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Sample records for relative risk results

  1. Excimer laser coronary angioplasty: relative risk analysis of clinical results

    NASA Astrophysics Data System (ADS)

    Bittl, John A.

    1992-08-01

    Reports of successful use of excimer laser coronary angioplasty for complex coronary artery disease abound, yet firm indications for its use have not been defined. We attempted to treat 858 coronary stenoses in 764 consecutive patients (mean age 61 years; range 32 - 91 years; 75% men; 76% with Class III or IV angina) with excimer laser angioplasty at 308 nm. Successful treatment was achieved in 86% of patients, as indicated by relative risk analysis. This showed that certain angiographic features, such as lesions at a vessel bifurcation (odds ratio, OR equals 0.46; 95% confidence interval 0.23, 0.88; P equals 0.017;) or in a tortuous segment (OR equals 0.54; 95% CI equals 0.34, 0.88; P equals 0.041), have decreased likelihood of clinical success. On the other hand, ostial stenoses (OR equals 1.06; 95% CI equals 0.44, 2.56, P equals 0.903) and saphenous vein graft lesions (OR equals 2.17; 95% CI equals 0.98, 4.82; P equals 0.051) have acceptable success rates. Diffuse disease (> 20 mm), total occlusions and calcified lesions were treated as successfully as all other lesion types. Successful treatment with excimer laser coronary angioplasty was also achieved in almost all patients (15/16) who had a prior unsuccessful attempt at balloon angioplasty in the lesion was crossed with a guidewire yet resists either balloon catheter passage or full dilatation. Follow-up angiography was obtained in 70% of eligible patients. Angiographic restenosis, defined by > 50% stenosis, was seen in 60% of patients. Relative risk analysis showed an increased risk of restenosis when adjunctive balloon angioplasty was not used (OR equals 1.68; 95% CI equals 1.02, 2.28; P equals 0.039). Other variables known to affect the outcome of balloon angioplasty, such as lesion length or stenosis in degenerated saphenous vein bypass graft, did not influence the

  2. [The time-related risk for knee osteoarthritis after ACL injury. Results from a systematic review].

    PubMed

    Spahn, G; Schiltenwolf, M; Hartmann, B; Grifka, J; Hofmann, G O; Klemm, H-T

    2016-01-01

    The aim of this review was to evaluate the time-related risk for knee osteoarthritis in patients after ACL injury. The primary search was carried out in different medical databases with the deadline 12.01.2014. The search strategy for the evaluation was [ACL] AND [osteoarthritis] including "all fields". All 1656 title/abstracts were reviewed by two independent researchers who selected 140 papers for full text review. Finally, a total of 21 relevant publications were identified for inclusion in this current paper. The incidence of knee osteoarthritis rises significantly over time. Two years after injury it was 6.9%, after 5 years 32.2%, after 7 years 36.3%, and after 10 years 79.6%. At the same time, the crude relative risk of OA rises as the time interval since injury increases. The relative risk of OA has already doubled by 2 years after ACL injury). By 7 years it has increased fivefold and compared with OA status at the time of injury it is still increasing significantly after 10 years. The ACL injury is a significant risk factor for the development of early-onset secondary knee osteoarthritis. Within 5 years of the injury the knee shows clear signs of osteoarthritis on MRI. However, these lesions are often not associated with any clinical signs. Knee osteoarthritis as a severe disease starts 8 years or later after the injury, when it requires treatment.

  3. Can a short film impact HIV-related risk and stigma perceptions? Results from an experiment in Abuja, Nigeria.

    PubMed

    Lapinski, Maria Knight; Nwulu, Paul

    2008-09-01

    HIV/AIDS-related stigma is believed to result in negative social consequences for people with the disease and to be a deterrent to HIV serostatus testing. The ability of communicators to change people's stigma perceptions and subsequently impact decisions to test, however, is not well understood. Based on the entertainment-education approach, this article presents the results of a field experiment conducted in Abuja, Nigeria, testing a mediated intervention designed to reduce HIV-related stigma and risk perceptions. The results indicate that the intervention was effective relative to a control in impacting perceptions of the severity of HIV and some stigma-related attitudes, particularly for male participants; and that for this sample, risk and stigma perceptions significantly impact intentions to test for HIV. It also showed that severity perceptions mediated the relationship between viewing the film and testing intent.

  4. Risk factors for anaesthetic-related death in cats: results from the confidential enquiry into perioperative small animal fatalities (CEPSAF).

    PubMed

    Brodbelt, D C; Pfeiffer, D U; Young, L E; Wood, J L N

    2007-11-01

    Cats are commonly anaesthetized in veterinary practice, but recent figures describing the frequency of or risk factors for anaesthetic-related death are not available. The aims of this study were to address these deficiencies. A nested case-control study was undertaken in 117 UK veterinary centres. All anaesthetic and sedation procedures and anaesthetic and sedation-related deaths (i.e. 'cases') occurring within 48 h were recorded. Details of patient, procedure, and perioperative management were recorded for all cases and randomly selected non-deaths (controls). A detailed statistical model of factors associated with anaesthetic and sedation-related death was constructed. Between June 2002 and June 2004, 175 deaths were classified as anaesthetic and sedation-related and 14 additional deaths (with insufficient information to be excluded) were included for the estimation of risk. During the study, 79 178 anaesthetic and sedation procedures were recorded and the overall risk of anaesthetic and sedation-related death was 0.24% (95% CI 0.20-0.27). Factors associated with increased odds of anaesthetic-related death were poor health status (ASA physical status classification), increasing age, extremes of weight, increasing procedural urgency and complexity, endotracheal intubation, and fluid therapy. Pulse monitoring and pulse oximetry were associated with reduced odds. The risk of anaesthetic-related death in cats appears to have decreased since the last published study in the UK. The results should aid the preoperative identification of cats at greatest risk. Greater care with endotracheal intubation and fluid administration are recommended, and pulse and pulse oximetry monitoring should be routinely implemented in cats.

  5. Physical Activity Related to Depression and Predicted Mortality Risk: Results from the Americans' Changing Lives Study

    ERIC Educational Resources Information Center

    Lee, Pai-Lin; Lan, William; Lee, Charles C.-L.

    2012-01-01

    This study examined the association between three types of physical activities (PA) and depression, and the relationship between PA and later mortality. Previous studies rarely assessed these associations in one single study in randomly selected population samples. Few studies have assessed these relations by adjusting the covariate of…

  6. Attitudes towards the sharing of genetic information with at-risk relatives: results of a quantitative survey.

    PubMed

    Heaton, Timothy J; Chico, Victoria

    2016-01-01

    To investigate public attitudes towards receiving genetic information arising from a test on a relative, 955 University of Sheffield students and staff were surveyed using disease vignettes. Strength of attitude was measured on whether, in the event of relevant information being discovered, they, as an at-risk relative, would want to be informed, whether the at-risk relative's interest should override proband confidentiality, and, if they had been the proband, willingness to give up confidentiality to inform such relatives. Results indicated considerably more complexity to the decision-making than simple statistical risk. Desire for information only slightly increased with risk of disease manifestation [log odds 0.05 (0.04, 0.06) per percentage point increase in manifestation risk]. Condition preventability was the primary factor increasing desire [modifiable baseline, non-preventable log odds -1.74 (-2.04, -1.44); preventable 0.64 (0.34, 0.95)]. Disease seriousness also increased desire [serious baseline, non-serious log odds -0.89 (-1.19, -0.59); fatal 0.55 (0.25, 0.86)]. Individuals with lower education levels exhibited much greater desire to be informed [GCSE log odds 1.67 (0.64, 2.66)]. Age did not affect desire. Our findings suggest that attitudes were influenced more by disease characteristics than statistical risk. Respondents generally expressed strong attitudes demonstrating that this was not an issue which people felt ambivalent about. We provide estimates of the British population in favour/against disclosure for various disease scenarios.

  7. CYP2C9 Genotypes Modify Benzodiazepine-Related Fall Risk: Original Results From Three Studies With Meta-Analysis.

    PubMed

    Ham, Annelies C; Ziere, Gijsbertus; Broer, Linda; Swart, Karin M A; Enneman, Anke W; van Dijk, Suzanne C; van Wijngaarden, Janneke P; van der Zwaluw, Nikita L; Brouwer-Brolsma, Elske M; Dhonukshe-Rutten, Rosalie A M; van Schoor, Natasja M; Zillikens, M Carola; van Gelder, Teun; de Vries, Oscar J; Lips, Paul; Deeg, Dorly J H; de Groot, Lisette C P G M; Hofman, Albert; Witkamp, Renger F; Uitterlinden, André G; Stricker, Bruno H; van der Velde, Nathalie

    2017-01-01

    To investigate whether the CYP2C9*2 and *3 variants modify benzodiazepine-related fall risk. Three prospective studies; the Rotterdam Study, B-PROOF, and LASA. Community-dwelling individuals living in or near five Dutch cities. There were 11,485 participants aged ≥55 years. Fall incidents were recorded prospectively. Benzodiazepine use was determined using pharmacy dispensing records or interviews. Cox proportional hazard models adjusted for age and sex were applied to determine the association between benzodiazepine use and fall risk stratified for CYP2C9 genotype and comparing benzodiazepine users to nonusers. The results of the three studies were combined applying meta-analysis. Within benzodiazepine users, the association between genotypes and fall risk was also assessed. Three thousand seven hundred five participants (32%) encountered a fall during 91,996 follow-up years, and 4% to 15% (depending on the study population) used benzodiazepines. CYP2C9 variants had frequencies of 13% for the *2 allele and 6% for the *3 allele. Compared to nonusers, current benzodiazepine use was associated with an 18% to 36% increased fall risk across studies with a combined hazard ratio (HR) = 1.26 (95% confidence interval [CI], 1.13; 1.40). CYP2C9*2 or *3 allele variants modified benzodiazepine-related fall risk. Compared to nonusers, those carrying a CYP2C9*2 or *3 allele and using benzodiazepines had a 45% increased fall risk (HR, 1.45 95% CI, 1.21; 1.73), whereas CYP2C9*1 homozygotes using benzodiazepines had no increased fall risk (HR, 1.14; 95% CI, 0.90; 1.45). Within benzodiazepine users, having a CYP2C9*2 or *3 allele was associated with an increased fall risk (HR, 1.35; 95% CI, 1.06; 1.72). Additionally, we observed an allele dose effect; heterozygous allele carriers had a fall risk of (HR = 1.30; 95% CI, 1.05; 1.61), and homozygous allele carriers of (HR = 1.91 95% CI, 1.23; 2.96). CYP2C9*2 and *3 allele variants modify benzodiazepine-related fall risk. Those

  8. Young adults’ risk perceptions of various tobacco products relative to cigarettes – results from the National Young Adult Health Survey

    PubMed Central

    Delnevo, Cristine D.

    2015-01-01

    Objectives Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Methods We examined risk perception responses among a nationally representative sample of young adults (ages 18–34)(n=2871)(including tobacco and non-tobacco users) from the 2011 National Young Adult Health Survey. Results Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to non-combustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22–33% of all respondents believed that SLT, snus, menthol cigarettes and cigars were more risky than cigarettes, but differences in this belief between current and non-users of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being “less risky” and rate cigars and SLT as being “more risky” than older young adults. Conclusion The public’s views of comparative tobacco risk perceptions vary widely by tobacco product type, and age group. While “less risky” perceptions may be associated with product use, perceptions that products are “more risky” than cigarettes may not necessarily dissuade people from their use. PMID:26304709

  9. Young Adults' Risk Perceptions of Various Tobacco Products Relative to Cigarettes: Results From the National Young Adult Health Survey.

    PubMed

    Wackowski, Olivia A; Delnevo, Cristine D

    2016-06-01

    Objectives Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method We examined risk perception responses among a nationally representative sample of young adults (age 18-34 years; n = 2,871, including tobacco and non-tobacco users) from the 2011 National Young Adult Health Survey. Results Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to noncombustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22% and 33% of all respondents believed that SLT, snus, menthol cigarettes, and cigars were more risky than cigarettes, but differences in this belief between current and nonusers of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being "less risky" and rate cigars and SLT as being "more risky" than older young adults. Conclusion The public's views of comparative tobacco risk perceptions vary widely by tobacco product type and age-group. While "less risky" perceptions may be associated with product use, perceptions that products are "more risky" than cigarettes may not necessarily dissuade people from their use. © 2015 Society for Public Health Education.

  10. Young Adults' Risk Perceptions of Various Tobacco Products Relative to Cigarettes: Results from the National Young Adult Health Survey

    ERIC Educational Resources Information Center

    Wackowski, Olivia A.; Delnevo, Cristine D.

    2016-01-01

    Objectives: Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method: We examined risk…

  11. Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991-2013).

    PubMed

    Makarem, Nour; Bandera, Elisa V; Lin, Yong; Jacques, Paul F; Hayes, Richard B; Parekh, Niyati

    2017-06-01

    Higher carbohydrate intake, glycaemic index (GI), and glycaemic load (GL) are hypothesised to increase cancer risk through metabolic dysregulation of the glucose-insulin axis and adiposity-related mechanisms, but epidemiological evidence is inconsistent. This prospective cohort study investigates carbohydrate quantity and quality in relation to risk of adiposity-related cancers, which represent the most commonly diagnosed preventable cancers in the USA. In exploratory analyses, associations with three site-specific cancers: breast, prostate and colorectal cancers were also examined. The study sample consisted of 3184 adults from the Framingham Offspring cohort. Dietary data were collected in 1991-1995 using a FFQ along with lifestyle and medical information. From 1991 to 2013, 565 incident adiposity-related cancers, including 124 breast, 157 prostate and sixty-eight colorectal cancers, were identified. Cox proportional hazards models were used to evaluate the role of carbohydrate nutrition in cancer risk. GI and GL were not associated with risk of adiposity-related cancers or any of the site-specific cancers. Total carbohydrate intake was not associated with risk of adiposity-related cancers combined or prostate and colorectal cancers. However, carbohydrate consumption in the highest v. lowest quintile was associated with 41 % lower breast cancer risk (hazard ratio (HR) 0·59; 95 % CI 0·36, 0·97). High-, medium- and low-GI foods were not associated with risk of adiposity-related cancers or prostate and colorectal cancers. In exploratory analyses, low-GI foods, were associated with 49 % lower breast cancer risk (HR 0·51; 95 % CI 0·32, 0·83). In this cohort of Caucasian American adults, associations between carbohydrate nutrition and cancer varied by cancer site. Healthier low-GI carbohydrate foods may prevent adiposity-related cancers among women, but these findings require confirmation in a larger sample.

  12. HIV prevalence and related risk behaviours among prisoners in Iran: results of the national biobehavioural survey, 2009

    PubMed Central

    Navadeh, Soodabeh; Mirzazadeh, Ali; Gouya, Mohammad Mehdi; Farnia, Marziyeh; Alasvand, Ramin; Haghdoost, Ali-Akbar

    2013-01-01

    Objectives To estimate the prevalence of HIV and related risk behaviours among prisoners in Iran in 2009. Methods Using multistage random sampling, we recruited 5,530 prisoners from 27 prisons in Iran. Behavioural data were collected using a face-to-face questionnaire-based interview, and HIV status was determined by ELISA of dried blood spots. Weighted estimates were calculated based on the sampling probability and response rate. Results HIV prevalence was 2.1% (95% CI 1.2 to 3.6). One in eight prisoners (12.3%, 95% CI 8.0% to 16.6%) had been tested for HIV in the last year and received results, 20.5% (95% CI 15.1 to 27.4%) had comprehensive knowledge about HIV and 24.7% (95% CI 17.9% to 32.9%) reported condom use at last vaginal/anal sex in prison. Although 16.5% (95% CI 12.5% to 21.5%) acknowledged a lifetime history of drug injection, only 22 prisoners reported drug injection inside the prison in the month preceding the interview. Of note, 12.9% (95% CI 10.6% to 15.6%) had been tattooed in prison. There were significant associations between HIV prevalence and a history of drug injection (adjusted odds ratio (AOR): 7.8, 95% CI 4.7 to 13.2), tattooing (AOR: 2.1, 95% CI 1.1 to 4.2) and age over 30 years (AOR: 1.4, 95% CI 1.1 to 1.9). Conclusions Considerable HIV prevalence among prisoners is found in Iran. Expanding harm reduction programmes inside prisons with inclusion of sexual risk reduction programmes and post-release programmes will help directly prevent acquisition and transmission of infection inside prisons and indirectly slow onward transmission in the outside communities. PMID:23986417

  13. Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991-2013)

    USDA-ARS?s Scientific Manuscript database

    High carbohydrate intake, glycemic index (GI), and glycemic load (GL) are hypothesized to increase cancer risk through metabolic dysregulation of the glucose-insulin axis and adiposity-related mechanisms, but epidemiologic evidence is inconsistent. This prospective cohort study investigates the impa...

  14. [Football as risk factor for a non-injury-related knee osteoarthritis - results from a systematic review and metaanalysis].

    PubMed

    Spahn, G; Grosser, V; Schiltenwolf, M; Schröter, F; Grifka, J

    2015-03-01

    Aim and Hyopthesis: This systematic review and the metanalysis were performed to investigate the relation between football activity and the potential risk of knee osteoarthritis (possible occupational disease). It was hypothesised that soccer players suffer more than controls from knee osteoarthritis also in cases with an absence of documented major injuries. The review and the metaanalysis were performed accordingly to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. On 2014.02.01 a search was conducted within the medical databases PubMed, Medline, Cochrane, EMBASE und Web-of-Science. A total of 4,649 papers underwent a "Title-Abstract-Review". Finally 6 publications were included in the metaanaylsis. There were no longitudinal community-based studies as well as no Cochrane Reviews regarding the risk of knee osteoarthritis in soccer players. After adjustment of major injuries of the knee, soccer players have a slightly increased risk for knee osteoarthritis: relative risk 1.3 (95 % CI 1.0 - 1.7); I(2) = 37.4 %; p = 0.002. In contrast, in studies without differentiation of injured and non-injured knees, the relative risk was significantly increased: 2.9 (95 % CI 2.0 - 4.1); I(2) = 56.3 %; p < 0.001. Soccer players are a very heterogeneous group. The soccer player's knee undergoes different loadings including minor and major injuries. But the individual load also strongly depends on the player's status, his position within the football field and many other factors. In the absence of a major trauma the soccer player has only a slightly increased risk for the development of osteoarthritis. Thus we conclude that an injury in professional football does not fulfil the characteristics of an occupational disease. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Using Formative Scenario Analysis approach for landslide risk analysis in a relatively scarce data environment: preliminary results

    NASA Astrophysics Data System (ADS)

    Zumpano, Veronica; Balteanu, Dan; Mazzorana, Bruno; Micu, Mihai

    2014-05-01

    It is increasingly important to provide to stakeholders tools that will enable them to better understand what is the state of the environment in which they live and manage and to help them to make decisions that aim to minimize the consequences of hydro-meteorological hazards. Very often, however, quantitative studies, especially for large areas, are difficult to perform. This is due to the fact that unfortunately isn't often possible to have the numerous data required to perform the analysis. In addition it has been proven that in scenario analysis, often deterministic approaches are not able to detect some features of the system revealing unexpected behaviors, and resulting in underestimation or omission of some impact factors. Here are presented some preliminary results obtained applying Formative Scenario Analysis that can be considered a possible solution for landslide risk analysis in cases where the data needed even if existent are not available. This method is an expert based approach that integrates intuitions and qualitative evaluations of impact factors with the quantitative analysis of relations between these factors: a group of experts with different but pertinent expertise, determine (by a rating procedure) quantitative relations between these factors, then through mathematical operations the scenarios describing a certain state of the system are obtained. The approach is applied to Buzau County (Romania), an area belonging to the Curvature Romanian Carpathians and Subcarpathians, a region strongly affected by environmental hazards. The region has been previously involved in numerous episodes of severe hydro-meteorological events that caused considerable damages (1975, 2005, 2006). In this application we are referring only to one type of landslides that can be described as shallow and medium-seated with a (mainly) translational movement that can go from slide to flow. The material involved can be either soil, debris or a mixture of both, in Romanian

  16. Violence Related Behaviors and Weapon Carrying Among Hispanic Adolescents: Results from the National Youth Risk Behavior Survey, 2001-2015.

    PubMed

    Khubchandani, Jagdish; Price, James H

    2018-04-01

    Hispanic youths are disproportionately represented in gangs in the United States, are more likely to drink alcohol at younger ages, and to live in poverty; all are risks for violence and weapon carrying. No studies to date have assessed violence related behaviors and weapon carrying in Hispanic youth over an extended period. This study utilized the national Youth Risk Behavior Surveys from 2001 to 2015 to assess trends in violence related behaviors and weapon carrying of Hispanic adolescents. Our analyses found both physical fighting and fighting on school property had statistically significant reductions from 2001 to 2015 for Hispanic females and their suicide attempts increased from 2009 to 2015. Hispanic males had statistically significant decreasing trends for: being in a physical fight in the past year, being bullied on school property, being in a physical fight on school property within the past year; threatened or injured with a weapon on school property in the past year; and having attempted suicide in the past year. Hispanic females and males had two groups of items highly predictive of weapon carrying behaviors: alcohol, tobacco, and other drug use and violent risk behaviors. Both female and male students who made mostly A's or B's in school were significantly less likely (about half as likely) to carry weapons. This data could be used to identify Hispanic adolescents at higher risk for weapon carrying and used as a basis for enriching programs to improve academic success of Hispanic adolescents.

  17. Perceived threat, risk perception, and efficacy beliefs related to SARS and other (emerging) infectious diseases: results of an international survey.

    PubMed

    de Zwart, Onno; Veldhuijzen, Irene K; Elam, Gillian; Aro, Arja R; Abraham, Thomas; Bishop, George D; Voeten, Hélène A C M; Richardus, Jan Hendrik; Brug, Johannes

    2009-01-01

    To study the levels of perceived threat, perceived severity, perceived vulnerability, response efficacy, and self-efficacy for severe acute respiratory syndrome (SARS) and eight other diseases in five European and three Asian countries. A computer-assisted phone survey was conducted among 3,436 respondents. The questionnaire focused on perceived threat, vulnerability, severity, response efficacy, and self-efficacy related to SARS and eight other diseases. Perceived threat of SARS in case of an outbreak in the country was higher than that of other diseases. Perceived vulnerability of SARS was at an intermediate level and perceived severity was high compared to other diseases. Perceived threat for SARS varied between countries in Europe and Asia with a higher perceived severity of SARS in Europe and a higher perceived vulnerability in Asia. Response efficacy and self-efficacy for SARS were higher in Asia compared to Europe. In multiple linear regression analyses, country was strongly associated with perceived threat. The relatively high perceived threat for SARS indicates that it is seen as a public health risk and offers a basis for communication in case of an outbreak. The strong association between perceived threat and country and different regional patterns require further research.

  18. Risk of brain tumours in relation to estimated RF dose from mobile phones: results from five Interphone countries

    PubMed Central

    Armstrong, B K; Bowman, J D; Giles, G G; Hours, M; Krewski, D; McBride, M; Parent, M E; Sadetzki, S; Woodward, A; Brown, J; Chetrit, A; Figuerola, J; Hoffmann, C; Jarus-Hakak, A; Montestruq, L; Nadon, L; Richardson, L; Villegas, R; Vrijheid, M

    2011-01-01

    Objectives The objective of this study was to examine the associations of brain tumours with radio frequency (RF) fields from mobile phones. Methods Patients with brain tumour from the Australian, Canadian, French, Israeli and New Zealand components of the Interphone Study, whose tumours were localised by neuroradiologists, were analysed. Controls were matched on age, sex and region and allocated the ‘tumour location’ of their matched case. Analyses included 553 glioma and 676 meningioma cases and 1762 and 1911 controls, respectively. RF dose was estimated as total cumulative specific energy (TCSE; J/kg) absorbed at the tumour's estimated centre taking into account multiple RF exposure determinants. Results ORs with ever having been a regular mobile phone user were 0.93 (95% CI 0.73 to 1.18) for glioma and 0.80 (95% CI 0.66 to 0.96) for meningioma. ORs for glioma were below 1 in the first four quintiles of TCSE but above 1 in the highest quintile, 1.35 (95% CI 0.96 to 1.90). The OR increased with increasing TCSE 7+ years before diagnosis (p-trend 0.01; OR 1.91, 95% CI 1.05 to 3.47 in the highest quintile). A complementary analysis in which 44 glioma and 135 meningioma cases in the most exposed area of the brain were compared with gliomas and meningiomas located elsewhere in the brain showed increased ORs for tumours in the most exposed part of the brain in those with 10+ years of mobile phone use (OR 2.80, 95% CI 1.13 to 6.94 for glioma). Patterns for meningioma were similar, but ORs were lower, many below 1.0. Conclusions There were suggestions of an increased risk of glioma in long-term mobile phone users with high RF exposure and of similar, but apparently much smaller, increases in meningioma risk. The uncertainty of these results requires that they be replicated before a causal interpretation can be made. PMID:21659469

  19. Associations of Time-Related Deployment Variables With Risk of Suicide Attempt Among Soldiers: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    PubMed

    Ursano, Robert J; Kessler, Ronald C; Naifeh, James A; Herberman Mash, Holly; Fullerton, Carol S; Aliaga, Pablo A; Wynn, Gary H; Ng, Tsz Hin H; Dinh, Hieu M; Sampson, Nancy A; Kao, Tzu-Cheg; Bliese, Paul D; Stein, Murray B

    2018-06-01

    There has been limited systematic examination of whether risk of suicide attempt (SA) among US Army soldiers is associated with time-related deployment variables, such as time in service before first deployment, duration of first deployment, and dwell time (DT) (ie, length of time between deployments). To examine the associations of time-related deployment variables with subsequent SA among soldiers who had deployed twice. Using administrative data from January 1, 2004, through December 31, 2009, this longitudinal, retrospective cohort study identified person-month records of active-duty Regular Army enlisted soldiers who had served continuously in the US Army for at least 2 years and deployed exactly twice. The dates of analysis were March 1 to December 1, 2017. There were 593 soldiers with a medically documented SA during or after their second deployment. An equal-probability sample of control person-months was selected from other soldiers with exactly 2 deployments (n = 19 034). Logistic regression analyses examined the associations of time in service before first deployment, duration of first deployment, and DT with subsequent SA. Suicide attempts during or after second deployment were identified using US Department of Defense Suicide Event Report records and International Classification of Diseases, Ninth Revision, Clinical Modification E950 to E958 diagnostic codes. Independent variables were constructed from US Army personnel records. Among 593 SA cases, most were male (513 [86.5%]), white non-Hispanic (392 [66.1%]), at least high school educated (477 [80.4%]), currently married (398 [67.1%]), and younger than 21 years when they entered the US Army (384 [64.8%]). In multivariable models adjusting for sociodemographics, service-related characteristics, and previous mental health diagnosis, odds of SA during or after second deployment were higher among soldiers whose first deployment occurred within the first 12 months of service vs after 12 months (odds

  20. Risk of brain tumours in relation to estimated RF dose from mobile phones: results from five Interphone countries.

    PubMed

    Cardis, E; Armstrong, B K; Bowman, J D; Giles, G G; Hours, M; Krewski, D; McBride, M; Parent, M E; Sadetzki, S; Woodward, A; Brown, J; Chetrit, A; Figuerola, J; Hoffmann, C; Jarus-Hakak, A; Montestruq, L; Nadon, L; Richardson, L; Villegas, R; Vrijheid, M

    2011-09-01

    The objective of this study was to examine the associations of brain tumours with radio frequency (RF) fields from mobile phones. Patients with brain tumour from the Australian, Canadian, French, Israeli and New Zealand components of the Interphone Study, whose tumours were localised by neuroradiologists, were analysed. Controls were matched on age, sex and region and allocated the 'tumour location' of their matched case. Analyses included 553 glioma and 676 meningioma cases and 1762 and 1911 controls, respectively. RF dose was estimated as total cumulative specific energy (TCSE; J/kg) absorbed at the tumour's estimated centre taking into account multiple RF exposure determinants. ORs with ever having been a regular mobile phone user were 0.93 (95% CI 0.73 to 1.18) for glioma and 0.80 (95% CI 0.66 to 0.96) for meningioma. ORs for glioma were below 1 in the first four quintiles of TCSE but above 1 in the highest quintile, 1.35 (95% CI 0.96 to 1.90). The OR increased with increasing TCSE 7+ years before diagnosis (p-trend 0.01; OR 1.91, 95% CI 1.05 to 3.47 in the highest quintile). A complementary analysis in which 44 glioma and 135 meningioma cases in the most exposed area of the brain were compared with gliomas and meningiomas located elsewhere in the brain showed increased ORs for tumours in the most exposed part of the brain in those with 10+ years of mobile phone use (OR 2.80, 95% CI 1.13 to 6.94 for glioma). Patterns for meningioma were similar, but ORs were lower, many below 1.0. There were suggestions of an increased risk of glioma in long-term mobile phone users with high RF exposure and of similar, but apparently much smaller, increases in meningioma risk. The uncertainty of these results requires that they be replicated before a causal interpretation can be made.

  1. Psychosocial risk factors in relation to other cardiovascular risk factors in coronary heart disease: Results from the EUROASPIRE IV survey. A registry from the European Society of Cardiology.

    PubMed

    Pogosova, Nana; Kotseva, Kornelia; De Bacquer, Dirk; von Känel, Roland; De Smedt, Delphine; Bruthans, Jan; Dolzhenko, Maryna

    2017-09-01

    Background Depression and anxiety are established psychosocial risk factors for coronary heart disease. Contemporary data on their prevalence and associations with other risk factors were evaluated as part of the EUROASPIRE IV survey. Design The design of this study was cross-sectional. Methods The study group consisted of 7589 patients from 24 European countries examined at a median of 1.4 years after hospitalisation due to coronary heart disease events. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Results Symptoms of anxiety (Hospital Anxiety and Depression Scale-Anxiety score ≥8) were seen in 26.3% of participants and were more prevalent in women (39.4%) vs men (22.1%). Of the patients, 22.4% (30.6% of women and 19.8% of men) had symptoms of depression (Hospital Anxiety and Depression Scale-Depression score ≥8). Nevertheless, antidepressants and anti-anxiety medications were prescribed to only 2.4% of patients at hospital discharge, and 2.7% and 5.0% of patients, respectively, continued to take them at interview. Both anxiety and depression were associated with female gender, lower educational level and more sedentary lifestyle. Anxiety was more prevalent in younger age groups and depression rates increased with advancing age. Depression was positively associated with current smoking, central obesity and self-reported diabetes. A number of positive lifestyle changes reduced the odds of anxiety and depression. Conclusions A substantial proportion of patients have anxiety and depression symptoms after coronary heart disease events but these conditions are undertreated. These disorders, especially depression, are associated with other risk factors, including educational level, sedentary lifestyle, smoking, unhealthy diet and reduced compliance with risk factor modification.

  2. [Cardiovascular Risk Assessment: preliminary results].

    PubMed

    Palmieri, Luigi; Rielli, Rita; Demattè, Luca; Donfrancesco, Chiara; La Terza, Giampaolo; De Sanctis Caiola, Patrizia; Dima, Francesco; Lo Noce, Cinzia; Giannelli, Anna Maria; Brignoli, Ovidio; Cuffari, Alfredo; De Rosa, Marisa; Addis, Antonio; Laurendi, Giovanna; Giampaoli, Simona

    2010-02-01

    The Italian National Prevention plan includes 10-year cardiovascular risk (CR) assessment of the Italian general population aged 35-69 years using the CUORE Project risk score. A national training program for general practitioners (GPs) was launched by the Ministry of Health in 2003. GPs were encouraged to collect data on risk factors and risk assessment and to contribute to the CUORE Project Cardiovascular Risk Observatory (CRO). The aim of this analysis is to demonstrate the feasibility and effectiveness of risk assessment in primary care. The cuore.exe software, free of charge for GPs and easily downloadable from the CUORE Project web site (www.cuore.iss.it), is the frame for the GP data collection. The CRO provides a platform to analyze data collected on risk assessment and risk factors, and compare results at regional and national level in order to support health policy makers in their decision process. From January 2007 to April 2009, 2858 GPs have downloaded the cuore.exe software; 102,113 risk assessments were sent to the CRO based on risk factors profile of 87,556 persons (3617 persons had more than 1 risk assessment). Mean level of CR was 3.1% in women and 8.4% in men; 30% of men and 65% of women were at low risk (CR < 3%), 9% of men and 0.4% of women were found at high risk (CR > or = 20%). Among those with at least 2 risk assessments, 8% shifted to a lower class of risk after 1 year. Mean level of systolic and diastolic blood pressure decreased by about 1% in 1 year; total cholesterol more than 2%, and prevalence of smokers decreased by about 3% in the second risk assessment. These data demonstrate that risk assessment can be included as a first step of prevention in primary care. The CUORE Project individual score is expected to become an important tool for GPs to assess their patients' CR, to promote primary prevention, and to focus attention to healthy lifestyle adoption.

  3. Alcohol Consumption in Relation to Risk and Severity of Chronic Widespread Pain: Results From a UK Population‐Based Study

    PubMed Central

    Beasley, Marcus; Prescott, Gordon J.; McNamee, Paul; Hannaford, Philip C.; McBeth, John; Lovell, Karina; Keeley, Phil; Symmons, Deborah P. M.; Woby, Steve; Norrie, John

    2015-01-01

    Objective To determine whether the reported level of alcohol consumption is associated with the likelihood of reporting chronic widespread pain (CWP) and, among persons with CWP, the associated disability. Methods In a population‐based study in 2 areas of the UK, participants self‐completed a postal questionnaire. They were classified according to whether they met the American College of Rheumatology definition of CWP and whether the pain was disabling (Chronic Pain Grade III or IV). They reported their usual level of alcohol consumption. Potential confounding factors on which information was available included age, sex, cigarette smoking, employment status, self‐reported weight and height, and level of deprivation. Results A total of 13,574 persons participated (mean age 55 years, 57% women) of whom 2,239 (16.5%) had CWP; 28% reported never regularly consuming alcohol, 28% reported consuming up to 5 units/week, 20% reported 6–10 units/week, and 24% reported >10 units/week. Among persons with CWP, disability was strongly linked to level of alcohol consumption. Prevalence of disability decreased with increasing alcohol consumption up to 35 units/week (odds ratio [OR]21–35 units alcohol/week versus never drinkers 0.33 [95% confidence interval (95% CI) 0.19–0.58]) adjusted for confounders. A similar relationship was found between reporting CWP and level of alcohol consumption (adjusted OR21–35 units alcohol/week versus never drinkers 0.76 [95% CI 0.61–0.94]). Conclusion This study has demonstrated strong associations between level of alcohol consumption and both CWP and related disabilities. However, the available evidence does not allow us to conclude that the association is causal. The strength of the associations means that specific studies to examine this potential relationship are warranted. PMID:26212017

  4. Health-related behaviours of people with diabetes and those with cardiometabolic risk factors: results from SHIELD.

    PubMed

    Green, A J; Bazata, D D; Fox, K M; Grandy, S

    2007-11-01

    The study assessed knowledge, attitudes and behaviours towards health, diabetes, diet and exercise among respondents with type 2 diabetes mellitus and those with cardiometabolic risk factors. Respondents in the SHIELD study reported their health conditions, exercise, diet and weight loss. Three groups were assessed: (i) type 2 diabetes, (ii) high risk (HR) defined as 3-5 of the following factors: abdominal obesity, BMI > or = 28 kg/m(2), reported diagnosis of dyslipidaemia, hypertension, coronary heart disease or stroke and (iii) low risk (LR) defined as < or = 2 factors. Comparisons across groups were made using analysis of variance. More type 2 diabetes and HR respondents (> 46%) received recommendations to change their lifestyle habits (increase exercise and change eating habits), compared with < 29% of LR respondents, p < 0.0001. Less than 25% of respondents agreed that type 2 diabetes is not as serious as type 1 diabetes and > 85% agreed that obesity can aggravate or contribute to onset of chronic conditions. Mean number of healthcare visits was highest in type 2 diabetes (11.0) than HR (9.4) and LR (6.1) groups, p < 0.05. Type 2 diabetes and HR respondents were least likely to report exercising regularly (26%), compared with LR (37%), p < 0.05. More type 2 diabetes (70%) and HR (72%) respondents reported trying to lose weight vs. LR respondents (55%), p < 0.05. Type 2 diabetes and HR respondents reported attitudes and knowledge conducive to good health, but the majority of respondents did not translate these positive traits into healthy behaviour with respect to diet, exercise and weight loss.

  5. Use of glucosamine and chondroitin supplements in relation to risk of colorectal cancer: Results from the Nurses’ Health Study and Health Professionals Follow-up Study

    PubMed Central

    Kantor, Elizabeth D.; Zhang, Xuehong; Wu, Kana; Signorello, Lisa B.; Chan, Andrew T.; Fuchs, Charles S.; Giovannucci, Edward L.

    2016-01-01

    Recent epidemiologic evidence has emerged to suggest that use of glucosamine and chondroitin supplements may be associated with reduced risk of colorectal cancer (CRC). We therefore evaluated the association between use of these non-vitamin, non-mineral supplements and risk of CRC in two prospective cohorts, the Nurses’ Health Study and Health Professionals Follow-up Study. Regular use of glucosamine and chondroitin was first assessed in 2002 and participants were followed until 2010, over which time 672 CRC cases occurred. Cox proportional hazards regression was used to estimate relative risks (RRs) within each cohort, and results were pooled using a random effects meta-analysis. Associations were comparable across cohorts, with a RR of 0.79 (95% CI: 0.63–1.00) observed for any use of glucosamine and a RR of 0.77 (95% CI: 0.59–1.01) observed for any use of chondroitin. Use of glucosamine in the absence of chondroitin was not associated with risk of CRC, whereas use of glucosamine + chondroitin was significantly associated with risk (RR: 0.77; 95% CI: 0.58–0.999). The association between use of glucosamine + chondroitin and risk of CRC did not change markedly when accounting for change in exposure status over follow-up (RR: 0.75; 95% CI: 0.58–0.96), nor did the association significantly vary by sex, aspirin use, body mass index, or physical activity. The association was comparable for cancers of the colon and rectum. Results support a protective association between use of glucosamine and chondroitin and risk of CRC. Further study is needed to better understand the chemopreventive potential of these supplements. PMID:27357024

  6. Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys

    PubMed Central

    2013-01-01

    Background Attempted and completed suicide constitute a major public health problem among young people world-wide, including South Africa (SA). Suicide attempt and completed suicide increase during the adolescent period. One in 5 adolescents considers attempting suicide, but statistics are frequently unreliable. Methods Data for this study were derived from the 2002 and 2008 South African Youth Risk Behaviour Surveys (YRBS). The study population comprised grades 8, 9, 10 and 11 students in governmental schools in the nine provinces of SA (N = 10,699 in 2002 and 10,270 in 2008). Key outcome measures were suicide ideation and suicide attempts. Results Of the total sample, 18% of the students in 2002 and 19% in 2008 reported to have seriously considered and/or made a plan to commit suicide during the past six months (Suicide ideation), whereas 18.5% of students in 2002 and 21.8% in 2008 reported that they had attempted suicide at least 1 time during the past six months. On both suicide measures girls have higher prevalence scores than boys, and older school learners score higher than younger learners. In addition, 32% of the learners reported feelings of sadness or hopelessness. These feelings contributed significantly to the explanation of suicide ideation and suicide attempt next to being the victim or actor in violent acts and illegal substance use. Conclusion The prevalence of suicide ideation and suicide attempts among South African adolescents is high and seems to be influenced by a wide spectrum of factors at the demographic, psychological and behavioural level. Hence, more research is needed to determine the behavioural and psychological determinants of suicide among youngsters in order to develop comprehensive intervention strategies for suicide prevention and care. PMID:24093214

  7. Age- and risk-related appropriateness of the use of available influenza vaccines in the Italian elderly population is advantageous: results from a budget impact analysis

    PubMed Central

    BARBIERI, M.; CAPRI, S.; WAURE, C. DE; BOCCALINI, S.; PANATTO, D.

