Jegley, Dawn; Rigney, Tom

2015-01-01

NASA has created the Environmentally Responsible Aviation (ERA) Project to explore and document the feasibility, benefits and technical risk of advanced vehicle configurations and enabling technologies that will reduce the impact of aviation on the environment. A critical aspect of this pursuit is the development of a lighter, more robust airframe that will enable the introduction of unconventional aircraft configurations that have higher lift-to-drag ratios, reduced drag, and lower community noise. The Airframe Technology subproject contains two elements. Under the Damage Arresting Composite Demonstration an advanced material system is being explored which will lead to lighter airframes that are more structural efficient than the composites used in aircraft today. Under the Adaptive Compliant Trailing Edge Flight Experiment a new concept of a flexible wing trailing edge is being evaluated which will reduce weight and improve aerodynamic performance. This presentation will describe the development these two airframe technologies.

WASTE REDUCTION OF TECHNOLOGY EVALUATIONS OF THE U.S. EPA WRITE PROGRAM

EPA Science Inventory

The Waste Reduction Innovative Technology Evaluation (WRITE)Program was established in 1989 to provide objective, accurate performance and cost data about waste reducing technologies for a variety of industrial and commercial application. EPA's Risk Reduction Engineering Laborato...

An Investigation of Biases and Framing Effects for Risk Analysis: An Information Technology Context

ERIC Educational Resources Information Center

Fox, Stuart A.

2012-01-01

An elusive and problematic theme of risk management has been managers' ability to effectively measure information technology (IT) risk in terms of degree of impact and probability of occurrence. The background of this problem delves deep into the rational understanding of probability, expected value, economic behavior, and subjective judgment.…

Improving treatment intensification to reduce cardiovascular disease risk: a cluster randomized trial

PubMed Central

2012-01-01

Background Blood pressure, lipid, and glycemic control are essential for reducing cardiovascular disease (CVD) risk. Many health care systems have successfully shifted aspects of chronic disease management, including population-based outreach programs designed to address CVD risk factor control, to non-physicians. The purpose of this study is to evaluate provision of new information to non-physician outreach teams on need for treatment intensification in patients with increased CVD risk. Methods Cluster randomized trial (July 1-December 31, 2008) in Kaiser Permanente Northern California registry of members with diabetes mellitus, prior CVD diagnoses and/or chronic kidney disease who were high-priority for treatment intensification: blood pressure ≥ 140 mmHg systolic, LDL-cholesterol ≥ 130 mg/dl, or hemoglobin A1c ≥ 9%; adherent to current medications; no recent treatment intensification). Randomization units were medical center-based outreach teams (4 intervention; 4 control). For intervention teams, priority flags for intensification were added monthly to the registry database with recommended next pharmacotherapeutic steps for each eligible patient. Control teams used the same database without this information. Outcomes included 3-month rates of treatment intensification and risk factor levels during follow-up. Results Baseline risk factor control rates were high (82-90%). In eligible patients, the intervention was associated with significantly greater 3-month intensification rates for blood pressure (34.1 vs. 30.6%) and LDL-cholesterol (28.0 vs 22.7%), but not A1c. No effects on risk factors were observed at 3 months or 12 months follow-up. Intervention teams initiated outreach for only 45-47% of high-priority patients, but also for 27-30% of lower-priority patients. Teams reported difficulties adapting prior outreach strategies to incorporate the new information. Conclusions Information enhancement did not improve risk factor control

Living with fire: How social scientists are helping wildland-urban interface communities reduce wildfire risk

Treesearch

Brian Cooke; Daniel Williams; Travis Paveglio; Matthew Carroll

2016-01-01

Reducing wildfire risk to lives and property is a critical issue for policy makers, land managers, and citizens who reside in high-risk fire areas of the United States - this is especially the case in the Rocky Mountain region and other western states. In order for a wildfire risk reduction effort to be effective in a U.S. wildland-urban interface (WUI)...

Vitamin D and reduced risk of breast cancer: a population-based case-control study.

PubMed

Knight, Julia A; Lesosky, Maia; Barnett, Heidi; Raboud, Janet M; Vieth, Reinhold

2007-03-01

Vitamin D, antiproliferative and proapoptotic in breast cancer cell lines, can reduce the development of mammary tumors in carcinogen-exposed rats. Current evidence in humans is limited with some suggestion that vitamin D-related factors may reduce the risk of breast cancer. We conducted a population-based case-control study to assess the evidence for a relationship between sources of vitamin D and breast cancer risk. Women with newly diagnosed invasive breast cancer were identified from the Ontario Cancer Registry. Women without breast cancer were identified through randomly selected residential telephone numbers. Telephone interviews were completed for 972 cases and 1,135 controls. Odds ratios (OR) and 95% confidence intervals (CI) for vitamin D-related variables were estimated using unconditional logistic regression with adjustment for potential confounders. Reduced breast cancer risks were associated with increasing sun exposure from ages 10 to 19 (e.g., OR, 0.65; 95% CI, 0.50-0.85 for the highest quartile of outdoor activities versus the lowest; P for trend = 0.0006). Reduced risk was also associated with cod liver oil use (OR, 0.76; 95% CI, 0.62-0.92) and increasing milk consumption (OR, 0.62 95% CI 0.45-0.86 for >or=10 glasses per week versus none; P for trend = 0.0004). There was weaker evidence for associations from ages 20 to 29 and no evidence for ages 45 to 54. We found strong evidence to support the hypothesis that vitamin D could help prevent breast cancer. However, our results suggest that exposure earlier in life, particularly during breast development, maybe most relevant. These results should be confirmed.

Can breast cancer patients use soyafoods to help reduce risk of CHD?

PubMed

Messina, Mark; Messina, Virginia; Jenkins, David J A

2012-09-01

Over the past 20 years, the popularity of soyafoods has increased in part because of research suggesting that these foods convey health benefits independent of their nutrient content. For example, in 1999, the US Food and Drug Administration approved a health-claim for soyafoods and CHD based on the hypocholesterolaemic effects of soya protein. However, soyafoods have become controversial in recent years because of concerns that their uniquely rich phyto-oestrogen (isoflavone) content may cause untoward effects in some individuals. Most notable in this regard is the concern that soyafoods are contraindicated for breast cancer patients and women at high risk of developing this disease. Furthermore, the hypocholesterolaemic effects of soya protein have been challenged. However, the results of recently published meta-analyses indicate that soya protein directly lowers circulating LDL-cholesterol levels by approximately 4 %. There is also intriguing evidence that soyafoods reduce CHD risk independent of their effects on lipid levels. In regard to the breast cancer controversy, recently published clinical and epidemiological data do not support observations in rodents that soyabean isoflavones increase breast cancer risk. In postmenopausal women, isoflavone exposure does not adversely affect breast tissue density or breast cell proliferation. Furthermore, both US and Chinese prospective epidemiological studies show that post-diagnosis soya consumption is associated with an improved prognosis. Therefore, soyafoods should be considered by women as healthy foods to include in diets aimed at reducing the risk of CHD regardless of their breast cancer status.

Failure mode and effect analysis in blood transfusion: a proactive tool to reduce risks.

PubMed

Lu, Yao; Teng, Fang; Zhou, Jie; Wen, Aiqing; Bi, Yutian

2013-12-01

The aim of blood transfusion risk management is to improve the quality of blood products and to assure patient safety. We utilize failure mode and effect analysis (FMEA), a tool employed for evaluating risks and identifying preventive measures to reduce the risks in blood transfusion. The failure modes and effects occurring throughout the whole process of blood transfusion were studied. Each failure mode was evaluated using three scores: severity of effect (S), likelihood of occurrence (O), and probability of detection (D). Risk priority numbers (RPNs) were calculated by multiplying the S, O, and D scores. The plan-do-check-act cycle was also used for continuous improvement. Analysis has showed that failure modes with the highest RPNs, and therefore the greatest risk, were insufficient preoperative assessment of the blood product requirement (RPN, 245), preparation time before infusion of more than 30 minutes (RPN, 240), blood transfusion reaction occurring during the transfusion process (RPN, 224), blood plasma abuse (RPN, 180), and insufficient and/or incorrect clinical information on request form (RPN, 126). After implementation of preventative measures and reassessment, a reduction in RPN was detected with each risk. The failure mode with the second highest RPN, namely, preparation time before infusion of more than 30 minutes, was shown in detail to prove the efficiency of this tool. FMEA evaluation model is a useful tool in proactively analyzing and reducing the risks associated with the blood transfusion procedure. © 2013 American Association of Blood Banks.