    2017-01-01

    Summary Introduction Nowadays, four different types of influenza vaccines are available in Italy: trivalent (TIV), quadrivalent (QIV), MF59-adjuvanted (aTIV) and intradermal TIV (idTIV) inactivated vaccines. Recently, a concept of the appropriateness (i.e. according to the age and risk factors) of the use of different vaccines has been established in Italy. We conducted a budget impact analysis of switching to a policy, in which the Italian elderly (who carry the major disease burden) received the available vaccines according to their age and risk profile. Methods A novel budget impact model was constructed with a time horizon of one influenza season. In the reference scenario the cohort of Italian elderly individuals could receive either available vaccine according to 2017/18 season market share. The alternative scenario envisaged the administration of TIV/QIV to people aged 65-74 years and at low risk of developing influenza-related complications, while aTIV/idTIV were allocated to high-risk 65-74-year-olds and all subjects aged ≥ 75 years. Results Switching to the alternative scenario would result in both significant health benefits and net budget savings. Particularly, it would be possible to prevent an additional 8201 cases of laboratory-confirmed influenza, 988 complications, 355 hospitalizations and 14 deaths. Despite the alternative strategy being associated with slightly higher vaccination costs, the total savings derived from fewer influenza events completely resets this increase with net budget savings of € 0.13 million. Conclusions An immunization policy in which influenza vaccines are administered according to the age and risk profile of Italian elderly individuals is advisable. PMID:29707658

  8. Age- and risk-related appropriateness of the use of available influenza vaccines in the Italian elderly population is advantageous: results from a budget impact analysis.

    PubMed

    Barbieri, M; Capri, S; Waure, C DE; Boccalini, S; Panatto, D

    2017-12-01

    Nowadays, four different types of influenza vaccines are available in Italy: trivalent (TIV), quadrivalent (QIV), MF59-adjuvanted (aTIV) and intradermal TIV (idTIV) inactivated vaccines. Recently, a concept of the appropriateness (i.e. according to the age and risk factors) of the use of different vaccines has been established in Italy. We conducted a budget impact analysis of switching to a policy, in which the Italian elderly (who carry the major disease burden) received the available vaccines according to their age and risk profile. A novel budget impact model was constructed with a time horizon of one influenza season. In the reference scenario the cohort of Italian elderly individuals could receive either available vaccine according to 2017/18 season market share. The alternative scenario envisaged the administration of TIV/QIV to people aged 65-74 years and at low risk of developing influenza-related complications, while aTIV/idTIV were allocated to high-risk 65-74-year-olds and all subjects aged ≥ 75 years. Switching to the alternative scenario would result in both significant health benefits and net budget savings. Particularly, it would be possible to prevent an additional 8201 cases of laboratory-confirmed influenza, 988 complications, 355 hospitalizations and 14 deaths. Despite the alternative strategy being associated with slightly higher vaccination costs, the total savings derived from fewer influenza events completely resets this increase with net budget savings of € 0.13 million. An immunization policy in which influenza vaccines are administered according to the age and risk profile of Italian elderly individuals is advisable.

  9. Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys.

    PubMed

    Shilubane, Hilda N; Ruiter, Robert A C; van den Borne, Bart; Sewpaul, Ronel; James, Shamagonam; Reddy, Priscilla S

    2013-10-04

    Attempted and completed suicide constitute a major public health problem among young people world-wide, including South Africa (SA). Suicide attempt and completed suicide increase during the adolescent period. One in 5 adolescents considers attempting suicide, but statistics are frequently unreliable. Data for this study were derived from the 2002 and 2008 South African Youth Risk Behaviour Surveys (YRBS). The study population comprised grades 8, 9, 10 and 11 students in governmental schools in the nine provinces of SA (N = 10,699 in 2002 and 10,270 in 2008). Key outcome measures were suicide ideation and suicide attempts. Of the total sample, 18% of the students in 2002 and 19% in 2008 reported to have seriously considered and/or made a plan to commit suicide during the past six months (Suicide ideation), whereas 18.5% of students in 2002 and 21.8% in 2008 reported that they had attempted suicide at least 1 time during the past six months. On both suicide measures girls have higher prevalence scores than boys, and older school learners score higher than younger learners. In addition, 32% of the learners reported feelings of sadness or hopelessness. These feelings contributed significantly to the explanation of suicide ideation and suicide attempt next to being the victim or actor in violent acts and illegal substance use. The prevalence of suicide ideation and suicide attempts among South African adolescents is high and seems to be influenced by a wide spectrum of factors at the demographic, psychological and behavioural level. Hence, more research is needed to determine the behavioural and psychological determinants of suicide among youngsters in order to develop comprehensive intervention strategies for suicide prevention and care.

  10. Results from Numerical General Relativity

    NASA Technical Reports Server (NTRS)

    Baker, John G.

    2011-01-01

    For several years numerical simulations have been revealing the details of general relativity's predictions for the dynamical interactions of merging black holes. I will review what has been learned of the rich phenomenology of these mergers and the resulting gravitational wave signatures. These wave forms provide a potentially observable record of the powerful astronomical events, a central target of gravitational wave astronomy. Asymmetric radiation can produce a thrust on the system which may accelerate the single black hole resulting from the merger to high relative velocity.

  11. Universal screening for Lynch syndrome among patients with colorectal cancer: Patient perspectives on screening and sharing results with at-risk relatives

    PubMed Central

    Hunter, Jessica Ezzell; Arnold, Kathleen A.; Cook, Jennifer E.; Zepp, Jamilyn; Gilmore, Marian J.; Rope, Alan F.; Davis, James V.; Bergen, Kellene M.; Esterberg, Elizabeth; Muessig, Kristin R.; Peterson, Susan K.; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia; Reiss, Jacob; Goddard, Katrina A.B.

    2018-01-01

    Universal screening for Lynch syndrome (LS) among all cases of colorectal cancer (CRC) could increase the diagnosis of LS and reduce morbidity and mortality of LS-associated cancers. Given universal screening includes all patients, irrespective of high risk factors such early age at onset or family history of CRC, it is important to understand perspectives of all patients and not just those at high risk. As part of a study to assess the feasibility and implementation of universal screening, 189 patients newly diagnosed with CRC were surveyed about their interest in screening for LS and communication of results with at-risk family members. Overall, participants responded positively regarding screening for LS, with most wanting to know their genetic risks in general (86%) and risk of hereditary CRC (93%). Prior to receiving screening results, most participants stated they intended to share their screening results with parents (89%), siblings (96%), and children (96%). Of the 28 participants who received a positive LS screening result, 26 (93%) reported sharing their result with at least one first-degree family member. Interest in screening for LS and communication of screening results with family members was not associated with high risk factors. This study indicates that patients are interested in being screened for LS and that sharing information on the risk of LS with at-risk family members is not a significant barrier. These findings provide novel insight into patient perspectives about screening for LS and can guide successful implementation of universal screening programs. PMID:28176204

  12. Long-term Results and Recurrence-Related Risk Factors for Crohn Disease in Patients Undergoing Side-to-Side Isoperistaltic Strictureplasty.

    PubMed

    Fazi, Marilena; Giudici, Francesco; Luceri, Cristina; Pronestì, Micaela; Tonelli, Francesco

    2016-05-01

    Side-to-side isoperistaltic strictureplasty (SSIS) is useful in patients undergoing surgery for Crohn disease (CD) to avoid wide small-bowel resections. To our knowledge, there are no definitive data regarding its recurrence risk factors. To evaluate the results obtained in a monocentric population of patients with CD who have undergone SSIS. From August 1996 to March 2010, 91 patients with CD underwent SSIS in our center. In this prospective observational study, side-to-side isoperistaltic strictureplasty was according the Michelassi technique in 69 patients and the Tonelli technique in 22 patients. Factors relating to the patient and the CD, surgery, and pharmacological therapy during the preoperative and perioperative periods were evaluated in association with medical or surgical recurrence. Side-to-side isoperistaltic strictureplasty. The recurrence-free curve was estimated using Kaplan-Meier analysis. Patients were stratified into cohorts in relation to the considered categorical variables and data were compared by using the Mantel-Cox log-rank test. Cox proportional hazard regression analysis was used to set up a predictive model simultaneously exploring the effects of all independent variables on a dichotomous outcome recurrence in relation to time. Among the 91 patients, the mean (SD) age was 39.5 (11.2) years and preoperative disease duration was 97.9 (85.8) months; 83 patients (91.2%) were followed up, of whom 37 (44.58%) experienced a recurrence at a mean (SD) of 55.46 (36.79) months after surgery (range, 9-140 months). The recurrence in the SSIS site at a mean (SD) of 48.25 (29.94) months after surgery affected 24 of 83 patients (28.9%), 9 being medical and 15 being surgical recurrence. Recurrence in the SSIS was statistically significantly associated with the time elapsed between diagnosis and surgery (P = .03). A borderline association between family history of CD and surgical recurrence (P = .054) was also found. Multivariate analysis

  13. Health risks related to illegal and on-line sale of drugs and food supplements: results of a survey on marketed products in Italy from 2011 to 2013.

    PubMed

    Gaudiano, Maria Cristina; Manna, Livia; Bartolomei, Monica; Rodomonte, Andrea Luca; Bertocchi, Paola; Antoniella, Eleonora; Romanini, Laura; Alimonti, Stefano; Rufini, Leandro; Valvo, Luisa

    2016-01-01

    The increasing illegal and on-line market of medicines and food supplements is helping the widespread diffusion of harmful counterfeit and forbidden products among consumers of developed countries. The objectives of this survey were the description of the main frauds recognized by public officers and the detection of illegal or counterfeit drugs and food supplements. Medicines and food supplements found by Police forces on the illegal market or resulting from seizures made by Italian Customs authorities were visually inspected and analysed to evaluate their quality and the presence of other undeclared substances. The visual inspection and the chemical analysis revealed unsuitable packaging (mostly lacking of adequate information for consumers), absence of the declared active substances and presence of undeclared active substances. Products containing doping agents, illegal substances and active ingredients requiring medical supervision were found. The present work confirmed the health risk associated with assumption of medicines purchased on the Internet and from the illegal supply chain and evidenced a new threat to consumer safety related to the presence of pharmaceutical active ingredients in food supplements claiming to contain only "natural ingredients".

  14. Relation among HPA and HPG neuroendocrine systems, transmissible risk and neighborhood quality on development of substance use disorder: results of a 10-year prospective study.

    PubMed

    Tarter, Ralph E; Kirisci, Levent; Kirillova, Galina; Reynolds, Maureen; Gavaler, Judy; Ridenour, Ty; Horner, Michelle; Clark, Duncan; Vanyukov, Michael

    2013-01-01

    Research has shown involvement of hormones of the hypothalamic pituitary adrenal (HPA) axis and hypothalamic pituitary gonadal (HPG) axis in the regulation of behaviors that contribute to SUD risk and its intergenerational transmission. Neighborhood environment has also been shown to relate to hormones of these two neuroendocrine systems and behaviors associated with SUD liability. Accordingly, it was hypothesized that (1) parental SUD severity and neighborhood quality correlate with activity of the HPG axis (testosterone level) and HPA axis (cortisol stability), and (2) transmissible risk during childhood mediates these hormone variables on development of SUD measured in adulthood. Transmissible risk for SUD measured by the transmissible liability index (TLI; Vanyukov et al., 2009) along with saliva cortisol and plasma testosterone were prospectively measured in boys at ages 10-12 and 16. Neighborhood quality was measured using a composite score encompassing indicators of residential instability and economic disadvantage. SUD was assessed at age 22. Neither hormone variable cross-sectionally correlated with transmissible risk measured at ages 10-12 and 16. However, the TLI at age 10-12 predicted testosterone level and cortisol stability at age 16. Moreover, testosterone level, correlated with cortisol stability at age 16, predicted SUD at age 22. HPA and HPG axes activity do not underlie variation in TLI, however, high transmissible risk in childhood predicts neuroendocrine system activity presaging development of SUD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. HIV-related risk factors among black African migrants and refugees in Christchurch, New Zealand: results from the Mayisha-NZ survey.

    PubMed

    Birukila, Gerida; Brunton, Cheryl; Dickson, Nigel

    2013-06-14

    To describe the demographic characteristics of, and HIV-related risk behaviours among, black African migrants and refugees in Christchurch. A cross-sectional survey of black African migrants and refugees in Christchurch was carried out. Ten trained African community researchers recruited study participants in social venues and events frequented by Africans. A short self-completed questionnaire collected data on demographic characteristics, previous HIV testing, HIV risk perception, previous STI diagnosis, utilization of health services and sexual behaviours. Valid questionnaires were obtained from 245 respondents (150 men and 95 women) with a mean age of 28 years (range 16 to 58). Participants came from 13 different African countries. Risk factors for HIV identified in this study included: low condom use, low HIV risk perception, having more than one sexual partner, previous STI diagnosis and lack of voluntary testing for HIV. Our findings justify the need for developing an HIV prevention strategy for black Africans in New Zealand that is informed by local evidence. This strategy should also address sexual health needs of Africans including barriers to condom use, the availability of HIV/STI screening services and targeting sexual behaviours that increase vulnerability to HIV infection.

  16. Absolute and relative risk of cardiovascular disease in men with prostate cancer: results from the Population-Based PCBaSe Sweden.

    PubMed

    Van Hemelrijck, Mieke; Garmo, Hans; Holmberg, Lars; Ingelsson, Erik; Bratt, Ola; Bill-Axelson, Anna; Lambe, Mats; Stattin, Pär; Adolfsson, Jan

    2010-07-20

    Cardiovascular disease (CVD) is a potential adverse effect of endocrine treatment (ET) for prostate cancer (PC). We investigated absolute and relative CVD risk in 76,600 patients with PC undergoing ET, curative treatment, or surveillance. PCBaSe Sweden is based on the National Prostate Cancer Register, which covers more than 96% of PC cases. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) of ischemic heart disease (IHD), acute myocardial infarction (MI), arrhythmia, heart failure, and stroke were calculated to compare observed and expected (using total Swedish population) numbers of CVD, taking into account age, calendar time, and previous CVD. Between 1997 and 2007, 30,642 patients with PC received primary ET, 26,432 curative treatment, and 19,527 surveillance. SIRs for CVD were elevated in all men with the highest for those undergoing ET, independent of circulatory disease history (SIR MI for men without circulatory disease history: 1.40 [95% CI, 1.31 to 1.49], 1.15 [95% CI, 1.01 to 1.31], and 1.20 [95% CI, 1.11 to 1.30] for men undergoing ET, curative treatment, and surveillance, respectively). Absolute risk differences (ARD) showed that two (arrhythmia) to eight (IHD) extra cases of CVD would occur per 1,000 person-years. SMRs showed similar patterns, with ARD of zero (arrhythmia) to three (IHD) per 1,000 person-years. Increased relative risks of nonfatal and fatal CVD were found among all men with PC, especially those treated with ET. Because ET is currently the only effective treatment for metastatic disease and the ARDs were rather small, our findings indicate that CVD risk should be considered when prescribing ET but should not constitute a contraindication when the expected gain is tangible.

  17. Evidence of increased STI/HIV-related risk behavior among male perpetrators of intimate partner violence in Guatemala: results from a national survey.

    PubMed

    Hembling, John; Andrinopoulos, Katherine

    2014-01-01

    Intimate partner violence (IPV) is a significant public health problem with a demonstrated link to increased sexually transmitted infection (STI)/HIV-related risk and vulnerability. While IPV is an important issue in Central America, the link to STI/HIV risk has not been explored in this region. In this study, the relationship between emotional and physical/sexual IPV and the STI/HIV-related risk behaviors of sex worker patronage and infidelity is assessed among male IPV perpetrators using data from a national survey conducted in 2009 in Guatemala (n = 4773 married/partnered men). Bivariate associations between background characteristics and emotional and physical IPV perpetration were explored. Logistic regression models were run to test associations between IPV for each sexual risk behavior. Perpetration of emotional and physical/sexual IPV was more common among married/partnered men who were older than 24, had more education, lived in urban areas, or were in common law versus married unions. Reports of past-year emotional IPV perpetration increased as wealth quintile increased. After adjusting for demographics and other characteristics, physical/sexual IPV perpetration was associated with past-year infidelity (AOR 1.9, 95% CI: 1.1-3.6). Lifetime emotional IPV (AOR 1.4, 95% CI: 1.1-1.7) and physical/sexual IPV 1.6 (95% CI 1.2-2.0) were positively associated with a history of sex worker patronage. Endorsement of traditional gender role norms showed a marginally positive association with past-year infidelity in the adjusted model (AOR 1.3, 95% CI 1.0-1.8). The study findings from Guatemala reinforce the growing evidence globally that male IPV perpetrators are more likely to engage in risky sexual behavior, including sex worker patronage and main partner infidelity. The concurrency of violence and increased STI/HIV risk may compound the health risks for female victims of IPV who also face injury and psychological trauma. Integration of prevention and screening of

  18. Roadway related tort liability and risk management.

    DOT National Transportation Integrated Search

    2010-06-01

    This workbook provide government employees background information related to tort liability and risk management. Past experience with lawsuits against government entities are summarized. The reasons for the lawsuits and results are analyzed. The obje...

  19. Diet and physical activity in people with intermediate cardiovascular risk and their relationship with the health-related quality of life: results from the MARK study.

    PubMed

    Sanchez-Aguadero, Natalia; Alonso-Dominguez, Rosario; Garcia-Ortiz, Luis; Agudo-Conde, Cristina; Rodriguez-Martin, Carmela; de Cabo-Laso, Angela; Sanchez-Salgado, Benigna; Ramos, Rafel; Maderuelo-Fernandez, Jose A; Gomez-Marcos, Manuel A; Recio-Rodriguez, Jose I

    2016-12-07

    To analyze the interplay between diet, physical activity and health-related quality of life in a Spanish randomly selected sample of individuals attended in general practitioners offices with intermediate cardiovascular risk. This study analyzed 314 subjects, aged 35-74 years (50.6% women), from the MARK study, conducted in Spain. Health related quality of life was measured by the SF-12 questionnaire. The assessment of the lifestyles included the diet quality index, the adherence to the Mediterranean diet and the leisure time physical activity practice. The highest values of health related quality of life were obtained in the area of vitality (51.05 ± 11.13), while the lowest were found in the general health (39.89 ± 8.85). In the multiple linear regression analysis, after adjustment for age, gender and other confounders, for each point of increase in the Mediterranean diet adherence score, there was an increase of 1.177 points in the mental component value (p < 0.01). Similarly, for each point of increase in the Diet Quality Index Score, there was an increase in the mental component of 0.553 (p < 0.05). Likewise, the physical activity was positively associated with the physical function and vitality (β = 0.090 and 0.087, (p < 0.01 and p < 0.05), respectively). In people with intermediate cardiovascular risk, better food habits and greater adherence to the Mediterranean diet are associated with higher scores on the mental component of quality of life. Likewise, increased physical activity is related with positive scores on the physical function.

  20. Patient, virus, and treatment-related risk factors in pediatric adenovirus infection after stem cell transplantation: results of a routine monitoring program.

    PubMed

    Mynarek, Martin; Ganzenmueller, Tina; Mueller-Heine, Annika; Mielke, Christopher; Gonnermann, Andrea; Beier, Rita; Sauer, Martin; Eiz-Vesper, Britta; Kohstall, Ute; Sykora, Karl-Walter; Heim, Albert; Maecker-Kolhoff, Britta

    2014-02-01

    Human adenovirus (HAdV) infection after hematopoietic stem cell transplantation (HSCT) is associated with significant morbidity and mortality in children. The optimal surveillance and treatment strategies are under discussion. Here, we present data from 238 consecutive pediatric allogeneic HSCT recipients who underwent transplantation in a single center who were included in a prospective, weekly HAdV DNAemia monitoring program by quantitative PCR. HAdV loads >1000 copies/mL were detected in 15.5% of all patients. Despite a low mortality directly attributed to HAdV infection (2 patients, 0.84%), blood HAdV loads >10,000 copies/mL (6.7% of all patients) were significant and independent risk factors for poor survival. We searched for patient, virus, and treatment-related risk factors of HAdV DNAemia and disease. Detection of HAdV in blood before day 50 post transplantation was a major independent risk factor for the development of blood HAdV loads >10,000 copies/mL. HAdV typing revealed A31, C1, and C2 as the predominant pathogens among several other HAdV strains with type C species detected in most patients with severe HAdV disease. Stool HAdV loads were prospectively monitored in 111 patients and correlated with but did not significantly precede detection in blood. Treatment with cidofovir led to stable or reduced viral load in 70% of patients with blood HAdV loads >1000 copies/mL. Thus, early occurrence of HAdV-DNA in blood of pediatric HSCT recipients predisposes for development of high viral loads. Control of HAdV infections was attempted by preemptive cidofovir treatment of patients with high blood HAdV loads or with symptomatic organ infections and correlated with low HAdV-attributed mortality. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  1. Middle School Risk Behavior 1995 Survey Results.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Instruction, Raleigh. Div. of Accountability Services/Research.

    The Youth Risk Behavior Survey (YRBS) Middle School Questionnaire, produced by the National Centers for Disease Control and Prevention, was administered for the first time in North Carolina in 1995. The survey monitored high-priority health-risk behaviors, including: (1) weapons and violence; (2) suicide-related behaviors; (3) vehicle safety; (4)…

  2. Calculating excess lifetime risk in relative risk models.

    PubMed

    Vaeth, M; Pierce, D A

    1990-07-01

    When assessing the impact of radiation exposure it is common practice to present the final conclusions in terms of excess lifetime cancer risk in a population exposed to a given dose. The present investigation is mainly a methodological study focusing on some of the major issues and uncertainties involved in calculating such excess lifetime risks and related risk projection methods. The age-constant relative risk model used in the recent analyses of the cancer mortality that was observed in the follow-up of the cohort of A-bomb survivors in Hiroshima and Nagasaki is used to describe the effect of the exposure on the cancer mortality. In this type of model the excess relative risk is constant in age-at-risk, but depends on the age-at-exposure. Calculation of excess lifetime risks usually requires rather complicated life-table computations. In this paper we propose a simple approximation to the excess lifetime risk; the validity of the approximation for low levels of exposure is justified empirically as well as theoretically. This approximation provides important guidance in understanding the influence of the various factors involved in risk projections. Among the further topics considered are the influence of a latent period, the additional problems involved in calculations of site-specific excess lifetime cancer risks, the consequences of a leveling off or a plateau in the excess relative risk, and the uncertainties involved in transferring results from one population to another. The main part of this study relates to the situation with a single, instantaneous exposure, but a brief discussion is also given of the problem with a continuous exposure at a low-dose rate.

  3. Calculating excess lifetime risk in relative risk models.

    PubMed Central

    Vaeth, M; Pierce, D A

    1990-01-01

    When assessing the impact of radiation exposure it is common practice to present the final conclusions in terms of excess lifetime cancer risk in a population exposed to a given dose. The present investigation is mainly a methodological study focusing on some of the major issues and uncertainties involved in calculating such excess lifetime risks and related risk projection methods. The age-constant relative risk model used in the recent analyses of the cancer mortality that was observed in the follow-up of the cohort of A-bomb survivors in Hiroshima and Nagasaki is used to describe the effect of the exposure on the cancer mortality. In this type of model the excess relative risk is constant in age-at-risk, but depends on the age-at-exposure. Calculation of excess lifetime risks usually requires rather complicated life-table computations. In this paper we propose a simple approximation to the excess lifetime risk; the validity of the approximation for low levels of exposure is justified empirically as well as theoretically. This approximation provides important guidance in understanding the influence of the various factors involved in risk projections. Among the further topics considered are the influence of a latent period, the additional problems involved in calculations of site-specific excess lifetime cancer risks, the consequences of a leveling off or a plateau in the excess relative risk, and the uncertainties involved in transferring results from one population to another. The main part of this study relates to the situation with a single, instantaneous exposure, but a brief discussion is also given of the problem with a continuous exposure at a low-dose rate. PMID:2269245

  4. Risk and protective factors of health-related quality of life in children and adolescents: Results of the longitudinal BELLA study.

    PubMed

    Otto, Christiane; Haller, Anne-Catherine; Klasen, Fionna; Hölling, Heike; Bullinger, Monika; Ravens-Sieberer, Ulrike

    2017-01-01

    Cross-sectional studies demonstrated associations of several sociodemographic and psychosocial factors with generic health-related quality of life (HRQoL) in children and adolescents. However, little is known about factors affecting the change in child and adolescent HRQoL over time. This study investigates potential psychosocial risk and protective factors of child and adolescent HRQoL based on longitudinal data of a German population-based study. Data from the BELLA study gathered at three measurement points (baseline, 1-year and 2-year follow-ups) were investigated in n = 1,554 children and adolescents aged 11 to 17 years at baseline. Self-reported HRQoL was assessed by the KIDSCREEN-10 Index. We examined effects of sociodemographic factors, mental health problems, parental mental health problems, as well as potential personal, familial, and social protective factors on child and adolescent HRQoL at baseline as well as over time using longitudinal growth modeling. At baseline, girls reported lower HRQoL than boys, especially in older participants; low socioeconomic status and migration background were both associated with low HRQoL. Mental health problems as well as parental mental health problems were negatively, self-efficacy, family climate, and social support were positively associated with initial HRQoL. Longitudinal analyses revealed less increase of HRQoL in girls than boys, especially in younger participants. Changes in mental health problems were negatively, changes in self-efficacy and social support were positively associated with the change in HRQoL over time. No effects were found for changes in parental mental health problems or in family climate on changes in HRQoL. Moderating effects for self-efficacy, family climate or social support on the relationships between the investigated risk factors and HRQoL were not found. The risk factor mental health problems negatively and the resource factors self-efficacy and social support positively affect the

  5. Pap smear in the prevention of HPV-related anal cancer: preliminary results of the study in a male population at risk.

    PubMed

    Pisano, Luigi; Tiradritti, Luana; Lorenzoni, Elisa; Zuccati, Giuliano; Matucci, Marzia; Butera, Daniela; Foxi, Prassede; Confortini, Massimo

    2016-12-01

    The aim of this work was to evaluate the role of human papillomavirus (HPV) testing and anal cytology, considering a population of HIV-positive and negative men who have sex with men (MSM), at high risk of sexually transmitted diseases (STD), in order to ascertain which of the methods examined is the best screening strategy for the prevention of anal cancer. In the period 06/2013-07/2014 at the "MTS Centre" of the University of Florence, 87 male patients, homo/bi-sexual, of which 46 HIV-negative and 41 HIV-positive, were recruited for anal Pap smear and HPV testing. All patients with an "abnormal" cytological result underwent anoscopy with possible biopsy. HPV testing was positive in 73 patients (83.6%). Cytology was negative in 50 patients (57.5%), inconclusive in 14 patients (16.1%), abnormal in 23 patients (26.4%): 14 ASC-US (19.2%), 4 ASC-H (5.5%), 5 L-SIL (6.8%), 0 H-SIL. Anoscopy with biopsy led to diagnosis of AIN I in 10 cases, of which 6 ASC-US+ and 4L-SIL+, AIN II in only 1 case, LS-IL+. Anal HPV testing, when used in primary screening, lead to a high number of "false positives", given the too high prevalence of HPV infection in MSM, the highest risk population targeted for screening. So we propose a screening program with anal cytology which has a high sensitivity for detection of AIN while is a poor predictor of the severity of these lesions; therefore, all patients with abnormal anal Pap smear should undergo anoscopy with biopsy.

  6. [The relationship of work-related psychosocial risk factors with depressive symptoms among Hungarian workers: preliminary results of the Hungarian Work Stress Survey].

    PubMed

    Nistor, Katalin; Nistor, Anikó; Ádám, Szilvia; Szabó, Anita; Konkolÿ Thege, Barna; Stauder, Adrienne

    2015-03-01

    Research has shown that psychosocial stress acts as a risk factor for mental disorders. The present study aims at processing the preliminary results of the Hungarian Survey of Work Stress, concerning the relationship between depressive symptoms and work stress. Cross-sectional survey among Hungarian workers was carried out (n = 1058, 27.5% man, 72.5% woman, age 37.2 years, SD = 11 years). Psychosocial factors were measured using the COPSOQ II questionnaire, while BDI-9 was used for the assessment of depressive symptoms. Statistical analysis was carried out applying Spearman's correlation and logistic regression. A quarter of the workers reported moderate or severe symptoms of depression (BDI≥19). The study confirmed the association between depressive symptoms and work-family conflict (OR = 2.21, CI: 1.82-2.68), possibilities for development (OR = 0.76, CI: 0.59-0.97) meaning of work (OR = 0.69, CI: 0.59-0.89) and commitment (OR = 0.60, CI: 0.47-0.78). The results point toward the need of such organizational measures that allow for the reduction of psychosocial stress.

  7. Assessing the Relative Risk of Aerocapture Using Probabalistic Risk Assessment

    NASA Technical Reports Server (NTRS)

    Percy, Thomas K.; Bright, Ellanee; Torres, Abel O.

    2005-01-01

    A recent study performed for the Aerocapture Technology Area in the In-Space Propulsion Technology Projects Office at the Marshall Space Flight Center investigated the relative risk of various capture techniques for Mars missions. Aerocapture has been proposed as a possible capture technique for future Mars missions but has been perceived by many in the community as a higher risk option as compared to aerobraking and propulsive capture. By performing a probabilistic risk assessment on aerocapture, aerobraking and propulsive capture, a comparison was made to uncover the projected relative risks of these three maneuvers. For mission planners, this knowledge will allow them to decide if the mass savings provided by aerocapture warrant any incremental risk exposure. The study focuses on a Mars Sample Return mission currently under investigation at the Jet Propulsion Laboratory (JPL). In each case (propulsive, aerobraking and aerocapture), the Earth return vehicle is inserted into Martian orbit by one of the three techniques being investigated. A baseline spacecraft was established through initial sizing exercises performed by JPL's Team X. While Team X design results provided the baseline and common thread between the spacecraft, in each case the Team X results were supplemented by historical data as needed. Propulsion, thermal protection, guidance, navigation and control, software, solar arrays, navigation and targeting and atmospheric prediction were investigated. A qualitative assessment of human reliability was also included. Results show that different risk drivers contribute significantly to each capture technique. For aerocapture, the significant drivers include propulsion system failures and atmospheric prediction errors. Software and guidance hardware contribute the most to aerobraking risk. Propulsive capture risk is mainly driven by anomalous solar array degradation and propulsion system failures. While each subsystem contributes differently to the risk of

  8. Intakes of Fruits, Vegetables, and Related Vitamins and Lung Cancer Risk: Results from the Shanghai Men's Health Study (2002–2009)

    PubMed Central

    Takata, Yumie; Xiang, Yong-Bing; Yang, Gong; Li, Honglan; Gao, Jing; Cai, Hui; Gao, Yu-Tang; Zheng, Wei; Shu, Xiao-Ou

    2013-01-01

    Most epidemiological studies evaluating the association of fruit and vegetable intakes on lung cancer risk were conducted in North American and European countries. We investigated the association of intakes of fruits, vegetables, dietary vitamins A and C, and folate with lung cancer risk among 61,491 Chinese adult men who were recruited to the Shanghai Men's Health Study, a population-based, prospective cohort study. Baseline dietary intake was assessed through a validated food frequency questionnaire during in-home visits. Multivariate Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of lung cancer risk associated with dietary intakes. During a median follow-up of 5.5 years, 359 incident lung cancer cases accrued after the first year of follow-up and 68.8% of them were current smokers. Intakes of green leafy vegetables, β-carotene-rich vegetables, watermelon, vitamin A, and carotenoids were inversely associated with lung cancer risk; the corresponding HR (95% CI) comparing the highest with the lowest quartiles were 0.72 (0.53–0.98), 0.69 (0.51–0.94), 0.65 (0.47–0.90), 0.63 (0.44–0.88), and 0.64 (0.46–0.88). Intake of all fruits and vegetables combined was marginally associated with lower risk. Our study suggests that the consumption of carotenoid-rich vegetables is inversely associated with lung cancer risk. PMID:23368913

  9. Age-related changes in physical fall risk factors: results from a 3 year follow-up of community dwelling older adults in Tasmania, Australia.

    PubMed

    Bird, Marie-Louise; Pittaway, Jane K; Cuisick, Isobel; Rattray, Megan; Ahuja, Kiran D K

    2013-11-11

    As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, and placing an escalating burden on health care systems. Sixty-nine independent community-dwelling adults (60-85 years, 18 males) had their leg strength, physical activity levels and their annual fall rate assessed at two timepoints over three years, (summer 2010 and summer 2013) monitoring balance. Force platform measures of medio-lateral sway range increased significantly under conditions of eyes open (mean difference MD 2.5 cm; 95% CI 2.2 to 2.8 cm) and eyes closed (MD 3.2 cm; 95% CI 2.8 to 3.6 cm), respectively (all p < 0.001) indicating worsening static balance control. Dynamic balance showed similar changes (p < 0.036). Leg strength was not significantly different between visits (p > 0.26). Physical activity reduced significantly (MD -909 Cal/week; 95% CI -347 to -1,470 Cal/week; p = 0.002) during the course of the study. Participants maintained aerobic activities, however resistance and balance exercise levels decreased non-significantly. The likelihood of falling was higher at the end of the study compared to the first timepoint (odds ratio 1.93, 95% CI 0.94 to 3.94; p = 0.07). Results of this study indicate that despite maintenance of leg strength there was an increase in medio-lateral sway over a relatively short time frame, with higher than expected increases in fall rates.

  10. Factors relating to pregnancy and birth and the risk of childhood brain tumors: results from an Australian case-control study.

    PubMed

    Greenop, Kathryn R; Blair, Eve M; Bower, Carol; Armstrong, Bruce K; Milne, Elizabeth

    2014-03-01

    Childhood brain tumors (CBT) are the leading cause of cancer death in children, yet their causes are largely known. This study investigated the association between maternal and birth characteristics and risk of CBT. Cases families were recruited from all 10 Australian pediatric oncology centers between 2005 and 2010. Control families were recruited via random-digit dialing, frequency matched to cases on the basis of child's age, sex, and State of residence. Maternal and birth characteristics of children were ascertained by questionnaires. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusting for relevant confounders. For this analysis, data on 319 case children and 1,079 control children were available. No association was found between risk of CBT and birth weight, fetal growth, birth order, gestational age, or maternal body mass index. The ORs for inadequate and excessive maternal gestational weight gain (GWG) (Institute of Medicine 2009 guidelines) were 1.8 (95% CI 1.2-2.6) and 1.4 (95% CI 1.0-2.1), respectively; similar findings for GWG were seen across categories of child's age, fetal growth, maternal body mass index and height, maternal smoking, and parental education. Risk of low grade glioma appeared increased with preterm birth (OR 1.6 (95% CI 0.8-3.1) and admission to neonatal intensive care (NICU) for >2 days (OR 1.7, 95% CI 0.9-3.6). We found little evidence of associations between risk of CBT and most birth characteristics. The associations we observed with GWG, prematurity and NICU admission require corroboration in other studies. © 2013 Wiley Periodicals, Inc.

  11. Preliminary Youth Risk Behavior Survey Results--1993.

    ERIC Educational Resources Information Center

    Johnson, Joyce, Comp.

    This paper provides the results of a 1993 survey of 2,684 New Hampshire high school students in regard to risk taking, personal violence, suicide, tobacco use, alcohol abuse, drug abuse, acquired immune deficiency syndrome (AIDS) education, sexual activity, nutrition, and exercise. It found that in the preceding 30 days, 10.8 percent of students…

  12. Low-Molecular-Weight Heparin and the Relative Risk of Surgical Site Bleeding Complications: Results of a Systematic Review and Meta-Analysis of Randomized Controlled Trials of Venous Thromboprophylaxis in Patients After Total Joint Arthroplasty.

    PubMed

    Suen, Kary; Westh, Roger N; Churilov, Leonid; Hardidge, Andrew J

    2017-09-01

    Venous thromboembolism causes significant morbidity and mortality in patients after total joint arthroplasty. Although network meta-analyses have demonstrated a benefit of various thromboprophylactic agents, there remains a concern in the surgical community regarding the resulting wound complications. There is currently no systematic review of the surgical site bleeding complications of thromboprophylactic agents. The aim of this study was to systematically review the surgical site bleeding outcomes of venous thromboembolism prophylaxis in this population. A systematic review and meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials comparing more than one of low-molecular-weight heparin (LMWH), warfarin, rivaroxaban, apixaban, dabigatran, aspirin, or no pharmacologic treatment in patients after total hip or knee arthroplasty were selected for inclusion. Five meta-analyses were performed to compare LMWH with control, warfarin, apixaban, rivaroxaban, and dabigatran. Forty-five randomized controlled trials of 56,730 patients were included. LMWH had a significantly increased relative risk of surgical site bleeding in comparison with control (relative risk, 2.32; 95% confidence interval, 1.40-3.85) and warfarin (1.54; 1.23-1.94). The relative risk of LMWH trended higher than apixaban (1.27; 1.00-1.63) and was similar to rivaroxaban (0.95; 0.74-1.23). Only 1 study reported the risk of surgical site bleeding in LMWH vs dabigatran (5.97; 2.08-17.11). LMWH increased the risk of surgical site bleeding compared with control, warfarin. and dabigatran and trended toward an increased risk compared with apixaban. The risk of surgical site bleeding was similar with LMWH and rivaroxaban. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Drastic increases in overweight and obesity from 1981 to 2010 and related risk factors: results from the Barbados Children's Health and Nutrition Study.

    PubMed

    Fernandez, Melissa Anne; Kubow, Stan; Gray-Donald, Katherine; Knight, JaDon; Gaskin, Pamela S

    2015-12-01

    To examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children. A cross-section of students were weighed and measured. The WHO BMI-for-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB. Barbados. Public-school students (n 580) in class 3. Based on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cut-offs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR=2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR=0·56; 95 % CI 0·36, 0·87). The sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados.

  14. Intake of α-linolenic acid and other fatty acids in relation to the risk of bladder cancer: results from the New Hampshire case–control study

    PubMed Central

    Brinkman, Maree T.; Karagas, Margaret R.; Zens, Michael S.; Schned, Alan R.; Reulen, Raoul C.; Zeegers, Maurice P.

    2012-01-01

    The role of dietary fat in bladder cancer aetiology is currently unclear due to few studies, equivocal findings and a lack of information on important dietary fatty acids. The aim of the present study was to investigate the association between the intake of major dietary fats and fatty acids and the risk of bladder cancer. A case–control study was conducted in New Hampshire, USA. Dietary data were collected from 322 cases and 239 controls, and OR and 95 % CI were calculated using unconditional logistic regression. Adjustment was made for potential confounders: sex, age, smoking status, pack-years smoked, cholesterol and energy intake. Statistically significant reduced odds of bladder cancer were observed for high intakes (highest quartile v. lowest quartile) of α-linolenic acid (ALA) (OR 0.26, 95% CI 0.10, 0.65; P for trend=0.01) and vegetable fat (OR 0.39, 95% CI 0.18, 0.86; P for trend=0.03). Borderline statistically significant reduced odds were detected for polyunsaturated fat (OR 0.43, 95% CI 0.19, 0.98; P for trend=0.07) and linoleic acid (OR 0.43, 95% CI 0.19, 0.96; P for trend=0.06). These fats and fatty acids were highly correlated and following adjustment for each other, the only potential inverse association to remain was for ALA. The present findings suggest that ALA may have a protective role against developing bladder cancer; however, further investigation and replication in other epidemiological studies are required. Future research should focus on the type, source and quantities of different dietary fatty acids consumed. PMID:21736846

  15. Intake of α-linolenic acid and other fatty acids in relation to the risk of bladder cancer: results from the New Hampshire case-control study.

    PubMed

    Brinkman, Maree T; Karagas, Margaret R; Zens, Michael S; Schned, Alan R; Reulen, Raoul C; Zeegers, Maurice P

    2011-10-01

    The role of dietary fat in bladder cancer aetiology is currently unclear due to few studies, equivocal findings and a lack of information on important dietary fatty acids. The aim of the present study was to investigate the association between the intake of major dietary fats and fatty acids and the risk of bladder cancer. A case-control study was conducted in New Hampshire, USA. Dietary data were collected from 322 cases and 239 controls, and OR and 95 % CI were calculated using unconditional logistic regression. Adjustment was made for potential confounders: sex, age, smoking status, pack-years smoked, cholesterol and energy intake. Statistically significant reduced odds of bladder cancer were observed for high intakes (highest quartile v. lowest quartile) of α-linolenic acid (ALA) (OR 0·26, 95 % CI 0·10, 0·65; P for trend = 0·01) and vegetable fat (OR 0·39, 95 % CI 0·18, 0·86; P for trend = 0·03). Borderline statistically significant reduced odds were detected for polyunsaturated fat (OR 0·43, 95 % CI 0·19, 0·98; P for trend = 0·07) and linoleic acid (OR 0·43, 95 % CI 0·19, 0·96; P for trend = 0·06). These fats and fatty acids were highly correlated and following adjustment for each other, the only potential inverse association to remain was for ALA. The present findings suggest that ALA may have a protective role against developing bladder cancer; however, further investigation and replication in other epidemiological studies are required. Future research should focus on the type, source and quantities of different dietary fatty acids consumed.

  16. Statistical analyses of the relative risk.

    PubMed Central

    Gart, J J

    1979-01-01

    Let P1 be the probability of a disease in one population and P2 be the probability of a disease in a second population. The ratio of these quantities, R = P1/P2, is termed the relative risk. We consider first the analyses of the relative risk from retrospective studies. The relation between the relative risk and the odds ratio (or cross-product ratio) is developed. The odds ratio can be considered a parameter of an exponential model possessing sufficient statistics. This permits the development of exact significance tests and confidence intervals in the conditional space. Unconditional tests and intervals are also considered briefly. The consequences of misclassification errors and ignoring matching or stratifying are also considered. The various methods are extended to combination of results over the strata. Examples of case-control studies testing the association between HL-A frequencies and cancer illustrate the techniques. The parallel analyses of prospective studies are given. If P1 and P2 are small with large samples sizes the appropriate model is a Poisson distribution. This yields a exponential model with sufficient statistics. Exact conditional tests and confidence intervals can then be developed. Here we consider the case where two populations are compared adjusting for sex differences as well as for the strata (or covariate) differences such as age. The methods are applied to two examples: (1) testing in the two sexes the ratio of relative risks of skin cancer in people living in different latitudes, and (2) testing over time the ratio of the relative risks of cancer in two cities, one of which fluoridated its drinking water and one which did not. PMID:540589

  17. Relativity Concept Inventory: Development, Analysis, and Results

    ERIC Educational Resources Information Center

    Aslanides, J. S.; Savage, C. M.

    2013-01-01

    We report on a concept inventory for special relativity: the development process, data analysis methods, and results from an introductory relativity class. The Relativity Concept Inventory tests understanding of relativistic concepts. An unusual feature is confidence testing for each question. This can provide additional information; for example,…

  18. Drugs and Alcohol: Their Relative Crash Risk

    PubMed Central

    Romano, Eduardo; Torres-Saavedra, Pedro; Voas, Robert B.; Lacey, John H.

    2014-01-01

    Objective: The purpose of this study was to determine (a) whether among sober (blood alcohol concentration [BAC] = .00%) drivers, being drug positive increases the drivers' risk of being killed in a fatal crash; (b) whether among drinking (BAC > .00%) drivers, being drug positive increases the drivers' risk of being killed in a fatal crash; and (c) whether alcohol and other drugs interact in increasing crash risk. Method: We compared BACs for the 2006, 2007, and 2008 crash cases drawn from the U.S. Fatality Analysis Reporting System (FARS) with control drug and blood alcohol data from participants in the 2007 U.S. National Roadside Survey. Only FARS drivers from states with drug information on 80% or more of the drivers who also participated in the 2007 National Roadside Survey were selected. Results: For both sober and drinking drivers, being positive for a drug was found to increase the risk of being fatally injured. When the drug-positive variable was separated into marijuana and other drugs, only the latter was found to contribute significantly to crash risk. In all cases, the contribution of drugs other than alcohol to crash risk was significantly lower than that produced by alcohol. Conclusions: Although overall, drugs contribute to crash risk regardless of the presence of alcohol, such a contribution is much lower than that by alcohol. The lower contribution of drugs other than alcohol to crash risk relative to that of alcohol suggests caution in focusing too much on drugged driving, potentially diverting scarce resources from curbing drunk driving. PMID:24411797

  19. Firefighter perceptions of cancer risk: Results of a qualitative study.

    PubMed

    Anderson, David A; Harrison, Tyler R; Yang, Fan; Wendorf Muhamad, Jessica; Morgan, Susan E

    2017-07-01

    Recent epidemiological research on firefighters indicates an increased incidence of specific types of cancer. Intervention is needed in the fire service yet little is known about how firefighters perceive their cancer risk. Participant observation (150 h, n = 100) and focus group (n = 17) data were collected from 15 fire stations in South Florida. Firefighters had at least 3 years of experience, ranks included drivers, captains, lieutenants, and specialty captains, with a median age of 51 years. From the qualitative analysis, two major categories (direct and indirect factors) for cancer risks emerged based on participant notions of cancer risk and cancer prevention behaviors as they relate to firefighting. Firefighters perceive cancer risks as the result of performing essential job tasks and from indirect job factors related to being a firefighter. The two categories of cancer risks suggest different points of entry for intervention. © 2017 Wiley Periodicals, Inc.

  20. Risk factors for age-related maculopathy.

    PubMed

    Connell, Paul P; Keane, Pearse A; O'Neill, Evelyn C; Altaie, Rasha W; Loane, Edward; Neelam, Kumari; Nolan, John M; Beatty, Stephen

    2009-01-01

    Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

  1. Results of a cluster randomised controlled trial to reduce risky use of alcohol, alcohol-related HIV risks and improve help-seeking behaviour among safety and security employees in the Western Cape, South Africa.

    PubMed

    Burnhams, Nadine Harker; London, Leslie; Laubscher, Ria; Nel, Elmarie; Parry, Charles

    2015-05-08

    To test the effectiveness of a programme aimed at reducing the risky use of alcohol and alcohol-related HIV risk and increase help-seeking behaviour among a sample of municipal employees in the Western Cape Province, South Africa. A clustered randomised controlled trial was conducted in 2011-2012 among 325 employees. The eight hour intervention, Team Awareness (TA), addressing behavioural risk among employees was administered to 168 employees in the intervention arm and the 157 employees in the control arm who received a one-hour wellness talk. The results show that TA had the greatest impact on risky drinking practices and hangover effects. There was a significant group × time interaction (F (1, 117) = 25.16, p<0.0001) with participants in the intervention condition reducing number of days on which they engaged in binge drinking. There was also a significant time effect with participants in the intervention condition reducing the likelihood of going to work with a hangover (F (1,117) = 4.10, p=0.045). No reduction in HIV-related risk behaviours were found. This intervention study was able to demonstrate a modest but significant reduction in risky drinking practices and hangover effects. This provides encouraging evidence for the effectiveness of interventions that address risky use of alcohol among employed persons, further providing a launch pad for strengthening and replicating future RCT studies on workplace prevention, especially in developing country settings. Pan-African Control Trial Registry (201301000458308) .

  2. NASA Space Radiation Risk Project: Overview and Recent Results

    NASA Technical Reports Server (NTRS)

    Blattnig, Steve R.; Chappell, Lori J.; George, Kerry A.; Hada, Megumi; Hu, Shaowen; Kidane, Yared H.; Kim, Myung-Hee Y.; Kovyrshina, Tatiana; Norman, Ryan B.; Nounu, Hatem N.; hide

    2015-01-01

    The NASA Space Radiation Risk project is responsible for integrating new experimental and computational results into models to predict risk of cancer and acute radiation syndrome (ARS) for use in mission planning and systems design, as well as current space operations. The project has several parallel efforts focused on proving NASA's radiation risk projection capability in both the near and long term. This presentation will give an overview, with select results from these efforts including the following topics: verification, validation, and streamlining the transition of models to use in decision making; relative biological effectiveness and dose rate effect estimation using a combination of stochastic track structure simulations, DNA damage model calculations and experimental data; ARS model improvements; pathway analysis from gene expression data sets; solar particle event probabilistic exposure calculation including correlated uncertainties for use in design optimization.

  3. Behavioural surveillance of sexually-related risk behaviours for the cross-border traveller population in Hong Kong: the evaluation of the overall effectiveness of relevant prevention programmes by comparing the results of two surveillance surveys.

    PubMed

    Lau, J T; Wong, W S

    2000-11-01

    The present study reports the results of 2 surveys of the first behavioural surveillance system (BSS) set up to monitor sexually-related risk behaviours practised by Hong Kong-China cross-border travellers. The 2 studies interviewed 1263 and 1448 male adult Hong Kong residents in 1997 and 1998 respectively. About one-third of the respondents had had sexual intercourse with a commercial sex worker (CSW) in the past 6 months; about 20% had had sexual intercourse with a CSW or a non-regular sex partner in a single trip; about 35-40% of the CSW clients had not used a condom during the intercourse and about 20% of the respondents reported that they had contracted STD. When the results of the 2 surveys were compared, no significant changes in the outcomes of the surveillance indicators were detected; instead, some unfavourable changes in terms of condom use were observed. The effectiveness of the relevant prevention programmes in Hong Kong is not evident.

  4. Denver Airport: Operating Results and Financial Risks

    DOT National Transportation Integrated Search

    1996-02-09

    Congress asked the General Accounting Office (GAO) to investigate the financial : viability of the Denver International Airport (DIA); more specifically to : (1) analyze the limited data available on actual results after DIA opened for : operations a...

  5. Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE).

    PubMed

    Stewart Williams, Jennifer; Kowal, Paul; Hestekin, Heather; O'Driscoll, Tristan; Peltzer, Karl; Yawson, Alfred; Biritwum, Richard; Maximova, Tamara; Salinas Rodríguez, Aarón; Manrique Espinoza, Betty; Wu, Fan; Arokiasamy, Perianayagam; Chatterji, Somnath

    2015-06-23

    In 2010 falls were responsible for approximately 80 % of disability stemming from unintentional injuries excluding traffic accidents in adults 50 years and over. Falls are becoming a major public health problem in low- and middle-income countries (LMICs) where populations are ageing rapidly. Nationally representative standardized data collected from adults aged 50 years and over participating in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 in China, Ghana, India, Mexico, the Russian Federation and South Africa are analysed. The aims are to identify the prevalence of, and risk factors for, past-year fall-related injury and to assess associations between fall-related injury and disability. Regression methods are used to identify risk factors and association between fall-related injury and disability. Disability was measured using the WHO Disability Assessment Schedule Version 2.0 (WHODAS 2.0). The prevalence of past-year fall-related injuries ranged from 6.6 % in India to 1.0 % in South Africa and was 4.0 % across the pooled countries. The proportion of all past-year injuries that were fall-related ranged from 73.3 % in the Russian Federation to 44.4 % in Ghana. Across the six countries this was 65.7 %. In the multivariable logistic regression, the odds of past-year fall-related injury were significantly higher for: women (OR: 1.27; 95 % CI: 0.99,1.62); respondents who lived in rural areas (OR: 1.36; 95 % CI: 1.06,1.75); those with depression (OR: 1.43; 95 % CI: 1.01,2.02); respondents who reported severe or extreme problems sleeping (OR: 1.54; 95 % CI: 1.15,2.08); and those who reported two or more (compared with no) chronic conditions (OR: 2.15; 95 % CI: 1.45,3.19). Poor cognition was also a significant risk factor for fall-related injury. The association between fall-related injury and the WHODAS measure of disability was highly significant (P<0.0001) with some attenuation after adjusting for confounders. Reporting two

  6. Will a quadruple multiplexed point-of-care screening strategy for HIV-related co-infections be feasible and impact detection of new co-infections in at-risk populations? Results from cross-sectional studies

    PubMed Central

    Pai, Nitika Pant; Dhurat, Rachita; Potter, Martin; Behlim, Tarannum; Landry, Geneviève; Vadnais, Caroline; Rodrigues, Camilla; Joseph, Lawrence; Shetty, Anjali

    2014-01-01

    Objectives Multiplexed point-of-care (POC) devices can rapidly screen for HIV-related co-infections (eg, hepatitis C (HCV), hepatitis B (HBV), syphilis) in one patient visit, but global evidence for this approach remains limited. This study aimed to evaluate a multiplex POC testing strategy to expedite screening for HIV-related co-infections in at-risk populations. Methods A multiplex strategy was developed with two subsequent versions of an investigational device Miriad. It was evaluated in two non-comparable settings and populations in two countries for feasibility of conduct, detection of new infections, preference and accuracy. Version 1 was evaluated in 375 sexually transmitted disease clinic attendees in Mumbai, India; version 2 was evaluated in 119 injection drug users in Montreal, Canada. Results Feasibility (completion rate) of the multiplex strategy was high (86.1% Mumbai; 92.4% Montreal). A total of 170 new infections were detected in Mumbai (56 HIV, 75 HBV, 37 syphilis, 2 HCV) versus 2 in Montreal. Preference was 60% in Mumbai and 97% in Montreal. Miriad version 1 specificities were high: HIV 99.7% (98.3% to 100%), HBV 99.3% (97.6% to 99.9%), HCV 99.7% (98.5% to 99.9%), syphilis 85.2% (80.9% to 88.8%); sensitivities were as follows: HIV 100% (94.8% to 100%), HBV 13.3% (6.6% to 23.2%), HCV 50% (1.3% to 98.7%), syphilis 86.1% (70.5% to 95.3%). With version 2, specificities improved: HIV 100% (97.2% to 100%), HBV 100% (97.3% to 100%), HCV 85.3% (73.8% to 93.0%), syphilis 98.1% (93.3% to 99.8%); sensitivities were: HIV 100% (47.3% to 100%), HCV 80.4% (66.1% to 90.6%), syphilis 100% (22.4% to 100%). Conclusions A quad multiplex POC strategy for HIV and co-infections was feasible to operationalise and preferred by patients in both settings. Many new infections were identified in Mumbai and accuracy improved with version 2 of the assay. Such a strategy will help expedite screening for co-infections, particularly where baseline screening is low. These findings

  7. Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

    PubMed Central

    Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

    2016-01-01

    In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

  8. Acceptability of Health Care-Related Risks: A Literature Review.

    PubMed

    Quintard, Bruno; Roberts, Tamara; Nitaro, Léa; Quenon, Jean-Luc; Michel, Philippe

    2016-03-01

    Risk management aims at reducing risks associated with hospital care to an acceptable level, both in their frequency and their impact on health. The social acceptability of risk on the part of the general population and of the health-care professionals, faced with regular information about adverse events, is undoubtedly evolving rapidly.In contrast to risk acceptability, the concept of risk perception is of limited interest to risk managers because it does not inform on the behaviors and actions resulting from these perceptions. The aim of this work was to define the concept of social acceptability of risk through an in-depth examination of a wide-ranging and multidisciplinary literature. A 1990-2010 English and French literature review was carried out in medical, epidemiological, and human and social sciences online databases, gray literature, and books. Of the 5931 references retrieved, 203 met the inclusion criteria. We identified contributions from 5 major research fields: economic, sociocognitive, psychometric, sociological/anthropological, and interactionist. When assessing risks, individuals use a variety of psychological and social processes that include their perception not only of a given risk but also of their own personal and social resources. This global perception has a direct impact on the responses and actual behavior of individuals and groups, enabling them to cope with the risk and/or manage it. Social acceptability includes perceptions related to risks and the stated intentions of individual behavior. This concept may therefore be relevant for defining local and national patient safety priorities.

  9. The effect of post-traumatic stress disorder on the risk of developing prescription opioid use disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III.

    PubMed

    Hassan, Ahmed N; Foll, Bernard Le; Imtiaz, Sameer; Rehm, Jürgen

    2017-10-01

    To evaluate the effect of baseline post-traumatic stress disorder (PTSD) and each symptoms cluster on the risk of developing opioid use disorder (OUD) in those exposed to opioid painkillers and to assess the effect of comorbid PTSD and OUD on functioning, OUD severity, and treatment seeking compared with individuals with OUD only. We obtained data from 4025 individuals exposed to opioid painkillers from the National Epidemiologic Survey on Alcohol and Related Conditions III. We matched individuals with baseline PTSD with individuals without PTSD on demographics, developmental background, family history, personalities, and exposure to stressful life events with propensity score methodology. We controlled for clinical diagnoses and other risk factors that may have occurred after PTSD onset. Quality of life was assessed with the SF-12; the number of diagnostic criteria met indicated OUD severity. Baseline PTSD predicted OUD after controlling for matching variables and other risk factors, including baseline mood/anxiety disorders and other substance use disorders (odds ratio[OR]: 1.58; 95% confidence interval[CI]: 1.14-2.17; p=0.02). Among individuals with PTSD, arousal/reactivity cluster predicted OUD. Individuals with comorbid PTSD and OUD had lower mean scores on the SF-12 scale and greater severity of OUD than individuals with OUD. There were no differences in help-seeking. Baseline PTSD increases the risk of developing OUD after exposure to opioid painkillers. Clinicians should screen for PTSD diagnosis and arousal/reactivity symptoms prior to prescribing painkillers. Integrated treatments are strongly recommended for patients with this dual diagnosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Prospective longitudinal evaluation of the effect of deployment-acquired traumatic brain injury on posttraumatic stress and related disorders: results from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    PubMed

    Stein, Murray B; Kessler, Ronald C; Heeringa, Steven G; Jain, Sonia; Campbell-Sills, Laura; Colpe, Lisa J; Fullerton, Carol S; Nock, Matthew K; Sampson, Nancy A; Schoenbaum, Michael; Sun, Xiaoying; Thomas, Michael L; Ursano, Robert J

    2015-11-01

    Traumatic brain injury (TBI) is increasingly recognized as a risk factor for deleterious mental health and functional outcomes. The purpose of this study was to examine the strength and specificity of the association between deployment-acquired TBI and subsequent posttraumatic stress and related disorders among U.S. Army personnel. A prospective, longitudinal survey of soldiers in three Brigade Combat Teams was conducted 1-2 months prior to an average 10-month deployment to Afghanistan (T0), upon redeployment to the United States (T1), approximately 3 months later (T2), and approximately 9 months later (T3). Outcomes of interest were 30-day prevalence postdeployment of posttraumatic stress disorder (PTSD), major depressive episode, generalized anxiety disorder, and suicidality, as well as presence and severity of postdeployment PTSD symptoms. Complete information was available for 4,645 soldiers. Approximately one in five soldiers reported exposure to mild (18.0%) or more-than-mild (1.2%) TBI(s) during the index deployment. Even after adjusting for other risk factors (e.g., predeployment mental health status, severity of deployment stress, prior TBI history), deployment-acquired TBI was associated with elevated adjusted odds of PTSD and generalized anxiety disorder at T2 and T3 and of major depressive episode at T2. Suicidality risk at T2 appeared similarly elevated, but this association did not reach statistical significance. The findings highlight the importance of surveillance efforts to identify soldiers who have sustained TBIs and are therefore at risk for an array of postdeployment adverse mental health outcomes, including but not limited to PTSD. The mechanism(s) accounting for these associations need to be elucidated to inform development of effective preventive and early intervention programs.

  11. The effect of graphical and numerical presentation of hypothetical prenatal diagnosis results on risk perception.

    PubMed

    Siegrist, Michael; Orlow, Pascale; Keller, Carmen

    2008-01-01

    To evaluate various formats for the communication of prenatal test results. In study 1 (N=400), female students completed a questionnaire assessing risk perception, affect, and perceived usefulness of prenatal test results. A randomized, 2 (risk level; low, high) x 4 (format; ratio with numerator 1, ratio with denominator 1000, Paling Perspective Scale, pictograms) design was used. Study 2 (N=200) employed a 2 (risk level; low, high) x 2 (format; Paling Perspective Scale, risk comparisons in numerical format) design. In study 1, the Paling Perspective Scale resulted in a higher level of perceived risk across different risk levels compared with the other formats. Furthermore, participants in the low-risk group perceived the test results as less risky compared with participants in the high-risk group (P < 0.001) when the Paling Perspective Scale was used. No significant differences between low and high risks were observed for the other 3 formats. In study 2, the Paling Perspective Scale evoked higher levels of perceived risks relative to the numerical presentation of risk comparisons. For both formats, we found that participants confronted with a high risk perceived test results as more risky compared with participants confronted with a low risk. The Paling Perspective Scale resulted in a higher level of perceived risk compared with the other formats. This effect must be taken into account when choosing a graphical or numerical format for risk communication.

  12. Peripheral intravenous catheter-related phlebitis and related risk factors.

    PubMed

    Nassaji-Zavareh, M; Ghorbani, R

    2007-08-01

    Peripheral intravenous catheter-related phlebitis is a common and significant problem in clinical practice. This study aims to investigate the incidence of phlebitis and to evaluate some important related factors. 300 patients admitted to medical and surgical wards of hospitals in Semnan, Iran from April 2003 to February 2004 were prospectively studied. Variables evaluated were age, gender, site and size of catheter, type of insertion and underlying conditions (diabetes mellitus, trauma, infectious disease and burns). Phlebitis was defined when at least four criteria were fulfilled (erythema, pain, tenderness, warmth, induration, palpable cord and swelling). Any patient who was discharged or their catheter removed before three days were excluded. Phlebitis occurred in 26 percent (95 percent confidence interval [CI] 21- 31 percent) of patients. There was no significant relationship between age, catheter bore size, trauma and phlebitis. Related risk factors were gender (odds-ratio [OR] 1.50, 95 percent CI 1.01-2.22), site (OR 3.25, 95 percent CI 2.26-4.67) and type of insertion (OR 2.04, 95 percent CI 1.36-3.05) of catheter, diabetes mellitus (OR 7.78, 95 percent CI 4.59-13.21), infectious disease (OR 6.21, 95 percent CI 4.27-9.03) and burns (OR 3.96, 95 percent CI 3.26-4.82). Phlebitis is still an important and ongoing problem in medical practice. In patients with diabetes mellitus and infectious diseases, more attention is needed.

  13. Nighttime Parenting Strategies and Sleep-Related Risks to Infants

    PubMed Central

    Volpe, Lane E.; Ball, Helen L.; McKenna, James J.

    2012-01-01

    A large social science and public health literature addresses infant sleep safety, with implications for infant mortality in the context of accidental deaths and Sudden Infant Death Syndrome (SIDS). As part of risk reduction campaigns in the USA, parents are encouraged to place infants supine and to alter infant bedding and elements of the sleep environment, and are discouraged from allowing infants to sleep unsupervised, from bed-sharing either at all or under specific circumstances, or from sofa-sharing. These recommendations are based on findings from large-scale epidemiological studies that generate odds ratios or relative risk statistics for various practices; however, detailed behavioural data on nighttime parenting and infant sleep environments are limited. To address this issue, this paper presents and discusses the implications of four case studies based on overnight observations conducted with first-time mothers and their four-month old infants. These case studies were collected at the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame USA between September 2002 and June 2004.Each case study provides a detailed description based on video analysis of sleep-related risks observed while mother-infant dyads spent the night in a sleep lab. The case studies provide examples of mothers engaged in the strategic management of nighttime parenting for whom sleep-related risks to infants arose as a result of these strategies. Although risk reduction guidelines focus on eliminating potentially risky infant sleep practices as if the probability of death from each were equal, the majority of instances in which these occur are unlikely to result in infant mortality. Therefore, we hypothesise that mothers assess potential costs and benefits within margins of risk which are not acknowledged by risk-reduction campaigns. Exploring why mothers might choose to manage sleep and nighttime parenting in ways that appear to increase potential risks to infants may help

  14. Nighttime parenting strategies and sleep-related risks to infants.

    PubMed

    Volpe, Lane E; Ball, Helen L; McKenna, James J

    2013-02-01

    A large social science and public health literature addresses infant sleep safety, with implications for infant mortality in the context of accidental deaths and Sudden Infant Death Syndrome (SIDS). As part of risk reduction campaigns in the USA, parents are encouraged to place infants supine and to alter infant bedding and elements of the sleep environment, and are discouraged from allowing infants to sleep unsupervised, from bed-sharing either at all or under specific circumstances, or from sofa-sharing. These recommendations are based on findings from large-scale epidemiological studies that generate odds ratios or relative risk statistics for various practices; however, detailed behavioural data on nighttime parenting and infant sleep environments are limited. To address this issue, this paper presents and discusses the implications of four case studies based on overnight observations conducted with first-time mothers and their four-month old infants. These case studies were collected at the Mother-Baby Behavioral Sleep Lab at the University of Notre Dame USA between September 2002 and June 2004. Each case study provides a detailed description based on video analysis of sleep-related risks observed while mother-infant dyads spent the night in a sleep lab. The case studies provide examples of mothers engaged in the strategic management of nighttime parenting for whom sleep-related risks to infants arose as a result of these strategies. Although risk reduction guidelines focus on eliminating potentially risky infant sleep practices as if the probability of death from each were equal, the majority of instances in which these occur are unlikely to result in infant mortality. Therefore, we hypothesise that mothers assess potential costs and benefits within margins of risk which are not acknowledged by risk-reduction campaigns. Exploring why mothers might choose to manage sleep and nighttime parenting in ways that appear to increase potential risks to infants may

  15. Are all risks equal? Early experiences of poverty-related risk and children's functioning.

    PubMed

    Roy, Amanda L; Raver, C Cybele

    2014-06-01

    Using cumulative risk and latent class analysis (LCA) models, we examined how exposure to deep poverty (income-to-needs ratio <0.50) and 4 poverty-related risks (i.e., single-parent household, residential crowding, caregiver depression, and multiple life stressors) in preschool is related to children's future difficulty in school in a longitudinal sample of 602 Head Start-enrolled, low-income families. Results from the LCA revealed 4 risk profiles: low risk, deep poverty and single, single and stressed, and deep poverty and crowded household. Tests of measurement invariance across racial/ethnic groups established that, although patterns of risk are similar across groups (i.e., risks covary in the same way), the prevalence of risk profiles differs. African American families were overrepresented in the "deep poverty and single" profile while Latino and White families were overrepresented in the "deep poverty and crowded" profile. Finally, children's third grade functioning in 3 domains (i.e., academic performance, behavior problems, and self-regulatory skills) was predicted using a cumulative risk index and LCA-identified risk profiles. Both approaches demonstrated that children who experienced higher levels of risk in preschool had worse school performance than children with low levels of risk. However, LCA also revealed that children who experienced "single and stressed" family settings had more behavior problems than low-risk children while children who experienced "deep poverty and crowded" family settings had worse academic performance. The results indicate that all risks are not equal for children's development and highlight the utility of LCA for tailoring intervention efforts to best meet the needs of target populations. PsycINFO Database Record (c) 2014 APA, all rights reserved

  16. Are All Risks Equal? Early Experiences of Poverty-Related Risk and Children’s Functioning

    PubMed Central

    Roy, Amanda L.; Raver, C. Cybele

    2014-01-01

    Using cumulative risk and latent class analysis (LCA) models, this research examines how exposure to deep poverty (income-to-needs ratio <.50) and four poverty-related risks (single-parent household, residential crowding, caregiver depression, and multiple life stressors) in preschool is related to children’s future difficulty in school in a longitudinal sample of 602 Head-Start enrolled, low-income families. Results from the LCA revealed four risk profiles: low risk, deep poverty and single, single and stressed, and deep poverty and crowded household. Tests of measurement invariance across racial/ethnic groups established that although patterns of risk are similar across groups (i.e. risks co-vary in the same way), the prevalence of risk profiles differ. African American families were over-represented in the ‘deep poverty and single’ profile while Latino and White families were over-represented in the ‘deep poverty and crowded’ profile. Finally, children’s third grade functioning in three domains (academic performance, behavior problems, self-regulatory skills) was predicted using a cumulative risk index and LCA identified risk profiles. Both approaches demonstrated that children who experienced higher levels of risk in preschool had worse school performance than children with low levels of risk. However, the LCA also revealed that children who experienced ‘single and stressed’ family settings had more behavior problems than low risk children while children who experienced ‘deep poverty and crowded’ family settings had worse academic performance. The results indicate that all risks are not equal for children’s development and highlight the utility of LCA for tailoring intervention efforts to best meet the needs of target populations. PMID:24749652

  17. Educational Aspiration-Expectation Discrepancies: Relation to Socioeconomic and Academic Risk-Related Factors

    ERIC Educational Resources Information Center

    Boxer, Paul; Goldstein, Sara E.; DeLorenzo, Tahlia; Savoy, Sarah; Mercado, Ignacio

    2011-01-01

    This study examines whether disconnection between educational aspirations and expectations is associated with socioeconomic status, academic performance, academic risk-related behaviors and related psychosocial factors in an ethnically and economically diverse sample of early adolescents from a public middle school (N = 761). Results suggest that…

  18. Information Uncertainty to Compare Qualitative Reasoning Security Risk Assessment Results

    SciTech Connect

    Chavez, Gregory M; Key, Brian P; Zerkle, David K

    2009-01-01

    The security risk associated with malevolent acts such as those of terrorism are often void of the historical data required for a traditional PRA. Most information available to conduct security risk assessments for these malevolent acts is obtained from subject matter experts as subjective judgements. Qualitative reasoning approaches such as approximate reasoning and evidential reasoning are useful for modeling the predicted risk from information provided by subject matter experts. Absent from these approaches is a consistent means to compare the security risk assessment results. Associated with each predicted risk reasoning result is a quantifiable amount of information uncertainty which canmore » be measured and used to compare the results. This paper explores using entropy measures to quantify the information uncertainty associated with conflict and non-specificity in the predicted reasoning results. The measured quantities of conflict and non-specificity can ultimately be used to compare qualitative reasoning results which are important in triage studies and ultimately resource allocation. Straight forward extensions of previous entropy measures are presented here to quantify the non-specificity and conflict associated with security risk assessment results obtained from qualitative reasoning models.« less

  19. 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…

  20. Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: Results from a longitudinal cohort of South African women who attend alcohol-serving venues

    PubMed Central

    Abler, Laurie; Sikkema, Kathleen J.; Watt, Melissa H.; Pitpitan, Eileen V.; Kalichman, Seth C.; Skinner, Donald; Pieterse, Desiree

    2014-01-01

    Background In South Africa, alcohol contributes to the HIV epidemic, in part, by influencing sexual behaviors. For some, high levels of alcohol consumption may be driven by previous traumatic experiences that result in traumatic stress. The purpose of this study was to quantify the longitudinal association between traumatic stress and unprotected sex among women who attend drinking venues and to assess whether this association was explained by mediation through alcohol use. Methods Data were collected in four waves over a year from a prospective cohort of 560 women who regularly attended alcohol-serving venues in a Cape Town township. Longitudinal mixed models examined: 1) the relationship between traumatic stress and counts of unprotected sex, and 2) whether alcohol use mediated the association between traumatic stress and unprotected sex. Results Most women reported elevated traumatic stress (80%) and hazardous alcohol use (88%) at least once during the study period. In models adjusted for covariates, traumatic stress was associated with unprotected sex (b=0.28, SE=0.06, t=4.82, p<.001). In addition, traumatic stress was associated with alcohol use (b=0.27, SE=0.02, t=14.25, p<.001), and was also associated with unprotected sex (b=0.20, SE=0.06, t=3.27, p<.01) while controlling for alcohol use (b=0.28, SE=0.07, t=4.25, p<.001). The test for the mediated effect established that alcohol use was a significant mediator, accounting for 27% of the total effect of traumatic stress on unprotected sex. Conclusions These results highlight the need to address traumatic stress among female venue patrons as an important precursor of HIV risk due to alcohol use. PMID:25394191

  1. Will a quadruple multiplexed point-of-care screening strategy for HIV-related co-infections be feasible and impact detection of new co-infections in at-risk populations? Results from cross-sectional studies.

    PubMed

    Pai, Nitika Pant; Dhurat, Rachita; Potter, Martin; Behlim, Tarannum; Landry, Geneviève; Vadnais, Caroline; Rodrigues, Camilla; Joseph, Lawrence; Shetty, Anjali

    2014-12-15

    Multiplexed point-of-care (POC) devices can rapidly screen for HIV-related co-infections (eg, hepatitis C (HCV), hepatitis B (HBV), syphilis) in one patient visit, but global evidence for this approach remains limited. This study aimed to evaluate a multiplex POC testing strategy to expedite screening for HIV-related co-infections in at-risk populations. A multiplex strategy was developed with two subsequent versions of an investigational device Miriad. It was evaluated in two non-comparable settings and populations in two countries for feasibility of conduct, detection of new infections, preference and accuracy. Version 1 was evaluated in 375 sexually transmitted disease clinic attendees in Mumbai, India; version 2 was evaluated in 119 injection drug users in Montreal, Canada. Feasibility (completion rate) of the multiplex strategy was high (86.1% Mumbai; 92.4% Montreal). A total of 170 new infections were detected in Mumbai (56 HIV, 75 HBV, 37 syphilis, 2 HCV) versus 2 in Montreal. Preference was 60% in Mumbai and 97% in Montreal. Miriad version 1 specificities were high: HIV 99.7% (98.3% to 100%), HBV 99.3% (97.6% to 99.9%), HCV 99.7% (98.5% to 99.9%), syphilis 85.2% (80.9% to 88.8%); sensitivities were as follows: HIV 100% (94.8% to 100%), HBV 13.3% (6.6% to 23.2%), HCV 50% (1.3% to 98.7%), syphilis 86.1% (70.5% to 95.3%). With version 2, specificities improved: HIV 100% (97.2% to 100%), HBV 100% (97.3% to 100%), HCV 85.3% (73.8% to 93.0%), syphilis 98.1% (93.3% to 99.8%); sensitivities were: HIV 100% (47.3% to 100%), HCV 80.4% (66.1% to 90.6%), syphilis 100% (22.4% to 100%). A quad multiplex POC strategy for HIV and co-infections was feasible to operationalise and preferred by patients in both settings. Many new infections were identified in Mumbai and accuracy improved with version 2 of the assay. Such a strategy will help expedite screening for co-infections, particularly where baseline screening is low. These findings are valuable to practitioners

  2. [Occupational risk related to optical radiation exposure in construction workers].

    PubMed

    Gobba, F; Modenese, A

    2012-01-01

    Optical Radiation is a relevant occupational risk in construction workers, mainly as a consequence of the exposure to the ultraviolet (UV) component of solar radiation (SR). Available data show that UV occupational limits are frequently exceeded in these workers, resulting in an increased occupational risk of various acute and chronic effects, mainly to skin and to the eye. One of the foremost is the carcinogenic effect: SR is indeed included in Group 1 IARC (carcinogenic to humans). UV exposure is related to an increase of the incidence of basal cell carcinoma, squamous cell carcinoma of the skin and cutaneous malignant melanoma (CMM). The incidence of these tumors, especially CMM, is constantly increasing in Caucasians in the last 50 years. As a conclusion, an adequate evaluation of the occupational risk related to SR, and adequate preventive measures are essential in construction workers. The role of occupational physicians in prevention is fundamental.

  3. Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: results from a longitudinal cohort of South African women who attend alcohol-serving venues.

    PubMed

    Abler, Laurie; Sikkema, Kathleen J; Watt, Melissa H; Pitpitan, Eileen V; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree

    2015-03-01

    In South Africa, alcohol contributes to the HIV epidemic, in part, by influencing sexual behaviors. For some, high levels of alcohol consumption may be driven by previous traumatic experiences that result in traumatic stress. The purpose of this study was to quantify the longitudinal association between traumatic stress and unprotected sex among women who attend drinking venues and to assess whether this association was explained by mediation through alcohol use. Data were collected in 4 waves over a year from a prospective cohort of 560 women who regularly attended alcohol-serving venues in a Cape Town township. Longitudinal mixed models examined (1) the relationship between traumatic stress and counts of unprotected sex and (2) whether alcohol use mediated the association between traumatic stress and unprotected sex. Most women reported elevated traumatic stress (80%) and hazardous alcohol use (88%) at least once during the study period. In models adjusted for covariates, traumatic stress was associated with unprotected sex (b = 0.28, SE = 0.06, t = 4.82, P < 0.001). In addition, traumatic stress was associated with alcohol use (b = 0.27, SE = 0.02, t = 14.25, P < 0.001) and was also associated with unprotected sex (b = 0.20, SE = 0.06, t = 3.27, P < 0.01) while controlling for alcohol use (b = 0.28, SE = 0.07, t = 4.25, P < 0.001). The test for the mediated effect established that alcohol use was a significant mediator, accounting for 27% of the total effect of traumatic stress on unprotected sex. These results highlight the need to address traumatic stress among female venue patrons as an important precursor of HIV risk due to alcohol use.

  4. The relation of communication to risk judgment and preventive behavior related to lead in tap water.

    PubMed

    Griffin, R J; Dunwoody, S

    2000-01-01

    More and more communities are becoming concerned about health risks posed by lead and other health hazards in their drinking water. Our study, applying the model of innovation diffusion to the adoption of preventive health behaviors, found that reliance on health professionals for information about lead in tap water was associated with residents perceiving risk from this hazard, their sense of efficacy in dealing with it, and their adoption of preventive behaviors. Mass media and pamphlets mailed directly to residents were relatively ineffective. Results suggest that interpersonal channels may be the best way to reach individuals who live in areas of highest risk from tap water lead.

  5. Enforcement Related to Minimum Risk Pesticides

    EPA Pesticide Factsheets

    If a product does not meet all the requirements of the minimum risk exemption, it must be registered unless eligible for some other exemption. Learn about enforcement actions EPA can take where unregistered products make pesticidal claims.

  6. Association between firearm ownership, firearm-related risk and risk reduction behaviours and alcohol-related risk behaviours.

    PubMed

    Wintemute, Garen J

    2011-12-01

    Alcohol use and firearm ownership are risk factors for violent injury and death. To determine whether firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours, the author conducted a cross-sectional study using Behavioral Risk Factor Surveillance System data for eight states in the USA from 1996 to 1997 (the most recent data available). Altogether, 15 474 respondents provided information on firearm exposure. After adjustment for demographics and state of residence, firearm owners were more likely than those with no firearms at home to have ≥5 drinks on one occasion (OR 1.32; 95% CI 1.16 to 1.50), to drink and drive (OR 1.79; 95% CI 1.34 to 2.39) and to have ≥60 drinks per month (OR 1.45; 95% CI 1.14 to 1.83). Heavy alcohol use was most common among firearm owners who also engaged in behaviours such as carrying a firearm for protection against other people and keeping a firearm at home that was both loaded and not locked away. The author concludes that firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours.

  7. Dispositional Optimism and Perceived Risk Interact to Predict Intentions to Learn Genome Sequencing Results

    PubMed Central

    Taber, Jennifer M.; Klein, William M. P.; Ferrer, Rebecca A.; Lewis, Katie L.; Biesecker, Leslie G.; Biesecker, Barbara B.