Trust, Perceived Risk, Perceived Ease of Use and Perceived Usefulness as Factors Related to mHealth Technology Use.

PubMed

Schnall, Rebecca; Higgins, Tracy; Brown, William; Carballo-Dieguez, Alex; Bakken, Suzanne

2015-01-01

Mobile technology use is nearly ubiquitous which affords the opportunity for using these technologies for modifying health related behaviors. At the same time, use of mobile health (mHealth) technology raises privacy and security concerns of consumers. The goal of this analysis was to understand the perceived ease of use, usefulness, risk and trust that contribute to behavioral intention to use a mobile application for meeting the healthcare needs of persons living with HIV (PLWH). To understand these issues, we conducted focus group sessions with 50 persons living with HIV and 30 HIV healthcare providers. We used the e-commerce acceptance model to analyze our focus group data. Findings from the study demonstrated the need for mHealth to be perceived as useful, easy to use, with little perceived risk accompanied by a measure of trust in the creators of the technology. Findings from this work can inform future work on patients and providers' perceptions of risk, trust, ease of use and usefulness of mHealth technology.

PROVIDING SOLUTIONS FOR A BETTER TOMORROW: REDUCING THE RISKS ASSOCIATED WITH LEAD IN SOIL; URL:

EPA Science Inventory

This brief publication describes, in general language, the health risks associated with exposure to soil and dust contaminated with lead as well as an innovative method to immobilize lead contaminants in the soil (and thereby reduce the risk of exposure) at Superfund sites. Also ...

ATDRS payload technology research and development

NASA Technical Reports Server (NTRS)

Anzic, G.; Connolly, D. J.; Fujikawa, G.; Andro, M.; Kunath, R. R.; Sharp, G. R.

1990-01-01

Four technology development tasks were chosen to reduce (or at least better understand) the technology risks associated with proposed approaches to Advanced Tracking and Data Relay Satellite (ATDRS). The four tasks relate to a Tri-Band Antenna feed system, a Digital Beamforming System for the S Band Multiple Access System (SMA), an SMA Phased Array Antenna, and a Configuration Thermal/Mechanical Analysis task. The objective, approach, and status of each are discussed.

Reduced risk of UC in families affected by appendicitis: a Danish national cohort study.

PubMed

Nyboe Andersen, Nynne; Gørtz, Sanne; Frisch, Morten; Jess, Tine

2017-08-01

The possible aetiological link between appendicitis and UC remains unclear. In order to investigate the hereditary component of the association, we studied the risk of UC in family members of individuals with appendicitis. A cohort of 7.1 million individuals was established by linkage of national registers in Denmark with data on kinship and diagnoses of appendicitis and UC. Poisson regression models were used to calculate first hospital contact rate ratios (RR) for UC with 95% CIs between individuals with or without relatives with a history of appendicitis. During 174 million person-years of follow-up between 1977 and 2011, a total of 190 004 cohort members developed appendicitis and 45 202 developed UC. Individuals having a first-degree relative with appendicitis before age 20 years had significantly reduced risk of UC (RR 0.90; 95% CI 0.86 to 0.95); this association was stronger in individuals with a family predisposition to UC (RR 0.66; 95% CI 0.51 to 0.83). Individuals with a first-degree relative diagnosed with appendicitis before age 20 years are at reduced risk of UC, particularly when there is a family predisposition to UC. Our findings question a previously hypothesised direct protective influence of appendicitis on inflammation of the large bowel. Rather, genetic or environmental factors linked to an increased risk of appendicitis while being protective against UC may explain the repeatedly reported reduced relative risk of UC in individuals with a history of appendicitis. 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/.

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users.

PubMed

Corsi, Karen F; Lehman, Wayne E; Min, Sung-Joon; Lance, Shannon P; Speer, Nicole; Booth, Robert E; Shoptaw, Steve

2012-06-04

This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk.

The Feasibility of Interventions to Reduce HIV Risk and Drug Use among Heterosexual Methamphetamine Users

PubMed Central

Corsi, Karen F.; Lehman, Wayne E.; Min, Sung-Joon; Lance, Shannon P.; Speer, Nicole; Booth, Robert E.; Shoptaw, Steve

2013-01-01

This paper reports on a feasibility study that examined contingency management among out-of-treatment, heterosexual methamphetamine users and the reduction of drug use and HIV risk. Fifty-eight meth users were recruited through street outreach in Denver from November 2006 through March 2007. The low sample size reflects that this was a pilot study to see if CM is feasible in an out-of-treatment, street-recruited population of meth users. Secondary aims were to examine if reductions and drug use and risk behavior could be found. Subjects were randomly assigned to contingency management (CM) or CM plus strengths-based case management (CM/SBCM), with follow-up at 4 and 8 months. Participants were primarily White (90%), 52% male and averaged 38 years old. Eighty-three percent attended at least one CM session, with 29% attending at least fifteen. All participants reduced meth use significantly at follow-up. Those who attended more sessions submitted more stimulant-free urines than those who attended fewer sessions. Participants assigned to CM/SBCM attended more sessions and earned more vouchers than clients in CM. Similarly, participants reported reduced needle-sharing and sex risk. Findings demonstrate that CM and SBCM may help meth users reduce drug use and HIV risk. PMID:23493796

Public perceptions of the risks of an unfamiliar technology: The case of using nuclear energy sources for space missions

NASA Astrophysics Data System (ADS)

Maharik, Michael

This thesis addresses the public perception of the risk of a technology not widely known to laypeople. Its aims were (1) to characterize public perceptions of the risk of using nuclear energy in space and decisions related to this risk, and (2) to extend the 'mental model' methodology to studying public perception of unfamiliar, risky technologies. A model of the physical processes capable of creating risks from using nuclear energy sources in space was first constructed. Then, knowledge and beliefs related to this topic were elicited from three different groups of people. The generality of the findings was examined in a constructive replication with environmentally-oriented people. The possibility of involving the public in decision-making processes related to engineering macro-design was then investigated. Finally, a communication regarding these risk processes was developed and evaluated in an experiment comparing it with communications produced by NASA. Although they included large portions of the expert model, people's beliefs also had gaps and misconceptions. Respondents often used scientific terms without a clear understanding of what they meant. Respondents' mental models sometimes contained scattered and inconsistent entries. The impact of pre-existing mental models was clearly seen. Different groups of people had different patterns of knowledge and beliefs. Nevertheless, respondents expressed reasonable and coherent opinions on choices among engineering options. The CMU brochure, derived from the study of readers' existing mental models, provided a better risk communication tool than NASA's material, reflecting primarily experts' perspective. The better performance of subjects reading either brochure generally reflected adding knowledge on issues that they had not previously known, rather than correcting wrong beliefs. The communication study confirmed a hypothesis that improving knowledge on risk processes related to the use of a technology causes a more

Can change in high-density lipoprotein cholesterol levels reduce cardiovascular risk?

PubMed

Dean, Bonnie B; Borenstein, Jeff E; Henning, James M; Knight, Kevin; Merz, C Noel Bairey

2004-06-01

The cardiovascular risk reduction observed in many trials of lipid-lowering agents is greater than expected on the basis of observed low-density lipoprotein cholesterol (LDL-C) level reductions. Our objective was to explore the degree to which high-density lipoprotein cholesterol (HDL-C) level changes explain cardiovascular risk reduction. A systematic review identified trials of lipid-lowering agents reporting changes in HDL-C and LDL-C levels and the incidence of coronary heart disease (CHD). The observed relative risk reduction (RRR) in CHD morbidity and mortality rates was calculated. The expected RRR, given the treatment effect on total cholesterol level, was calculated for each trial with logistic regression coefficients from observational studies. The difference between observed and expected RRR was plotted against the change in HDL-C level, and a least-squares regression line was calculated. Fifty-one trials were identified. Nineteen statin trials addressed the association of HDL-C with CHD. Limited numbers of trials of other therapies precluded additional analyses. Among statin trials, therapy reduced total cholesterol levels as much as 32% and LDL-C levels as much as 45%. HDL-C level increases were <10%. Treatment effect on HDL-C levels was not a significant linear predictor of the difference in observed and expected CHD mortality rates, although we observed a trend in this direction (P =.08). Similarly, HDL-C effect was not a significant linear predictor of the difference between observed and expected RRRs for CHD morbidity (P =.20). Although a linear trend toward greater risk reduction was observed with greater effects on HDL-C, differences were not statistically significant. The narrow range of HDL-C level increases in the statin trials likely reduced our ability to detect a beneficial HDL-C effect, if present.