    2015-01-01

    Objective Dispositional optimism and risk perceptions are each associated with health-related behaviors and decisions and other outcomes, but little research has examined how these constructs interact, particularly in consequential health contexts. The predictive validity of risk perceptions for health-related information seeking and intentions may be improved by examining dispositional optimism as a moderator, and by testing alternate types of risk perceptions, such as comparative and experiential risk. Method Participants (n = 496) had their genomes sequenced as part of a National Institutes of Health pilot cohort study (ClinSeq®). Participants completed a cross-sectional baseline survey of various types of risk perceptions and intentions to learn genome sequencing results for differing disease risks (e.g., medically actionable, nonmedically actionable, carrier status) and to use this information to change their lifestyle/health behaviors. Results Risk perceptions (absolute, comparative, and experiential) were largely unassociated with intentions to learn sequencing results. Dispositional optimism and comparative risk perceptions interacted, however, such that individuals higher in optimism reported greater intentions to learn all 3 types of sequencing results when comparative risk was perceived to be higher than when it was perceived to be lower. This interaction was inconsistent for experiential risk and absent for absolute risk. Independent of perceived risk, participants high in dispositional optimism reported greater interest in learning risks for nonmedically actionable disease and carrier status, and greater intentions to use genome information to change their lifestyle/health behaviors. Conclusions The relationship between risk perceptions and intentions may depend on how risk perceptions are assessed and on degree of optimism. PMID:25313897

  8. Downsizing, reengineering and patient safety: numbers, newness and resultant risk.

    PubMed

    Knox, G E; Kelley, M; Hodgson, S; Simpson, K R; Carrier, L; Berry, D

    1999-01-01

    Downsizing and reengineering are facts of life in contemporary healthcare organizations. In most instances, these organizational changes are undertaken in an attempt to increase productivity or cut operational costs with results measured in these terms. Less often considered are potential detrimental effects on patient safety or strategies, which might be used to minimize these risks.

  9. Youth Risk Behavior Survey Results, 1995. Executive Summary.

    ERIC Educational Resources Information Center

    New Hampshire State Dept. of Education, Concord.

    An 84-item multiple choice Youth Risk Behavior Survey was administered to 2,092 students in 62 public high schools in New Hampshire during the spring of 1995. The survey covered behaviors in six categories: (1) behaviors that result in unintentional or intentional injuries; (2) tobacco use; (3) alcohol and other drug use; (4) sexual behaviors that…

  10. Increased Risk Taking in Relation to Chronic Stress in Adults

    PubMed Central

    Ceccato, Smarandita; Kudielka, Brigitte M.; Schwieren, Christiane

    2016-01-01

    Chronic stress is a public health problem that affects a significant part of the population. While the physiological damage it causes is under ongoing scrutiny, its behavioral effects have been overlooked. This is one of the first studies to examine the relation between chronic stress and decision-making, using a standard lottery paradigm. We measured risk taking in the gain domain through binary choices between financially incentivized lotteries. We then measured self-reported chronic stress with the Trier Inventory for the Assessment of Chronic Stress (TICS). We additionally collected hair samples in a subsample of volunteers, in order to quantify accumulation of the stress hormone cortisol. We discovered a significant positive, though modest, correlation between self-reported chronic stress and risk taking that is stronger for women than for men. This confirms part of the findings in acute stress research that show a connection between higher stress and increased risk taking. However, unlike the biologically-based results from acute stress research, we did not identify a significant relation between hair cortisol and behavior. In line with previous literature, we found a clear gender difference in risk taking and self-reports: women generally take less risk and report slightly higher stress levels than men. We conclude that perceived chronic stress can impact behavior in risky situations. PMID:26858663

  11. Dispositional optimism and perceived risk interact to predict intentions to learn genome sequencing results.

    PubMed

    Taber, Jennifer M; Klein, William M P; Ferrer, Rebecca A; Lewis, Katie L; Biesecker, Leslie G; Biesecker, Barbara B

    2015-07-01

    Dispositional optimism and risk perceptions are each associated with health-related behaviors and decisions and other outcomes, but little research has examined how these constructs interact, particularly in consequential health contexts. The predictive validity of risk perceptions for health-related information seeking and intentions may be improved by examining dispositional optimism as a moderator, and by testing alternate types of risk perceptions, such as comparative and experiential risk. Participants (n = 496) had their genomes sequenced as part of a National Institutes of Health pilot cohort study (ClinSeq®). Participants completed a cross-sectional baseline survey of various types of risk perceptions and intentions to learn genome sequencing results for differing disease risks (e.g., medically actionable, nonmedically actionable, carrier status) and to use this information to change their lifestyle/health behaviors. Risk perceptions (absolute, comparative, and experiential) were largely unassociated with intentions to learn sequencing results. Dispositional optimism and comparative risk perceptions interacted, however, such that individuals higher in optimism reported greater intentions to learn all 3 types of sequencing results when comparative risk was perceived to be higher than when it was perceived to be lower. This interaction was inconsistent for experiential risk and absent for absolute risk. Independent of perceived risk, participants high in dispositional optimism reported greater interest in learning risks for nonmedically actionable disease and carrier status, and greater intentions to use genome information to change their lifestyle/health behaviors. The relationship between risk perceptions and intentions may depend on how risk perceptions are assessed and on degree of optimism. (c) 2015 APA, all rights reserved.

  12. Human relations as a coronary risk factor.

    PubMed

    Corbellini, P; Maisano, G

    1988-11-01

    Psychological variables are significant in the evolution of coronary heart disease (CHD). Two types of personality have been identified as constituting coronary risk: Type 1 which is hypercompetitive and anxious, and Type 2 which is overscrupulous and guilt prone. Both these behavioural types are formed during infancy, and are thought to be neurotic. In rehabilitation it is therefore necessary to take into consideration the psychological as well as the physiological aspects, and so the evaluation of the patient's suitability for return to work, should be, at least in part, psychosomatic. The approach used by the Cardiac Rehabilitation Centre of Udine seems to point towards a successful strategy. The aim of the strategy is to improve the chances of secondary prevention, to correct risk factors on a long-term basis, and to arrive at safe and reliable criteria for return to work.

  13. Risk Analysis Related to Quality Management Principles

    NASA Astrophysics Data System (ADS)

    Vykydal, David; Halfarová, Petra; Nenadál, Jaroslav; Plura, Jiří; Hekelová, Edita

    2012-12-01

    Efficient and effective implementation of quality management principles asks for a responsible approach from top managers' perspectives. A study of the current state of affairs in Czech organizations discovers a lot of shortcomings in this field that can be changed to vary managerial risks. The article identifies and analyses some of them and gives short guidance for appropriate treatment. Text of the article reflects the authors' experience as well as knowledge obtained from the systematic analysis of industrial companies' environments.

  14. [Risk groups as related to gastric cancer].

    PubMed

    Vartan'ian, M G; Zhandarova, L F; Korzhenskiĭ, F P

    1979-01-01

    Under examination were the features of life, labour, habits, inheritance pattern, a type of diet, the course of the disease in 440 gastric cancer patients. The most typical and frequently observed factors were singled out. The material obtained was processed by an electronic computer. The informative value of the risk factors was checked by selection, using questionnaires of patients irrespective of the reason of their referring to the clinic. The age of patients over 40 and the character of work should become the basic indication for limiting the number of persons subject to a gastrological examination.

  15. Relative risk assessment of cruise ships biosolids disposal alternatives.

    PubMed

    Avellaneda, Pedro M; Englehardt, James D; Olascoaga, Josefina; Babcock, Elizabeth A; Brand, Larry; Lirman, Diego; Rogge, Wolfgang F; Solo-Gabriele, Helena; Tchobanoglous, George

    2011-10-01

    A relative risk assessment of biosolids disposal alternatives for cruise ships is presented in this paper. The area of study encompasses islands and marine waters of the Caribbean Sea. The objective was to evaluate relative human health and ecological risks of (a) dewatering/incineration, (b) landing the solids for disposal, considering that in some countries land-disposed solids might be discharged in the near-shore environment untreated, and (c) deep ocean disposal. Input to the Bayesian assessment consisted of professional judgment based on available literature and modeling information, data on constituent concentrations in cruise ship biosolids, and simulations of constituent concentrations in Caribbean waters assuming ocean disposal. Results indicate that human health and ecological risks associated with land disposal and shallow ocean disposal are higher than those of the deep ocean disposal and incineration. For incineration, predicted ecological impacts were lower relative to deep ocean disposal before considering potential impacts of carbon emissions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Relative risk for concussions in young female soccer players.

    PubMed

    Strand, Sarah; Lechuga, David; Zachariah, Thomas; Beaulieu, Kathryn

    2015-01-01

    The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p < .001, α = .05, CI = 95%). This demonstrates that the relative risk of probable concussions in young female soccer players is significantly higher than in a control group of nonsoccer players of the same sex and age.

  17. Colorectal Cancer Risks in Relatives of Young-Onset Cases: Is Risk the Same Across All First Degree Relatives?

    PubMed Central

    Boardman, Lisa A.; Morlan, Bruce W.; Rabe, Kari G.; Petersen, Gloria M.; Lindor, Noralane M.; Nigon, Sandra K; Goldberg, Julia; Gallinger, Steven

    2007-01-01

    Background and Aims In the last fifteen years, several single-gene Mendelian disorders have been discovered that may account for some of the familial aggregation detected in large population studies of colorectal cancer (CRC). Mutations in DNA mismatch repair (MMR) genes cause HNPCC-Lynch Syndrome, the most common of the recognized CRC-predisposition syndromes, in which one major feature is a young age for cancer onset. However, for young onset microsatellite stable( MSS) CRC, the familial risk for CRC is unknown. Methods Cases with CRC < 50 years old were identified through Minnesota Cancer Surveillance System (MCSS), and Mayo Clinic, Rochester, MN. CRC in which the DNA MMR function was deficient as evidenced by high level microsatellite instability and/or loss of expression of MMR gene product by immunostaining were excluded. A total of 278 probands (131 from MCSS; 147 from Mayo Clinic) were included. Data on 1862 relatives were collected, of whom 68 were found to have had CRC and an additional 165 had primary cancers of other types. Results Compared to SEER data, relatives of young onset CRC probands had increased risks for CRC. This relative risk was increased among first degree relatives (RR=1.65; 95% C.I.=1.29–2.07), and was greater for siblings (RR = 2.67; 95% C.I=1.50–4.41) than parents (RR= 1.5; 95% C.I.=1.14–1.94) Conclusions We studied 278 probands with young-onset microsatellite stable CRC. We determined that the relative risk for CRC was greatest in siblings, which is consistent with an autosomal recessive inheritance pattern. PMID:17702662

  18. Risk Taking in Late Adolescence: Relations between Sociomoral Reasoning, Risk Stance, and Behavior

    ERIC Educational Resources Information Center

    Shaw, Leigh A.; Amsel, Eric; Schillo, Joshua

    2011-01-01

    This study explored relations among late adolescents' sociomoral reasoning about risk taking, risk stance, and behavior. One-hundred and thirty-two participants (18-20-year-olds) were surveyed about their own risk stance (Avoidant, Opportunistic, Curious, Risk Seeking) and behavior in three realms (Alcohol Use, Drug Use, Reckless Driving), and…

  19. Humorous Relations: Attentiveness, Pleasure and Risk

    ERIC Educational Resources Information Center

    Mayo, Cris

    2014-01-01

    This article focuses on the structures of humor and joke telling that require particular kinds of attentiveness and particular relationships between speaker and audience, or more specifically, between classmates. First, I will analyze the pedagogical and relational preconditions that are necessary for humor to work. If humor is to work well, the…

  20. [Mitomycin C HIVEC. Update and results in high risk patients.

    PubMed

    Guerrero-Ramos, Félix; Castellano-Gauna, Daniel; García-Rojo, Esther; Duarte-Ojeda, José Manuel; de la Rosa-Kehrmann, Federico; Villacampa-Aubá, Felipe

    2018-05-01

    Adjuvant endovesical treatment is a research field in constant exploration with the aim to minimize the risk of recurrence and progression of non muscle invasive bladder tumors. Over the last years, the administration of chemotherapy in a chemo hyperthermia regimen has been added to the existing regimens. There are various systems for its administration, but this article focus on HIVEC (Hyperthermic IntraVEsical Chemotherapy) and its current status. In this review article we update the results of this system in the case-scenarios it has been used (preoperative with ablative intention and as adjuvant therapy with prophylactic purposes), tolerance and security issues, on-going clinical trials and future perspectives.

  1. Relative radiological risks derived from different TENORM wastes in Malaysia.

    PubMed

    Ismail, B; Teng, I L; Muhammad Samudi, Y

    2011-11-01

    In Malaysia technologically enhanced naturally occurring radioactive materials (TENORM) wastes are mainly the product of the oil and gas industry and mineral processing. Among these TENORM wastes are tin tailing, tin slag, gypsum and oil sludge. Mineral processing and oil and gas industries produce large volume of TENORM wastes that has become a radiological concern to the authorities. A study was carried out to assess the radiological risk related to workers working at these disposal sites and landfills as well as to the members of the public should these areas be developed for future land use. Radiological risk was assessed based on the magnitude of radiation hazard, effective dose rates and excess cancer risks. Effective dose rates and excess cancer risks were estimated using RESRAD 6.4 computer code. All data on the activity concentrations of NORM in wastes and sludges used in this study were obtained from the Atomic Energy Licensing Board, Malaysia, and they were collected over a period of between 5 and 10 y. Results obtained showed that there was a wide range in the total activity concentrations (TAC) of nuclides in the TENORM wastes. With the exception of tin slag and tin tailing-based TENORM wastes, all other TENORM wastes have TAC values comparable to that of Malaysia's soil. Occupational Effective Dose Rates estimated in all landfill areas were lower than the 20 mSv y(-1) permissible dose limit. The average Excess Cancer Risk Coefficient was estimated to be 2.77×10(-3) risk per mSv. The effective dose rates for residents living on gypsum and oil sludge-based TENORM wastes landfills were estimated to be lower than the permissible dose limit for members of the public, and was also comparable to that of the average Malaysia's ordinary soils. The average excess cancer risk coefficient was estimated to be 3.19×10(-3) risk per mSv. Results obtained suggest that gypsum and oil sludge-based TENORM wastes should be exempted from any radiological regulatory

  2. Assessing the risk of work-related international travel.

    PubMed

    Druckman, Myles; Harber, Philip; Liu, Yihang; Quigley, Robert L

    2014-11-01

    To identify factors affecting the likelihood of requiring medical services during international business trips. Data from more than 800,000 international trips and medical assistance cases provided to 48 multinational corporations in 2009. Travel destination countries were grouped into four a priori risk-related categories. Travel to "low" medical risk countries in aggregate accounted for more hospitalizations and medical evacuations than travel to "high" medical risk countries. Nevertheless, the risk per trip was much higher for travel to higher medical risk countries. Corporations with employees on international travel should allocate sufficient resources to manage and ideally prevent medical issues during business travel. Travel medicine must focus on more than infectious diseases, and programs are necessary for both high- and low-risk regions. Improved understanding of travel-related needs determines resource allocation and risk mitigation efforts.

  3. Pigmentary characteristics and moles in relation to melanoma risk.

    PubMed

    Titus-Ernstoff, Linda; Perry, Ann E; Spencer, Steven K; Gibson, Jennifer J; Cole, Bernard F; Ernstoff, Marc S

    2005-08-10

    Although benign and atypical moles are considered key melanoma risk factors, previous studies of their influence were small and/or institution-based. We conducted a population-based case-control study in the state of New Hampshire. Individuals of ages 20-69 with an incident diagnosis of first primary cutaneous melanoma were ascertained through the New Hampshire State Cancer Registry. Controls were identified through New Hampshire driver's license lists and frequency-matched by age and gender to cases. We interviewed 423 eligible cases and 678 eligible controls. Host characteristics, including mole counts, were evaluated using logistic regression analyses. Our results showed that pigmentary factors, including eye color (OR = 1.57 for blue eyes compared to brown), hair color (OR = 1.85 for blonde/red hair color compared to brown/black), freckles before age 15 (OR = 2.39 for freckles present compared to absent) and sun sensitivity (OR = 2.25 for peeling sunburn followed by no tan or a light tan and 2.42 for sunburn followed by tan compared to tanning immediately), were related to melanoma risk; these associations held after adjustment for sun-related factors and for moles. In analyses confined to skin examination participants, the covariate-adjusted effects of benign and atypical moles were moderately strong. Compared to 0-4 benign moles, risk increased steadily for 5-14 moles (OR = 1.71), 15-24 moles (OR = 3.55) and >or= 25 moles (OR = 4.33). Risk also increased with the number of atypical moles; compared to none, the ORs for having 1, 2-3, or >or= 4 atypical moles were 2.08, 1.84 and 3.80, respectively. Although risk was highest for those with multiple benign and atypical moles, the interaction was not of statistical significance. Our findings, arising from the first population- and incidence-based study to evaluate atypical moles in relation to melanoma risk, confirm the importance of host susceptibility, represented by pigmentary factors and the tendency to

  4. Australian Adolescents' Perceptions of Health-Related Risks.

    ERIC Educational Resources Information Center

    Moore, Susan M.; Rosenthal, Doreen A.

    1992-01-01

    Evaluates the perceptions of adolescents (n=189) of their risks and ascertains the relationship between risk perception and actual risky behavior in five areas: AIDS, STDs, serious car accidents, lung cancer, and skin cancer. Results indicated that although late-adolescent students underestimated risk behavior, they were able to make judgments…

  5. INTEGRATED RISK ASSESSMENT - RESULTS FROM AN INTERNATIONAL WORKSHOP

    EPA Science Inventory

    The WHO International Programme on Chemical Safety and international partners have developed a framework for integrated assessment of human health and ecological risks and four case studies. An international workshop was convened to consider how ecological and health risk assess...

  6. Quantifying the relative risk of sex offenders: risk ratios for static-99R.

    PubMed

    Hanson, R Karl; Babchishin, Kelly M; Helmus, Leslie; Thornton, David

    2013-10-01

    Given the widespread use of empirical actuarial risk tools in corrections and forensic mental health, it is important that evaluators and decision makers understand how scores relate to recidivism risk. In the current study, we found strong evidence for a relative risk interpretation of Static-99R scores using 8 samples from Canada, United Kingdom, and Western Europe (N = 4,037 sex offenders). Each increase in Static-99R score was associated with a stable and consistent increase in relative risk (as measured by an odds ratio or hazard ratio of approximately 1.4). Hazard ratios from Cox regression were used to calculate risk ratios that can be reported for Static-99R. We recommend that evaluators consider risk ratios as a useful, nonarbitrary metric for quantifying and communicating risk information. To avoid misinterpretation, however, risk ratios should be presented with recidivism base rates.

  7. Perceptions of risk from workers in high risk industries with work related musculoskeletal disorders.

    PubMed

    Hunter, D; Silverstein, B

    2014-01-01

    Work-related musculoskeletal disorders (WMSDs) remain a major occupational health problem, despite decades of research, outreach, and intervention. The aim of this study is to promote early identification and prevention of WMSDs by developing education and outreach materials grounded in interview data collected from workers that have recently filed for workers compensation (WC) for WMSDs. We conducted semi-structured telephone interviews with WC claimants (n=66) from high risk industries identified through the use of a Prevention Index (PI) in Washington state with WMSDs of the back, shoulder, hand/wrist, or knee. Perceptions regarding the degree of exposure to WMSD risk factors, the social construction of pain, and the potential to implement injury-prevention measures varied widely. Many workers dismissed their injuries as the result of "fluke" or "freak" occurrences and framed their exposure to risk factors for WMSDs as either inevitable or "just part of the job." Workers in high-risk industries for WMSDs described their work conditions in ways that suggested: (1) a lack of awareness of the potential for developing a WMSD, (2) a view of work-related pain as normal, and/or (3) a pattern of self-blame for WMSD onset. A paradigm that either asserts the inevitability of WMSDs or dismisses potential control measures presents both a significant barrier to injury prevention efforts as well as a major opportunity for future occupational health research.

  8. Results Of The 2003 Wyoming Youth Risk Behavior Survey.

    ERIC Educational Resources Information Center

    Engstrom, Martha C.; Parrie, Chelsey; Miller, Russell; Li, Yuan

    2004-01-01

    The Youth Risk Behavior Survey (YRBS) was developed by the Centers for Disease Control and Prevention to measure the major health risk behaviors performed by youth. These health risk behaviors include: behaviors that contribute to intentional and unintentional injuries; the use of tobacco, alcohol, and other drugs; sexual behaviors that contribute…

  9. Postnatal risk factors associated with hearing loss among high-risk preterm infants: tertiary center results from Turkey.

    PubMed

    Eras, Zeynep; Konukseven, Ozlem; Aksoy, Hatice Tatar; Canpolat, Fuat Emre; Genç, Aydan; Sakrucu, Evrim Durgut; Develioğlu, Omer; Dilmen, Ugur

    2014-06-01

    The aim of this study was to determine the postnatal risk factors associated with hearing loss as well as the prevalence of hearing loss among high-risk preterm infants in newborn hearing screening (NHS). We performed a retrospective study of high-risk preterm infants born with a gestational age ≤32 weeks and/or a birth weight ≤1,500 g. A NHS procedure was performed by automated auditory brainstem response (AABR) and automated evoked otoacoustic emission (TEOAE). Infants who failed TEOAE or AABR or both tests were referred to a tertiary audiology center for diagnosis confirmation and management. Postnatal risk factors associated with hearing loss were evaluated and compared for preterm infants with and without hearing loss. 1,360 high-risk preterm infants were assessed. Permanent hearing loss was found in 19 (1.4%) infants. Multivariate analysis revealed that proven sepsis (p = 0.019), mechanical ventilation ≥5 days (p = 0.024), loop diuretics (p = 0.001), patent ductus arteriosus ligation (p = 0.018) and operation for retinopathy of prematurity (ROP) (p = 0.034) were significant related factors for the hearing loss. This study showed a low prevalence of hearing loss and an association between operation for ROP and hearing loss in preterm infants, which has not been defined previously. Our results suggest that every neonatal intensive care unit should determine their own risk factors and take precautions to prevent hearing loss for these high-risk preterm infants.

  10. Relation between Kidney Length and Cardiovascular and Renal Risk in High-Risk Patients

    PubMed Central

    van der Sande, Nicolette G.C.; Visseren, Frank L.J.; van der Graaf, Yolanda; Nathoe, Hendrik M.; de Borst, Gert Jan; Leiner, Tim

    2017-01-01

    Background and objectives Kidney length is often measured during routine abdominal ultrasonography and may be of use to identify patients at high vascular and renal risk. We aimed to explore patient characteristics related to kidney length, from which reference values were derived, and evaluate the relationship between kidney length and the risk of cardiovascular events and ESRD in high-risk patients. Design, setting, participants, & measurements The study population consisted of 10,251 patients with clinical manifest arterial disease or vascular risk factors included in the Second Manifestations of ARTerial disease (SMART) Study cohort between 1996 and 2014. Linear regression was used to explore patient characteristics of kidney length. The relationship between kidney length and cardiovascular events (myocardial infarction, stroke, and cardiovascular mortality), all-cause mortality, and ESRD was analyzed using Cox regression. Kidney length was analyzed in tertiles, using the second tertile as the reference category. Results Kidney length was strongly correlated with body surface area (2.04 mm; 95% confidence interval [95% CI], 1.95 to 2.13 per 0.1 m2 increase) and eGFR (1.62 mm; 95% CI, 1.52 to 1.73 per 10 ml/min per 1.73 m2 increase). During the median follow-up of 6.3 years, 1317 patients experienced a cardiovascular event, including 711 myocardial infarctions, 369 strokes, and 735 vascular cause deaths. A total of 1462 patients died of any cause and 52 patients developed ESRD. Irrespective of eGFR, patients in the third tertile of kidney length (11.7–16.1 cm) were at higher risk of cardiovascular mortality (hazard ratio, 1.33; 95% CI, 1.05 to 1.67) and cardiovascular events (hazard ratio, 1.28; 95% CI, 1.09 to 1.50). Patients in the first tertile of kidney length (7.8–10.8 cm) were not at higher risk of cardiovascular adverse events. Conclusions Large kidney length is related to higher risk of cardiovascular events and mortality in high-risk patients

  11. Review on risk factors related to lower back disorders at workplace

    NASA Astrophysics Data System (ADS)

    A' Tifah Jaffar, Nur; Nasrull Abdol Rahman, Mohd

    2017-08-01

    This review examines the evidence of the occurrence of risk exposure on work-related lower back disorders in the workplace. This review also investigates potential interactions between the risk factors in the workplace which include heavy physical work risk factor, static work postures risk factor, frequent bending and twisting risk factor, lifting risk factor, pushing and pulling risk factor, repetitive work risk factor, vibration risk factor, psychological and psychosocial risk factor that may be associated with symptoms of musculoskeletal disorders of lower back. These risk factors can reinforce each other and their influence can also be mediated by cultural or social factors. A systematic review of the literature was carried out by searching using databases and the searching strategy was used combined keyword for risk factors, work-related lower back disorders, heavy physical work, static work postures, frequent bending and twisting, lifting, pushing and pulling, repetitive work, vibration, psychological and psychosocial risk factor. A total of 67 articles were identified and reviewed. The risk factors identified that related for low back disorder are seven which are heavy physical work, static work postures, frequent bending and twisting, lifting, pushing and pulling, repetitive work, vibration, psychological and psychosocial risk factor and the level of evidence supporting the relationship with lower back disorders also described such as strong, moderate, insufficient, limited and no evidence. This result confirms that, existing of higher physical and psychosocial demand related to reported risk factors of low back disorders. The result also showed that previous reviews had evaluated relationship between risk factors of low back disorders and specific types of musculoskeletal disorders. This review also highlights the scarves evidence regarding some of the frequently reported risk factors for work related lower back disorders.

  12. Disentangling the risk assessment and intimate partner violence relation: Estimating mediating and moderating effects.

    PubMed

    Williams, Kirk R; Stansfield, Richard

    2017-08-01

    To manage intimate partner violence (IPV), the criminal justice system has turned to risk assessment instruments to predict if a perpetrator will reoffend. Empirically determining whether offenders assessed as high risk are those who recidivate is critical for establishing the predictive validity of IPV risk assessment instruments and for guiding the supervision of perpetrators. But by focusing solely on the relation between calculated risk scores and subsequent IPV recidivism, previous studies of the predictive validity of risk assessment instruments omitted mediating factors intended to mitigate the risk of this behavioral recidivism. The purpose of this study was to examine the mediating effects of such factors and the moderating effects of risk assessment on the relation between assessed risk (using the Domestic Violence Screening Instrument-Revised [DVSI-R]) and recidivistic IPV. Using a sample of 2,520 perpetrators of IPV, results revealed that time sentenced to jail and time sentenced to probation each significantly mediated the relation between DVSI-R risk level and frequency of reoffending. The results also revealed that assessed risk moderated the relation between these mediating factors and IPV recidivism, with reduced recidivism (negative estimated effects) for high-risk perpetrators but increased recidivism (positive estimate effects) for low-risk perpetrators. The implication is to assign interventions to the level of risk so that no harm is done. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Development of Relative Risk Model for Regional Groundwater Risk Assessment: A Case Study in the Lower Liaohe River Plain, China

    PubMed Central

    Li, Xianbo; Zuo, Rui; Teng, Yanguo; Wang, Jinsheng; Wang, Bin

    2015-01-01

    Increasing pressure on water supply worldwide, especially in arid areas, has resulted in groundwater overexploitation and contamination, and subsequent deterioration of the groundwater quality and threats to public health. Environmental risk assessment of regional groundwater is an important tool for groundwater protection. This study presents a new approach for assessing the environmental risk assessment of regional groundwater. It was carried out with a relative risk model (RRM) coupled with a series of indices, such as a groundwater vulnerability index, which includes receptor analysis, risk source analysis, risk exposure and hazard analysis, risk characterization, and management of groundwater. The risk map is a product of the probability of environmental contamination and impact. The reliability of the RRM was verified using Monte Carlo analysis. This approach was applied to the lower Liaohe River Plain (LLRP), northeastern China, which covers 23604 km2. A spatial analysis tool within GIS which was used to interpolate and manipulate the data to develop environmental risk maps of regional groundwater, divided the level of risk from high to low into five ranks (V, IV, III, II, I). The results indicate that areas of relative risk rank (RRR) V cover 2324 km2, covering 9.8% of the area; RRR IV covers 3986 km2, accounting for 16.9% of the area. It is a new and appropriate method for regional groundwater resource management and land use planning, and is a rapid and effective tool for improving strategic decision making to protect groundwater and reduce environmental risk. PMID:26020518

  14. Evaluating Equating Results: Percent Relative Error for Chained Kernel Equating

    ERIC Educational Resources Information Center

    Jiang, Yanlin; von Davier, Alina A.; Chen, Haiwen

    2012-01-01

    This article presents a method for evaluating equating results. Within the kernel equating framework, the percent relative error (PRE) for chained equipercentile equating was computed under the nonequivalent groups with anchor test (NEAT) design. The method was applied to two data sets to obtain the PRE, which can be used to measure equating…

  15. Study finds increases in risk of leukemias related to treatment

    Cancer.gov

    A new study describes the pattern of risk for chemotherapy-related acute myeloid leukemia among adult cancer survivors over the past three decades who have previously been treated with chemotherapy for other cancers. These patterns coincide with major shi

  16. Exploring risk communication - results of a research project focussed on effectiveness evaluation

    NASA Astrophysics Data System (ADS)

    Charrière, Marie; Bogaard, Thom; Junier, Sandra; Mostert, Erik

    2016-04-01

    The need for effective science communication and outreach efforts is widely acknowledged in the academic community. In the field of Disaster Risk Reduction, the importance of communication is clearly stressed, e.g. in the newly adopted Sendai Framework for Disaster Risk Reduction 2015-2030 (under the 1st priority of action: understanding disaster risk). Consequently, we see increasing risk communication activities. However, the effectiveness of these activities is rarely evaluated. To address this gap, several research activities were conducted in the context of the Marie Curie Initial Training Network "Changes", the results of which we will present and discuss. First, results of a literature review show, among others, that research on effectiveness is mainly focussed on the assessment of users' needs and their ability to understand the content, rather than on the final impact of the risk communication efforts. Moreover, lab-environment research is more often undertaken than assessment of real communication efforts. Second, a comparison between perceptions of risk managers and the general public of risk communication in a French Alps Valley highlighted a gap between the two groups in terms of amount of information needed (who wants more), the important topics to address (what) and the media to use (how). Third, interviews with developers of smartphone applications for disseminating avalanche risk information showed a variety of current practices and the absence of measurements of real their effectiveness. However, our analysis allowed identifying good practices that can be an inspiration for risk communication related to other hazards. Fourth, an exhibition has been set up following a collaborative approached based on stakeholder engagement. Using a pre/post-test design, the immediate impact of the exhibition, which aimed at increasing the risk awareness of the population (Ubaye Valley, France), was measured. The data obtained suggests that visiting the exhibition

  17. Mars Science Laboratory relative humidity observations: Initial results.

    PubMed

    Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, J A; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

    2014-09-01

    The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppmMSL relative humidity observation provides good dataHighest detected relative humidity reading during first MSL 100 sols is RH75.

  18. Mars Science Laboratory relative humidity observations: Initial results

    PubMed Central

    Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, JA; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

    2014-01-01

    The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Key Points Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppm MSL relative humidity observation provides good data Highest detected relative humidity reading during first MSL 100 sols is RH75% PMID:26213667

  19. Risk communication related to animal products derived from biotechnology.

    PubMed

    McCrea, D

    2005-04-01

    Previous chapters of this review have dealt with the key considerations related to the application of biotechnology in veterinary science and animal production. This article explores the theory and practice of risk communication and sets out the basic principles for good risk communication when dealing with new technologies, uncertainty, and cautious and sceptical consumers. After failure to communicate with consumers and stakeholders about the risk to human health from bovine spongiform encephalopathy (BSE) in the 1990s, Government Agencies in the United Kingdom have made significant improvements in risk communication. The official inquiry that followed the BSE crisis concluded that a policy of openness was the correct approach, and this article emphasises the importance of consultation, consistency and transparency. There are, however, many different factors that affect public perception of risk (religious, political, social, cultural, etc.) and developing effective risk communication strategies must take all of these complex issues into consideration.

  20. The evolution of risk perceptions related to bovine spongiform encephalopathy--Canadian consumer and producer behavior.

    PubMed

    Yang, Jun; Goddard, Ellen

    2011-01-01

    In this study the dynamics of risk perceptions related to bovine spongiform encephalopathy (BSE) held by Canadian consumers and cow-calf producers were evaluated. Since the first domestic case of BSE in 2003, Canadian consumers and cow-calf producers have needed to make decisions on whether or not their purchasing/production behavior should change. Such changes in their behavior may relate to their levels of risk perceptions about BSE, risk perceptions that may be evolving over time and be affected by BSE media information available. An econometric analysis of the behavior of consumers and cow-calf producers might identify the impacts of evolving BSE risk perceptions. Risk perceptions related to BSE are evaluated through observed market behavior, an approach that differs from traditional stated preference approaches to eliciting risk perceptions at a particular point in time. BSE risk perceptions may be specified following a Social Amplification of Risk Framework (SARF) derived from sociology, psychology, and economics. Based on the SARF, various quality and quantity indices related to BSE media information are used as explanatory variables in risk perception equations. Risk perceptions are approximated using a predictive difference approach as defined by Liu et al. (1998). Results showed that Canadian consumer and cow-calf producer risk perceptions related to BSE have been amplified or attenuated by both quantity and quality of BSE media information. Government policies on risk communications need to address the different roles of BSE information in Canadian consumers' and cow-calf producers' behavior.

  1. Results of a diabetic retinopathy screening. Risk markers analysis.

    PubMed

    Ancochea, G; Martín Sánchez, M D

    2016-01-01

    To identify risk markers for retinopathy in patients from our geographic area, and to compare them with those published in other studies. To design a screening interval strategy, taking into account these results, and compare it with intervals suggested in published studies. Cross-sectional observational study on 383 diabetic patients with no previous retinopathy diagnosis, who were screened for diabetic retinopathy. An analysis was made on the possible association between patient factors and presence of retinopathy. A greater probability for finding retinopathy in diabetic patients was associated to insulin treatment in our study, with a statistical significance level of 95%. In patients with less than 10year onset of their diabetes, only mild retinopathy without macular oedema was found. Insulin treatment and time of onset of diabetes should be taken into account when designing efficient screening strategies for diabetic retinopathy. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  2. Dietary fiber intake reduces risk of inflammatory bowel disease: result from a meta-analysis.

    PubMed

    Liu, Xiaoqin; Wu, Yili; Li, Fang; Zhang, Dongfeng

    2015-09-01

    Several epidemiological investigations have been conducted to evaluate the relationship between dietary fiber intake and inflammatory bowel diseases, but the results are inconsistent. This meta-analysis was performed to quantitatively summarize the evidence from observational studies. PubMed, Embase, and Web of Knowledge were searched for relevant articles published up to November 2014. The combined relative risks were calculated with the fixed- or random-effects model. Dose-response relationship was assessed using restricted cubic spline model. We hypothesized that the meta-analysis could yield a summary effect, which would indicate that dietary fiber intake could decrease the risk of ulcerative colitis and Crohn disease (CD). Overall, 8 articles involving 2 cohort studies, 1 nested case-control study, and 5 case-control studies were finally included in this study. The pooled relative risks with 95% confidence intervals of ulcerative colitis and CD for the highest vs lowest categories of dietary fiber intake were 0.80 (0.64-1.00) and 0.44 (0.29-0.69), respectively. A linear dose-response relationship was found between dietary fiber and CD risk, and the risk of CD decreased by 13% (P < .05) for every 10 g/d increment in fiber intake. The results from this meta-analysis indicated that the intake of dietary fiber was significantly associated with a decreased risk of inflammatory bowel disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. A risk-factor analysis of medical litigation judgments related to fall injuries in Korea.

    PubMed

    Kim, Insook; Won, Seonae; Lee, Mijin; Lee, Won

    2018-01-01

    The aim of this study was to find out the risk factors through analysis of seven medical malpractice judgments related to fall injuries. The risk factors were analysed by using the framework that approaches falls from a systems perspective and comprised people, organisational or environmental factors, with each factor being comprised of subfactors. The risk factors found in each of the seven judgments were aggregated into one framework. The risk factors related to patients (i.e. the people factor) were age, pain, related disease, activities and functional status, urination state, cognitive function impairment, past history of fall, blood transfusion, sleep endoscopy state and uncooperative attitude. The risk factors related to the medical staff and caregivers (i.e. people factor) were observation negligence, no fall prevention activities and negligence in managing high-risk group for fall. Organisational risk factors were a lack of workforce, a lack of training, neglecting the management of the high-risk group, neglecting the management of caregivers and the absence of a fall prevention procedure. Regarding the environment, the risk factors were found to be the emergency room, chairs without a backrest and the examination table. Identifying risk factors is essential for preventing fall accidents, since falls are preventable patient-safety incidents. Falls do not happen as a result of a single risk factor. Therefore, a systems approach is effective to identify risk factors, especially organisational and environmental factors.

  4. Listeria monocytogenes in Retail Delicatessens: an Interagency Risk Assessment-model and baseline results.

    PubMed

    Pouillot, Régis; Gallagher, Daniel; Tang, Jia; Hoelzer, Karin; Kause, Janell; Dennis, Sherri B

    2015-01-01

    The Interagency Risk Assessment-Listeria monocytogenes (Lm) in Retail Delicatessens provides a scientific assessment of the risk of listeriosis associated with the consumption of ready-to-eat (RTE) foods commonly prepared and sold in the delicatessen (deli) of a retail food store. The quantitative risk assessment (QRA) model simulates the behavior of retail employees in a deli department and tracks the Lm potentially present in this environment and in the food. Bacterial growth, bacterial inactivation (following washing and sanitizing actions), and cross-contamination (from object to object, from food to object, or from object to food) are evaluated through a discrete event modeling approach. The QRA evaluates the risk per serving of deli-prepared RTE food for the susceptible and general population, using a dose-response model from the literature. This QRA considers six separate retail baseline conditions and provides information on the predicted risk of listeriosis for each. Among the baseline conditions considered, the model predicts that (i) retail delis without an environmental source of Lm (such as niches), retail delis without niches that do apply temperature control, and retail delis with niches that do apply temperature control lead to lower predicted risk of listeriosis relative to retail delis with niches and (ii) retail delis with incoming RTE foods that are contaminated with Lm lead to higher predicted risk of listeriosis, directly or through cross-contamination, whether the contaminated incoming product supports growth or not. The risk assessment predicts that listeriosis cases associated with retail delicatessens result from a sequence of key events: (i) the contaminated RTE food supports Lm growth; (ii) improper retail and/or consumer storage temperature or handling results in the growth of Lm on the RTE food; and (iii) the consumer of this RTE food is susceptible to listeriosis. The risk assessment model, therefore, predicts that cross

  5. A PARENT–ADOLESCENT INTERVENTION TO INCREASE SEXUAL RISK COMMUNICATION: RESULTS OF A RANDOMIZED CONTROLLED TRIAL

    PubMed Central

    Villarruel, Antonia M.; Cherry, Carol Loveland; Cabriales, Esther Gallegos; Ronis, David L.; Zhou, Yan

    2009-01-01

    This article reports results of a randomized controlled trial designed to test an intervention to increase parent–adolescent sexual risk communication among Mexican parents. Data were analyzed from parents (n = 791) randomly assigned to an HTV risk reduction or health promotion intervention. Measures were administered at pretest, posttest, and 6– and 12–month follow–ups. Generalized estimation equation (GEE) analysis indicates parents in the HIV risk reduction intervention reported significantly more general communication (p < .005), more sexual risk communication (p < .001) and more comfort with communication (p < .001) than parents in the control intervention. Behavioral, normative, and control beliefs significantly mediated the effect of the intervention on all communication outcomes. This study demonstrates the efficacy of an intervention to increase the quality and quantity of parent–adolescent communication related to general and sex–specific communication. PMID:18956979

  6. Height, selected genetic markers and prostate cancer risk: results from the PRACTICAL consortium.

    PubMed

    Lophatananon, Artitaya; Stewart-Brown, Sarah; Kote-Jarai, Zsofia; Olama, Ali Amin Al; Garcia, Sara Benlloch; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Giles, Graham G; Fitzgerald, Liesel M; Southey, Melissa C; Pharoah, Paul; Pashayan, Nora; Gronberg, Henrik; Wiklund, Fredrik; Aly, Markus; Stanford, Janet L; Brenner, Hermann; Dieffenbach, Aida K; Arndt, Volker; Park, Jong Y; Lin, Hui-Yi; Sellers, Thomas; Slavov, Chavdar; Kaneva, Radka; Mitev, Vanio; Batra, Jyotsna; Spurdle, Amanda; Clements, Judith A; Easton, Douglas; Eeles, Rosalind A; Muir, Kenneth

    2017-08-22

    Evidence on height and prostate cancer risk is mixed, however, recent studies with large data sets support a possible role for its association with the risk of aggressive prostate cancer. We analysed data from the PRACTICAL consortium consisting of 6207 prostate cancer cases and 6016 controls and a subset of high grade cases (2480 cases). We explored height, polymorphisms in genes related to growth processes as main effects and their possible interactions. The results suggest that height is associated with high-grade prostate cancer risk. Men with height >180 cm are at a 22% increased risk as compared to men with height <173 cm (OR 1.22, 95% CI 1.01-1.48). Genetic variants in the growth pathway gene showed an association with prostate cancer risk. The aggregate scores of the selected variants identified a significantly increased risk of overall prostate cancer and high-grade prostate cancer by 13% and 15%, respectively, in the highest score group as compared to lowest score group. There was no evidence of gene-environment interaction between height and the selected candidate SNPs.Our findings suggest a role of height in high-grade prostate cancer. The effect of genetic variants in the genes related to growth is seen in all cases and high-grade prostate cancer. There is no interaction between these two exposures.