Navy Ship Propulsion Technologies: Options for Reducing Oil Use - Background for Congress

DTIC Science & Technology

2006-07-26

at [http://www50.dt.navy.mil/reports/hydrobulb/]. 10 U.S. Department of Defense, Climate Change, Energy Efficiency, and Ozone Protection, Protecting...Vessels, Reducing Shipboard Fuel Consumption and Emissions,” op cit, and Climate Change, Energy Efficiency, and Ozone Protection, Protecting National...retrofitted with the SkySails technology trouble-free.67 CRS-26 68 “The Economic and Sustainable Utilisation in the Cargo Shipping Industry of Wind

Primary Dietary Intervention Study to Reduce the Risk of Islet Autoimmunity in Children at Increased Risk for Type 1 Diabetes

PubMed Central

Hummel, Sandra; Pflüger, Maren; Hummel, Michael; Bonifacio, Ezio; Ziegler, Anette-G.

2011-01-01

OBJECTIVE To determine whether delaying the introduction of gluten in infants with a genetic risk of islet autoimmunity is feasible, safe, and may reduce the risk of type 1 diabetes–associated islet autoimmunity. RESEARCH DESIGN AND METHODS A total of 150 infants with a first-degree family history of type 1 diabetes and a risk HLA genotype were randomly assigned to a first gluten exposure at age 6 months (control group) or 12 months (late-exposure group) and were followed 3 monthly until the age of 3 years and yearly thereafter for safety (for growth and autoantibodies to transglutaminase C [TGCAs]), islet autoantibodies to insulin, GAD, insulinoma-associated protein 2, and type 1 diabetes. RESULTS Adherence to the dietary-intervention protocol was reported from 70% of families. During the first 3 years, weight and height were similar in children in the control and late-exposure groups, as was the probability of developing TGCAs (14 vs. 4%; P = 0.1). Eleven children in the control group and 13 children in the late-exposure group developed islet autoantibodies (3-year risk: 12 vs. 13%; P = 0.6). Seven children developed diabetes, including four in the late-exposure group. No significant differences were observed when children were analyzed as per protocol on the basis of the reported first gluten exposure of the children. CONCLUSIONS Delaying gluten exposure until the age of 12 months is safe but does not substantially reduce the risk for islet autoimmunity in genetically at-risk children. PMID:21515839

Laboratory Testing of Electro-Osmotic Pulse Technology to Reduce and Maintain Low Moisture Content in Concrete

DTIC Science & Technology

2009-02-01

technology minimizes harmful effects to concrete and rebar and prevents over drying, pore blocking and electrode polarization. Principles of EOP...LABORATORY TESTING OF ELECTRO-OSMOTIC PULSE TECHNOLOGY TO REDUCE AND MAINTAIN LOW MOISTURE CONTENT IN CONCRETE Orange S. Marshall, Vincent F...Laboratory 2009 Army Corrosion Summit Clearwater Beach, FL 6 January 2009 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting

Reducing stroke in women with risk factor management: blood pressure and cholesterol.

PubMed

Baghshomali, Sanam; Bushnell, Cheryl

2014-09-01

Stroke is a major cause of death and disability in adults worldwide. Prevention focused on modifiable risk factors, such as hypertension and hyperlipidemia, has shown them to be of significant importance in decreasing the risk of stroke. Multiple studies have brought to light the differences between men and women with regards to stroke and these risk factors. Women have a higher prevalence of stroke, mortality and disability and it has been shown that preventive and treatment options are not as comprehensive for women. Hence, it is of great necessity to evaluate and summarize the differences in gender and stroke risk factors in order to target disparities and optimize prevention, especially because women have a higher lifetime risk of stroke. The purpose of this review is to summarize sex differences in the prevalence of hypertension and hyperlipidemia. In addition, we will review the sex differences in stroke prevention effectiveness and adherence to blood pressure and cholesterol medications, and suggest future directions for research to reduce the burden of stroke in women.

Risk-Based Prioritization of Research for Aviation Security Using Logic-Evolved Decision Analysis

NASA Technical Reports Server (NTRS)

Eisenhawer, S. W.; Bott, T. F.; Sorokach, M. R.; Jones, F. P.; Foggia, J. R.

2004-01-01

The National Aeronautics and Space Administration is developing advanced technologies to reduce terrorist risk for the air transportation system. Decision support tools are needed to help allocate assets to the most promising research. An approach to rank ordering technologies (using logic-evolved decision analysis), with risk reduction as the metric, is presented. The development of a spanning set of scenarios using a logic-gate tree is described. Baseline risk for these scenarios is evaluated with an approximate reasoning model. Illustrative risk and risk reduction results are presented.

Understanding the impact of supervision on reducing medication risks: an interview study in long-term elderly care.

PubMed

Vermeulen, J A; Kleefstra, S M; Zijp, E M; Kool, R B

2017-07-06

In 2009, the Dutch Health Care Inspectorate (IGZ) observed several serious risks to safety involving medication within elderly care facilities. However, by 2011, high risks had been reduced in almost all the organisations we visited. And yet the IGZ analysed too the alarming increase in the number of incidents arising in the self-reported national indicator of medication safety between 2009 and 2010. The aim of this study was to understand the factors that can explain this contradiction between the increase in self-reported medication incidents and the observation of the IGZ in reducing the risks to medication safety through supervision. We interviewed health care professionals of ten care facilities, visited by the IGZ, who were involved in, or responsible for, the improvement of medication safety in their institutions. As outcome measures we used the rate of medication safety risk per facility; the perceptions of the participant with regard to the reports of medication incidents; the level of medication safety of the facility; the measures used to improve medication safety; and the supervision of medication safety. This was a mixed methods study, qualitative in that we used semi-structured interviews, and quantitative, by calculating risks for the different organisations we visited. The findings from both study methods resulted in a comprehensive view and an in-depth understanding of this contradiction. The contradiction between the increase in self-reported medication incidents and the observation of reduced risks was explained by three themes: activities designed to improve medication safety, the reporting of medication incidents, and, lastly, the impact of supervision. The focus of the IGZ on issues of medication safety stimulated most elderly care facilities to reduce medication risks. Also, a change in the culture of reporting incidents caused an increase in the number of reported incidents. Supervision contributed to an improvement in actions geared towards

Mild traumatic brain injury is associated with reduced cortical thickness in those at risk for Alzheimer's disease.

PubMed

Hayes, Jasmeet P; Logue, Mark W; Sadeh, Naomi; Spielberg, Jeffrey M; Verfaellie, Mieke; Hayes, Scott M; Reagan, Andrew; Salat, David H; Wolf, Erika J; McGlinchey, Regina E; Milberg, William P; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

2017-03-01

Moderate-to-severe traumatic brain injury is one of the strongest environmental risk factors for the development of neurodegenerative diseases such as late-onset Alzheimer's disease, although it is unclear whether mild traumatic brain injury, or concussion, also confers risk. This study examined mild traumatic brain injury and genetic risk as predictors of reduced cortical thickness in brain regions previously associated with early Alzheimer's disease, and their relationship with episodic memory. Participants were 160 Iraq and Afghanistan War veterans between the ages of 19 and 58, many of whom carried mild traumatic brain injury and post-traumatic stress disorder diagnoses. Whole-genome polygenic risk scores for the development of Alzheimer's disease were calculated using summary statistics from the largest Alzheimer's disease genome-wide association study to date. Results showed that mild traumatic brain injury moderated the relationship between genetic risk for Alzheimer's disease and cortical thickness, such that individuals with mild traumatic brain injury and high genetic risk showed reduced cortical thickness in Alzheimer's disease-vulnerable regions. Among males with mild traumatic brain injury, high genetic risk for Alzheimer's disease was associated with cortical thinning as a function of time since injury. A moderated mediation analysis showed that mild traumatic brain injury and high genetic risk indirectly influenced episodic memory performance through cortical thickness, suggesting that cortical thinning in Alzheimer's disease-vulnerable brain regions is a mechanism for reduced memory performance. Finally, analyses that examined the apolipoprotein E4 allele, post-traumatic stress disorder, and genetic risk for schizophrenia and depression confirmed the specificity of the Alzheimer's disease polygenic risk finding. These results provide evidence that mild traumatic brain injury is associated with greater neurodegeneration and reduced memory performance

Accepting uncertainty, assessing risk: decision quality in managing wildfire, forest resource values, and new technology

Treesearch

Jeffrey G. Borchers

2005-01-01

The risks, uncertainties, and social conflicts surrounding uncharacteristic wildfire and forest resource values have defied conventional approaches to planning and decision-making. Paradoxically, the adoption of technological innovations such as risk assessment, decision analysis, and landscape simulation models by land management organizations has been limited. The...

Reducing environmental risk associated with laboratory decommissioning and property transfer.

PubMed

Dufault, R; Abelquist, E; Crooks, S; Demers, D; DiBerardinis, L; Franklin, T; Horowitz, M; Petullo, C; Sturchio, G

2000-12-01

The need for more or less space is a common laboratory problem. Solutions may include renovating existing space, leaving or demolishing old space, or acquiring new space or property for building. All of these options carry potential environmental risk. Such risk can be the result of activities related to the laboratory facility or property (e.g., asbestos, underground storage tanks, lead paint), or the research associated with it (e.g., radioactive, microbiological, and chemical contamination). Regardless of the option chosen to solve the space problem, the potential environmental risk must be mitigated and the laboratory space and/or property must be decommissioned or rendered safe prior to any renovation, demolition, or property transfer activities. Not mitigating the environmental risk through a decommissioning process can incur significant financial liability for any costs associated with future decommissioning cleanup activities. Out of necessity, a functioning system, environmental due diligence auditing, has evolved over time to assess environmental risk and reduce associated financial liability. This system involves a 4-phase approach to identify, document, manage, and clean up areas of environmental concern or liability, including contamination. Environmental due diligence auditing includes a) historical site assessment, b) characterization assessment, c) remedial effort and d) final status survey. General practice standards from the American Society for Testing and Materials are available for conducting the first two phases. However, standards have not yet been developed for conducting the third and final phases of the environmental due diligence auditing process. Individuals involved in laboratory decommissioning work in the biomedical research industry consider this a key weakness.

Reducing environmental risk associated with laboratory decommissioning and property transfer.

PubMed Central

Dufault, R; Abelquist, E; Crooks, S; Demers, D; DiBerardinis, L; Franklin, T; Horowitz, M; Petullo, C; Sturchio, G

2000-01-01

The need for more or less space is a common laboratory problem. Solutions may include renovating existing space, leaving or demolishing old space, or acquiring new space or property for building. All of these options carry potential environmental risk. Such risk can be the result of activities related to the laboratory facility or property (e.g., asbestos, underground storage tanks, lead paint), or the research associated with it (e.g., radioactive, microbiological, and chemical contamination). Regardless of the option chosen to solve the space problem, the potential environmental risk must be mitigated and the laboratory space and/or property must be decommissioned or rendered safe prior to any renovation, demolition, or property transfer activities. Not mitigating the environmental risk through a decommissioning process can incur significant financial liability for any costs associated with future decommissioning cleanup activities. Out of necessity, a functioning system, environmental due diligence auditing, has evolved over time to assess environmental risk and reduce associated financial liability. This system involves a 4-phase approach to identify, document, manage, and clean up areas of environmental concern or liability, including contamination. Environmental due diligence auditing includes a) historical site assessment, b) characterization assessment, c) remedial effort and d) final status survey. General practice standards from the American Society for Testing and Materials are available for conducting the first two phases. However, standards have not yet been developed for conducting the third and final phases of the environmental due diligence auditing process. Individuals involved in laboratory decommissioning work in the biomedical research industry consider this a key weakness. PMID:11121365

Relative risk of reducing the lifetime blood donation deferral for men who have had sex with men versus currently tolerated transfusion risks.

PubMed

Vamvakas, Eleftherios C

2011-01-01

The risks of known and emerging transfusion-transmitted infections (TTIs) from reducing the current lifetime blood donation deferral for men who have had sex with men (MSM) to 1 or 5 years were compared to the risk from continuing to transfuse in the United States 12.5% of platelet doses as pooled whole-blood-derived (rather than single-donor) platelets. Assumptions made in mathematical models and blood donor/transfusion studies of the risks of TTIs since 2000 were evaluated. The number of HIV, hepatitis B virus, or hepatitis C virus TTIs from reducing the MSM deferral to 1 year is, respectively, 0.88, 2.94, or 66.9, many more than 10 times smaller than the risk from pooled platelets. If erroneous release of HIV-positive units (a risk independent of a donor's source of infection) is not considered, the MSM risk is 1 HIV-infectious donation per 17 to 56 million MSM donations. Any purportedly increased risk of human herpesvirus-8 transmission from MSM donors is far smaller than the risk of transfusion-associated sepsis from pooled platelets. Single-donor platelets from MSM after 5 years' abstinence are as safe or 5 times safer than our current pooled platelets--if the next TTI to emerge were transmitted, respectively, sexually or by another route. Thus, acceptance of MSM as blood donors after 1 or 5 years' abstinence may result in a postulated increase in risk that is so much smaller than the currently tolerated transfusion risk and so small in absolute terms that the ethical question of fairness to the MSM group justifies the change in policy. Copyright © 2011 Elsevier Inc. All rights reserved.

Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk.

PubMed

Sauerland, Carmel; Engelking, Constance; Wickham, Rita; Corbi, Dominick

2006-11-27

To review the literature regarding the incidence, current practice, guideline recommendations, nursing management, and knowledge gaps relevant to vesicant extravasation. Published research articles, books, case reports, and national guidelines. Vesicant extravasation is a relatively rare but significant complication of chemotherapy administration. Extravasation may have a range of consequences that can cause serious physical and quality-of-life effects. Knowledge of risk factors and preventive measures can reduce patient risk. Data-based and empirical management strategies such as immediate local measures (agent withdrawal, comfort measures, and medical interventions) may minimize risk for extravasation, as well as lead to timely recognition and management and decreased morbidity should extravasation occur. Vesicant extravasation and sequelae constitute a complex patient problem that clinicians should strive to prevent or to minimize injury should it occur. To this end, clinicians must demonstrate awareness of risks and use specialized knowledge while administering vesicant agents. Only nurses knowledgeable about extravasation and skilled in associated techniques should assume responsibility for vesicant administration.

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

PubMed

Vantamay, Nottakrit

2015-09-01

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

Trust, Perceived Risk, Perceived Ease of Use and Perceived Usefulness as Factors Related to mHealth Technology Use

PubMed Central

Schnall, Rebecca; Higgins, Tracy; Brown, William; Carballo-Dieguez, Alex; Bakken, Suzanne

2017-01-01

Mobile technology use is nearly ubiquitous which affords the opportunity for using these technologies for modifying health related behaviors. At the same time, use of mobile health (mHealth) technology raises privacy and security concerns of consumers. The goal of this analysis was to understand the perceived ease of use, usefulness, risk and trust that contribute to behavioral intention to use a mobile application for meeting the healthcare needs of persons living with HIV (PLWH). To understand these issues, we conducted focus group sessions with 50 persons living with HIV and 30 HIV healthcare providers. We used the e-commerce acceptance model to analyze our focus group data. Findings from the study demonstrated the need for mHealth to be perceived as useful, easy to use, with little perceived risk accompanied by a measure of trust in the creators of the technology. Findings from this work can inform future work on patients and providers’ perceptions of risk, trust, ease of use and usefulness of mHealth technology. PMID:26262094

Automated Technology for In-home Fall Risk Assessment and Detection Sensor System

PubMed Central

Rantz, Marilyn J.; Skubic, Marjorie; Abbott, Carmen; Galambos, Colleen; Pak, Youngju; Ho, Dominic K.C.; Stone, Erik E.; Rui, Liyang; Back, Jessica; Miller, Steven J.

2013-01-01

Falls are a major problem for older adults. A continuous, unobtrusive, environmentally mounted in-home monitoring system that automatically detects when falls have occurred or when the risk of falling is increasing could alert health care providers and family members so they could intervene to improve physical function or mange illnesses that are precipitating falls. Researchers at the University of Missouri (MU)Center for Eldercare and Rehabilitation Technology are testing such sensor systems for fall risk assessment and detection in older adults’ apartments in a senior living community. Initial results comparing ground truth fall risk assessment data and GAITRite gait parameters with gait parameters captured from Mircosoft Kinect and Pulse-Dopplar radar are reported. PMID:23675644

Reduced risk-taking behavior as a trait feature of anxiety.