  7. Relating results from earthworm toxicity tests to agricultural soil

    USGS Publications Warehouse

    Beyer, W.N.; Greig-Smith, P.W.

    1992-01-01

    The artificial soil tests of the European Economic Community and of the Organization for Economic Cooperation produce data relating earthworm mortality to pesticide concentrations in soil under laboratory conditions. To apply these results to agricultural soils it is necessary to relate these concentrations to amounts of pesticide applied per area. This paper reviews the relevant published literature and suggests a simple relation for regulatory use. Hazards to earthworms from pesticides are suggested to be greatest soon after application, when the pesticides may be concentrated in a soil layer a few millimeters thick. For estimating exposure of earthworms, however, a thicker soil layer should be considered, to account for their movement through soil. During favorable weather conditions, earthworms belonging to species appropriate to the artificial soil test have been reported to confine their activity to a layer about 5 cm. If a 5-cm layer is accepted as relevant for regulatory purposes, then an application of 1 kg/ha would be equivalent to 1-67 ppm (dry) in the artificial soil test.

  8. Wisconsin Youth Risk Behaviors: 1993 Survey Results. Bulletin No. 94305.

    ERIC Educational Resources Information Center

    Fernan, Steven A.; And Others

    How can state leaders mobilize to meet the health and safety needs of its school-age children? To understand more about children's health, the Wisconsin Department of Public Instruction (DPI) has surveyed Wisconsin students. In 1993 the DPI and the U.S. Centers for Disease Control (CDC) joined forces to conduct the Youth Risk Behavior Survey.…

  9. Risk factors related to asymptomatic bacteriuria in pregnant women.

    PubMed

    Kovavisarach, Ekachai; Vichaipruck, Maytina; Kanjarahareutai, Suwattana

    2009-05-01

    To determine the risk factors related to asymptomatic bacteriuria (ABU) in pregnant women. Three hundred and sixty asymptomatic pregnant women who attended their first antenatal appointment at Rajavithi Hospital from August 1 and October 31 2005 were enrolled. Those with symptoms of urinary tract infection within one month, those who had been prescribed antibiotics during the previous seven days, and those with medical or obstetric complications, vaginal bleeding, and history of urinary tract disease were excluded. Urine specimens were collected by clean-catched midstream urine technique for culture. Several risk factors related to ABU and obstetric and demographic characteristics were recorded. The prevalence of ABU in pregnant women was 10.0%. The significant risk factors related to ABU in pregnancy was lower education level < or = grade 6 (p < 0.05) with 2.17-time risk of ABU compared with higher education level > grade 6. Maternal and gestational age, occupation, monthly income, gravidity, previous history of urinary tract infection and anemia were not statistically associated with ABU. Lower education level (< or = grade 6) should be the only significant risk factor related to ABU in Thai pregnant women under limited sample size.

  10. Tradeoffs in Risk and Return of Financial Hedging Solutions to Mitigate Drought-Related Financial Risks for Water Utilities

    NASA Astrophysics Data System (ADS)

    Baum, R.; Characklis, G. W.

    2016-12-01

    Financial hedging solutions have been examined as tools for effectively mitigating water scarcity related financial risks for water utilities, and have become more prevalent as conservation (resulting in reduced revenues) and water transfers (resulting in increased costs) play larger roles in drought management. Individualized financial contracts (i.e. designed for a single utility) provide evidence of the potential benefits of financial hedging. However, individualized contracts require substantial time and information to develop, limiting their widespread implementation. More generalized contracts have also shown promise, and would allow the benefits of risk pooling to be more effectively realized, resulting in less expensive contracts. Risk pooling reduces the probability of an insurer making payouts that deviate significantly from the mean, but given that the financial risks of drought are spatially correlated amongst utilities, these more extreme "fat tail" risks remain. Any group offering these hedging contracts, whether a third-party insurer or a "mutual" comprised of many utilities, will need to balance the costs (i.e. additional risk) and benefits (i.e. returns) of alternative approaches to managing the extreme risks (e.g. through insurance layers). The balance of these different approaches will vary depending on the risk pool being considered, including the number, size and exposure of the participating utilities. This work first establishes a baseline of the tradeoffs between risk and expected return in insuring against the financial risks of water scarcity without alternative hedging approaches for water utilities across all climate divisions of the United States. Then various scenarios are analyzed to provide insight into how to maximize returns for risk pooling portfolios at various risk levels through balancing different insurance layers and hedging approaches. This analysis will provide valuable information for designing optimal financial risk

  11. Selected Indicators of Adolescent Suicide in High School Students: Results of the 1993 North Carolina Youth Risk Behavior Survey.

    ERIC Educational Resources Information Center

    Mikow, Victoria A.

    Results of a survey show that high school students in North Carolina think about, attempt, and are injured as the result of a suicide attempt with alarming frequency. This report summarizes suicide-related data from the North Carolina Youth Risk Behavior Survey (1993). Younger students are more at risk of suicide than older students; more than one…

  12. Relative risk analysis of several manufactured nanomaterials: an insurance industry context.

    PubMed

    Robichaud, Christine Ogilvie; Tanzil, Dicksen; Weilenmann, Ulrich; Wiesner, Mark R

    2005-11-15

    A relative risk assessment is presented for the industrial fabrication of several nanomaterials. The production processes for five nanomaterials were selected for this analysis, based on their current or near-term potential for large-scale production and commercialization: single-walled carbon nanotubes, bucky balls (C60), one variety of quantum dots, alumoxane nanoparticles, and nano-titanium dioxide. The assessment focused on the activities surrounding the fabrication of nanomaterials, exclusive of any impacts or risks with the nanomaterials themselves. A representative synthesis method was selected for each nanomaterial based on its potential for scaleup. A list of input materials, output materials, and waste streams for each step of fabrication was developed and entered into a database that included key process characteristics such as temperature and pressure. The physical-chemical properties and quantities of the inventoried materials were used to assess relative risk based on factors such as volatility, carcinogenicity, flammability, toxicity, and persistence. These factors were first used to qualitatively rank risk, then combined using an actuarial protocol developed by the insurance industry for the purpose of calculating insurance premiums for chemical manufacturers. This protocol ranks three categories of risk relative to a 100 point scale (where 100 represents maximum risk): incident risk, normal operations risk, and latent contamination risk. Results from this analysis determined that relative environmental risk from manufacturing each of these five materials was comparatively low in relation to other common industrial manufacturing processes.

  13. Results of Needs Assessments Related to Citizen Science Projects

    NASA Astrophysics Data System (ADS)

    Buxner, Sanlyn; Bracey, Georgia; Glushko, Anna; Bakerman, Maya; Gay, Pamela L.; CosmoQuest Team

    2017-01-01

    The CosmoQuest Virtual Research Facility invites the public and classrooms to participate in NASA Science Mission Directorate related research that leads to publishable results and data catalogues. One of the main goals of the project is to support professional scientists in doing science and the general public--including parents, children, teachers, and students--in learning and doing science. Through the effort, the CosmoQuest team is developing a variety of supports and opportunities to support the doing and teaching of science. To inform our efforts, we have implemented a set of needs surveys to assess the needs of our different audiences. These surveys are being used to understand the interests, motivations, resources, challenges and demographics of our growing CosmoQuest community and others interested in engaging in citizen science projects. The surveys include those for teachers, parents, adult learners, planetarium professionals, subject matter experts (SMEs), and the general public. We will share the results of these surveys and discuss the implications of the results for broader education and outreach programs.

  14. Treatment-related neuroendocrine prostate cancer resulting in Cushing's syndrome.

    PubMed

    Ramalingam, Sundhar; Eisenberg, Adva; Foo, Wen Chi; Freedman, Jennifer; Armstrong, Andrew J; Moss, Larry G; Harrison, Michael R

    2016-12-01

    Here we present, to the best of our knowledge, the first case of a paraneoplastic Cushing's syndrome (hypercortisolism) resulting from treatment-related neuroendocrine prostate cancer - a highly aggressive and difficult disease to treat. A 51-year-old man was started on androgen deprivation therapy after presenting with metastatic prostate cancer, characterized by diffuse osseous metastasis. Shortly thereafter, he developed progressive disease with biopsy proven neuroendocrine prostate cancer as well as symptoms of increased skin pigmentation, hypokalemia, hypertension, hyperglycemia and profound weakness, consistent with ectopic Cushing's syndrome. Molecular analysis of the patient's tumor through RNA sequencing showed high expression of several genes including CHGA, ASCL1, CALCA, HES6, PCSK1, CALCB and INSM1 confirming his neuroendocrine phenotype; elevated POMC expression was found, supporting the diagnosis of ectopic Cushing's syndrome. © 2016 The Japanese Urological Association.

  15. Themes in the literature related to cardiovascular disease risk reduction.

    PubMed

    Cohen, Shannon Munro; Kataoka-Yahiro, Merle

    2009-01-01

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

  16. Binge drinking among adolescents: prevalence, risk practices and related variables.

    PubMed

    Golpe, Sandra; Isorna, Manuel; Barreiro, Carmen; Braña, Teresa; Rial, Antonio

    2017-09-29

    According to the last Survey on Drug Use among Secondary School Students (ESTUDES 2014-2015), consumption levels of alcohol and other substances have decreased in the last years in Spain. However, available data on binge drinking remain worrying, given the negative consequences related with this pattern. The aim of this paper is to analyse binge drinking among adolescents, providing updated data on prevalence in addition to information about the consequences and some predictive factors of binge drinking. A correlational method was used for this purpose, comprised of administering a survey to Compulsory Secondary School, High School and Vocational Training students. Based on a sample of 3,419 Galician adolescents aged between 12 and 18 years (M = 14.57; SD = 1.76), the results show that binge drinking is a common and global practice, with few socio-demographic differences but related with a wide range of risk practices. Furthermore, variables such as consumption expectancies, consumption by family and friends, as well as curfew time and allowance money have been identified as interesting predictive factors that should be taken into account at the preventive level.

  17. 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

  18. Cancer-related fatigue: Mechanisms, risk factors, and treatments

    PubMed Central

    Bower, Julienne E.

    2015-01-01

    Fatigue is one of the most common and distressing side effects of cancer and its treatment, and may persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and may be a risk factor for reduced survival. The prevalence and course of fatigue in cancer patients has been well characterized, and there is growing understanding of underlying biological mechanisms. Inflammation has emerged as a key biological pathway for cancer-related fatigue, with studies documenting links between markers of inflammation and fatigue before, during, and particularly after treatment. There is considerable variability in the experience of cancer-related fatigue that is not explained by disease- or treatment-related characteristics, suggesting that host factors may play an important role in the development and persistence of this symptom. Indeed, longitudinal studies have begun to identify genetic, biological, psychosocial, and behavioral risk factors for cancer-related fatigue. Given the multi-factorial nature of cancer-related fatigue, a variety of intervention approaches have been examined in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. Although there is currently no gold standard for treating fatigue, several of these approaches have shown beneficial effects and can be recommended to patients. This report provides a state of the science review of mechanisms, risk factors, and interventions for cancer-related fatigue, with a focus on recent longitudinal studies and randomized trials that have targeted fatigued patients. PMID:25113839

  19. Emotional reactions to alcohol-related words: Differences between low- and high-risk drinkers.

    PubMed

    Gantiva, Carlos; Delgado, Rafael; Romo-González, Tania

    2015-11-01

    Research that has examined responses to alcohol-related words in drinkers has mostly linked such responses to memory, attentional, and perceptual bias. However, studies of emotional processing in alcoholics have not received much attention. The main goal of the present study was to identify the features and differences of emotional responses to alcohol-related words in low- and high-risk drinkers. A total of 149 low-risk drinkers and 125 high-risk drinkers evaluated five alcohol-related words and 15 words from the Affective Norms for English Words in the dimensions of valence, arousal, and dominance using the Self-Assessment Manikin. The results indicated that high-risk drinkers evaluated alcohol-related words as more appetitive and arousing. These results, together with findings in the attention and memory research literature, suggest that alcohol-related words can serve as conditioned cues in alcohol consumption. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. F8 haplotype and inhibitor risk: results from the Hemophilia Inhibitor Genetics Study (HIGS) Combined Cohort

    PubMed Central

    Schwarz, John; Astermark, Jan; Menius, Erika D.; Carrington, Mary; Donfield, Sharyne M.; Gomperts, Edward D.; Nelson, George W.; Oldenburg, Johannes; Pavlova, Anna; Shapiro, Amy D.; Winkler, Cheryl A.; Berntorp, Erik

    2012-01-01

    Background Ancestral background, specifically African descent, confers higher risk for development of inhibitory antibodies to factor VIII (FVIII) in hemophilia A. It has been suggested that differences in the distribution of factor VIII gene (F8) haplotypes, and mismatch between endogenous F8 haplotypes and those comprising products used for treatment could contribute to risk. Design and Methods Data from the HIGS Combined Cohort were used to determine the association between F8 haplotype 3 (H3) vs. haplotypes 1 and 2 (H1+H2) and inhibitor risk among individuals of genetically-determined African descent. Other variables known to affect inhibitor risk including type of F8 mutation and HLA were included in the analysis. A second research question regarding risk related to mismatch in endogenous F8 haplotype and recombinant FVIII products used for treatment was addressed. Results H3 was associated with higher inhibitor risk among those genetically-identified (N=49) as of African ancestry, but the association did not remain significant after adjustment for F8 mutation type and the HLA variables. Among subjects of all racial ancestries enrolled in HIGS who reported early use of recombinant products (N=223), mismatch in endogenous haplotype and the FVIII proteins constituting the products used did not confer greater risk for inhibitor development. Conclusion H3 was not an independent predictor of inhibitor risk. Further, our findings did not support a higher risk of inhibitors in the presence of a haplotype mismatch between the FVIII molecule infused and that of the individual. PMID:22958194

  1. A Probabilistic Risk Assessment of Groundwater-Related Risks at Excavation Sites

    NASA Astrophysics Data System (ADS)

    Jurado, A.; de Gaspari, F.; Vilarrasa, V.; Sanchez-Vila, X.; Fernandez-Garcia, D.; Tartakovsky, D. M.; Bolster, D.

    2010-12-01

    Excavation sites such as those associated with the construction of subway lines, railways and highway tunnels are hazardous places, posing risks to workers, machinery and surrounding buildings. Many of these risks can be groundwater related. In this work we develop a general framework based on a probabilistic risk assessment (PRA) to quantify such risks. This approach is compatible with standard PRA practices and it employs many well-developed risk analysis tools, such as fault trees. The novelty and computational challenges of the proposed approach stem from the reliance on stochastic differential equations, rather than reliability databases, to compute the probabilities of basic events. The general framework is applied to a specific case study in Spain. It is used to estimate and minimize risks for a potential construction site of an underground station for the new subway line in the Barcelona metropolitan area.

  2. The Relations among Cumulative Risk, Parenting, and Behavior Problems during Early Childhood

    ERIC Educational Resources Information Center

    Trentacosta, Christopher J.; Hyde, Luke W.; Shaw, Daniel S.; Dishion, Thomas J.; Gardner, Frances; Wilson, Melvin

    2008-01-01

    Background: This study examined relations among cumulative risk, nurturant and involved parenting, and behavior problems across early childhood. Methods: Cumulative risk, parenting, and behavior problems were measured in a sample of low-income toddlers participating in a family-centered program to prevent conduct problems. Results: Path analysis…

  3. Development of a relative risk model for evaluating ecological risk of water environment in the Haihe River Basin estuary area.

    PubMed

    Chen, Qiuying; Liu, Jingling; Ho, Kin Chung; Yang, Zhifeng

    2012-03-15

    Ecological risk assessment for water environment is significant to water resource management of basin. Effective environmental management and systems restoration such as the Haihe River Basin require holistic understanding of the relative importance of various stressor-related impacts throughout the basin. As an effective technical tool for evaluating the ecological risk, relative risk model (RRM) was applied in regional scale successfully. In this study, the risk transfer from upstream of basin was considered and the RRM was developed through introducing the source-stressor-habitat exposure filter (SSH), the endpoint-habitat exposure filter (EH) and the stressor-endpoint effect filter (SE) to reflect the meaning of exposure and effect more explicit. Water environment which includes water quality, water quantity and aquatic ecosystems was selected as the assessment endpoints. We created a conceptual model which depicting potential and effect pathways from source to stressor to habitat to endpoint. The Haihe River Basin estuary (HRBE) was selected as the model case. The results showed that there were two low risk regions, one medium risk region and two high risk regions in the HRBE. The results also indicated that urbanization was the biggest source, the second was shipping and the third was industry, their risk scores are 5.65, 4.71 and 3.68 respectively. Furthermore, habitat destruction was the largest stressor with the risk scores (2.66), the second was oxygen consuming organic pollutants (1.75) and the third was pathogens (1.75). So these three stressors were the main influencing factors of the ecological pressure in the study area. For habitats, open waters (9.59) and intertidal mudflat were enduring the bigger pressure and should be taken considerable attention. Ecological service values damaged (30.54) and biodiversity decreased were facing the biggest risk pressure. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Spatial Relative Risk Patterns of Autism Spectrum Disorders in Utah

    ERIC Educational Resources Information Center

    Bakian, Amanda V.; Bilder, Deborah A.; Coon, Hilary; McMahon, William M.

    2015-01-01

    Heightened areas of spatial relative risk for autism spectrum disorders (ASD), or ASD hotspots, in Utah were identified using adaptive kernel density functions. Children ages four, six, and eight with ASD from multiple birth cohorts were identified by the Utah Registry of Autism and Developmental Disabilities. Each ASD case was gender-matched to…

  5. Cancer-related fatigue--mechanisms, risk factors, and treatments.

    PubMed

    Bower, Julienne E

    2014-10-01

    Fatigue is one of the most common adverse effects of cancer that might persist for years after treatment completion in otherwise healthy survivors. Cancer-related fatigue causes disruption in all aspects of quality of life and might be a risk factor of reduced survival. The prevalence and course of fatigue in patients with cancer have been well characterized and there is growing understanding of the underlying biological mechanisms. Inflammation seems to have a key role in fatigue before, during, and after cancer-treatment. However, there is a considerable variability in the presentation of cancer-related fatigue, much of which is not explained by disease-related or treatment-related characteristics, suggesting that host factors might be important in the development and persistence of this symptom. Indeed, longitudinal studies have identified genetic, biological, psychosocial, and behavioural risk factors associated with cancer-related fatigue. Although no current gold-standard treatment for fatigue is available, a variety of intervention approaches have shown beneficial effects in randomized controlled trials, including physical activity, psychosocial, mind-body, and pharmacological treatments. This Review describes the mechanisms, risk factors, and possible interventions for cancer-related fatigue, focusing on recent longitudinal studies and randomized trials that have targeted fatigued patients.

  6. Relative risk analysis in regulating the use of radiation-emitting medical devices. A preliminary application

    SciTech Connect

    Jones, E.D.; Banks, W.W.; Altenbach, T.J.

    1995-09-01

    This report describes a preliminary application of an analysis approach for assessing relative risks in the use of radiation- emitting medical devices. Results are presented on human-initiated actions and failure modes that are most likely to occur in the use of the Gamma Knife, a gamma irradiation therapy device. This effort represents an initial step in a US Nuclear Regulatory Commission (NRC) plan to evaluate the potential role of risk analysis in regulating the use of nuclear medical devices. For this preliminary application of risk assessment, the focus was to develop a basic process using existing techniques for identifying themore » most likely risk contributors and their relative importance. The approach taken developed relative risk rankings and profiles that incorporated the type and quality of data available and could present results in an easily understood form. This work was performed by the Lawrence Livermore National Laboratory for the NRC.« less

  7. Skin disease symptoms and related risk factors among young workers in high-risk jobs.

    PubMed

    Aktas, Emine; Esin, M Nihal

    2016-08-01

    Occupational skin diseases are the one of the most frequent diseases in many industrialized countries. The studies about skin disease (SD) on young workers were limited. In this study, we aim to evaluate the prevalence of SD symptoms and related risk factors among young workers in high-risk occupations. This cross-sectional study was undertaken between 2011 and 2012 in two vocational training centres. We included 455 young workers who were working as hairdressers, jewellers, or car mechanics. Data were collected with the Nordic Occupational Skin Questionnaire, which was adapted to Turkish for young workers. The average age of the young workers was 17.9 ± 1.7 years. Of the 455 young workers, 52.7% were female and 47.3% were male. During the previous 12 months, the prevalences of the total SD symptoms, hand/forearm eczema symptoms and urticaria symptoms were 49.7%, 44.4%, and 13.4%, respectively. Those who worked as car mechanics were 5.8 times more likely [odds ratio (OR) 5.81, 95%CI: 2.58-13.10) to have a dry skin type, 2.9 times more likely (OR 2.86, 95%CI: 1.72-4.75) to work for >12 h daily, 2.6 times more likely (OR 2.59, 95%CI: 1.25-5.35) to have worked for >5 years, and 3.0 times more likely (OR 3.05, 95%CI: 1.14-8.14) to have SD symptoms. The results indicate that young workers in high-risk jobs have a high frequency of skin symptoms. These results could provide a basis for occupational health professionals to plan prevention programmes for young workers. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Socioeconomic differences in alcohol-related risk-taking behaviours.

    PubMed

    Livingston, Michael

    2014-11-01

    There is substantial research showing that low socioeconomic position is a predictor of negative outcomes from alcohol consumption, while alcohol consumption itself does not exhibit a strong social gradient. This study aims to examine socioeconomic differences in self-reported alcohol-related risk-taking behaviour to explore whether differences in risk-taking while drinking may explain some of the socioeconomic disparities in alcohol-related harm. Cross-sectional data from current drinkers (n = 21 452) in the 2010 wave of the Australian National Drug Strategy Household Survey were used. Ten items on risk-taking behaviour while drinking were combined into two risk scores, and zero-inflated Poisson regression was used to assess the relationship between socioeconomic position and risk-taking while controlling for age, sex and alcohol consumption. Socioeconomically advantaged respondents reported substantially higher rates of alcohol-related hazardous behaviour than socioeconomically disadvantaged respondents. Controlling for age, sex, volume of drinking and frequency of heavy drinking, respondents living in the most advantaged quintile of neighbourhoods reported significantly higher rates of hazardous behaviour than those in the least advantaged quintile. A similar pattern was evident for household income. Socioeconomically advantaged Australians engage in alcohol-related risky behaviour at higher rates than more disadvantaged Australians even with alcohol consumption controlled. The significant socioeconomic disparities in negative consequences linked to alcohol consumption cannot in this instance be explained via differences in behaviour while drinking. Other factors not directly related to alcohol consumption may be responsible for health inequalities in outcomes with significant alcohol involvement. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  9. Sex differences in event-related risk for major depression.

    PubMed

    Maciejewski, P K; Prigerson, H G; Mazure, C M

    2001-05-01

    This study sought to determine if women are more likely than men to experience an episode of major depression in response to stressful life events. Sex differences in event-related risk for depression were examined by means of secondary analyses employing data from the Americans' Changing Lives study. The occurrence and time of occurrence of depression onset and instances of stressful life events within a 12-month period preceding a structured interview were documented in a community-based sample of 1024 men and 1800 women. Survival analytical techniques were used to examine sex differences in risk for depression associated with generic and specific stressful life events. Women were approximately three times more likely than men to experience major depression in response to any stressful life event. Women and men did not differ in risk for depression associated with the death of a spouse or child, events affecting their relationship to a spouse/partner (divorce and marital/love problems) or events corresponding to acute financial or legal difficulties. Women were at elevated risk for depression associated with more distant interpersonal losses (death of a close friend or relative) and other types of events (change of residence, physical attack, or life-threatening illness/injury). Stressful life events overall, with some exceptions among specific event types, pose a greater risk for depression among women compared to men.

  10. Socioeconomic status and the risk of developing rheumatoid arthritis: results from the Swedish EIRA study

    PubMed Central

    Bengtsson, C; Nordmark, B; Klareskog, L; Lundberg, I; Alfredsson, L; the, E

    2005-01-01

    Objective: To study whether formal education and occupational class are associated with incidence of rheumatoid arthritis overall and with the incidence of the two major subgroups of rheumatoid arthritis—seropositive (RF+) and seronegative (RF–) disease. Methods: 930 cases and 1126 controls participated in a population based case–control study using incident cases of rheumatoid arthritis, carried out in Sweden during the period May 1996 to June 2001. The relative risk (RR) of developing rheumatoid arthritis with 95% confidence interval (CI) was calculated for different levels of formal education compared with university degree and for different occupational classes compared with higher non-manual employees. Results: Subjects without a university degree had an increased risk of rheumatoid arthritis compared with those with a university degree (RR = 1.4 (95% CI, 1.2 to 1.8)). For manual employees, assistant and intermediate non-manual employees together, the risk of developing rheumatoid arthritis was about 20% more than for non-manual employees. These increased risks were more pronounced for RF+ than for RF– rheumatoid arthritis and were mainly confined to women. Smoking could not of its own explain the observed associations between risk of rheumatoid arthritis in different socioeconomic groups in Sweden. Conclusions: There was an association between high socioeconomic status and lower risk of rheumatoid arthritis in a population based investigation that was representative for the Swedish population. The study shows that as yet unexplained environmental or lifestyle factors, or both, influence the risk of rheumatoid arthritis, even in the relatively egalitarian Swedish society. PMID:15843455

  11. Explanatory risk factors in the relations between schizotypy and indicators of suicide risk.

    PubMed

    Jahn, Danielle R; DeVylder, Jordan E; Hilimire, Matthew R

    2016-04-30

    Schizotypy has been linked to suicide risk, but it is not known whether established suicide-related risk factors mediate this relation. The aim of this study was to assess the mediating effects of depressive symptoms, social anxiety, self-esteem, and intimate disclosure in peer relationships in the relation between interpersonal schizotypy and suicide ideation or lifetime suicide attempts. This aim was tested in 590 young adults using a nonparametric bootstrapping procedure. After inclusion of the mediators, interpersonal schizotypy was no longer directly associated with either suicide ideation or lifetime suicide attempts. Depression and self-esteem mediated the relation between interpersonal schizotypy and suicide ideation. No variables mediated the relation between interpersonal schizotypy and lifetime suicide attempts, and there were no significant direct relations when mediators were included. Schizotypy appears to be a distal risk factor for suicidal behavior; assessing depressive symptoms and self-esteem may provide more proximal information about suicide risk, and may be targets for mitigating suicide risk in individuals with schizotypy. Published by Elsevier Ireland Ltd.

  12. Are twins at risk of cancer: results from the Swedish family-cancer database.

    PubMed

    Hemminki, Kari; Chen, Bowang

    2005-10-01

    A few twin studies on cancer have addressed questions on the possible carcinogenic or protective effects of twining by comparing the occurrence of cancer in twins and singletons. The nationwide Swedish Family-Cancer Database of 10.2 million individuals and 69,654 0- to 70-year-old twin pairs were used to calculate standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for all main cancers compared to singletons. The overall risk of cancer in same- or different-sex twins was at the same level as the risk for singletons. Testicular cancer, particularly seminoma, was increased among same-sex twins (1.54) and all twins to an SIR of 1.38. Among other tumors, neurinomas and non-thyroid endocrine gland tumors were increased. Colorectal cancers and leukemia were decreased among all twins. Melanoma and squamous cell skin cancer were decreased in male same-sex twins. The data on this unselected population of twins suggest that twinning per se is not a risk factor of cancer. In utero hormonal exposures or postnatal growth stimulation may be related to the risk of testicular cancer and pituitary tumors. Protective effects against colorectal cancer may be related to a beneficial diet, and in melanoma and skin cancer, to socioeconomic factors. The study involved multiple comparisons, and internal consistency between the results was one of the main factors considered for their plausibility. The results should encourage others working on twin and singleton populations to examine the specific associations and emerging hypotheses.

  13. Potential public health impact of Age-Related Eye Disease Study results: AREDS report no. 11.

    PubMed

    Bressler, Neil M; Bressler, Susan B; Congdon, Nathan G; Ferris, Frederick L; Friedman, David S; Klein, Ronald; Lindblad, Anne S; Milton, Roy C; Seddon, Johanna M

    2003-11-01

    To estimate the potential public health impact of the findings of the Age-Related Eye Disease Study (AREDS) on reducing the number of persons developing advanced age-related macular degeneration (AMD) during the next 5 years in the United States. The AREDS clinical trial provides estimates of AMD progression rates and of reduction in risk of developing advanced AMD when a high-dose nutritional supplement of antioxidants and zinc is used. These results are applied to estimates of the US population at risk, to estimate the number of people who would potentially avoid advanced AMD during 5 years if those at risk were to take a supplement such as that used in AREDS. An estimated 8 million persons at least 55 years old in the United States have monocular or binocular intermediate AMD or monocular advanced AMD. They are considered to be at high risk for advanced AMD and are those for whom the AREDS formulation should be considered. Of these people, 1.3 million would develop advanced AMD if no treatment were given to reduce their risk. If all of these people at risk received supplements such as those used in AREDS, more than 300,000 (95% confidence interval, 158,000-487,000) of them would avoid advanced AMD and any associated vision loss during the next 5 years. If people at high risk for advanced AMD received supplements such as those suggested by AREDS results, the potential impact on public health in the United States would be considerable during the next 5 years.

  14. Improved Airborne Gravity Results Using New Relative Gravity Sensor Technology

    NASA Astrophysics Data System (ADS)

    Brady, N.

    2013-12-01

    Airborne gravity data has contributed greatly to our knowledge of subsurface geophysics particularly in rugged and otherwise inaccessible areas such as Antarctica. Reliable high quality GPS data has renewed interest in improving the accuracy of airborne gravity systems and recent improvements in the electronic control of the sensor have increased the accuracy and ability of the classic Lacoste and Romberg zero length spring gravity meters to operate in turbulent air conditions. Lacoste and Romberg type gravity meters provide increased sensitivity over other relative gravity meters by utilizing a mass attached to a horizontal beam which is balanced by a ';zero length spring'. This type of dynamic gravity sensor is capable of measuring gravity changes on the order of 0.05 milliGals in laboratory conditions but more commonly 0.7 to 1 milliGal in survey use. The sensor may have errors induced by the electronics used to read the beam position as well as noise induced by unwanted accelerations, commonly turbulence, which moves the beam away from its ideal balance position otherwise known as the reading line. The sensor relies on a measuring screw controlled by a computer which attempts to bring the beam back to the reading line position. The beam is also heavily damped so that it does not react to most unwanted high frequency accelerations. However this heavily damped system is slow to react, particularly in turns where there are very high Eotvos effects. New sensor technology utilizes magnetic damping of the beam coupled with an active feedback system which acts to effectively keep the beam locked at the reading line position. The feedback system operates over the entire range of the system so there is now no requirement for a measuring screw. The feedback system operates at very high speed so that even large turbulent events have minimal impact on data quality and very little, if any, survey line data is lost because of large beam displacement errors. Airborne testing

  15. A Nation at Risk Revisited: Did "Wrong" Reasoning Result in "Right" Results? At What Cost?

    ERIC Educational Resources Information Center

    Guthrie, James W.; Springer, Matthew G.

    2004-01-01

    A Nation at Risk (NAR; National Commission on Excellence in Education, 1983) proclaimed in 1983 that U.S. K-12 educational achievement was on a downward trajectory and that American technological and economic preeminence was consequently imperiled. Both assertions were incorrect. American education achievement was not then declining and the…

  16. Anesthesiologist- and System-Related Risk Factors for Risk-Adjusted Pediatric Anesthesia-Related Cardiac Arrest.

    PubMed

    Zgleszewski, Steven E; Graham, Dionne A; Hickey, Paul R; Brustowicz, Robert M; Odegard, Kirsten C; Koka, Rahul; Seefelder, Christian; Navedo, Andres T; Randolph, Adrienne G

    2016-02-01

    Pediatric anesthesia-related cardiac arrest (ARCA) is an uncommon but potentially preventable adverse event. Infants and children with more severe underlying disease are at highest risk. We aimed to identify system- and anesthesiologist-related risk factors for ARCA. We analyzed a prospectively collected patient cohort data set of anesthetics administered from 2000 to 2011 to children at a large tertiary pediatric hospital. Pre-procedure systemic disease level was characterized by ASA physical status (ASA-PS). Two reviewers independently reviewed cardiac arrests and categorized their anesthesia relatedness. Factors associated with ARCA in the univariate analyses were identified for reevaluation after adjustment for patient age and ASA-PS. Cardiac arrest occurred in 142 of 276,209 anesthetics (incidence 5.1/10,000 anesthetics); 72 (2.6/10,000 anesthetics) were classified as anesthesia-related. In the univariate analyses, risk of ARCA was much higher in cardiac patients and for anesthesiologists with lower annual caseload and/or fewer annual days delivering anesthetics (all P < 0.001). Anesthesiologists with the highest academic rank and years of experience also had higher odds of ARCA (P = 0.02). After risk adjustment for ASA-PS ≥ III and age ≤ 6 months, however, the association with lower annual days delivering anesthetics remained (P = 0.03), but the other factors were no longer significant. Case-mix explained most associations between higher risk of pediatric ARCA and anesthesiologist-related variables at our institution, but the association with fewer annual days delivering anesthetics remained. Our findings highlight the need for rigorous adjustment for patient risk factors in anesthesia patient safety studies.

  17. Personal Genomic Testing for Cancer Risk: Results From the Impact of Personal Genomics Study.

    PubMed

    Gray, Stacy W; Gollust, Sarah E; Carere, Deanna Alexis; Chen, Clara A; Cronin, Angel; Kalia, Sarah S; Rana, Huma Q; Ruffin, Mack T; Wang, Catharine; Roberts, J Scott; Green, Robert C

    2017-02-20

    Purpose Significant concerns exist regarding the potential for unwarranted behavior changes and the overuse of health care resources in response to direct-to-consumer personal genomic testing (PGT). However, little is known about customers' behaviors after PGT. Methods Longitudinal surveys were given to new customers of 23andMe (Mountain View, CA) and Pathway Genomics (San Diego, CA). Survey data were linked to individual-level PGT results through a secure data transfer process. Results Of the 1,042 customers who completed baseline and 6-month surveys (response rate, 71.2%), 762 had complete cancer-related data and were analyzed. Most customers reported that learning about their genetic risk of cancers was a motivation for testing (colorectal, 88%; prostate, 95%; breast, 94%). No customers tested positive for pathogenic mutations in highly penetrant cancer susceptibility genes. A minority of individuals received elevated single nucleotide polymorphism-based PGT cancer risk estimates (colorectal, 24%; prostate, 24%; breast, 12%). At 6 months, customers who received elevated PGT cancer risk estimates were not significantly more likely to change their diet, exercise, or advanced planning behaviors or engage in cancer screening, compared with individuals at average or reduced risk. Men who received elevated PGT prostate cancer risk estimates changed their vitamin and supplement use more than those at average or reduced risk (22% v 7.6%, respectively; adjusted odds ratio, 3.41; 95% CI, 1.44 to 8.18). Predictors of 6-month behavior include baseline behavior (exercise, vitamin or supplement use, and screening), worse health status (diet and vitamin or supplement use), and older age (advanced planning, screening). Conclusion Most adults receiving elevated direct-to-consumer PGT single nucleotide polymorphism-based cancer risk estimates did not significantly change their diet, exercise, advanced care planning, or cancer screening behaviors.

  18. Personal Genomic Testing for Cancer Risk: Results From the Impact of Personal Genomics Study

    PubMed Central

    Gollust, Sarah E.; Carere, Deanna Alexis; Chen, Clara A.; Cronin, Angel; Kalia, Sarah S.; Rana, Huma Q.; Ruffin, Mack T.; Wang, Catharine; Roberts, J. Scott; Green, Robert C.

    2017-01-01

    Purpose Significant concerns exist regarding the potential for unwarranted behavior changes and the overuse of health care resources in response to direct-to-consumer personal genomic testing (PGT). However, little is known about customers’ behaviors after PGT. Methods Longitudinal surveys were given to new customers of 23andMe (Mountain View, CA) and Pathway Genomics (San Diego, CA). Survey data were linked to individual-level PGT results through a secure data transfer process. Results Of the 1,042 customers who completed baseline and 6-month surveys (response rate, 71.2%), 762 had complete cancer-related data and were analyzed. Most customers reported that learning about their genetic risk of cancers was a motivation for testing (colorectal, 88%; prostate, 95%; breast, 94%). No customers tested positive for pathogenic mutations in highly penetrant cancer susceptibility genes. A minority of individuals received elevated single nucleotide polymorphism-based PGT cancer risk estimates (colorectal, 24%; prostate, 24%; breast, 12%). At 6 months, customers who received elevated PGT cancer risk estimates were not significantly more likely to change their diet, exercise, or advanced planning behaviors or engage in cancer screening, compared with individuals at average or reduced risk. Men who received elevated PGT prostate cancer risk estimates changed their vitamin and supplement use more than those at average or reduced risk (22% v 7.6%, respectively; adjusted odds ratio, 3.41; 95% CI, 1.44 to 8.18). Predictors of 6-month behavior include baseline behavior (exercise, vitamin or supplement use, and screening), worse health status (diet and vitamin or supplement use), and older age (advanced planning, screening). Conclusion Most adults receiving elevated direct-to-consumer PGT single nucleotide polymorphism-based cancer risk estimates did not significantly change their diet, exercise, advanced care planning, or cancer screening behaviors. PMID:27937091

  19. Finasteride Concentrations and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial

    PubMed Central

    Till, Cathee; Goodman, Phyllis J.; Chen, Xiaohong; Leach, Robin J.; Johnson-Pais, Teresa L.; Hsing, Ann W.; Hoque, Ashraful; Tangen, Catherine M.; Chu, Lisa; Parnes, Howard L.; Schenk, Jeannette M.; Reichardt, Juergen K. V.; Thompson, Ian M.; Figg, William D.