PubMed

Giorgetta, Cinzia; Grecucci, Alessandro; Zuanon, Sophia; Perini, Laura; Balestrieri, Matteo; Bonini, Nicolao; Sanfey, Alan G; Brambilla, Paolo

2012-12-01

Affect can have a significant influence on decision-making processes and subsequent choice. One particularly relevant type of negative affect is anxiety, which serves to enhance responses to threatening stimuli or situations. In its exaggerated form, it can lead to psychiatric disorders, with detrimental consequences for quality of life, including the ability to make choices. This study investigated, for the first time, how pathological anxiety affects risk-taking behavior. In this study, 20 anxious participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for either generalized anxiety disorder (n = 10) and for panic attack disorder (n = 10), as well as 20 matched nonanxious controls, performed a gambling task. To investigate the tendency toward either a risk-seeking or a risk-averse behavior, we employed a task that did not allow for learning from outcomes. Anxious participants made significantly fewer risky choices than matched nonanxious participants. Specifically, they become risk-avoidant after gains. Moreover, anxious participants not only were less happy after gains but were also less sad after losses, and they also evinced less desire to change their choices after losses than did nonanxious participants. Importantly, whereas the desire to switch choice was followed by actual choice switch for all participants, happiness directly predicted subsequent risky choices, particularly in the nonanxious participants. Further analyses revealed that the anxious participants' risk-avoidance behavior was independent of different types of anxiety disorder (panic attack disorder and generalized anxiety disorder) as well as of the effects of psychotropic drugs treatment. This study demonstrates a specific role for anxiety in individual decision making. In particular, hypersensitivity to potential threats and pessimistic evaluation of future events reduced risk-taking behavior. PsycINFO Database Record (c) 2012 APA, all rights

Application of a risk analysis method to different technologies for producing a monoclonal antibody employed in hepatitis B vaccine manufacturing.

PubMed

Milá, Lorely; Valdés, Rodolfo; Tamayo, Andrés; Padilla, Sigifredo; Ferro, Williams

2012-03-01

CB.Hep-1 monoclonal antibody (mAb) is used for a recombinant Hepatitis B vaccine manufacturing, which is included in a worldwide vaccination program against Hepatitis B disease. The use of this mAb as immunoligand has been addressed into one of the most efficient steps of active pharmaceutical ingredient purification process. Regarding this, Quality Risk Management (QRM) provides an excellent framework for the risk management use in pharmaceutical manufacturing and quality decision-making applications. Consequently, this study sought applying a prospective risk analysis methodology Failure Mode Effects Analysis (FMEA) as QRM tool for analyzing different CB.Hep-1 mAb manufacturing technologies. As main conclusions FMEA was successfully used to assess risks associated with potential problems in CB.Hep-1 mAb manufacturing processes. The severity and occurrence of risks analysis evidenced that the percentage of very high severe risks ranged 31.0-38.7% of all risks and the huge majority of risks have a very low occurrence level (61.9-83.3%) in all assessed technologies. Finally, additive Risk Priority Number, was descending ordered as follow: transgenic plants (2636), ascites (2577), transgenic animals (2046) and hollow fiber bioreactors (1654), which also corroborated that in vitro technology, should be the technology of choice for CB.Hep-1 mAb manufacturing in terms of risks and mAb molecule quality. Copyright © 2011 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

The effect of an Internet-based intervention designed to reduce HIV/AIDS sexual risk among Mexican adolescents.

PubMed

Castillo-Arcos, Lubia Del Carmen; Benavides-Torres, Raquel Alicia; López-Rosales, Fuensanta; Onofre-Rodríguez, Dora Julia; Valdez-Montero, Carolina; Maas-Góngora, Lucely

2016-01-01

The purpose of the study was to evaluate the effect of an Internet-based intervention to reduce sexual risk behaviors and increase resilience to sexual risk behaviors among Mexican adolescents, a key HIV/AIDS risk group. The study had a quasi-experimental design with single-stage cluster sampling. Participants ages 14-17 were stratified by gender and randomly assigned to either receive intervention "Connect" (which included face-to-face and Internet-based sessions designed to reduce sexual risk behaviors and increase resilience to sexual risk) or control (a general educational video on reducing health risks). A total of 9 survey instruments were administered online through SurveyMonkey pre- and post-intervention to assess changes in sexual risk and protective factors as well as two outcomes of interest: risky sexual behaviors and resilience. Pearson correlation assessed instrument reliability while multivariable linear regression models assessed two study hypotheses: (1) the effect of the intervention on sexual behavior and resilience is mediated by adolescent age, gender, and sexual experience and (2) risk and protective factors are mediators between the intervention and sexual behavior. The sample was composed of 193 adolescents between 14 and 17 years old (n = 96 in the control group and n = 97 in the experimental group). Survey instruments were reliable. Age was associated with pre-to-post test changes in sexual resilience (β = -6.10, p = .019), which partially mediated the effect of the intervention on sexual resilience (β = 5.70, p = .034). Social support was associated with pre-to-post test changes in risky sexual behavior (β = -0.17, p = .039). Intervention "Connect" was independently associated with improved self-reported resilience to risky sexual behaviors, though not with a reduction in those behaviors in multivariate analyses. This is the first Internet-based intervention designed to reduce HIV/AIDS sexual risk among

How can inequalities in mortality be reduced? A quantitative analysis of 6 risk factors in 21 European populations.

PubMed

Eikemo, Terje A; Hoffmann, Rasmus; Kulik, Margarete C; Kulhánová, Ivana; Toch-Marquardt, Marlen; Menvielle, Gwenn; Looman, Caspar; Jasilionis, Domantas; Martikainen, Pekka; Lundberg, Olle; Mackenbach, Johan P

2014-01-01

Socioeconomic inequalities in mortality are one of the greatest challenges for health policy in all European countries, but the potential for reducing these inequalities is unclear. We therefore quantified the impact of equalizing the distribution of six risk factors for mortality: smoking, overweight, lack of physical exercise, lack of social participation, low income, and economic inactivity. We collected and harmonized data on mortality and risk factors by educational level for 21 European populations in the early 2000s. The impact of the risk factors on mortality in each educational group was determined using Population Attributable Fractions. We estimated the impact on inequalities in mortality of two scenarios: a theoretical upward levelling scenario in which inequalities in the risk factor were completely eliminated, and a more realistic best practice scenario, in which inequalities in the risk factor were reduced to those seen in the country with the smallest inequalities for that risk factor. In general, upward levelling of inequalities in smoking, low income and economic inactivity hold the greatest potential for reducing inequalities in mortality. While the importance of low income is similar across Europe, smoking is more important in the North and East, and overweight in the South. On the basis of best practice scenarios the potential for reducing inequalities in mortality is often smaller, but still substantial in many countries for smoking and physical inactivity. Theoretically, there is a great potential for reducing inequalities in mortality in most European countries, for example by equity-oriented tobacco control policies, income redistribution and employment policies. Although it is necessary to achieve substantial degrees of upward levelling to make a notable difference for inequalities in mortality, the existence of best practice countries with more favourable distributions for some of these risk factors suggests that this is feasible.

How Can Inequalities in Mortality Be Reduced? A Quantitative Analysis of 6 Risk Factors in 21 European Populations

PubMed Central

Eikemo, Terje A.; Hoffmann, Rasmus; Kulik, Margarete C.; Kulhánová, Ivana; Toch-Marquardt, Marlen; Menvielle, Gwenn; Looman, Caspar; Jasilionis, Domantas; Martikainen, Pekka; Lundberg, Olle; Mackenbach, Johan P.

2014-01-01

Background Socioeconomic inequalities in mortality are one of the greatest challenges for health policy in all European countries, but the potential for reducing these inequalities is unclear. We therefore quantified the impact of equalizing the distribution of six risk factors for mortality: smoking, overweight, lack of physical exercise, lack of social participation, low income, and economic inactivity. Methods We collected and harmonized data on mortality and risk factors by educational level for 21 European populations in the early 2000s. The impact of the risk factors on mortality in each educational group was determined using Population Attributable Fractions. We estimated the impact on inequalities in mortality of two scenarios: a theoretical upward levelling scenario in which inequalities in the risk factor were completely eliminated, and a more realistic best practice scenario, in which inequalities in the risk factor were reduced to those seen in the country with the smallest inequalities for that risk factor. Findings In general, upward levelling of inequalities in smoking, low income and economic inactivity hold the greatest potential for reducing inequalities in mortality. While the importance of low income is similar across Europe, smoking is more important in the North and East, and overweight in the South. On the basis of best practice scenarios the potential for reducing inequalities in mortality is often smaller, but still substantial in many countries for smoking and physical inactivity. Interpretation Theoretically, there is a great potential for reducing inequalities in mortality in most European countries, for example by equity-oriented tobacco control policies, income redistribution and employment policies. Although it is necessary to achieve substantial degrees of upward levelling to make a notable difference for inequalities in mortality, the existence of best practice countries with more favourable distributions for some of these risk

Probabilistic Causal Analysis for System Safety Risk Assessments in Commercial Air Transport

NASA Technical Reports Server (NTRS)

Luxhoj, James T.

2003-01-01

Aviation is one of the critical modes of our national transportation system. As such, it is essential that new technologies be continually developed to ensure that a safe mode of transportation becomes even safer in the future. The NASA Aviation Safety Program (AvSP) is managing the development of new technologies and interventions aimed at reducing the fatal aviation accident rate by a factor of 5 by year 2007 and by a factor of 10 by year 2022. A portfolio assessment is currently being conducted to determine the projected impact that the new technologies and/or interventions may have on reducing aviation safety system risk. This paper reports on advanced risk analytics that combine the use of a human error taxonomy, probabilistic Bayesian Belief Networks, and case-based scenarios to assess a relative risk intensity metric. A sample case is used for illustrative purposes.

Sources, behaviour, and environmental and human health risks of high-technology rare earth elements as emerging contaminants.

PubMed

Gwenzi, Willis; Mangori, Lynda; Danha, Concilia; Chaukura, Nhamo; Dunjana, Nothando; Sanganyado, Edmond

2018-04-26

Recent studies show that high-technology rare earth elements (REEs) of anthropogenic origin occur in the environment including in aquatic systems, suggesting REEs are contaminants of emerging concern. However, compared to organic contaminants, there is a lack of comprehensive reviews on the anthropogenic sources, environmental behaviour, and public and ecological health risks of REEs. The current review aims to: (1) identify anthropogenic sources, transfer mechanisms, and environmental behaviour of REEs; (2) highlight the human and ecological health risks of REEs and propose mitigation measures; and (3) identify knowledge gaps and future research directions. Out of the 17 REEs, La, Gd, Ce and Eu are the most studied. The main sources of anthropogenic REE include; medical facilities, petroleum refining, mining and technology industries, fertilizers, livestock feeds, and electronic wastes and recycling plants. REEs are mobilized and transported in the environment by hydrological and wind-driven processes. Ecotoxicological effects include reduced plant growth, function and nutritional quality, genotoxicity and neurotoxicity in animals, trophic bioaccumulation, chronic and acute toxicities in soil organisms. Human exposure to REEs occurs via ingestion of contaminated water and food, inhalation, and direct intake during medical administration. REEs have been detected in human hair, nails, and biofluids. In humans, REEs cause nephrogenic systemic fibrosis and severe damage to nephrological systems associated with Gd-based contrast agents, dysfunctional neurological disorder, fibrotic tissue injury, oxidative stress, pneumoconiosis, cytotoxicity, anti-testicular effects, and male sterility. Barring REEs in medical devices, epidemiological evidence directly linking REEs in the environment to human health conditions remains weak. To minimize health risks, a conceptual framework and possible mitigation measures are highlighted. Future research is needed to better understand

Rethinking risk assessment for emerging technology first-in-human trials.

PubMed

Genske, Anna; Engel-Glatter, Sabrina

2016-03-01

Recent progress in synthetic biology (SynBio) has enabled the development of novel therapeutic opportunities for the treatment of human disease. In the near future, first-in-human trials (FIH) will be indicated. FIH trials mark a key milestone in the translation of medical SynBio applications into clinical practice. Fostered by uncertainty of possible adverse events for trial participants, a variety of ethical concerns emerge with regards to SynBio FIH trials, including 'risk' minimization. These concerns are associated with any FIH trial, however, due to the novelty of the approach, they become more pronounced for medical applications of emerging technologies (emTech) like SynBio. To minimize potential harm for trial participants, scholars, guidelines, regulations and policy makers alike suggest using 'risk assessment' as evaluation tool for such trials. Conversely, in the context of emTech FIH trials, we believe it to be at least questionable to contextualize uncertainty of potential adverse events as 'risk' and apply traditional risk assessment methods. Hence, this issue needs to be discussed to enable alterations of the evaluation process before the translational phase of SynBio applications begins. In this paper, we will take the opportunity to start the debate and highlight how a misunderstanding of the concept of risk, and the possibilities and limitations of risk assessment, respectively, might impair decision-making by the relevant regulatory authorities and research ethics committees, and discuss possible solutions to tackle the issue.

SIMPLE DECISION RULES REDUCE REINJURY RISK AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

PubMed Central

Grindem, Hege; Snyder-Mackler, Lynn; Moksnes, Håvard; Engebretsen, Lars; Risberg, May Arna

2016-01-01

Background Knee reinjury after anterior cruciate ligament (ACL) reconstruction is common and increases the risk of osteoarthritis. There is sparse evidence to guide return to sport (RTS) decisions in this population. Objectives To assess the relationship between knee reinjury after ACL reconstruction and 1) return to level I sports, 2) timing of return to sports, and 3) knee function prior to return. Methods 106 patients who participated in pivoting sports participated in this prospective two year cohort study. Sports participation and knee reinjury were recorded monthly. Knee function was assessed with the Knee Outcome Survey–Activities of Daily Living Scale, global rating scale of function, and quadriceps strength and hop test symmetry. Pass RTS criteria was defined as scores >90 on all tests, failure as failing any. Results Patients who returned to level I sports had 4.32 (p=0.048) higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51 % for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2 % of those who failed RTS criteria suffered reinjuries versus 5.6 % of those who passed (HR: 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate. Conclusion Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. Return to sport 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduces the reinjury rate. PMID:27162233

NRMRL SCIENCE PUBLICATIONS (NATIONAL RISK MANAGEMENT RESEARCH LABORATORY, EPA, CINCINNATI, OH)

EPA Science Inventory

The National Risk Management Research Laboratory (NRMRL)is the U.S.EPA's center for investigating technological and management approaches for preventing and reducing risks from pollution that threaten human health and the environment. The focus of the Laboratory's research progra...

AIRS-Light Instrument Concept and Critical Technology Development

NASA Technical Reports Server (NTRS)

Maschhoff, Kevin

2001-01-01

Understanding Earth's climate, atmospheric transport mechanisms, and the hydrologic cycle requires a precise knowledge of global atmospheric circulation, temperature profiles, and water vapor distribution. The accuracy of advanced sounders such as AIRS/AMSU/HSB on NASA's Aqua spacecraft can match radiosonde accuracy. It is essential to fold those capabilities fully into the NPOESS, enabling soundings of radiosonde accuracy, every 6 hours around the globe on an operational basis. However, the size, mass, power demands, and thermal characteristics of the Aqua sounding instrument suite cannot be accommodated on the NPOESS spacecraft. AIRS-Light is an instrument concept, developed under the Instrument Incubator Program, which provides IR sounding performance identical to the AIRS instrument, but uses advances in HgCdTe FPA technology and pulse tube cooler technology, as well as design changes to dramatically reduce the size, mass, and power demand, allowing AIRS-Light to meet all NPOESS spacecraft interface requirements. The instrument concept includes substantial re-use of AIRS component designs, including the complex AIRS FPA, to reduce development risk and cost. The AIRS-Light Instrument Incubator program fostered the development of photovoltaic-mode HgCdTe detector array technology for the 13.5-15.4 micron band covered by photoconductive-mode HgCdTe arrays in AIRS, achieved state of the art results in this band, and substantially reduced the development risk for this last new technology needed for AIRS-Light implementation, A demonstration of a prototype 14.5-15.4 micron band IRFPA in a reduced heat-load dewar together with the IMAS pulse tube cryocooler is in progress.

Using Simulation to Compare 4 Categories of Intervention for Reducing Cardiovascular Disease Risks

PubMed Central

Homer, Jack; Trogdon, Justin; Wile, Kristina; Orenstein, Diane

2014-01-01

The Prevention Impacts Simulation Model (PRISM) projects the multiyear impacts of 22 different interventions aimed at reducing risk of cardiovascular disease. We grouped these into 4 categories: clinical, behavioral support, health promotion and access, and taxes and regulation. We simulated impacts for the United States overall and also for a less-advantaged county with a higher death rate. Of the 4 categories of intervention, taxes and regulation reduce costs the most in the short term (through 2020) and long term (through 2040) and reduce deaths the most in the long term; they are second to clinical interventions in reducing deaths in the short term. All 4 categories combined were required to bring costs and deaths in the less-advantaged county down to the national level. PMID:24832142

Insulin use increases risk of asthma but metformin use reduces the risk in patients with diabetes in a Taiwanese population cohort.