    2015-01-01

    Objective In the Prostate Cancer Prevention Trial (PCPT), finasteride reduced the risk of prostate cancer by 25%, even though high-grade prostate cancer was more common in the finasteride group. However, it remains to be determined whether finasteride concentrations may affect prostate cancer risk. In this study, we examined the association between serum finasteride concentrations and the risk of prostate cancer in the treatment arm of the PCPT and determined factors involved in modifying drug concentrations. Methods Data for this nested case-control study are from the PCPT. Cases were drawn from men with biopsy-proven prostate cancer and matched controls. Finasteride concentrations were measured using a liquid chromatography-mass spectrometry validated assay. The association of serum finasteride concentrations with prostate cancer risk was determined by logistic regression. We also examine whether polymorphisms in the enzyme target and metabolism genes of finasteride are related to drug concentrations using linear regression. Results and Conclusions Among men with detectable finasteride concentrations, there was no association between finasteride concentrations and prostate cancer risk, low-grade or high-grade, when finasteride concentration was analyzed as a continuous variable or categorized by cutoff points. Since there was no concentration-dependent effect on prostate cancer, any exposure to finasteride intake may reduce prostate cancer risk. Of the twenty-seven SNPs assessed in the enzyme target and metabolism pathway, five SNPs in two genes, CYP3A4 (rs2242480; rs4646437; rs4986910), and CYP3A5 (rs15524; rs776746) were significantly associated with modifying finasteride concentrations. These results suggest that finasteride exposure may reduce prostate cancer risk and finasteride concentrations are affected by genetic variations in genes responsible for altering its metabolism pathway. Trial Registration ClinicalTrials.gov NCT00288106 PMID:25955319

  20. Exact results for the finite time thermodynamic uncertainty relation

    NASA Astrophysics Data System (ADS)

    Manikandan, Sreekanth K.; Krishnamurthy, Supriya

    2018-03-01

    We obtain exact results for the recently discovered finite-time thermodynamic uncertainty relation, for the dissipated work W d , in a stochastically driven system with non-Gaussian work statistics, both in the steady state and transient regimes, by obtaining exact expressions for any moment of W d at arbitrary times. The uncertainty function (the Fano factor of W d ) is bounded from below by 2k_BT as expected, for all times τ, in both steady state and transient regimes. The lower bound is reached at τ=0 as well as when certain system parameters vanish (corresponding to an equilibrium state). Surprisingly, we find that the uncertainty function also reaches a constant value at large τ for all the cases we have looked at. For a system starting and remaining in steady state, the uncertainty function increases monotonically, as a function of τ as well as other system parameters, implying that the large τ value is also an upper bound. For the same system in the transient regime, however, we find that the uncertainty function can have a local minimum at an accessible time τm , for a range of parameter values. The large τ value for the uncertainty function is hence not a bound in this case. The non-monotonicity suggests, rather counter-intuitively, that there might be an optimal time for the working of microscopic machines, as well as an optimal configuration in the phase space of parameter values. Our solutions show that the ratios of higher moments of the dissipated work are also bounded from below by 2k_BT . For another model, also solvable by our methods, which never reaches a steady state, the uncertainty function, is in some cases, bounded from below by a value less than 2k_BT .

  1. Risk Factors Associated with Age-Related Macular Degeneration

    PubMed Central

    2006-01-01

    Objective: To investigate possible risk factors for age-related macular degeneration (AMD) in participants in the Age-Related Eye Disease Study (AREDS). Design: Case-control study. Participants: Of the 4757 persons enrolled in AREDS, 4519 persons aged 60 to 80 years were included in this study. The lesions associated with AMD ranged from absent in both eyes to advanced in one eye. Main Outcome Measures: Stereoscopic color fundus photographs of the macula were used to place participants into one of five groups, based on the frequency and severity of lesions associated with AMD. Participants with fewer than 15 small drusen served as the control group. Results: Staged model building techniques were used to compare each of the four case groups with the control group. Increased age was a consistent finding of all four of the case groups compared with the control group, and all the following associations were age adjusted. Persons with either intermediate drusen, extensive small drusen, or the pigment abnormalities associated with AMD (group 2) were more likely to be female, more likely to have a history of arthritis, and less likely to have a history of angina. Persons with one or more large drusen or extensive intermediate drusen (group 3) were more likely to use hydrochlorothiazide diuretics and more likely to have arthritis. Hypertension, hyperopia, presence of lens opacities, and white race were also found more frequently in this group as well as in persons with neovascular AMD (group 5). Only persons in group 5 were more likely to have an increased body mass index, whereas persons with geographic atrophy (group 4) as well as those in groups 3 and 5 were more likely to have completed fewer years in school or to be smokers. Those with geographic atrophy were also more likely to use thyroid hormones and antacids. Conclusions: Our findings for smoking and hypertension, which have been noted in previous studies, suggest that two important public health recommendations

  2. Relative risk analysis of the use of radiation-emitting medical devices: A preliminary application

    SciTech Connect

    Jones, E.D.

    This report describes the development of a risk analysis approach for evaluating the use of radiation-emitting medial devices. This effort was performed by Lawrence Livermore National Laboratory for the US Nuclear Regulatory Commission (NRC). The assessment approach has bee applied to understand the risks in using the Gamma Knife, a gamma irradiation therapy device. This effort represents an initial step to evaluate the potential role of risk analysis for developing regulations and quality assurance requirements in the use of nuclear medical devices. The risk approach identifies and assesses the most likely risk contributors and their relative importance for the medicalmore » system. The approach uses expert screening techniques and relative risk profiling to incorporate the type, quality, and quantity of data available and to present results in an easily understood form.« less

  3. Trauma-related risk factors for substance abuse among male versus female young adults.

    PubMed

    Danielson, Carla Kmett; Amstadter, Ananda B; Dangelmaier, Ruth E; Resnick, Heidi S; Saunders, Benjamin E; Kilpatrick, Dean G

    2009-04-01

    Clinical efforts to reduce risk for Substance Use Disorders (SUDs) among young adults rely on the empirical identification of risk factors for addictive behaviors in this population. Exposure to traumatic events and Posttraumatic Stress Disorder (PTSD) have been linked with SUDs in various populations. Emerging data, particularly from adolescent samples, suggest that traumatic event exposure increases risk for SUDs for young women, but not young men. The purpose of the current study was to examine trauma-related risk factors for alcohol and drug abuse among a national sample of young adults and compare such risk factors between men and women. Participants were 1753 young adults who participated in the 7-8 year follow-up telephone-based survey to the original National Survey of Adolescents. In the full sample, 29.1% met criteria for substance abuse. Trauma-related risk factors for alcohol and drug abuse differed for men and women. Clinical implications of these results are discussed.

  4. Relative Risk Appraisal, the September 11 Attacks, and Terrorism-Related Fears

    PubMed Central

    Marshall, Randall D.; Bryant, Richard A.; Amsel, Lawrence; Suh, Eun Jung; Cook, Joan M.; Neria, Yuval

    2013-01-01

    There are now replicated findings that posttraumatic stress disorder (PTSD) symptoms related to the September 11, 2001, attacks occurred in large numbers of persons who did not fit the traditional definition of exposure to a traumatic event. These data are not explained by traditional epidemiologic “bull’s eye” disaster models, which assume the psychological effects are narrowly, geographically circumscribed, or by existing models of PTSD onset. In this article, the authors develop a researchable model to explain these and other terrorism-related phenomena by synthesizing research and concepts from the cognitive science, risk appraisal, traumatic stress, and anxiety disorders literatures. They propose the new term relative risk appraisal to capture the psychological function that is the missing link between the event and subjective response in these and other terrorism-related studies to date. Relative risk appraisal highlights the core notion from cognitive science that human perception is an active, multidimensional process, such that for unpredictable societal threats, proximity to the event is only one of several factors that influence behavioral responses. Addressing distortions in relative risk appraisal effectively could reduce individual and societal vulnerability to a wide range of adverse economic and ethnopolitical consequences to terrorist attacks. The authors present ways in which these concepts and related techniques can be helpful in treating persons with September 11– or terrorism-related distress or psychopathology. PMID:17516775

  5. The Roles of School Readiness and Poverty-Related Risk for 6th Grade Outcomes

    PubMed Central

    Pressler, Emily; Raver, C. Cybele; Friedman-Krauss, Allison H.; Roy, Amanda

    2016-01-01

    Low-income students are at increased risk for grade retention and suspension, which dampens their chances of high school graduation, college attendance, and future success. Drawing from a sample of 357 children and their families who participated in the Chicago School Readiness Project, we examine whether greater exposure to cumulative poverty-related risk from preschool through 5th grade is associated with greater risk of student retention and suspension in 6th grade. Logistic regression results indicate that exposure to higher levels of cumulative risk across the elementary school years is associated with students’ increased risk of retention in 6th grade, even after controlling for child school readiness skills and other covariates. Importantly, findings of the association between average cumulative risk exposure and student suspension are more complex; the role of poverty-related risk is reduced to non-significance once early indicators of child school readiness and other covariates are included in regression models. While, children’s early externalizing behavior prior to kindergarten places children at greater risk of suspension 7 years later, children’s higher levels of internalizing behaviors and early math skills are associated with significantly decreased risk of suspension in the 6th grade. Together, findings from the study suggest the complex ways that both early school readiness and subsequent exposure to poverty-related risk may both serve as compelling predictors of children’s likelihood of “staying on track” academically in the 6th grade. PMID:27867447

  6. Glossary of terms related to health, exposure, and risk assessment

    SciTech Connect

    Not Available

    1989-03-01

    Many state and local agencies are developing or implementing programs to control emissions of toxic air pollutants. To successfully carry out these programs, agency personnel must be familiar with a wide range of issues and terms related to health, exposure, and risk assessment for toxic air pollutants. Understanding these issues and terms is not always an easy task. This glossary was prepared by the U.S. EPA's Air Risk Information Support Center (Air RISC) as a resource tool for State and local air pollution control agencies and U.S. EPA Regional Offices. The purpose of the glossary is to define terms thatmore » are commonly used in health, exposure, and risk assessments for toxic air pollutants.« less

  7. Risk Factors and Biomarkers of Age-Related Macular Degeneration

    PubMed Central

    Lambert, Nathan G.; Singh, Malkit K.; ElShelmani, Hanan; Mansergh, Fiona C.; Wride, Michael A.; Padilla, Maximilian; Keegan, David; Hogg, Ruth E.; Ambati, Balamurali K.

    2016-01-01

    A biomarker can be a substance or structure measured in body parts, fluids or products that can affect or predict disease incidence. As age-related macular degeneration (AMD) is the leading cause of blindness in the developed world, much research and effort has been invested in the identification of different biomarkers to predict disease incidence, identify at risk individuals, elucidate causative pathophysiological etiologies, guide screening, monitoring and treatment parameters, and predict disease outcomes. To date, a host of genetic, environmental, proteomic, and cellular targets have been identified as both risk factors and potential biomarkers for AMD. Despite this, their use has been confined to research settings and has not yet crossed into the clinical arena. A greater understanding of these factors and their use as potential biomarkers for AMD can guide future research and clinical practice. This article will discuss known risk factors and novel, potential biomarkers of AMD in addition to their application in both academic and clinical settings. PMID:27156982

  8. [Identification of risk factors in relatives of type-2 diabetics].

    PubMed

    Cuevas-Alvarez, Norma Angélica; Vela-Otero, Yolanda; Carrada-Brav, Teodoro

    2006-01-01

    To identify risk factors and warning signs in a sample of first-degree relatives of type-2 diabetics at the Family Medicine Unit 2 of the General Hospital in Irapuato, Guanajuato, Mexico. In a non-probabilistic sample of 360 relatives, a 14-item questionnaire was applied to measure abdominal perimeter and body mass index (obesity and overweight), eating habits, addictions and sedentarism. The questionnaire was made by general consent of experts, by applying Cronbach's alpha reliability coefficient. Specific rates of prevalence by sex and age groups were estimated. 233 (65%) relatives were females. As part of their family history background, arterial hypertension was recorded in 263 (73%) and acute myocardial infarction in 97 (27%). Among the dangerous food for health consumed by the relatives of diabetics are cola drinks in 94.7%, red meat in 83%, candies in 74.7% and chips in 65.8%; only half of them consumed fresh fruits and vegetables; a quarter of them ate prickly pears or whole wheat bread. There were 163 (45.3%) persons with high-risk abdominal perimeter, and sedentarism was present in 267 (74.2%). However, obesity was 3 times more frequent in females, but excessive drinking or smoking habits were 7 times more prevailing in males. A high-risk behavior was demonstrated among relativies of diabetic patients. Therefore, a public-health educational program is required to modify risky habits. A change towards prevention rather than cure is much needed in health staff.

  9. Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study.

    PubMed Central

    Grover, S. A.; Lowensteyn, I.; Esrey, K. L.; Steinert, Y.; Joseph, L.; Abrahamowicz, M.

    1995-01-01

    OBJECTIVE--To evaluate the ability of doctors in primary care to assess risk patients' risk of coronary heart disease. DESIGN--Questionnaire survey. SETTING--Continuing medical education meetings, Ontario and Quebec, Canada. SUBJECTS--Community based doctors who agreed to enroll in the coronary health assessment study. MAIN OUTCOME MEASURE--Ratings of coronary risk factors and estimates by doctors of relative and absolute coronary risk of two hypothetical patients and the "average" 40 year old Canadian man and 70 year old Canadian woman. RESULTS--253 doctors answered the questionnaire. For 30 year olds the doctors rated cigarette smoking as the most important risk factor and raised serum triglyceride concentrations as the least important; for 70 year old patients they rated diabetes as the most important risk factor and raised serum triglyceride concentrations as the least important. They rated each individual risk factor as significantly less important for 70 year olds than for 30 year olds (all risk factors, P < 0.001). They showed a strong understanding of the relative importance of specific risk factors, and most were confident in their ability to estimate coronary risk. While doctors accurately estimated the relative risk of a specific patient (compared with the average adult) they systematically overestimated the absolute baseline risk of developing coronary disease and the risk reductions associated with specific interventions. CONCLUSIONS--Despite guidelines on targeting patients at high risk of coronary disease accurate assessment of coronary risk remains difficult for many doctors. Additional strategies must be developed to help doctors to assess better their patients' coronary risk. PMID:7728035

  10. The Perils of Picky Eating: Dietary Breadth Is Related to Extinction Risk in Insectivorous Bats

    PubMed Central

    Boyles, Justin G.; Storm, Jonathan J.

    2007-01-01

    Several recent papers evaluate the relationship between ecological characteristics and extinction risk in bats. These studies report that extinction risk is negatively related to geographic range size and positively related to habitat specialization. Here, we evaluate the hypothesis that extinction risk is also related to dietary specialization in insectivorous vespertilionid bats using both traditional and phylogenetically-controlled analysis of variance. We collected dietary data and The World Conservation Union (IUCN) rankings for 44 Australian, European, and North American bat species. Our results indicate that species of conservation concern (IUCN ranking near threatened or above) are more likely to have a specialized diet than are species of least concern. Additional analyses show that dietary breadth is not correlated to geographic range size or wing morphology, characteristics previously found to correlate with extinction risk. Therefore, there is likely a direct relationship between dietary specialization and extinction risk; however, the large variation in dietary breadth within species of least concern suggests that diet alone cannot explain extinction risk. Our results may have important implications for the development of predictive models of extinction risk and for the assignment of extinction risk to insectivorous bat species. Similar analyses should be conducted on additional bat families to assess the generality of this relationship between niche breadth and extinction risk. PMID:17653286

  11. Dietary Flavonoid Intake and Smoking-Related Cancer Risk: A Meta-Analysis

    PubMed Central

    Woo, Hae Dong; Kim, Jeongseon

    2013-01-01

    Purpose To systematically investigate the effects of dietary flavonoids and flavonoid subclasses on the risk of smoking-related cancer in observational studies. Methods Summary estimates and corresponding standard errors were calculated using the multivariate-adjusted odds ratio (OR) or relative risk (RR) and 95% CI of selected studies and weighted by the inverse variance. Results A total of 35 studies, including 19 case-controls (9,525 cases and 15,835 controls) and 15 cohort studies (988,082 subjects and 8,161 cases), were retrieved for the meta-analysis. Total dietary flavonoids and most of the flavonoid subclasses were inversely associated with smoking-related cancer risk (OR: 0.82, 95% CI: 0.72-0.93). In subgroup analyses by cancer site, significant associations were observed in aerodigestive tract and lung cancers. Total dietary flavonoid intake was significantly associated with aerodigestive tract cancer risk (OR: 0.67, 95% CI: 0.54-0.83) marginally associated with lung cancer risk (OR: 0.84, 95% CI: 0.71-1.00). Subgroup analyses by smoking status showed significantly different results. The intake of total flavonoids, flavonols, flavones, and flavanones, as well as the flavonols quercetin and kaempferol was significantly associated with decreased risk of smoking-related cancer in smokers, whereas no association was observed in non-smokers, except for flavanones. In meta-analysis for the effect of subclasses of dietary flavonoids by cancer type, aerodigestive tract cancer was inversely associated with most flavonoid subclasses. Conclusion The protective effects of flavonoids on smoking-related cancer risk varied across studies, but the overall results indicated that intake of dietary flavonoids, especially flavonols, was inversely associated with smoking-related cancer risk. The protective effects of flavonoids on smoking-related cancer risk were more prominent in smokers. PMID:24069431

  12. Patient clusters in acute, work-related back pain based on patterns of disability risk factors.

    PubMed

    Shaw, William S; Pransky, Glenn; Patterson, William; Linton, Steven J; Winters, Thomas

    2007-02-01

    To identify subgroups of patients with work-related back pain based on disability risk factors. Patients with work-related back pain (N = 528) completed a 16-item questionnaire of potential disability risk factors before their initial medical evaluation. Outcomes of pain, functional limitation, and work disability were assessed 1 and 3 months later. A K-Means cluster analysis of 5 disability risk factors (pain, depressed mood, fear avoidant beliefs, work inflexibility, and poor expectations for recovery) resulted in 4 sub-groups: low risk (n = 182); emotional distress (n = 103); severe pain/fear avoidant (n = 102); and concerns about job accommodation (n = 141). Pain and disability outcomes at follow-up were superior in the low-risk group and poorest in the severe pain/fear avoidant group. Patients with acute back pain can be discriminated into subgroups depending on whether disability is related to pain beliefs, emotional distress, or workplace concerns.

  13. Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide—An Overview

    PubMed Central

    Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

    2017-01-01

    People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools. PMID:28257103

  14. Results of the Phoenix Relative Humidity Sensor Recalibration

    NASA Astrophysics Data System (ADS)

    Martinez, G.; Fischer, E.; Renno, N. O.

    2017-12-01

    We show results of the recalibration of the Thermal and Electrical Conductivity Probe (TECP) relative humidity (RH) sensor of the Phoenix Mars lander [Zent et al., 2009]. Due to uncertainties in its pre-flight calibration, which partially overlapped the environmental conditions found at the Phoenix landing site [Tamppari et al., 2010], only the raw, unprocessed output of the TECP RH sensor is available in NASA's Planetary Data System (PDS). The sensor's calibration was revised in 2016 to correct for inaccuracies at the lowest temperatures [Zent et al., 2016], but the new processed RH values were not posted in the PDS. We have been using a spare engineering unit of the TECP to recalibrate the sensor in the full range of Phoenix landing site conditions in the Michigan Mars Environmental Chamber (MMEC) [Fischer et al., 2016]. We compare raw output data of the engineering unit in the MMEC with that of the flight unit from the preflight calibration. We observed that the engineering unit's RH sensor output was shifted to higher values compared to the flight unit's output at the same conditions of temperature and humidity. Based on this shift, we use a translation function that fits the in-situ measurements of the flight unit into the engineering unit output space. To improve the accuracy of this function, we use additional observations corresponding to saturated conditions when near-surface fog was observed [Whiteway et al., 2009], as well as observations around noon when the RH is expected to be below 5%. The entire range of conditions observed on the Martian surface is covered in our recalibration. The raw output of the sensor is used to obtain a new calibration function. This allows us to obtain high-level RH data at Martian polar conditions. The recalibrated data will be posted in the PDS. REFERENCES: Fischer, E., et al. (2016), Astrobiology, 16, 12, doi: 10.1089/ast.2016.1525. Tamppari, L. K., et al. (2010), J. Geophys. Res., 115, E00E17, doi:10.1029/2009JE003415

  15. Cigarette smoking and the risk of adult leukemia: results from the Three Mile Island cohort study.

    PubMed

    Xu, Xiaohui; Talbott, Evelyn O; Zborowski, Jeanne V; Rager, Judith R

    2007-01-01

    Smoking is an unconfirmed risk factor for the development of leukemia. The authors examined the potential link using data from the Three Mile Island cohort for the period 1979-1995. Eligible for analysis were 24,539 individuals aged 14 years or older who were followed up over 16 years from the Three Mile Island cohort. The authors identified all incident leukemia cases through the Pennsylvania Department of Health Cancer Registry. They used the Cox proportional hazards model to evaluate the relationships and observed 42 incident leukemia cases, including 15 acute myeloid leukemia (AML) cases, in the cohort. After controlling for other confounding factors, the authors found current smoking to be associated with an increased risk of adult AML (relative risk = 3.47; 95% confidence interval = 1.002-11.99). The authors also observed a marginally significant linear trend of risk of AML associated with the number of years smoked (p = .06). The results from this study suggested that cigarette smoking was associated with an increased risk of adult AML. Further investigation is required to confirm these findings.

  16. Risk Factors of Mortality from All Asbestos-Related Diseases: A Competing Risk Analysis.

    PubMed

    Abós-Herràndiz, Rafael; Rodriguez-Blanco, Teresa; Garcia-Allas, Isabel; Rosell-Murphy, Isabel-Magdalena; Albertí-Casas, Constança; Tarrés, Josep; Krier-Günther, Illona; Martinez-Artés, Xavier; Orriols, Ramon; Grimau-Malet, Isidre; Canela-Soler, Jaume

    2017-01-01

    The mortality from all malignant and nonmalignant asbestos-related diseases remains unknown. The authors assessed the incidence and risk factors for all asbestos-related deaths. The sample included 544 patients from an asbestos-exposed community in the area of Barcelona (Spain), between Jan 1, 1970, and Dec 31, 2006. Competing risk regression through a subdistribution hazard analysis was used to estimate risk factors for the outcomes. Asbestos-related deaths were observed in 167 (30.7%) patients and 57.5% of these deaths were caused by some type of mesothelioma. The incidence rate after diagnosis was 3,600 per 100,000 person-years. In 7.5% of patients death was non-asbestos-related, while pleural and peritoneal mesothelioma were identified in 87 (16.0%) and 18 (3.3%) patients, respectively. Age, sex, household exposure, cumulative nonmalignant asbestos-related disease, and single malignant pathology were identified as risk factors for asbestos-related death. These findings suggest the need to develop a preventive approach to the community and to improve the clinical follow-up process of these patients.

  17. Prospect relativity: how choice options influence decision under risk.

    PubMed

    Stewart, Neil; Chater, Nick; Stott, Henry P; Reimers, Stian

    2003-03-01

    In many theories of decision under risk (e.g., expected utility theory, rank-dependent utility theory, and prospect theory), the utility of a prospect is independent of other options in the choice set. The experiments presented here show a large effect of the available options, suggesting instead that prospects are valued relative to one another. The judged certainty equivalent for a prospect is strongly influenced by the options available. Similarly, the selection of a preferred prospect is strongly influenced by the prospects available. Alternative theories of decision under risk (e.g., the stochastic difference model, multialternative decision field theory, and range frequency theory), where prospects are valued relative to one another, can provide an account of these context effects.

  18. Changes in Classes of Injury-Related Risks and Consequences of Risk-Level Drinking: a Latent Transition Analysis.

    PubMed

    Cochran, Gerald; Field, Craig; Caetano, Raul

    2015-07-01

    Risk-level drinking, drinking and driving, and alcohol-related violence are risk factors that result in injuries. The current study sought to identify which subgroups of patients experience the most behavioral change following a brief intervention. A secondary analysis of data from a brief alcohol intervention study was conducted. The sample (N = 664) includes at-risk drinkers who experienced an injury and were admitted for care to a Level 1 trauma center. Injury-related items from the Short Inventory of Problems+6 were used to perform a latent transition analysis to describe class transitions participants experienced following discharge. Four classes emerged for the year before and after the current injury. Most individuals transitioned from higher-risk classes into those with lower risk. Some participants maintained risky profiles, and others increased risks and consequences. Drinking and driving remained a persistent problem among the study participants. Although a large portion of intervention recipients improved risks and consequences of alcohol use following discharge, more intensive intervention services may be needed for a subset of patients who showed little or no improvement.

  19. Orbitofrontal sulcogyral patterns are related to temperamental risk for psychopathology.

    PubMed

    Whittle, Sarah; Bartholomeusz, Cali; Yücel, Murat; Dennison, Meg; Vijayakumar, Nandita; Allen, Nicholas B

    2014-02-01

    There are marked individual differences in the pattern of cortical (sulcogyral) folding in the orbitofrontal cortex (OFC), and there is a growing literature suggesting that these individual differences are associated with risk for psychotic disorders. To date, however, no study has investigated whether OFC folding patterns are associated with broader risk factors relevant to a range of psychopathology. This study helps address this knowledge gap by examining whether OFC sulcogyral folding patterns are associated with putative risk factors, specifically affective temperament and psychiatric symptoms, in a large community sample (N = 152) of adolescents. Results showed that the most common pattern of folding ('Type I', marked by discontinuity of the medial orbital sulcus and continuity of the lateral orbital sulcus) was associated with low levels of Surgency, high levels of Negative Affectivity (in girls) and higher depressive symptoms. This pattern was also associated with reduced thickness of OFC gray matter. Overall, the findings, combined with previous work, suggest some specificity of neurodevelopmental risk for different types of psychopathology. Thus, these results have the potential to inform the early identification of at-risk individuals.

  20. Usage of skin care products and risk of rheumatoid arthritis: results from the Swedish EIRA study

    PubMed Central

    2012-01-01

    Introduction The aim of this study was to investigate the association between exposure to cosmetics, often containing mineral oil, and the risk of developing rheumatoid arthritis (RA). The study was performed against the background that occupational exposure to mineral oil has recently been shown to be associated with an increased risk for RA in man, and that injection of or percutaneous exposure to mineral-oil-containing cosmetics can induce arthritis in certain rat strains. Methods A population-based case-control study of incident cases of RA was performed among the population aged 18 to 70 years in a defined area of Sweden during May 1996 to December 2003. A case was defined as an individual from the study base, who received for the first time a diagnosis of RA according to the 1987 American College of Rheumatology criteria. Controls were randomly selected from the study base with consideration taken for age, gender and residential area. Cases (n = 1,419) and controls (n = 1,674) answered an extensive questionnaire regarding environmental and lifestyle factors including habits of cosmetic usage. The relative risk of developing RA was calculated for subjects with different cosmetic usage compared with subjects with low or no usage. Analysis was also performed stratifying the cases for presence/absence of rheumatoid factor and antibodies to citrulline-containing peptides. Results The relative risks of developing RA associated with use of cosmetics were all close to one, both for women and men, for different exposure categories, and in relation to different subgroups of RA. Conclusion This study does not support the hypothesis that ordinary usage of common cosmetics as body lotions, skin creams, and ointments, often containing mineral oil, increase the risk for RA in the population in general. We cannot exclude, however, that these cosmetics can contribute to arthritis in individuals carrying certain genotypes or simultaneously being exposed to other arthritis

  1. Estimating relative risks for common outcome using PROC NLP.

    PubMed

    Yu, Binbing; Wang, Zhuoqiao

    2008-05-01

    In cross-sectional or cohort studies with binary outcomes, it is biologically interpretable and of interest to estimate the relative risk or prevalence ratio, especially when the response rates are not rare. Several methods have been used to estimate the relative risk, among which the log-binomial models yield the maximum likelihood estimate (MLE) of the parameters. Because of restrictions on the parameter space, the log-binomial models often run into convergence problems. Some remedies, e.g., the Poisson and Cox regressions, have been proposed. However, these methods may give out-of-bound predicted response probabilities. In this paper, a new computation method using the SAS Nonlinear Programming (NLP) procedure is proposed to find the MLEs. The proposed NLP method was compared to the COPY method, a modified method to fit the log-binomial model. Issues in the implementation are discussed. For illustration, both methods were applied to data on the prevalence of microalbuminuria (micro-protein leakage into urine) for kidney disease patients from the Diabetes Control and Complications Trial. The sample SAS macro for calculating relative risk is provided in the appendix.

  2. Waterborne disease-related risk perceptions in the Sonora River basin, Mexico.

    PubMed

    Morua, Agustin Robles; Halvorsen, Kathleen E; Mayer, Alex S

    2011-05-01

    Waterborne disease is estimated to cause about 10% of all diseases worldwide. However, related risk perceptions are not well understood, particularly in the developing world where waterborne disease is an enormous problem. We focus on understanding risk perceptions related to these issues in a region within northern Mexico. Our findings show how waterborne disease problems and solutions are understood in eight small communities along a highly contaminated river system. We found major differences in risk perceptions between health professionals, government officials, and lay citizens. Health professionals believed that a high level of human-waste-related risk existed within the region. Few officials and lay citizens shared this belief. In addition, few officials and lay citizens were aware of poor wastewater-management-related disease outbreaks and water contamination. Finally, aside from health professionals, a few interviewees understood the importance of basic hygiene and water treatment measures that could help to prevent disease. Our results add to the literature on environmentally-related risk perceptions in the developing world. We discuss recommendations for improving future human-wastewater-related risk communication within the region. © 2011 Society for Risk Analysis.

  3. [Stress and Burnout Risk in Nursery School Teachers: Results from a Survey].

    PubMed

    Jungbauer, J; Ehlen, S

    2015-06-01

    This article presents results from a study of 834 nursery school teachers in Germany, investigating working conditions, stress, and stress-related health problems. In order to evaluate the extent of mental and psychosomatic troubles, as well as the risk of burnout, we used the standardised questionnaire "Burnout Screening Scales" (BOSS I). Data analysis yielded a high percentage of nursery school teachers who reported a remarkably high stress level; nearly 20% can be considered as a high-risk group for burnout. Poor staff conditions in many nurseries turned out to be the crucial stress source, along with large groups, insufficient teacher-child ratio, time pressure and multitasking. In the concluding discussion of the study results, we consider possible measures to reduce stress and to improve working conditions for nursery school teachers. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Dietary flavonoid intake and smoking-related cancer risk: a meta-analysis.

    PubMed

    Woo, Hae Dong; Kim, Jeongseon

    2013-01-01

    To systematically investigate the effects of dietary flavonoids and flavonoid subclasses on the risk of smoking-related cancer in observational studies. Summary estimates and corresponding standard errors were calculated using the multivariate-adjusted odds ratio (OR) or relative risk (RR) and 95% CI of selected studies and weighted by the inverse variance. A total of 35 studies, including 19 case-controls (9,525 cases and 15,835 controls) and 15 cohort studies (988,082 subjects and 8,161 cases), were retrieved for the meta-analysis. Total dietary flavonoids and most of the flavonoid subclasses were inversely associated with smoking-related cancer risk (OR: 0.82, 95% CI: 0.72-0.93). In subgroup analyses by cancer site, significant associations were observed in aerodigestive tract and lung cancers. Total dietary flavonoid intake was significantly associated with aerodigestive tract cancer risk (OR: 0.67, 95% CI: 0.54-0.83) marginally associated with lung cancer risk (OR: 0.84, 95% CI: 0.71-1.00). Subgroup analyses by smoking status showed significantly different results. The intake of total flavonoids, flavonols, flavones, and flavanones, as well as the flavonols quercetin and kaempferol was significantly associated with decreased risk of smoking-related cancer in smokers, whereas no association was observed in non-smokers, except for flavanones. In meta-analysis for the effect of subclasses of dietary flavonoids by cancer type, aerodigestive tract cancer was inversely associated with most flavonoid subclasses. The protective effects of flavonoids on smoking-related cancer risk varied across studies, but the overall results indicated that intake of dietary flavonoids, especially flavonols, was inversely associated with smoking-related cancer risk. The protective effects of flavonoids on smoking-related cancer risk were more prominent in smokers.

  5. Alcohol and the risk for latent autoimmune diabetes in adults: results based on Swedish ESTRID study.

    PubMed

    Rasouli, Bahareh; Andersson, Tomas; Carlsson, Per-Ola; Dorkhan, Mozhgan; Grill, Valdemar; Groop, Leif; Martinell, Mats; Tuomi, Tiinamaja; Carlsson, Sofia

    2014-11-01

    Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes. Our aim was to investigate whether alcohol consumption is associated with the risk of latent autoimmune diabetes in adults (LADA), an autoimmune form of diabetes with features of type 2 diabetes. A population-based case-control study was carried out to investigate the association of alcohol consumption and the risk of LADA. We used data from the ESTRID case-control study carried out between 2010 and 2013, including 250 incident cases of LADA (glutamic acid decarboxylase antibodies (GADAs) positive) and 764 cases of type 2 diabetes (GADA negative), and 1012 randomly selected controls aged ≥35. Logistic regression was used to estimate the odds ratios (ORs) of diabetes in relation to alcohol intake, adjusted for age, sex, BMI, family history of diabetes, smoking, and education. Alcohol consumption was inversely associated with the risk of type 2 diabetes (OR 0.95, 95% CI 0.92-0.99 for every 5-g increment in daily intake). Similar results were observed for LADA, but stratification by median GADA levels revealed that the results only pertained to LADA with low GADA levels (OR 0.85, 95% CI 0.76-0.94/5 g alcohol per day), whereas no association was observed with LADA having high GADA levels (OR 1.00, 95% CI 0.94-1.06/5 g per day). Every 5-g increment of daily alcohol intake was associated with a 10% increase in GADA levels (P=0.0312), and a 10% reduction in homeostasis model assessment of insulin resistance (P=0.0418). Our findings indicate that alcohol intake may reduce the risk of type 2 diabetes and type 2-like LADA, but has no beneficial effects on diabetes-related autoimmunity. © 2014 The authors.

  6. Risk factors for water sports-related cervical spine injuries.

    PubMed

    Chang, Spencer K Y; Tominaga, Gail T; Wong, Jan H; Weldon, Edward J; Kaan, Kenneth T

    2006-05-01

    To examine risk factors associated with water sports-related cervical spine injuries (WSCSI). A retrospective analysis of all patients admitted for WSCSI from 1993 to 1997 was performed. The severity of cervical spine injury was assessed by review of medical records and imaging studies. Mechanisms of injury and activities at the time of injury were noted to determine risk factors for cervical spine injuries caused by wave forced impacts (WFI) from activities such as bodysurfing and body boarding. These risks were compared with injuries incurred by shallow water dives (SWD). One hundred patients were analyzed (mean age, 36 years old); 89% were male, 62% were nonresidents of Hawaii, and 75% had a large build. Patients without radiographic evidence of fractures, subluxations, and/or dislocations (n = 26) were significantly older (48 versus 32 years old, p < 0.0001) with a higher rate of pre-existing cervical spine abnormalities (65% versus 15%, p < 0.0001) compared with the remainder of patients (n = 74). Seventy-seven percent of WFI involved nonresidents. The mean age of WFI patients was significantly older than patients involved in SWD (42 versus 25 years). Ninety-six percent of wave-related accidents occurred at moderately to severely rated shorebreak beaches. Wave forced impacts of the head with the ocean bottom typically occurred at moderate to severe shorebreaks, and involved inexperienced, large-build males in their 40s. Spinal stenosis and degenerative spondylosis may increase the risk of cervical spine injury associated with WFI due to the increased risk of neck hyperextension and hyperflexion impacts inherent to this activity.

  7. Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

    PubMed

    Schiff, Gordon D; Reyes Nieva, Harry; Griswold, Paula; Leydon, Nicholas; Ling, Judy; Federico, Frank; Keohane, Carol; Ellis, Bonnie R; Foskett, Cathy; Orav, E John; Yoon, Catherine; Goldmann, Don; Weissman, Joel S; Bates, David W; Biondolillo, Madeleine; Singer, Sara J

    2017-08-01

    Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Chart reviews conducted at baseline and postintervention for intervention sites. Staff and patient survey data collected at baseline and postintervention for intervention and control sites. Chart reviews demonstrated significant improvements in documentation of abnormal results, patient notification, documentation of an action or treatment plan, and evidence of a completed plan (all P<0.001). Mean days between laboratory test date and evidence of completed action/treatment plan decreased by 19.4 days (P<0.001). Staff surveys showed modest but nonsignificant improvement for intervention practices relative to controls overall and for the 3 high-risk domains that were the focus of PROMISES. A consortium of stakeholders, quality improvement tools, coaches, and learning network decreased selected ambulatory safety risks often seen in malpractice claims.

  8. Pregnancy-related Characteristics and Breast Cancer Risk

    PubMed Central

    Brasky, Theodore M.; Li, Yanli; Jaworowicz, David J.; Potischman, Nancy; Ambrosone, Christine B.; Hutson, Alan D.; Nie, Jing; Shields, Peter G.; Trevisan, Maurizio; Rudra, Carole B.; Edge, Stephen B.; Freudenheim, Jo L.