PubMed

Chen, Chiung-Zuei; Hsu, Chih-Hui; Li, Chung-Yi; Hsiue, Tzuen-Ren

2017-12-01

Recent reports have suggested that insulin promotes airway smooth muscle contraction and enhances airway hyperresponsiveness, which are cardinal features of asthma. In contrast, metformin can reduce both airway inflammatory and remodeling properties. However, these results are all from in vitro and animal studies. This study investigated whether diabetes and various antidiabetic agents associate with the risk of asthma. We used a retrospective population-based cohort study using Taiwan's National Health Insurance claim database from 2000 to 2010 and a Cox proportional hazards regression model to compare the incidence of asthma between patients with diabetes (n = 19,428) and a matched non-diabetic group (n = 38,856). We also used a case-control study nested from the above cohort including 1,982 incident cases of asthma and 1,982 age- and sex-matched controls. A time density sampling technique was used to assess the effects of various antidiabetic agents on the risk of asthma. The incidence of asthma was significantly higher in the diabetic cohort than that in the non-diabetic cohort after adjustment for age, sex, and obesity, with a hazard ratio of 1.30 (95% confidence interval [CI]: 1.24-1.38). Insulin was found to increase the risk of asthma among diabetic patients (odds ratio [OR] 2.23; 95% CI: 1.52-3.58). In contrast, the use of metformin correlated with a decreased risk of asthma (OR 0.75; 95% CI: 0.60-0.95). Individuals with diabetes are at an increased risk of asthma. Insulin may further increase the risk of asthma, but the risk could possibly be reduced by using metformin.

Online social integration is associated with reduced mortality risk.

PubMed

Hobbs, William R; Burke, Moira; Christakis, Nicholas A; Fowler, James H

2016-11-15

Social interactions increasingly take place online. Friendships and other offline social ties have been repeatedly associated with human longevity, but online interactions might have different properties. Here, we reference 12 million social media profiles against California Department of Public Health vital records and use longitudinal statistical models to assess whether social media use is associated with longer life. The results show that receiving requests to connect as friends online is associated with reduced mortality but initiating friendships is not. Additionally, online behaviors that indicate face-to-face social activity (like posting photos) are associated with reduced mortality, but online-only behaviors (like sending messages) have a nonlinear relationship, where moderate use is associated with the lowest mortality. These results suggest that online social integration is linked to lower risk for a wide variety of critical health problems. Although this is an associational study, it may be an important step in understanding how, on a global scale, online social networks might be adapted to improve modern populations' social and physical health.

Online social integration is associated with reduced mortality risk

PubMed Central

Hobbs, William R.; Burke, Moira; Christakis, Nicholas A.; Fowler, James H.

2016-01-01

Social interactions increasingly take place online. Friendships and other offline social ties have been repeatedly associated with human longevity, but online interactions might have different properties. Here, we reference 12 million social media profiles against California Department of Public Health vital records and use longitudinal statistical models to assess whether social media use is associated with longer life. The results show that receiving requests to connect as friends online is associated with reduced mortality but initiating friendships is not. Additionally, online behaviors that indicate face-to-face social activity (like posting photos) are associated with reduced mortality, but online-only behaviors (like sending messages) have a nonlinear relationship, where moderate use is associated with the lowest mortality. These results suggest that online social integration is linked to lower risk for a wide variety of critical health problems. Although this is an associational study, it may be an important step in understanding how, on a global scale, online social networks might be adapted to improve modern populations’ social and physical health. PMID:27799553

Insights and perspectives on dietary modifications to reduce the risk of cardiovascular disease

USDA-ARS?s Scientific Manuscript database

This article summarizes presentations from, “Insights and Perspectives on Dietary Modifications to Reduce the Risk of Cardiovascular Disease”, a symposium held at the American Society for Nutrition (ASN) Annual Meeting and Scientific Sessions in conjunction with Experimental Biology 2014 in San Dieg...

Of Malthus and Methuselah: does longevity treatment aggravate global catastrophic risks?

NASA Astrophysics Data System (ADS)

Jebari, Karim

2014-12-01

Global catastrophic risk is a term that refers to the risk of the occurrence of an event that kills at least millions of people across several continents. While it has been argued by a number of scholars that one major potential risk comes from technology, the obscure nature of future technologies makes it difficult to utilize traditional probabilistic risk for the meaningful study of these risks. This article describes an alternative approach and applies it to a research program that has attracted a considerable amount of resources recently: namely longevity research. The aim of this research is to delay or reverse the ageing process. This article argues that this research program is much more risky or less beneficial than its proponents argue. In particular, they tend to underestimate the concerns associated with the potentially drastic population growth that longevity treatment could cause. The ethical benefit often ascribed to longevity treatment is that such treatment would add more subjective life-years that are worth living. However, in light of contemporary environmental problems, such an increase of the human population might be reckless. Drastically reducing fertility to reduce risks associated with environmental stress would make the benefits of such technology much less compelling.

Malpractice risk and cost are significantly reduced after tort reform.

PubMed

Stewart, Ronald M; Geoghegan, Kathy; Myers, John G; Sirinek, Kenneth R; Corneille, Michael G; Mueller, Deborah; Dent, Daniel L; Wolf, Steven E; Pruitt, Basil A

2011-04-01

Rising medical malpractice premiums have reached a crisis point in many areas of the United States. In 2003 the Texas legislature passed a comprehensive package of tort reform laws that included a cap at $250,000 on noneconomic damages in most medical malpractice cases. We hypothesized that tort reform laws significantly reduce the risk of malpractice lawsuit in an academic medical center. We compared malpractice prevalence, incidence, and liability costs before and after comprehensive state tort reform measures were implemented. Two prospectively maintained institutional databases were used to calculate and characterize malpractice risk: a surgical operation database and a risk management and malpractice database. Risk groups were divided into pretort reform (1992 to 2004) and post-tort reform groups (2004 to the present). Operative procedures were included for elective, urgent, and emergency general surgery procedures. During the study period, 98,513 general surgical procedures were performed. A total of 28 lawsuits (25 pre-reform, 3 postreform) were filed, naming general surgery faculty or residents. The prevalence of lawsuits filed/100,000 procedures performed is as follows: before reform, 40 lawsuits/100,000 procedures, and after reform, 8 lawsuits/100,000 procedures (p < 0.01, relative risk 0.21 [95% CI 0.063 to 0.62]). Virtually all of the liability and defense cost was in the pretort reform period: $595,000/year versus $515/year in the postreform group (p < 0.01). Implementation of comprehensive tort reform in Texas was associated with a significant decrease in the prevalence and cost of surgical malpractice lawsuits at one academic medical center. Copyright © 2011. Published by Elsevier Inc.

[French recommendations on control measures to reduce the infectious risk in immunocompromised patients].

PubMed

Zahar, J-R; Jolivet, S; Adam, H; Dananché, C; Lizon, J; Alfandari, S; Boulestreau, H; Baghdadi, N; Bay, J-O; Bénéteau, A-M; Bougnoux, M-E; Brenier-Pinchart, M-P; Dalle, J-H; Fournier, S; Fuzibet, J-G; Kauffmann-Lacroix, C; Le Guinche, I; Lepelletier, D; Loukili, N; Lory, A; Morvan, M; Oumedaly, R; Ribaud, P; Rohrlich, P; Vanhems, P; Aho, S; Vanjak, D; Gangneux, J-P

2017-12-01

The increase use of immunosuppressive treatments in patients with solid cancer and/or inflammatory diseases requires revisiting our practices for the prevention of infectious risk in the care setting. A review of the literature by a multidisciplinary working group at the beginning of 2014 wished to answer the following 4 questions to improve healthcare immunocompromised patients: (I) How can we define immunocompromised patients with high, intermediate and low infectious risk, (II) which air treatment should be recommended for this specific population? (III) What additional precautions should be recommended for immunocompromised patients at risk for infection? (IV) Which global environmental control should be recommended? Based on data from the literature and using the GRADE method, we propose 15 recommendations that could help to reduce the risk of infection in these exposed populations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Non-sedentary Lifestyle Can Reduce Hip Fracture Risk among Older Caucasians Adults: The Adventist Health Study-2.

PubMed

Lousuebsakul-Matthews, Vichuda; Thorpe, Donna; Knutsen, Raymond; Beeson, W Larry; Fraser, Gary E; Knutsen, Synnove F

2015-01-01

The beneficial effect of physical activity on reducing hip fracture risk has been supported in many previous studies. The present cohort study explores the relationship between total daily physical activity expressed as MET-hour/day and hip fracture risk among men over 50 years of age and postmenopausal women (n=22,836). Associations between self-reported hip fracture incidence and total daily physical activity and selected lifestyle factors were assessed using Cox proportional hazard regression. In gender-specific multivariable models, total activity above average (≥ 51 MET-hours per day for men, ≥ 48 MET-hours per day for women) compared to those with sedentary lifestyle (< 40 MET-hours per day) reduced the risk of hip fracture by 60% among men (HR=0.40, 95%CI: 0.23-0.70) (Ptrend=0.002) and 48% among women (HR=0.52, 95%CI: 0.32-0.84) (Ptrend=0.01). Our findings suggest that a moderate level of physical activity and avoiding a sedentary lifestyle can reduce the risk of hip fracture among the elderly.

Statins Reduce the Risks of Relapse to Addiction in Rats

PubMed Central

Chauvet, Claudia; Nicolas, Celine; Lafay-Chebassier, Claire; Jaber, Mohamed; Thiriet, Nathalie; Solinas, Marcello

2016-01-01

Statins are drugs that have been used for decades in humans for the treatment of hypercholesterolemia. More recently, several lines of evidence demonstrate that statins, in addition to their peripheral effects, produce a wide variety of effects in the brain and may be beneficial in neurological and psychiatric conditions. In this study, we allowed rats to self-administer cocaine for several weeks and, at the end of self-administration training, we treated them with low doses of statins daily for a 21-day period of abstinence. Chronic administration of brain-penetrating statins, simvastatin (1 mg/kg) and atorvastatin (1 mg/kg), reduced cocaine seeking compared with vehicle, whereas administration of pravastatin (2 mg/kg), a statin with low brain penetrability, did not. Importantly, the effects of brain-penetrating statins persisted even after discontinuation of the treatment and were specific for drug seeking because drug taking was not altered by simvastatin treatment. Finally, the effects of simvastatin were found to generalize to another drug of abuse such as nicotine, but not to food reward, and to reinstatement of cocaine seeking induced by stress. These results demonstrate that brain-penetrating statins can reduce risks of relapse to addiction. Given their well-known safety profile in humans, statins could be a novel effective treatment for relapse to cocaine and nicotine addiction and their use could be implemented in clinical settings without major health risks. PMID:26466819

Reducing risk for anxiety and depression in adolescents: Effects of a single-session intervention teaching that personality can change

PubMed Central

Schleider, Jessica L.; Weisz, John R.

2016-01-01

Efforts to reduce youth mental health problems have advanced greatly but have not lowered overall rates of youth mental illness. Thus, a need exists for disseminable, mechanism-targeted approaches to reducing risk of youth psychopathology. Accordingly, we conducted a randomized-controlled trial testing whether a single-session intervention teaching growth personality mindsets (the belief that personality is malleable) reduced known risk factors for anxiety and depression in adolescents experiencing or at risk for internalizing problems (N=96, ages 12-15). Compared to a supportive-therapy control, a 30-minute computer-guided mindset intervention strengthened adolescents’ perceived control; this improvement was associated with increases in growth mindsets. Further, electrodermal activity recovery slopes showed that youths receiving the mindset intervention recovered from a lab-based social stressor over three times as fast as control group youths. Improvements in growth mindsets and perceived control were linked with faster stress recovery. Results suggest a disseminable strategy for reducing internalizing problem risk among adolescents. PMID:27697671

The precautionary principle: what is the risk of reusing disposable drops in routine ophthalmology consultations and what are the costs of reducing this risk to zero?

PubMed

Somner, J E A; Cavanagh, D J; Wong, K K Y; Whitelaw, M; Thomson, T; Mansfield, D

2010-02-01

Instilling eye drops is a ubiquitous procedure in eye clinics. This audit aimed to assess the risk of contamination of disposable droppers and to quantify the financial and waste implications of reducing this risk to zero by using disposable droppers only once. A total of 100 disposable Minims were used to place one drop in each eye of 70 patients. The dropper tip was then cultured for aerobic and anaerobic microbes. Coagulase-negative staphylococcus was cultured from five samples. The contamination rate per drop application was 2.5%. The risk of cross-contamination with coagulase-negative staphylococcus would be between 1 : 400 and 1 : 80 if the bottle was reused once or six times. Reducing this risk to zero costs between pound2.75 and pound4.6 million per annum and generates between 6.85 and 11.42 more tonnes of paper waste and between 12.69 and 21.15 more tonnes of plastic waste than a strategy that reuses the disposable dropper. Reducing the risk of dropper contamination and subsequent cross infection has financial and environmental costs. As exposure to coagulase-negative staphylococcus is not necessarily associated with infection, it would be useful to decide acceptable risk levels for a given cost to maximise both cost-effectiveness and patient safety.

Analysis, Evaluation and Measures to Reduce Environmental Risk within Watershed Areas of the Eastern Zauralye District Lakes

NASA Astrophysics Data System (ADS)

Rasskasova, N. S.; Bobylev, A. V.; Malaev, A. V.

2017-11-01

The authors have performed an analysis for the use of watershed areas of the lakes of the Eastern Zauralye district (the territory to the east of Ural) for national economic purposes. The analysis gave a possibility to assess the impact of watersheds depending on the applied technologies on the dump of various runoff into the reservoir waters. The watershed areas of all lakes have been found to be actively used as pastures, farmland and recreational resources. Some of the main sources of solid and liquid industrial waste are cattle farms and agricultural land using outdated equipment and technologies. The study of 26 km of the watershed line areas showed that pollutants (household garbage, fuels and lubricants) and organic substances (phosphorus and nitrogen) got into the waters of the reservoirs. The maximum runoff of solid and liquid waste into the waters of the lakes happens in summer which leads to increased concentrations of organic substances, an increase in productivity of alga and higher aquatic flora determining the degree of eutrophication and trophy in the reservoirs. The average annual trophic status of TSI lakes of the Eastern Zauralye district is 56 which corresponds to the typical phase of eutrophy. The reduced transparency of lakes is also the evidence of an increase in biological productivity of reservoirs, their eutrophication and, as a result, the water quality deterioration. The intensive eutrophication of reservoirs, in its turn, most significantly affects the concentration of the ammonium form of nitrogen, total phosphorus and total nitrogen, increase in pH and deterioration of oxygen condition. The authors have developed various activities to reduce a technogenic risk in the watershed areas of the lakes in the Eastern Zauralye district which can be applied to other areas using the analogy method.

Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: balancing methodological rigor and research ethics.

PubMed

Underhill, Kristen

2013-10-01

The growing evidence base for biomedical HIV prevention interventions - such as oral pre-exposure prophylaxis, microbicides, male circumcision, treatment as prevention, and eventually prevention vaccines - has given rise to concerns about the ways in which users of these biomedical products may adjust their HIV risk behaviors based on the perception that they are prevented from infection. Known as risk compensation, this behavioral adjustment draws on the theory of "risk homeostasis," which has previously been applied to phenomena as diverse as Lyme disease vaccination, insurance mandates, and automobile safety. Little rigorous evidence exists to answer risk compensation concerns in the biomedical HIV prevention literature, in part because the field has not systematically evaluated the study designs available for testing these behaviors. The goals of this Commentary are to explain the origins of risk compensation behavior in risk homeostasis theory, to reframe risk compensation as a testable response to the perception of reduced risk, and to assess the methodological rigor and ethical justification of study designs aiming to isolate risk compensation responses. Although the most rigorous methodological designs for assessing risk compensation behavior may be unavailable due to ethical flaws, several strategies can help investigators identify potential risk compensation behavior during Phase II, Phase III, and Phase IV testing of new technologies. Where concerns arise regarding risk compensation behavior, empirical evidence about the incidence, types, and extent of these behavioral changes can illuminate opportunities to better support the users of new HIV prevention strategies. This Commentary concludes by suggesting a new way to conceptualize risk compensation behavior in the HIV prevention context. Copyright © 2013 Elsevier Ltd. All rights reserved.

Study designs for identifying risk compensation behavior among users of biomedical HIV prevention technologies: Balancing methodological rigor and research ethics

PubMed Central