    2013-01-01

    Breast tissues undergo extensive physiologic changes during pregnancy, which may affect breast carcinogenesis. Gestational hypertension, pre-eclampsia/eclampsia, gestational diabetes, pregnancy weight gain, and nausea and vomiting (N&V) during pregnancy may be indicative of altered hormonal and metabolic profiles and could impact breast cancer risk. Here, we examined associations between these characteristics of a woman’s pregnancy and her subsequent breast cancer risk. Participants were parous women that were recruited to a population-based case-control study (Western New York Exposures and Breast Cancer Study). Cases (n=960), aged 35-79 years, had incident, primary, histologically-confirmed breast cancer. Controls (n=1,852) were randomly selected from Motor Vehicle records (<65 years) or Medicare rolls (≥65 years). Women were queried on their lifetime pregnancy experiences. Multivariable-adjusted logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). N&V during pregnancy was inversely associated with breast cancer risk. Relative to those who never experienced N&V, ever experiencing N&V was associated with decreased risk (OR 0.69, 95% CI: 0.56-0.84) as were increased N&V severity (P-trend<0.001), longer duration (P-trend<0.01), and larger proportion of affected pregnancies (P-trend<0.0001) among women with ≥3 pregnancies. Associations were stronger for more recent pregnancies (<5y). Findings did not differ by menopausal status or breast cancer subtype including estrogen receptor and HER2 expression status. Other pregnancy characteristics examined were not associated with risk. We observed strong inverse associations between pregnancy N&V and breast cancer risk. Replication of these findings and exploration of underlying mechanisms could provide important insight into breast cancer etiology and prevention. PMID:23737027

  9. Multi-hazard risk analysis related to hurricanes

    NASA Astrophysics Data System (ADS)

    Lin, Ning

    Hurricanes present major hazards to the United States. Associated with extreme winds, heavy rainfall, and storm surge, landfalling hurricanes often cause enormous structural damage to coastal regions. Hurricane damage risk assessment provides the basis for loss mitigation and related policy-making. Current hurricane risk models, however, often oversimplify the complex processes of hurricane damage. This dissertation aims to improve existing hurricane risk assessment methodology by coherently modeling the spatial-temporal processes of storm landfall, hazards, and damage. Numerical modeling technologies are used to investigate the multiplicity of hazards associated with landfalling hurricanes. The application and effectiveness of current weather forecasting technologies to predict hurricane hazards is investigated. In particular, the Weather Research and Forecasting model (WRF), with Geophysical Fluid Dynamics Laboratory (GFDL)'s hurricane initialization scheme, is applied to the simulation of the wind and rainfall environment during hurricane landfall. The WRF model is further coupled with the Advanced Circulation (AD-CIRC) model to simulate storm surge in coastal regions. A case study examines the multiple hazards associated with Hurricane Isabel (2003). Also, a risk assessment methodology is developed to estimate the probability distribution of hurricane storm surge heights along the coast, particularly for data-scarce regions, such as New York City. This methodology makes use of relatively simple models, specifically a statistical/deterministic hurricane model and the Sea, Lake and Overland Surges from Hurricanes (SLOSH) model, to simulate large numbers of synthetic surge events, and conducts statistical analysis. The estimation of hurricane landfall probability and hazards are combined with structural vulnerability models to estimate hurricane damage risk. Wind-induced damage mechanisms are extensively studied. An innovative windborne debris risk model is

  10. The Influence of Media Communication on Risk Perception and Behavior Related to Mad Cow Disease in South Korea

    PubMed Central

    Park, Jee-Eun; Sohn, Aeree

    2013-01-01

    Objectives The purpose of this study was to ascertain the influence of media communication on risk behavior related to mad cow disease (MCD). Methods Mothers of elementary school students in Seoul were recruited as the survey participants of this study. Results Media reports affected risk behavior related to MCD. Also, knowledge and attitude toward MCD affects risk behavior. Conclusion Risk-related information provided by the media should maintain consistency and objectivity. For effective risk communication, there should be an open communication between the government and public, experts, and related industries, who should all collaborate. PMID:24159557

  11. A systematic review of risk and protective factors associated with family related violence in refugee families.

    PubMed

    Timshel, Isabelle; Montgomery, Edith; Dalgaard, Nina Thorup

    2017-08-01

    The current systematic review summarizes the evidence from studies examining the risk and protective factors associated with family related violence in refugee families. Data included 15 peer-reviewed qualitative and quantitative studies. In order to gain an overview of the identified risk and protective factors an ecological model was used to structure the findings. At the individual level, parental trauma experiences/mental illness, substance abuse and history of child abuse were found to be risk factors. Family level risk factors included parent-child interaction, family structure and family acculturation stress. At the societal level low socioeconomic status was identified as a risk factor. Cultural level risk factors included patriarchal beliefs. Positive parental coping strategies were a protective factor. An ecological analysis of the results suggests that family related violence in refugee families is a result of accumulating, multiple risk factors on the individual, familial, societal and cultural level. The findings suggest that individual trauma and exile related stress do not only affect the individual but have consequences at a family level. Thus, interventions targeting family related violence should not only include the individual, but the family. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Preliminary Results of National Amyotrophic Lateral Sclerosis (ALS) Registry Risk Factor Survey Data

    PubMed Central

    2016-01-01

    Background The National ALS Registry is made up of two components to capture amyotrophic lateral sclerosis (ALS) cases: national administrative databases (Medicare, Medicaid, Veterans Health Administration and Veterans Benefits Administration) and self-identified cases captured by the Registry’s web portal. This study describes self-reported characteristics of U.S. adults with ALS using the data collected by the National ALS Registry web portal risk factor surveys only from October 19, 2010 through December 31, 2013. Objective To describe findings from the National ALS Registry’s web portal risk factor surveys. Measurements The prevalence of select risk factors among adults with ALS was determined by calculating the frequencies of select risk factors—smoking and alcohol (non, current and former) histories, military service and occupational history, and family history of neurodegenerative diseases such as ALS, Alzheimer’s and/or Parkinson’s. Results Nearly half of survey respondents were ever smokers compared with nearly 41% of adults nationally. Most respondents were ever drinkers which is comparable to national estimates. The majority were light drinkers. Nearly one-quarter of survey respondents were veterans compared with roughly 9% of US adults nationally. Most respondents were retired or disabled. The industries in which respondents were employed for the longest time were Professional and Scientific and Technical Services. When family history of neurodegenerative diseases in first degree relatives was evaluated against our comparison group, the rates of ALS were similar, but were higher for Parkinson’s disease, Alzheimer’s disease and any neurodegenerative diseases. Conclusions The National ALS Registry web portal, to our knowledge, is the largest, most geographically diverse collection of risk factor data about adults living with ALS. Various characteristics were consistent with other published studies on ALS risk factors and will allow

  13. Backcountry snowmobilers' risk perceptions, avalanche related information seeking behaviours, preparedness and decision-making processes

    NASA Astrophysics Data System (ADS)

    Baker, Jennifer

    Although there has been substantial research on the avoidance of risk, much less has been completed on voluntary risk. This study examined backcountry snowmobilers' risk perceptions, avalanche related information seeking behaviours, and decision-making processes when dealing with avalanches and backcountry risk in Canada. To accomplish this, in-depth, semi-structured interviews were conducted with 17 participants who were involved in backcountry snowmobiling. Interviews were done both in person and by telephone. The results of this study show that, unlike previous research on snowmobilers, the participants of this study were well prepared and knowledgeable about backcountry risks. All 17 participants stated that they carried a shovel, probe, and transceiver with them on each backcountry trip, and 10 participants had taken an avalanche safety course. Group dynamics and positive peer pressure were influential in promoting safe backcountry behaviour. KEYWORDS: Backcountry snowmobiling, Avalanches, Voluntary Risk, Preparedness, Decision-Making.

  14. Relation of Cardiometabolic Risk Factors between Parents and Children.

    PubMed

    Halvorsen, Tanya; Moran, Antoinette; Jacobs, David R; Steffen, Lyn M; Sinaiko, Alan R; Zhou, Xia; Steinberger, Julia

    2015-11-01

    To explore the relations of parent-child cardiometabolic risk factors and assess the influence of adiposity on these associations. Associations of adiposity, blood pressure (BP), lipids, fasting insulin and glucose, and a risk factor cluster score (CS) were evaluated in a cross-sectional study of 179 parents and their children (6-18 years, N = 255). Insulin resistance was assessed by euglycemic clamp in parents and children aged 10 years or older. Metabolic syndrome in parents was defined by National Cholesterol Education Program's Adult Treatment Panel III criteria. CSs of the risk factors were created based on age-specific z-scores. Analyses included Pearson correlation and linear regression, adjusted for parent and child age, sex, race, and body mass index (BMI), accounting for within-family correlation. We found positive parent-child correlations for measures of adiposity (BMI, BMI percentile, waist, subcutaneous fat, and visceral fat; r = 0.22-0.34, all P ≤ .003), systolic BP (r = 0.20, P = .002), total cholesterol (r = 0.39, P < .001), low-density lipoprotein cholesterol (r = 0.34, P < .001), high density lipoprotein cholesterol (r = 0.26, P < .001), triglycerides (r = 0.19, P = .01), and insulin sensitivity (r = 0.22, P = .02) as well as CSs (r = 0.15, P = .02). After adjustment for BMI all parent-child correlations, except systolic BP, remained significant. Although adiposity is strongly correlated between parents and children, many cardiometabolic risk factors correlate independent of parent and child BMI. Adverse parental cardiometabolic profiles may identify at-risk children independent of the child's adiposity status. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. MicroRNA Related Polymorphisms and Breast Cancer Risk

    PubMed Central

    Khan, Sofia; Greco, Dario; Michailidou, Kyriaki; Milne, Roger L.; Muranen, Taru A.; Heikkinen, Tuomas; Aaltonen, Kirsimari; Dennis, Joe; Bolla, Manjeet K.; Liu, Jianjun; Hall, Per; Irwanto, Astrid; Humphreys, Keith; Li, Jingmei; Czene, Kamila; Chang-Claude, Jenny; Hein, Rebecca; Rudolph, Anja; Seibold, Petra; Flesch-Janys, Dieter; Fletcher, Olivia; Peto, Julian; dos Santos Silva, Isabel; Johnson, Nichola; Gibson, Lorna; Aitken, Zoe; Hopper, John L.; Tsimiklis, Helen; Bui, Minh; Makalic, Enes; Schmidt, Daniel F.; Southey, Melissa C.; Apicella, Carmel; Stone, Jennifer; Waisfisz, Quinten; Meijers-Heijboer, Hanne; Adank, Muriel A.; van der Luijt, Rob B.; Meindl, Alfons; Schmutzler, Rita K.; Müller-Myhsok, Bertram; Lichtner, Peter; Turnbull, Clare; Rahman, Nazneen; Chanock, Stephen J.; Hunter, David J.; Cox, Angela; Cross, Simon S.; Reed, Malcolm W. R.; Schmidt, Marjanka K.; Broeks, Annegien; Veer, Laura J. V. a. n't.; Hogervorst, Frans B.; Fasching, Peter A.; Schrauder, Michael G.; Ekici, Arif B.; Beckmann, Matthias W.; Bojesen, Stig E.; Nordestgaard, Børge G.; Nielsen, Sune F.; Flyger, Henrik; Benitez, Javier; Zamora, Pilar M.; Perez, Jose I. A.; Haiman, Christopher A.; Henderson, Brian E.; Schumacher, Fredrick; Le Marchand, Loic; Pharoah, Paul D. P.; Dunning, Alison M.; Shah, Mitul; Luben, Robert; Brown, Judith; Couch, Fergus J.; Wang, Xianshu; Vachon, Celine; Olson, Janet E.; Lambrechts, Diether; Moisse, Matthieu; Paridaens, Robert; Christiaens, Marie-Rose; Guénel, Pascal; Truong, Thérèse; Laurent-Puig, Pierre; Mulot, Claire; Marme, Frederick; Burwinkel, Barbara; Schneeweiss, Andreas; Sohn, Christof; Sawyer, Elinor J.; Tomlinson, Ian; Kerin, Michael J.; Miller, Nicola; Andrulis, Irene L.; Knight, Julia A.; Tchatchou, Sandrine; Mulligan, Anna Marie; Dörk, Thilo; Bogdanova, Natalia V.; Antonenkova, Natalia N.; Anton-Culver, Hoda; Darabi, Hatef; Eriksson, Mikael; Garcia-Closas, Montserrat; Figueroa, Jonine; Lissowska, Jolanta; Brinton, Louise; Devilee, Peter; Tollenaar, Robert A. E. M.; Seynaeve, Caroline; van Asperen, Christi J.; Kristensen, Vessela N.; Slager, Susan; Toland, Amanda E.; Ambrosone, Christine B.; Yannoukakos, Drakoulis; Lindblom, Annika; Margolin, Sara; Radice, Paolo; Peterlongo, Paolo; Barile, Monica; Mariani, Paolo; Hooning, Maartje J.; Martens, John W. M.; Collée, J. Margriet; Jager, Agnes; Jakubowska, Anna; Lubinski, Jan; Jaworska-Bieniek, Katarzyna; Durda, Katarzyna; Giles, Graham G.; McLean, Catriona; Brauch, Hiltrud; Brüning, Thomas; Ko, Yon-Dschun; Brenner, Hermann; Dieffenbach, Aida Karina; Arndt, Volker; Stegmaier, Christa; Swerdlow, Anthony; Ashworth, Alan; Orr, Nick; Jones, Michael; Simard, Jacques; Goldberg, Mark S.; Labrèche, France; Dumont, Martine; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M.; Mannermaa, Arto; Hamann, Ute; Chenevix-Trench, Georgia; Blomqvist, Carl; Aittomäki, Kristiina; Easton, Douglas F.; Nevanlinna, Heli

    2014-01-01

    Genetic variations, such as single nucleotide polymorphisms (SNPs) in microRNAs (miRNA) or in the miRNA binding sites may affect the miRNA dependent gene expression regulation, which has been implicated in various cancers, including breast cancer, and may alter individual susceptibility to cancer. We investigated associations between miRNA related SNPs and breast cancer risk. First we evaluated 2,196 SNPs in a case-control study combining nine genome wide association studies (GWAS). Second, we further investigated 42 SNPs with suggestive evidence for association using 41,785 cases and 41,880 controls from 41 studies included in the Breast Cancer Association Consortium (BCAC). Combining the GWAS and BCAC data within a meta-analysis, we estimated main effects on breast cancer risk as well as risks for estrogen receptor (ER) and age defined subgroups. Five miRNA binding site SNPs associated significantly with breast cancer risk: rs1045494 (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.88–0.96), rs1052532 (OR 0.97; 95% CI: 0.95–0.99), rs10719 (OR 0.97; 95% CI: 0.94–0.99), rs4687554 (OR 0.97; 95% CI: 0.95–0.99, and rs3134615 (OR 1.03; 95% CI: 1.01–1.05) located in the 3′ UTR of CASP8, HDDC3, DROSHA, MUSTN1, and MYCL1, respectively. DROSHA belongs to miRNA machinery genes and has a central role in initial miRNA processing. The remaining genes are involved in different molecular functions, including apoptosis and gene expression regulation. Further studies are warranted to elucidate whether the miRNA binding site SNPs are the causative variants for the observed risk effects. PMID:25390939

  16. MicroRNA related polymorphisms and breast cancer risk.

    PubMed

    Khan, Sofia; Greco, Dario; Michailidou, Kyriaki; Milne, Roger L; Muranen, Taru A; Heikkinen, Tuomas; Aaltonen, Kirsimari; Dennis, Joe; Bolla, Manjeet K; Liu, Jianjun; Hall, Per; Irwanto, Astrid; Humphreys, Keith; Li, Jingmei; Czene, Kamila; Chang-Claude, Jenny; Hein, Rebecca; Rudolph, Anja; Seibold, Petra; Flesch-Janys, Dieter; Fletcher, Olivia; Peto, Julian; dos Santos Silva, Isabel; Johnson, Nichola; Gibson, Lorna; Aitken, Zoe; Hopper, John L; Tsimiklis, Helen; Bui, Minh; Makalic, Enes; Schmidt, Daniel F; Southey, Melissa C; Apicella, Carmel; Stone, Jennifer; Waisfisz, Quinten; Meijers-Heijboer, Hanne; Adank, Muriel A; van der Luijt, Rob B; Meindl, Alfons; Schmutzler, Rita K; Müller-Myhsok, Bertram; Lichtner, Peter; Turnbull, Clare; Rahman, Nazneen; Chanock, Stephen J; Hunter, David J; Cox, Angela; Cross, Simon S; Reed, Malcolm W R; Schmidt, Marjanka K; Broeks, Annegien; Van't Veer, Laura J; Hogervorst, Frans B; Fasching, Peter A; Schrauder, Michael G; Ekici, Arif B; Beckmann, Matthias W; Bojesen, Stig E; Nordestgaard, Børge G; Nielsen, Sune F; Flyger, Henrik; Benitez, Javier; Zamora, Pilar M; Perez, Jose I A; Haiman, Christopher A; Henderson, Brian E; Schumacher, Fredrick; Le Marchand, Loic; Pharoah, Paul D P; Dunning, Alison M; Shah, Mitul; Luben, Robert; Brown, Judith; Couch, Fergus J; Wang, Xianshu; Vachon, Celine; Olson, Janet E; Lambrechts, Diether; Moisse, Matthieu; Paridaens, Robert; Christiaens, Marie-Rose; Guénel, Pascal; Truong, Thérèse; Laurent-Puig, Pierre; Mulot, Claire; Marme, Frederick; Burwinkel, Barbara; Schneeweiss, Andreas; Sohn, Christof; Sawyer, Elinor J; Tomlinson, Ian; Kerin, Michael J; Miller, Nicola; Andrulis, Irene L; Knight, Julia A; Tchatchou, Sandrine; Mulligan, Anna Marie; Dörk, Thilo; Bogdanova, Natalia V; Antonenkova, Natalia N; Anton-Culver, Hoda; Darabi, Hatef; Eriksson, Mikael; Garcia-Closas, Montserrat; Figueroa, Jonine; Lissowska, Jolanta; Brinton, Louise; Devilee, Peter; Tollenaar, Robert A E M; Seynaeve, Caroline; van Asperen, Christi J; Kristensen, Vessela N; Slager, Susan; Toland, Amanda E; Ambrosone, Christine B; Yannoukakos, Drakoulis; Lindblom, Annika; Margolin, Sara; Radice, Paolo; Peterlongo, Paolo; Barile, Monica; Mariani, Paolo; Hooning, Maartje J; Martens, John W M; Collée, J Margriet; Jager, Agnes; Jakubowska, Anna; Lubinski, Jan; Jaworska-Bieniek, Katarzyna; Durda, Katarzyna; Giles, Graham G; McLean, Catriona; Brauch, Hiltrud; Brüning, Thomas; Ko, Yon-Dschun; Brenner, Hermann; Dieffenbach, Aida Karina; Arndt, Volker; Stegmaier, Christa; Swerdlow, Anthony; Ashworth, Alan; Orr, Nick; Jones, Michael; Simard, Jacques; Goldberg, Mark S; Labrèche, France; Dumont, Martine; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M; Mannermaa, Arto; Hamann, Ute; Chenevix-Trench, Georgia; Blomqvist, Carl; Aittomäki, Kristiina; Easton, Douglas F; Nevanlinna, Heli

    2014-01-01

    Genetic variations, such as single nucleotide polymorphisms (SNPs) in microRNAs (miRNA) or in the miRNA binding sites may affect the miRNA dependent gene expression regulation, which has been implicated in various cancers, including breast cancer, and may alter individual susceptibility to cancer. We investigated associations between miRNA related SNPs and breast cancer risk. First we evaluated 2,196 SNPs in a case-control study combining nine genome wide association studies (GWAS). Second, we further investigated 42 SNPs with suggestive evidence for association using 41,785 cases and 41,880 controls from 41 studies included in the Breast Cancer Association Consortium (BCAC). Combining the GWAS and BCAC data within a meta-analysis, we estimated main effects on breast cancer risk as well as risks for estrogen receptor (ER) and age defined subgroups. Five miRNA binding site SNPs associated significantly with breast cancer risk: rs1045494 (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.88-0.96), rs1052532 (OR 0.97; 95% CI: 0.95-0.99), rs10719 (OR 0.97; 95% CI: 0.94-0.99), rs4687554 (OR 0.97; 95% CI: 0.95-0.99, and rs3134615 (OR 1.03; 95% CI: 1.01-1.05) located in the 3' UTR of CASP8, HDDC3, DROSHA, MUSTN1, and MYCL1, respectively. DROSHA belongs to miRNA machinery genes and has a central role in initial miRNA processing. The remaining genes are involved in different molecular functions, including apoptosis and gene expression regulation. Further studies are warranted to elucidate whether the miRNA binding site SNPs are the causative variants for the observed risk effects.

  17. Relative contributions of four exposure pathways to influenza infection risk.

    PubMed

    Nicas, Mark; Jones, Rachael M

    2009-09-01

    The relative contribution of four influenza virus exposure pathways-(1) virus-contaminated hand contact with facial membranes, (2) inhalation of respirable cough particles, (3) inhalation of inspirable cough particles, and (4) spray of cough droplets onto facial membranes-must be quantified to determine the potential efficacy of nonpharmaceutical interventions of transmission. We used a mathematical model to estimate the relative contributions of the four pathways to infection risk in the context of a person attending a bed-ridden family member ill with influenza. Considering the uncertainties in the sparse human subject influenza dose-response data, we assumed alternative ratios of 3,200:1 and 1:1 for the infectivity of inhaled respirable virus to intranasally instilled virus. For the 3,200:1 ratio, pathways (1), (2), and (4) contribute substantially to influenza risk: at a virus saliva concentration of 10(6) mL(-1), pathways (1), (2), (3), and (4) contribute, respectively, 31%, 17%, 0.52%, and 52% of the infection risk. With increasing virus concentrations, pathway (2) increases in importance, while pathway (4) decreases in importance. In contrast, for the 1:1 infectivity ratio, pathway (1) is the most important overall: at a virus saliva concentration of 10(6) mL(-1), pathways (1), (2), (3), and (4) contribute, respectively, 93%, 0.037%, 3.3%, and 3.7% of the infection risk. With increasing virus concentrations, pathway (3) increases in importance, while pathway (4) decreases in importance. Given the sparse knowledge concerning influenza dose and infectivity via different exposure pathways, nonpharmaceutical interventions for influenza should simultaneously address potential exposure via hand contact to the face, inhalation, and droplet spray.

  18. Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses.

    PubMed

    Cromie, J E; Robertson, V J; Best, M O

    2000-04-01

    Physical therapists are at risk for work-related musculoskeletal disorders (WMSDs). Little is known of how therapists respond or of what actions they take to prevent injury. The purpose of this study was to investigate the prevalence and severity of WMSDs in physical therapists, contributing risk factors, and their responses to injury. As part of a larger study, a systematic sample of 1 in 4 therapists on a state register (n=824) was surveyed. An 8-page questionnaire was mailed to each subject. Questions investigated musculoskeletal symptoms, specialty areas, tasks and job-related risk factors, injury prevention strategies, and responses to injury. Lifetime prevalence of WMSDs was 91%, and 1 in 6 physical therapists moved within or left the profession as a result of WMSDs. Younger therapists reported a higher prevalence of WMSDs in most body areas. Use of mobilization and manipulation techniques was related to increased prevalence of thumb symptoms. Risk factors pertaining to workload were related to a higher prevalence of neck and upper-limb symptoms, and postural risk factors were related to a higher prevalence of spinal symptoms. Strategies used to reduce work-related injury in industry may also apply to physical therapists. Increased risk of thumb symptoms associated with mobilization techniques suggests that further research is needed to establish recommendations for practice. The issues for therapists who move within or leave the profession are unknown, and further research is needed to better understand their needs and experiences.

  19. Multiple imputation for handling missing outcome data when estimating the relative risk.

    PubMed

    Sullivan, Thomas R; Lee, Katherine J; Ryan, Philip; Salter, Amy B

    2017-09-06

    Multiple imputation is a popular approach to handling missing data in medical research, yet little is known about its applicability for estimating the relative risk. Standard methods for imputing incomplete binary outcomes involve logistic regression or an assumption of multivariate normality, whereas relative risks are typically estimated using log binomial models. It is unclear whether misspecification of the imputation model in this setting could lead to biased parameter estimates. Using simulated data, we evaluated the performance of multiple imputation for handling missing data prior to estimating adjusted relative risks from a correctly specified multivariable log binomial model. We considered an arbitrary pattern of missing data in both outcome and exposure variables, with missing data induced under missing at random mechanisms. Focusing on standard model-based methods of multiple imputation, missing data were imputed using multivariate normal imputation or fully conditional specification with a logistic imputation model for the outcome. Multivariate normal imputation performed poorly in the simulation study, consistently producing estimates of the relative risk that were biased towards the null. Despite outperforming multivariate normal imputation, fully conditional specification also produced somewhat biased estimates, with greater bias observed for higher outcome prevalences and larger relative risks. Deleting imputed outcomes from analysis datasets did not improve the performance of fully conditional specification. Both multivariate normal imputation and fully conditional specification produced biased estimates of the relative risk, presumably since both use a misspecified imputation model. Based on simulation results, we recommend researchers use fully conditional specification rather than multivariate normal imputation and retain imputed outcomes in the analysis when estimating relative risks. However fully conditional specification is not without its

  20. Risk of breast cancer after false-positive results in mammographic screening.

    PubMed

    Román, Marta; Castells, Xavier; Hofvind, Solveig; von Euler-Chelpin, My

    2016-06-01

    Women with false-positive results are commonly referred back to routine screening. Questions remain regarding their long-term outcome of breast cancer. We assessed the risk of screen-detected breast cancer in women with false-positive results. We conducted a joint analysis using individual level data from the population-based screening programs in Copenhagen and Funen in Denmark, Norway, and Spain. Overall, 150,383 screened women from Denmark (1991-2008), 612,138 from Norway (1996-2010), and 1,172,572 from Spain (1990-2006) were included. Poisson regression was used to estimate the relative risk (RR) of screen-detected cancer for women with false-positive versus negative results. We analyzed information from 1,935,093 women 50-69 years who underwent 6,094,515 screening exams. During an average 5.8 years of follow-up, 230,609 (11.9%) women received a false-positive result and 27,849 (1.4%) were diagnosed with screen-detected cancer. The adjusted RR of screen-detected cancer after a false-positive result was 2.01 (95% CI: 1.93-2.09). Women who tested false-positive at first screen had a RR of 1.86 (95% CI: 1.77-1.96), whereas those who tested false-positive at third screening had a RR of 2.42 (95% CI: 2.21-2.64). The RR of breast cancer at the screening test after the false-positive result was 3.95 (95% CI: 3.71-4.21), whereas it decreased to 1.25 (95% CI: 1.17-1.34) three or more screens after the false-positive result. Women with false-positive results had a twofold risk of screen-detected breast cancer compared to women with negative tests. The risk remained significantly higher three or more screens after the false-positive result. The increased risk should be considered when discussing stratified screening strategies. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  1. Threshold Evaluation of Emergency Risk Communication for Health Risks Related to Hazardous Ambient Temperature.

    PubMed

    Liu, Yang; Hoppe, Brenda O; Convertino, Matteo

    2018-04-10

    Emergency risk communication (ERC) programs that activate when the ambient temperature is expected to cross certain extreme thresholds are widely used to manage relevant public health risks. In practice, however, the effectiveness of these thresholds has rarely been examined. The goal of this study is to test if the activation criteria based on extreme temperature thresholds, both cold and heat, capture elevated health risks for all-cause and cause-specific mortality and morbidity in the Minneapolis-St. Paul Metropolitan Area. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear model is used to derive the exposure-response functions between daily maximum heat index and mortality (1998-2014) and morbidity (emergency department visits; 2007-2014). Specific causes considered include cardiovascular, respiratory, renal diseases, and diabetes. Six extreme temperature thresholds, corresponding to 1st-3rd and 97th-99th percentiles of local exposure history, are examined. All six extreme temperature thresholds capture significantly increased relative risks for all-cause mortality and morbidity. However, the cause-specific analyses reveal heterogeneity. Extreme cold thresholds capture increased mortality and morbidity risks for cardiovascular and respiratory diseases and extreme heat thresholds for renal disease. Percentile-based extreme temperature thresholds are appropriate for initiating ERC targeting the general population. Tailoring ERC by specific causes may protect some but not all individuals with health conditions exacerbated by hazardous ambient temperature exposure. © 2018 Society for Risk Analysis.

  2. Reward, Attention, and HIV-related Risk in HIV+ Individuals

    PubMed Central

    Anderson, Brian A.; Kronemer, Sharif I.; Rilee, Jessica J.; Sacktor, Ned; Marvel, Cherie L.

    2015-01-01

    Human immunodeficiency virus (HIV) is often contracted through engaging in risky reward-motivated behaviors such as needle sharing and unprotected sex. Understanding the factors that make an individual more vulnerable to succumbing to the temptation to engage in these risky behaviors is important to limiting the spread of HIV. One potential source of this vulnerability concerns the degree to which an individual is able to resist paying attention to irrelevant reward information. In the present study, we examine this possible link by characterizing individual differences in value-based attentional bias in a sample of HIV+ individuals with varying histories of risk-taking behavior. Participants learned associations between experimental stimuli and monetary reward outcome. The degree of attentional bias for these reward-associated stimuli, reflected in their ability to capture attention when presented as task-irrelevant distractors, was then assessed both immediately and six months following reward learning. Value-driven attentional capture was related to substance abuse history and non-planning impulsiveness during the time leading up to contraction of HIV as measured via self report. These findings suggest a link between the ability to ignore reward-associated information and prior HIV-related risk-taking behavior. Additionally, particular aspects of HIV-associated neurocognitive disorders were related to attentional bias, including motor deficits commonly associated with HIV-induced damage to the basal ganglia. PMID:26484383

  3. Reward, attention, and HIV-related risk in HIV+ individuals.

    PubMed

    Anderson, Brian A; Kronemer, Sharif I; Rilee, Jessica J; Sacktor, Ned; Marvel, Cherie L

    2016-08-01

    Human immunodeficiency virus (HIV) is often contracted through engaging in risky reward-motivated behaviors such as needle sharing and unprotected sex. Understanding the factors that make an individual more vulnerable to succumbing to the temptation to engage in these risky behaviors is important to limiting the spread of HIV. One potential source of this vulnerability concerns the degree to which an individual is able to resist paying attention to irrelevant reward information. In the present study, we examine this possible link by characterizing individual differences in value-based attentional bias in a sample of HIV+ individuals with varying histories of risk-taking behavior. Participants learned associations between experimental stimuli and monetary reward outcome. The degree of attentional bias for these reward-associated stimuli, reflected in their ability to capture attention when presented as task-irrelevant distractors, was then assessed both immediately and six months following reward learning. Value-driven attentional capture was related to substance abuse history and non-planning impulsiveness during the time leading up to contraction of HIV as measured via self-report. These findings suggest a link between the ability to ignore reward-associated information and prior HIV-related risk-taking behavior. Additionally, particular aspects of HIV-associated neurocognitive disorders were related to attentional bias, including motor deficits commonly associated with HIV-induced damage to the basal ganglia. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. EPA's Response to Health Risks from Dioxin and Related ...

    EPA Pesticide Factsheets

    In 2003, EPA produced an external review draft of a multi-year comprehensive reassessment of dioxin exposure and human health effects. This reassessment, Exposure and Human Health Reassessment of 2,3,7,8-Tetrachlorodibenzo-p-Dioxin (TCDD) and Related Compounds, was submitted to the National Academy of Sciences (NAS) for review in October 2004. In 2006, the NAS expert panel published its review titled Health Risks from Dioxin and Related Compounds: Evaluation of the EPA Reassessment. The NAS expert panel’s Key Findings, as listed in the Public Summary of its review, identified “three areas that require substantial improvement to support a scientifically robust health assessment: •Justification of approaches to dose-response modeling for cancer and non-cancer end points. •Transparency and clarity in selection of key data sets for analysis. •Transparency, thoroughness, and clarity in quantitative uncertainty analysis.” The NAS also recommended that “EPA routinely monitor new scientific information related to TCDD…with the understanding that future revisions should provide a risk assessment based on the current state-of-the-science.” The objective of this project is to respond to NAS coments on dose-response modeling conducted in the EPA Reassessment of the health effects associated with dioxin exposure. In order to do this, we will address the Key Findings of the NAS review in a transparent and open manner.

  5. The Atlas of Natural Hazards and Risks of Austria: first results for fluvial and pluvial floods

    NASA Astrophysics Data System (ADS)

    Mergili, Martin; Tader, Andreas; Glade, Thomas; Neuhold, Clemens; Stiefelmeyer, Heinz

    2015-04-01

    Incoherent societal adaptation to natural processes results in significant losses every year. A better knowledge of the spatial and temporal distribution of hazards and risks, and of particular hot spots in a given region or period, is essential for reducing adverse impacts. Commonly, different hazard and risk estimations are performed within individual approaches based on tailor-made concepts. This works well as long as specific cases are considered. The advantage of such a procedure is that each individual hazard and risk is addressed in the best possible manner. The drawback, however, consists in the fact that the results differ significantly in terms of quality and accuracy and therefore cannot be compared. Hence, there is a need to develop a strategy and concept which uses similar data sources of equivalent quality in order to adequately analyze the different natural hazards and risks at broader scales. The present study is aiming to develop such a platform. The project Risk:ATlas focuses on the design of an atlas visualizing the most relevant natural hazards and, in particular, possible consequences for the entire territory of Austria. Available as a web-based tool and as a printed atlas, it is seen as a key tool to improve the basis for risk reduction, risk adaptation and risk transfer. The atlas is founded on those data sets available for the entire territory of Austria at a consistent resolution and quality. A 1 m resolution DEM and the official cadastre and building register represent the core, further data sets are employed according to the requirements for each natural hazard and risk. In this contribution, the methodology and the preliminary results for fluvial and pluvial floods and their consequences to buildings for three selected test areas in different types of landscapes (rural, urban and mountainous) are presented. Flooding depths expected for annualities of 30, 100 and 300 are derived from existing data sets for fluvial floods and are computed

  6. Risk Factors for Developing Work-Related Musculoskeletal Disorders during Dairy Farming.

    PubMed

    Taghavi, Sayed Mohammad; Mokarami, Hamidreza; Ahmadi, Omran; Stallones, Lorann; Abbaspour, Asghar; Marioryad, Hossein

    2017-01-01

    Dairy farming work involves frequent use of poor postures. These postures may increase the risk of developing musculoskeletal disorders among dairy workers. To assess postural load during performance of various tasks related to dairy farming. This cross-sectional study was conducted on a dairy farm in Iran. In order to assess postural load, tasks related to dairy farming were divided into 3 categories: feeding, milking, and manure disposal. Each task was then divided into its constituent work subdivisions (tasks). Finally, the working posture for each work subdivision was evaluated using Rapid Entire Body Assessment (REBA). Based on the results from the REBA score, the poorest risk scores (risk level 4) were associated with the following tasks: (1) manure disposal, (2) filling feed bags, and (3) pouring milk into a bucket. Other tasks such as filling corn containers, pouring corn into the milling machine, preparing the feed, pouring food into mangers, attaching the milking machine, and pouring milk from a bucket into a tank imposed high risk (risk level 3). The risk for the tasks of washing and disinfecting the udders were assessed as medium risks. The risk levels associated with most of the tasks on the studied farm were unacceptably high. Therefore, it is essential to implement ergonomic interventions to reduce risk levels of the tasks.

  7. Common genetic variants related to genomic integrity and risk of papillary thyroid cancer

    PubMed Central

    Neta, Gila; Brenner, Alina V.; Sturgis, Erich M.; Pfeiffer, Ruth M.; Hutchinson, Amy A.; Aschebrook-Kilfoy, Briseis; Yeager, Meredith; Xu, Li; Wheeler, William; Abend, Michael; Ron, Elaine; Tucker, Margaret A.; Chanock, Stephen J.; Sigurdson, Alice J.

    2011-01-01

    DNA damage is an important mechanism in carcinogenesis, so genes related to maintaining genomic integrity may influence papillary thyroid cancer (PTC) risk. Candidate gene studies targeting some of these genes have identified only a few polymorphisms associated with risk of PTC. Here, we expanded the scope of previous candidate studies by increasing the number and coverage of genes related to maintenance of genomic integrity. We evaluated 5077 tag single-nucleotide polymorphisms (SNPs) from 340 candidate gene regions hypothesized to be involved in DNA repair, epigenetics, tumor suppression, apoptosis, telomere function and cell cycle control and signaling pathways in a case–control study of 344 PTC cases and 452 matched controls. We estimated odds ratios for associations of single SNPs with PTC risk and combined P values for SNPs in the same gene region or pathway to obtain gene region-specific or pathway-specific P values using adaptive rank-truncated product methods. Nine SNPs had P values <0.0005, three of which were in HDAC4 and were inversely related to PTC risk. After multiple comparisons adjustment, no SNPs remained associated with PTC risk. Seven gene regions were associated with PTC risk at P < 0.01, including HUS1, ALKBH3, HDAC4, BAK1, FAF1_CDKN2C, DACT3 and FZD6. Our results suggest a possible role of genes involved in maintenance of genomic integrity in relation to risk of PTC. PMID:21642358

  8. Transfusion-related acute lung injury risk mitigation: an update.

    PubMed

    Otrock, Z K; Liu, C; Grossman, B J

    2017-11-01

    Transfusion-related acute lung injury (TRALI) is a life-threatening complication of transfusion. Greater understanding of the pathophysiology of this syndrome has much improved during the last two decades. Plasma-containing components from female donors with leucocyte antibodies were responsible for the majority of TRALI fatalities before mitigation strategies were implemented. Over the past 15 years, measures to mitigate risk for TRALI have been implemented worldwide and they continued to evolve with time. The AABB requires that all plasma containing components and whole blood for transfusion must be collected from men, women who have not been pregnant, or women who have tested negative for human leucocyte antigen antibodies. Although the incidence of TRALI has decreased following the institution of TRALI mitigation strategies, TRALI is still the most common cause of transfusion-associated death in the United States. In this review, we focus on TRALI risk mitigation strategies. We describe the measures taken by blood collection facilities to reduce the risk of TRALI in the United States, Canada and European countries. We also review the literature for the effectiveness of these measures. © 2017 International Society of Blood Transfusion.

  9. Some recent experimental results related to nuclear chirality

    NASA Astrophysics Data System (ADS)

    Timár, J.; Kuti, I.; Sohler, D.; Starosta, K.; Koike, T.; Paul, E. S.

    2014-09-01

    Detailed band structures of three chiral-candidate nuclei, 134Pr, 132La and 103Rh have been studied. The aim of the study was twofold. First, to try to explore the reasons behind the contradiction between the theoretically predicted chirality in these nuclei and the recently observed fingerprints that suggest non-chiral interpretation for the previous chiral candidate band doublets. Second, to search for multiple chiral bands of different types in these nuclei. In 134Pr a new πh11/2vh11/2 band has been observed besides the previously known chiral-candidate πh11/2vh11/2 doublet. This new band and the yrare πh11/2vh11/2 band show the expected features of a chiral doublet structure. This fact combined with the observed similarity between the band structures of 134Pr and 132La suggests that chirality might exist in these nuclei. The detailed study of the 103Rh band structure resulted in the observation of two new chiral-doublet looking structures besides the previously known one. This is indicative of possible existence of multiple chiral doublet structure in this nucleus.

  10. Height, height-related SNPs, and risk of non-melanoma skin cancer

    PubMed Central

    Li, Xin; Liang, Liming; Feng, Yen-Chen Anne; De Vivo, Immaculata; Giovannucci, Edward; Tang, Jean Y; Han, Jiali

    2017-01-01

    Background: Adult height has been associated with risk of several site-specific cancers, including melanoma. However, less attention has been given to non-melanoma skin cancer (NMSC). Methods: We prospectively examined the risk of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in relation to adult height in the Nurses' Health Study (NHS, n=117 863) and the Health Professionals Follow-up Study (HPFS, n=51 111). We also investigated the relationships between height-related genetic markers and risk of BCC and SCC in the genetic data sets of the NHS and HPFS (3898 BCC cases, and 8530 BCC controls; 527 SCC cases, and 8962 SCC controls). Results: After controlling for potential confounding factors, the hazard ratios were 1.09 (95% CI: 1.02, 1.15) and 1.10 (95% CI: 1.07, 1.13) for the associations between every 10 cm increase in height and risk of SCC and BCC respectively. None of the 687 height-related single-nucleotide polymorphisms (SNPs) was significantly associated with the risk of SCC or BCC, nor were the genetic scores combining independent height-related loci. Conclusions: Our data from two large cohorts provide further evidence that height is associated with an increased risk of NMSC. More studies on height-related genetic loci and early-life exposures may help clarify the underlying mechanisms. PMID:27846199

  11. Relation between Kidney Length and Cardiovascular and Renal Risk in High-Risk Patients.

    PubMed

    van der Sande, Nicolette G C; Visseren, Frank L J; van der Graaf, Yolanda; Nathoe, Hendrik M; de Borst, Gert Jan; Leiner, Tim; Blankestijn, Peter J

    2017-06-07

    Kidney length is often measured during routine abdominal ultrasonography and may be of use to identify patients at high vascular and renal risk. We aimed to explore patient characteristics related to kidney length, from which reference values were derived, and evaluate the relationship between kidney length and the risk of cardiovascular events and ESRD in high-risk patients. The study population consisted of 10,251 patients with clinical manifest arterial disease or vascular risk factors included in the Second Manifestations of ARTerial disease (SMART) Study cohort between 1996 and 2014. Linear regression was used to explore patient characteristics of kidney length. The relationship between kidney length and cardiovascular events (myocardial infarction, stroke, and cardiovascular mortality), all-cause mortality, and ESRD was analyzed using Cox regression. Kidney length was analyzed in tertiles, using the second tertile as the reference category. Kidney length was strongly correlated with body surface area (2.04 mm; 95% confidence interval [95% CI], 1.95 to 2.13 per 0.1 m 2 increase) and eGFR (1.62 mm; 95% CI, 1.52 to 1.73 per 10 ml/min per 1.73 m 2 increase). During the median follow-up of 6.3 years, 1317 patients experienced a cardiovascular event, including 711 myocardial infarctions, 369 strokes, and 735 vascular cause deaths. A total of 1462 patients died of any cause and 52 patients developed ESRD. Irrespective of eGFR, patients in the third tertile of kidney length (11.7-16.1 cm) were at higher risk of cardiovascular mortality (hazard ratio, 1.33; 95% CI, 1.05 to 1.67) and cardiovascular events (hazard ratio, 1.28; 95% CI, 1.09 to 1.50). Patients in the first tertile of kidney length (7.8-10.8 cm) were not at higher risk of cardiovascular adverse events. Large kidney length is related to higher risk of cardiovascular events and mortality in high-risk patients, irrespective of eGFR. Kidney length may serve as a clinical marker to further identify patients at

  12. Sexual HIV Risk Among Male Parolees and Their Female Partners: The Relate Project

    PubMed Central

    Comfort, Megan; Reznick, Olga Grinstead; Dilworth, Samantha E.; Binson, Diane; Darbes, Lynae A.; Neilands, Torsten B.

    2014-01-01

    Background The massively disproportionate impact of America’s prison boom on communities of color has raised questions about how incarceration may affect health disparities, including disparities in HIV. Primary partners are an important source of influence on sexual health. In this paper, we investigate sexual HIV risk among male-female couples following a man’s release from prison. Methods We draw upon data from the Relate Project, a novel cross-sectional survey of recently released men and their female partners in Oakland and San Francisco, California (N=344). Inferential analyses use the actor-partner model to explore actor and partner effects on sexual HIV risk outcomes. Results Dyadic analyses of sexual HIV risk among male parolees and their female partners paint a complex portrait of couples affected by incarceration and of partners’ influences on each other. Findings indicate that demographic factors such as education level and employment status, individual psycho-social factors such as perception of risk, and relationship factors such as commitment and power affect sexual HIV risk outcomes. Conclusion The Relate Project provides a novel dataset for the dyadic analysis of sexual risk among male parolees and their female partners, and results highlight the importance of focusing on the couple as a unit when assessing HIV risk and protective behaviors. Results also indicate potentially fruitful avenues for population-specific interventions that may help to reduce sexual health disparities among couples affected by incarceration. PMID:25642396

  13. Energy drinks and alcohol-related risk among young adults.

    PubMed

    Caviness, Celeste M; Anderson, Bradley J; Stein, Michael D

    2017-01-01

    Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours"). Negative alcohol outcomes included past-30-day binge drinking, past-30-day alcohol use disorder, and drinking-related consequences. Just over half (50.5%) reported no use of energy drinks,18.3% reported using energy drinks without concurrent alcohol use, and 31.2% reported concurrent use of energy drinks and alcohol. Relative to those who reported concurrent use of energy drinks with alcohol, and controlling for background characteristics and frequency of alcohol consumption, those who didn't use energy drinks and those who used without concurrent alcohol use had significantly lower binge drinking, negative consequences, and rates of alcohol use disorder (P < .05 for all outcomes). There were no significant differences between the no-use and energy drink without concurrent alcohol groups on any alcohol-related measure (P > .10 for all outcomes). Concurrent energy drink and alcohol use is associated with increased risk for negative alcohol consequences in young adults. Clinicians providing care to young adults could consider asking patients about concurrent energy drink and alcohol use as a way to begin a conversation about risky alcohol consumption while addressing 2 substances commonly used by this population.

  14. Bone and fall-related fracture risks in women and men with a recent clinical fracture.

    PubMed

    van Helden, Svenhjalmar; van Geel, Antonia C M; Geusens, Piet P; Kessels, Alfons; Nieuwenhuijzen Kruseman, Arie C; Brink, Peter R G

    2008-02-01

    Worldwide fracture rates are increasing as a result of the aging population, and prevention, both primary and secondary, is an important public health goal. Therefore, we systematically analyzed risk factors in subjects with a recent clinical fracture. All men and women over fifty years of age who had been treated in the emergency department of, or hospitalized at, our institution because of a recent fracture during a one-year period were offered the opportunity to undergo an evidence-based bone and fall-related risk-factor assessment and bone densitometry. The women included in this study were also compared with a group of postmenopausal women without a fracture history who had been included in another cohort study. Of the 940 consecutive patients, 797 (85%) were eligible for this study and 568 (60%) agreed to participate. The prevalence of fall-related risk factors (75% [95% confidence interval = 71% to 78%]; n = 425) and the prevalence of bone-related risk factors (53% [95% confidence interval = 49% to 57%]; n = 299) at the time of fracture were higher than the prevalence of osteoporosis (35% [95% confidence interval = 31% to 39%]; n = 201) as defined by a dual x-ray absorptiometry T score of related risk factors were present irrespective of the fracture location, patient age, or gender. An overlap between bone and fall-related risk factors was found in 50% of the patients. After adjusting for age, weight, and height, we found that women with a fracture more frequently had a diagnosis of osteoporosis (odds ratio = 2.9; 95% confidence interval = 2.0 to 4.1) and had a more extensive history of falls (odds ratio = 4.0; 95% confidence interval = 2.7 to 5.9) than did the postmenopausal women without a fracture history. Men and women over fifty years of age who had recently sustained a clinical fracture had, at the time of that fracture, bone and fall-related risk factors that were greater than the risk predicted by

  15. Trampoline related injuries in children: risk factors and radiographic findings.

    PubMed

    Klimek, Peter Michael; Juen, David; Stranzinger, Enno; Wolf, Rainer; Slongo, Theddy

    2013-05-01

    Backyard trampolines are immensely popular among children, but are associated with an increase of trampoline-related injuries. The aim of this study was to evaluate radiographs of children with trampoline related injuries and to determine the risk factors. Between 2003 and 2009, 286 children under the age of 16 with backyard trampoline injuries were included in the study. The number of injuries increased from 13 patients in 2003 to 86 in 2009. The median age of the 286 patients was 7 years (range: 1-15 years). Totally 140 (49%) patients were males, and 146 (51%) females. Medical records and all available diagnostic imaging were reviewed. A questionnaire was sent to the parents to evaluate the circumstances of each injury, the type of trampoline, the protection equipment and the experience of the children using the trampoline. The study was approved by the Institutional Ethics Committee of the University Hospital of Bern. The questionnaires and radiographs of the 104 patients were available for evaluation. A fracture was sustained in 51 of the 104 patients. More than 75% of all patients sustaining injuries and in 90% of patients with fractures were jumping on the trampoline with other children at the time of the accident. The most common fractures were supracondylar humeral fractures (29%) and forearm fractures (25%). Fractures of the proximal tibia occurred especially in younger children between 2-5 years of age. Children younger than 5 years old are at risk for specific proximal tibia fractures ("Trampoline Fracture"). A child jumping simultaneously with other children has a higher risk of suffering from a fracture.

  16. Anxious and depressive symptoms in the French Asbestos-Related Diseases Cohort: risk factors and self-perception of risk.

    PubMed

    Mounchetrou Njoya, Ibrahim; Paris, Christophe; Dinet, Jerome; Luc, Amandine; Lighezzolo-Alnot, Joelle; Pairon, Jean-Claude; Thaon, Isabelle

    2017-04-01

    Asbestos is known to be an independent risk factor for lung and pleural cancers. However, to date, little attention has been paid to the psychological effects of asbestos exposure among exposed subjects. The objectives of this study were to estimate the prevalence of anxious and depressive symptoms among >2000 French participants of the Asbestos-Related Diseases Cohort (ARDCO), 6 years after their inclusion, to identify the risk factors associated with those anxious and depressive symptoms and to evaluate the impact of the asbestos-risk perception. The ARDCO was constituted in four regions of France between October 2003 and December 2005, by including former asbestos workers. Between 2011 and 2012, participants of the ARDCO program were invited to undergo another chest CT scan 6 years after the previous scan. Participants were asked to complete questionnaires including asbestos exposure assessment, Hospital Anxiety and Depression Scale (HADS), asbestos-risk perception and self-perception of asbestos-related diseases. Among the 2225 participants, 2210 fully completed questionnaires were collected and analyzed. The prevalence of symptoms of probable anxiety and probable depression was 19.7% and 9.9%, respectively. The risk of anxious and depressive symptoms was independently associated with self-perception of the intensity of asbestos exposure, asbestos-risk perception and self-perception of asbestos-related diseases. The results obtained in this large study confirm that previously asbestos-exposed subjects are likely to develop anxious and depressive symptoms. Finally, implications related to the prevention of anxiety and depression among asbestos-exposed workers is discussed. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  17. Medication-related risk factors associated with health-related quality of life among community-dwelling elderly in China.

    PubMed

    Zhang, Sha; Meng, Long; Qiu, Feng; Yang, Jia-Dan; Sun, Shusen

    2018-01-01

    Previous studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ. The study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression. A total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life. Patient's internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.

  18. Treatment decision-making and the form of risk communication: results of a factorial survey.

    PubMed

    Hembroff, Larry A; Holmes-Rovner, Margaret; Wills, Celia E

    2004-11-16

    Prospective users of preventive therapies often must evaluate complex information about therapeutic risks and benefits. The purpose of this study was to evaluate the effect of relative and absolute risk information on patient decision-making in scenarios typical of health information for patients. Factorial experiments within a telephone survey of the Michigan adult, non-institutionalized, English-speaking population. Average interview lasted 23 minutes. Subjects and sample design: 952 randomly selected adults within a random-digit dial sample of Michigan households. Completion rate was 54.3%. When presented hypothetical information regarding additional risks of breast cancer from a medication to prevent a bone disease, respondents reduced their willingness to recommend a female friend take the medication compared to the baseline rate (66.8% = yes). The decrease was significantly greater with relative risk information. Additional benefit information regarding preventing heart disease from the medication increased willingness to recommend the medication to a female friend relative to the baseline scenario, but did not differ between absolute and relative risk formats. When information about both increased risk of breast cancer and reduced risk of heart disease were provided, typical respondents appeared to make rational decisions consistent with Expected Utility Theory, but the information presentation format affected choices. Those 11% - 33% making decisions contrary to the medical indications were more likely to be Hispanic, older, more educated, smokers, and to have children in the home. In scenarios typical of health risk information, relative risk information led respondents to make non-normative decisions that were "corrected" when the frame used absolute risk information. This population sample made generally rational decisions when presented with absolute risk information, even in the context of a telephone interview requiring remembering rates given. The

  19. Endogenous hormones, muscle strength, and risk of fall-related fractures in older women.

    PubMed

    Sipilä, Sarianna; Heikkinen, Eino; Cheng, Sulin; Suominen, Harri; Saari, Päivi; Kovanen, Vuokko; Alén, Markku; Rantanen, Taina

    2006-01-01

    Among older people, fracture-causing fall often leads to health deterioration. The role of endogenous hormone status and muscle strength on fall-related fracture risk is unclear. This study investigates if, after adjustment for bone density, endogenous hormones and muscle strength would predict fall-related limb fracture incidence in older community-dwelling women followed-up over 10 years. As a part of a prospective population-based study, 187 75-year-old women were investigated. Serum estradiol, testosterone, sex hormone binding globulin, and dehydroepiandrosterone sulfate concentrations were analyzed, and isometric muscle strength and bone mineral density were assessed. Fall-related limb fractures were gathered from patient records. Serum estradiol concentration was a significant predictor of fall-related limb fractures. Women with serum estradiol concentrations less than 0.022 nmol/L had a 3-fold risk (relative risk 3.05; 95% confidence interval, 1.26-7.36), and women with estradiol concentrations between 0.022 and 0.066 nmol/L doubled the risk (relative risk 2.24; 95% confidence interval, 0.97-5.19) of fall-related limb fracture compared to the women with estradiol concentrations ()above 0.066 nmol/L. Adjustment for muscle strength and bone mineral density did not materially change the risk estimates. High muscle strength was associated with a low incidence of fall-related limb fractures. This study showed that in 75-year-old women higher serum estradiol concentration and greater muscle strength were independently associated with a low incidence of fall-related limb fractures even after adjustment for bone density. Our results suggest that hormonal status and muscle strength have their own separate mechanisms protecting from fall-related fractures. This finding is of importance in developing preventive strategies, but calls for further study.

  20. Socioeconomic-related Risk and STI Infection among African-American Adolescent Females

    PubMed Central

    Sales, Jessica M.; Smearman, Erica L.; Swartzendruber, Andrea; Brown, Jennifer L.; Brody, Gene; DiClemente, Ralph J.

    2014-01-01

    Introduction Virtually no studies have examined the potential role that chronic stress, particularly the stress associated with socioeconomic (SES) strain, may play on STI risk. This study examined the association between SES-related risk at baseline to STI acquisition and reinfection over 36 months of follow-up. Methods 627 African-American female adolescents, ages 14–20 years, recruited from sexual health clinics in Atlanta, GA participated in a randomized controlled HIV prevention trial, and returned for at least 1 follow-up assessment. Following baseline assessment, 6 waves of data collection occurred prospectively over 36 months. Chronic SES-related risk was assessed as a sum of yes-no exposure to seven risk indicators. Laboratory confirmed tests for C. trachomatis and N. gonorrheoea were performed at each follow-up. Results In multivariable regression analysis, SES-related risk significantly predicted STI acquisition over 36 months (AOR = 1.22) and STI reinfection (AOR = 1.16) above and beyond other known correlates of STI. Discussion Findings demonstrate that SES-related risk was predictive of both STI acquisition and reinfection among young African-American females. They are consistent with propositions that some health disparities observed in adulthood may be linked to earlier chronically stress-inducing life experiences, particularly experiences associated with low SES conditions. Although various explanations exist for the observed connection between SES-related risk and subsequent STI acquisition and/or reinfection across 36 months of follow-up, these findings highlight the need for further research to elucidate the exact pathway(s) by which SES-related risk influences later STI acquisition in order to refine STI prevention interventions for this population. PMID:24974317

  1. Prospective associations between vitamin D status, vitamin D-related gene polymorphisms, and risk of tobacco-related cancers.

    PubMed

    Deschasaux, Mélanie; Souberbielle, Jean-Claude; Latino-Martel, Paule; Sutton, Angela; Charnaux, Nathalie; Druesne-Pecollo, Nathalie; Galan, Pilar; Hercberg, Serge; Le Clerc, Sigrid; Kesse-Guyot, Emmanuelle; Ezzedine, Khaled; Touvier, Mathilde

    2015-11-01

    decreased risk of tobacco-related cancers, especially in smokers. These results, which are supported by mechanistic plausibility, suggest that vitamin D may contribute to the prevention of tobacco-induced cancers in smokers and deserve additional investigation. The SU.VI.MAX trial was registered at clinicaltrials.gov as NCT00272428. © 2015 American Society for Nutrition.

  2. Exploration of health risks related to air pollution and temperature in three Latin American cities

    NASA Astrophysics Data System (ADS)

    Romero-Lankao, P.; Borbor Cordova, M.; Qin, H.

    2013-12-01

    We explore whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities. Our results show the association between air pollution levels and socioeconomic vulnerabilities did not always correlate within the study cities. Furthermore, the spatial differences in socioeconomic vulnerabilities within cities do not necessarily correspond with the spatial distribution of health impacts. The present study improves our understanding of the multifaceted nature of health risks and vulnerabilities associated with global environmental change. The findings suggest that health risks from atmospheric conditions and pollutants exist without boundaries or social distinctions, even exhibiting characteristics of a boomerang effect (i.e., affecting rich and poor alike) on a smaller scale such as areas within urban regions. We used human mortality, a severe impact, to measure health risks from air pollution and extreme temperatures. Public health data of better quality (e.g., morbidity, hospital visits) are needed for future research to advance our understanding of the nature of health risks related to climate hazards.

  3. Parental nutrient intake and risk of retinoblastoma resulting from new germline RB1 mutation

    PubMed Central

    Bunin, Greta R; Li, Yimei; Ganguly, Arupa; Meadows, Anna T; Tseng, Marilyn

    2013-01-01

    Purpose We conducted a case-control study to examine the role of parents’ nutrient intake before their child’s conception in the child’s risk of sporadic bilateral retinoblastoma, which results from a new germline RB1 mutation. Methods Parents of 206 cases from 9 North American institutions and 269 friend and relative controls participated; fathers of 182 cases and 223 controls and mothers of 202 cases and 260 controls provided useable information in telephone interviews on their diet in the year before the child’s conception. We also asked parents about supplements, a significant source of nutrients in users. Results Father’s intake of dairy-associated nutrients and his use of calcium supplements were associated with decreased risk while his intake of copper, manganese, and vitamin E was associated with increased risk. Mother’s use of multivitamins close to conception was associated with lower risk as was her intake of several micronutrients found in these supplements. In analyses to elucidate the primary factor from multiple correlated factors, the most robust findings were for father’s calcium intake (adjusted OR=0.46 – 0.63 for 700 mg increase) and calcium supplement use (OR=0.35 – 0.41) and mother’s multivitamin use (ORs 0.28 – 0.48). Conclusions There are few directly relevant studies but some data indirectly support the biologic plausibility of the inverse associations with father’s calcium intake and mother’s use of multivitamins; however, we cannot rule out contributions of bias, confounding, or chance. Our findings provide a starting point for further investigation of diet in the etiology of retinoblastoma and new germline mutation generally. PMID:23224327

  4. Occupational safety threats among dental personnel and related risk factors.

    PubMed

    Gurbuz, M Kezban; Çatli, Tolgahan; Cingi, Cemal; Yaz, Aytekin; Bal, Cengiz

    2013-11-01

    Occupational diseases are primarily considered to be important health problems for individuals with occupations in heavy industry fields. Although dentists work in very clean and elegant offices, they are frequently exposed to various chemicals and high-intensity, sound-producing instruments, such as compressors and aerators. In our study, we aimed to investigate the risk for occupational hearing loss of dental personnel, by performing pure-tone audiometry in 40 dentists and comparing the results with those of healthy individuals. We also sampled the nasal mucosa to investigate the effects of occupational chemicals on the nasal mucosa of the dentists. The pure-tone audiometric thresholds at 5 different frequencies (1000, 2000, 4000, 6000, and 8000 Hz) and working time were evaluated as potential risk factors. The pure-tone audiometric results (as decibels) at each frequency and the median values for each side (right and left ears) were significantly higher for dentists than for the control group (P < 0.05). The pure-tone audiometric results did not significantly differ between the women and men in the study group (P > 0.05). The findings in the nasal mucosa (goblet cell hyperplasia, neutrophil/eosinophil/basophil distribution, metaplasia, dysplasia, premalignant or malignant cells) were similar in the study and control groups (P > 0.05). In conclusion, our study indicated that high-intensity, sound-producing equipment is an important occupational threat for dentists, whereas chemical agents have minimal hazardous effects.

  5. A method for determining weights for excess relative risk and excess absolute risk when applied in the calculation of lifetime risk of cancer from radiation exposure.

    PubMed

    Walsh, Linda; Schneider, Uwe

    2013-03-01

    Radiation-related risks of cancer can be transported from one population to another population at risk, for the purpose of calculating lifetime risks from radiation exposure. Transfer via excess relative risks (ERR) or excess absolute risks (EAR) or a mixture of both (i.e., from the life span study (LSS) of Japanese atomic bomb survivors) has been done in the past based on qualitative weighting. Consequently, the values of the weights applied and the method of application of the weights (i.e., as additive or geometric weighted means) have varied both between reports produced at different times by the same regulatory body and also between reports produced at similar times by different regulatory bodies. Since the gender and age patterns are often markedly different between EAR and ERR models, it is useful to have an evidence-based method for determining the relative goodness of fit of such models to the data. This paper identifies a method, using Akaike model weights, which could aid expert judgment and be applied to help to achieve consistency of approach and quantitative evidence-based results in future health risk assessments. The results of applying this method to recent LSS cancer incidence models are that the relative EAR weighting by cancer solid cancer site, on a scale of 0-1, is zero for breast and colon, 0.02 for all solid, 0.03 for lung, 0.08 for liver, 0.15 for thyroid, 0.18 for bladder and 0.93 for stomach. The EAR weighting for female breast cancer increases from 0 to 0.3, if a generally observed change in the trend between female age-specific breast cancer incidence rates and attained age, associated with menopause, is accounted for in the EAR model. Application of this method to preferred models from a study of multi-model inference from many models fitted to the LSS leukemia mortality data, results in an EAR weighting of 0. From these results it can be seen that lifetime risk transfer is most highly weighted by EAR only for stomach cancer. However

  6. Coffee, caffeine, and risk of completed suicide: results from three prospective cohorts of American adults.

    PubMed

    Lucas, Michel; O'Reilly, Eilis J; Pan, An; Mirzaei, Fariba; Willett, Walter C; Okereke, Olivia I; Ascherio, Alberto

    2014-07-01

    To evaluate the association between coffee and caffeine consumption and suicide risk in three large-scale cohorts of US men and women. We accessed data of 43,599 men enrolled in the Health Professionals Follow-up Study (HPFS, 1988-2008), 73,820 women in the Nurses' Health Study (NHS, 1992-2008), and 91,005 women in the NHS II (1993-2007). Consumption of caffeine, coffee, and decaffeinated coffee, was assessed every 4 years by validated food-frequency questionnaires. Deaths from suicide were determined by physician review of death certificates. Multivariate adjusted relative risks (RRs) were estimated with Cox proportional hazard models. Cohort specific RRs were pooled using random-effect models. We documented 277 deaths from suicide. Compared to those consuming ≤ 1 cup/week of caffeinated coffee (< 8 oz/237 ml), the pooled multivariate RR (95% confidence interval [CI]) of suicide was 0.55 (0.38-0.78) for those consuming 2-3 cups/day and 0.47 (0.27-0.81) for those consuming ≥ 4 cups/day (P trend < 0.001). The pooled multivariate RR (95% CI) for suicide was 0.75 (0.63-0.90) for each increment of 2 cups/day of caffeinated coffee and 0.77 (0.63-0.93) for each increment of 300 mg/day of caffeine. These results from three large cohorts support an association between caffeine consumption and lower risk of suicide.

  7. Summary of Results from the Risk Management Program for the Mars Microrover Flight Experiment

    NASA Technical Reports Server (NTRS)

    Shishko, Robert; Matijevic, Jacob R.

    2000-01-01

    On 4 July 1997, the Mars Pathfinder landed on the surface of Mars carrying the first planetary rover, known as the Sojourner. Formally known as the Microrover Flight Experiment (MFEX), the Sojourner was a low cost, high-risk technology demonstration, in which new risk management techniques were tried. This paper summarizes the activities and results of the effort to conduct a low-cost, yet meaningful risk management program for the MFEX. The specific activities focused on cost, performance, schedule, and operations risks. Just as the systems engineering process was iterative and produced successive refinements of requirements, designs, etc., so was the risk management process. Qualitative risk assessments were performed first to gain some insights for refining the microrover design and operations concept. These then evolved into more quantitative analyses. Risk management lessons from the manager's perspective is presented for other low-cost, high-risk space missions.

  8. Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis

    PubMed Central

    2010-01-01

    Background Age-related macular degeneration (AMD) is the leading cause of blindness in Western countries. Numerous risk factors have been reported but the evidence and strength of association is variable. We aimed to identify those risk factors with strong levels of evidence which could be easily assessed by physicians or ophthalmologists to implement preventive interventions or address current behaviours. Methods A systematic review identified 18 prospective and cross-sectional studies and 6 case control studies involving 113,780 persons with 17,236 cases of late AMD that included an estimate of the association between late AMD and at least one of 16 pre-selected risk factors. Fixed-effects meta-analyses were conducted for each factor to combine odds ratio (OR) and/or relative risk (RR) outcomes across studies by study design. Overall raw point estimates of each risk factor and associated 95% confidence intervals (CI) were calculated. Results Increasing age, current cigarette smoking, previous cataract surgery, and a family history of AMD showed strong and consistent associations with late AMD. Risk factors with moderate and consistent associations were higher body mass index, history of cardiovascular disease, hypertension, and higher plasma fibrinogen. Risk factors with weaker and inconsistent associations were gender, ethnicity, diabetes, iris colour, history of cerebrovascular disease, and serum total and HDL cholesterol and triglyceride levels. Conclusions Smoking, previous cataract surgery and a family history of AMD are consistent risk factors for AMD. Cardiovascular risk factors are also associated with AMD. Knowledge of these risk factors that may be easily assessed by physicians and general ophthalmologists may assist in identification and appropriate referral of persons at risk of AMD. PMID:21144031

  9. Evaluation of hip fracture risk in relation to fall direction.

    PubMed

    Nankaku, Manabu; Kanzaki, Hideto; Tsuboyama, Tadao; Nakamura, Takashi

    2005-11-01

    The purpose of this study is to evaluate hip fracture risk in relation to fall direction, and to elucidate factors that influence the impact force in falls on the hip. Eight healthy volunteers performed deliberate falls in three directions (lateral, posterolateral and posterior) on a force platform covered by a mattress of 13 cm thickness. Fall descent motions and impact postures were examined by a three-dimensional analyzer. The maximum ground force reaction, velocity of the greater trochanter at impact, and activity of quadriceps and gluteus medius were measured. In all trials of lateral and posterolateral falls, but not of posterior falls, the subjects hit their greater trochanter directly on the mattress. The impact forces were between 2,000 N and 4,000 N. Posterolateral falls showed significantly higher velocity at impact than did posterior falls. The height and the lower limb length exhibited positive correlations with the impact force in all directions of fall. In the lateral fall, there was a positive correlation between the activity of quadriceps and the impact force. In view of the impact point, force, and velocity, the posterolateral fall seemed to carry the highest risk of hip fracture.

  10. Identifying Patterns in Extreme Precipitation Risk and the Related Impacts

    NASA Astrophysics Data System (ADS)

    Schroeer, K.; Tye, M. R.

    2017-12-01

    Extreme precipitation can harm human life and assets through flooding, hail, landslides, or debris flows. Flood risk assessments typically concentrate on river or mountain torrent channels, using water depth, flow velocity, and/or sediment deposition to quantify the risk. In addition, extreme events with high recurrence intervals are often the main focus. However, damages from short-term and localized convective showers often occur away from watercourses. Also, damages from more frequent small scale extremes, although usually less disastrous, can accumulate to considerable financial burdens. Extreme convective precipitation is expected to intensify in a warmer climate, and vulnerability patterns might change in tandem with changes in the character of precipitation and flood types. This has consequences for adaptation planners who want to establish effective protection measures and reduce the cost from natural hazards. Here we merge hydrological and exposure data to identify patterns of risk under varying synoptic conditions. Exposure is calculated from a database of 76k damage claims reported to the national disaster fund in 480 municipalities in south eastern Austria from 1990-2015. Hydrological data comprise sub-daily precipitation (59 gauges) and streamflow (62 gauges) observations. We use synoptic circulation types to identify typical precipitation patterns. They indicate the character of precipitation even if a gauge is not in close proximity, facilitating potential future research with regional climate model data. Results show that more claims are reported under synoptic conditions favouring convective precipitation (on average 1.5-3 times more than on other days). For agrarian municipalities, convective precipitation damages are among the costliest after long low-intensity precipitation events. In contrast, Alpine communities are particularly vulnerable to convective high-intensity rainfall. In addition to possible observational error, uncertainty is present

  11. Terrorism-related risk management for health care facilities.

    PubMed

    Reid, Daniel J; Reid, William H

    2005-01-01

    Clinicians should have a basic understanding of the physical and financial risk to mental health facilities related to external threat, such as (but not necessarily limited to) terrorism. Patient care and accessibility to mental health services rest not only on clinical skills, but on a place to practice them and an organized system supported by staff, physical facilities and funding. Clinicians who have some familiarity with the non-clinical requirements for care are in a position to support non-clinical staff in preventing care from being interrupted by external threats or events such as terrorist activity, and/or serving at the interface of facility operations and direct clinical care. Readers should note that this article is an introduction to the topic and cannot address all local, state, and national standards for hospital safety, or insurance providers' individual facility requirements.

  12. Risk Perception Analysis Related To Existing Dams In Italy

    NASA Astrophysics Data System (ADS)

    Solimene, Pellegrino

    2013-04-01

    earthfill dam is illustrated by defining the risk analysis during its construction and operation. A qualitative "Event Tree Analysis" makes clear with an example the probability of occurrence of the events triggered by an earthquake, and leads to a classification of the damage level. Finally, a System Dynamics (SD) approach is presented to investigate possibilities of a preventive planning in relationship to the risk, so that it's possible to establish shared procedures to achieve the correct management in any crisis phase. As a qualitative result of a SD application, figure 1 presents a flow-chart about a case study on the same dam so to illustrate the emergency planning in a step by step procedure according to the Regulations.

  13. Risks of beryllium disease related to work processes at a metal, alloy, and oxide production plant.

    PubMed

    Kreiss, K; Mroz, M M; Zhen, B; Wiedemann, H; Barna, B

    1997-08-01

    To describe relative hazards in sectors of the beryllium industry, risk factors of beryllium disease and sensitisation related to work process were sought in a beryllium manufacturing plant producing pure metal, oxide, alloys, and ceramics. All 646 active employees were interviewed; beryllium sensitisation was ascertained with the beryllium lymphocyte proliferation blood test on 627 employees; clinical evaluation and bronchoscopy were offered to people with abnormal test results; and industrial hygiene measurements related to work processes taken in 1984-93 were reviewed. 59 employees (9.4%) had abnormal blood tests, 47 of whom underwent bronchoscopy. 24 new cases of beryllium disease were identified, resulting in a beryllium disease prevalence of 4.6%, including five known cases (29/632). Employees who had worked in ceramics had the highest prevalence of beryllium disease (9.0%). Employees in the pebble plant (producing beryllium metal) who had been employed after 1983 also had increased risk, with a prevalence of beryllium disease of 6.4%, compared with 1.3% of other workers hired in the same period, and a prevalence of abnormal blood tests of 19.2%. Logistic regression modelling confirmed these two risk factors for beryllium disease related to work processes and the dependence on time of the risk at the pebble plant. The pebble plant was not associated with the highest gravimetric industrial hygiene measurements available since 1984. Further characterisation of exposures in beryllium metal production may be important to understanding how beryllium exposures confer high contemporary risk of beryllium disease.

  14. Higher order aberrations and relative risk of symptoms after LASIK.

    PubMed

    Sharma, Munish; Wachler, Brian S Boxer; Chan, Colin C K

    2007-03-01

    To understand what level of higher order aberrations increases the relative risk of visual symptoms in patients after myopic LASIK. This study was a retrospective comparative analysis of 103 eyes of 62 patients divided in two groups, matched for age, gender, pupil size, and spherical equivalent refraction. The symptomatic group comprised 36 eyes of 24 patients after conventional LASIK with different laser systems evaluated in our referral clinic and the asymptomatic control group consisted of 67 eyes of 38 patients following LADARVision CustomCornea wavefront LASIK. Comparative analysis was performed for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity, refractive cylinder, and higher order aberrations. Wavefront analysis was performed with the LADARWave aberrometer at 6.5-mm analysis for all eyes. Blurring of vision was the most common symptom (41.6%) followed by double image (19.4%), halo (16.7%), and fluctuation in vision (13.9%) in symptomatic patients. A statistically significant difference was noted in UCVA (P = .001), BSCVA (P = .001), contrast sensitivity (P < .001), and manifest cylinder (P = .001) in the two groups. The percentage difference between the symptomatic and control group mean root-mean-square (RMS) values ranged from 157% to 206% or 1.57 to 2.06 times greater. Patients with visual symptoms after LASIK have significantly lower visual acuity and contrast sensitivity and higher mean RMS values for higher order aberrations than patients without symptoms. Root-mean-square values of greater than two times the normal after-LASIK population for any given laser platform may increase the relative risk of symptoms.

  15. Human health risk assessment related to contaminated land: state of the art.

    PubMed

    Swartjes, F A

    2015-08-01

    Exposure of humans to contaminants from contaminated land may result in many types of health damage ranging from relatively innocent symptoms such as skin eruption or nausea, on up to cancer or even death. Human health protection is generally considered as a major protection target. State-of-the-art possibilities and limitations of human health risk assessment tools are described in this paper. Human health risk assessment includes two different activities, i.e. the exposure assessment and the hazard assessment. The combination of these is called the risk characterization, which results in an appraisal of the contaminated land. Exposure assessment covers a smart combination of calculations, using exposure models, and measurements in contact media and body liquids and tissue (biomonitoring). Regarding the time frame represented by exposure estimates, biomonitoring generally relates to exposure history, measurements in contact media to actual exposures, while exposure calculations enable a focus on exposure in future situations. The hazard assessment, which is different for contaminants with or without a threshold for effects, results in a critical exposure value. Good human health risk assessment practice accounts for tiered approaches and multiple lines of evidence. Specific attention is given here to phenomena such as the time factor in human health risk assessment, suitability for the local situation, background exposure, combined exposure and harmonization of human health risk assessment tools.

  16. Anemia risk in relation to lead exposure in lead-related manufacturing.

    PubMed

    Hsieh, Nan-Hung; Chung, Shun-Hui; Chen, Szu-Chieh; Chen, Wei-Yu; Cheng, Yi-Hsien; Lin, Yi-Jun; You, Su-Han; Liao, Chung-Min

    2017-05-05

    Lead-exposed workers may suffer adverse health effects under the currently regulated blood lead (BPb) levels. However, a probabilistic assessment about lead exposure-associated anemia risk is lacking. The goal of this study was to examine the association between lead exposure and anemia risk among factory workers in Taiwan. We first collated BPb and indicators of hematopoietic function data via health examination records that included 533 male and 218 female lead-exposed workers between 2012 and 2014. We used benchmark dose (BMD) modeling to estimate the critical effect doses for detection of abnormal indicators. A risk-based probabilistic model was used to characterize the potential hazard of lead poisoning for job-specific workers by hazard index (HI). We applied Bayesian decision analysis to determine whether BMD could be implicated as a suitable BPb standard. Our results indicated that HI for total lead-exposed workers was 0.78 (95% confidence interval: 0.50-1.26) with risk occurrence probability of 11.1%. The abnormal risk of anemia indicators for male and female workers could be reduced, respectively, by 67-77% and 86-95% by adopting the suggested BPb standards of 25 and 15 μg/dL. We conclude that cumulative exposure to lead in the workplace was significantly associated with anemia risk. This study suggests that current BPb standard needs to be better understood for the application of lead-exposed population protection in different scenarios to provide a novel standard for health management. Low-level lead exposure risk is an occupational and public health problem that should be paid more attention.

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

    PubMed

    Caponecchia, Carlo

    2012-09-01

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

  18. Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease.

    PubMed

    Forstmeier, Simon; Maercker, Andreas; Maier, Wolfgang; van den Bussche, Hendrik; Riedel-Heller, Steffi; Kaduszkiewicz, Hanna; Pentzek, Michael; Weyerer, Siegfried; Bickel, Horst; Tebarth, Franziska; Luppa, Melanie; Wollny, Anja; Wiese, Birgitt; Wagner, Michael

    2012-06-01

    Midlife motivational abilities, that is, skills to initiate and persevere in the implementation of goals, have been related to mental and physical health, but their association with risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) has not yet been directly investigated. This relation was examined with data from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). A total of 3,327 nondemented participants (50.3% of a randomly selected sample) aged 75-89 years were recruited in primary care and followed up twice (after 1.5 and 3 years). Motivation-related occupational abilities were estimated on the basis of the main occupation (assessed at follow-up II) using the Occupational Information Network (O* NET) database, which provides detailed information on worker characteristics and abilities. Cox proportional hazards models were used to evaluate the relative risk of developing MCI and AD in relation to motivation-related occupational abilities, adjusting for various covariates. Over the 3 years of follow-up, 15.2% participants developed MCI and 3.0% developed AD. In a fully adjusted model, motivation-related occupational abilities were found to be associated with a reduced risk of MCI (HR: 0.77; 95% CI: 0.64-0.92). Motivation-related occupational abilities were associated with reduced risk of AD in ApoE ε4 carriers (HR: 0.48; CI: 0.25-0.91), but not in noncarriers (HR: 0.99; CI: 0.65-1.53). These results suggest that midlife motivational abilities are associated with reduced risk of MCI in general and with reduced risk of AD in ApoE ε4 carriers. Revealing the mechanisms underlying this association may inform novel prevention strategies for decelerating cognitive decline in old age. PsycINFO Database Record (c) 2012 APA, all rights reserved

  19. Cognitive risk factors explain the relations between neuroticism and social anxiety for males and females.

    PubMed

    Allan, Nicholas P; Oglesby, Mary E; Uhl, Aubree; Schmidt, Norman B

    2017-04-01

    The hierarchical model of vulnerabilities to emotional distress contextualizes the relation between neuroticism and social anxiety as occurring indirectly through cognitive risk factors. In particular, inhibitory intolerance of uncertainty (IU; difficulty in uncertain circumstances), fear of negative evaluation (FNE; fear of being judged negatively), and anxiety sensitivity (AS) social concerns (fear of outwardly observable anxiety) are related to social anxiety. It is unclear whether these risk factors uniquely relate to social anxiety, and whether they account for the relations between neuroticism and social anxiety. The indirect relations between neuroticism and social anxiety through these and other risk factors were examined using structural equation modeling in a sample of 462 individuals (M age = 36.56, SD = 12.93; 64.3% female). Results indicated that the relations between neuroticism and social anxiety could be explained through inhibitory IU, FNE, and AS social concerns. No gender differences were found. These findings provide support for the hierarchical model of vulnerabilities to emotional distress disorders, although the cognitive risk factors accounted for variance beyond their contribution to the relation between neuroticism and social anxiety, suggesting a more complex model than that expressed in the hierarchical model of vulnerabilities.

  20. Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences.

    PubMed

    Wilson, Sandra R; Fink, Arlene; Verghese, Shinu; Beck, John C; Nguyen, Khue; Lavori, Philip

    2007-03-01

    To evaluate a new alcohol-related risk score for research use. Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect post-intervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors. Three primary care group practices in southern California. Six hundred sixty-five patients aged 65 and older. A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score. Mean post-intervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (P<.001). The difference between the combined report and usual care was significant (P<.001) and directly proportional to baseline risk. The three-level risk classification did not reveal approximately 57.3% of the intervention effect detected by the risk score. The risk score also was sufficiently sensitive to detect the intervention effect within the subset of hypertensive patients (n=112; P=.001). As an outcome measure in intervention trials, the finely grained risk score is more sensitive than the trinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined.

  1. Optimal Scaling of HIV-Related Sexual Risk Behaviors in Ethnically Diverse Homosexually Active Men.

    ERIC Educational Resources Information Center

    Cochran, Susan D.; And Others

    1995-01-01

    Used homogeneity analysis and latent class analysis to analyze sexual behavior patterns in two samples of homosexually active men. Results support the existence of a single, nonlinear, latent dimension underlying male homosexual behaviors consistent with HIV-related risk taking, providing an efficient means to scale sexual behavior patterns. (RJM)

  2. Reduction of work-related musculoskeletal risk factors following ergonomics education of sewing machine operators.

    PubMed

    Bulduk, Sıdıka; Bulduk, Emre Özgür; Süren, Tufan

    2017-09-01

    Work-related musculoskeletal disorders (WMSDs) are a major hazard for sewing machine operators. Ergonomics education is recommended for reducing musculoskeletal disorders at workstations. This study aimed to evaluate the effect of an ergonomics education in reducing the exposure to risk factors for WMSDs among sewing machine operators. In this study of 278 workers, their exposure to the risk of WMSDs was assessed using the quick exposure check scale prior to them attending an ergonomics education programme and then again 3 months after the programme. The scores for risk exposure before the education programme were moderate for back (static) and back (dynamic), high for shoulder/arm and very high for wrist/hand and neck. The results obtained 3 months later were low for back (static) and shoulder/arm, and moderate for back (dynamic), wrist/hand and neck. Based on our results, ergonomics education can reduce the exposure to risk factors for WMSDs in the workplace.

  3. Low Vision Rehabilitation, Age-Related Vision Loss, and Risk: A Critical Interpretive Synthesis

    PubMed Central

    Laliberte Rudman, Debbie; Egan, Mary Y.; McGrath, Colleen E.; Kessler, Dorothy; Gardner, Paula; King, Judy; Ceci, Christine

    2016-01-01

    Purpose: Given the centrality of risk in geriatric rehabilitation, it is critically important to attend to how conceptualizations of risk shape research, policies, and rehabilitation practices. This paper presents a critical interpretive synthesis (CIS) of literature addressing risk and low vision rehabilitation for older adults with age-related vision loss (ARVL) to identify key guiding assumptions regarding risk and discuss implications for what gets attended to, and not attended to, within research and rehabilitation. Design and Methods: This CIS combined guidelines proposed by Dixon-Woods and colleagues (2006—Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology, 6, 35) and Alvesson and Sandberg (2011—Generating research questions through problematization. Academy of Management Review, 36, 247–271; 2013—Constructing research questions: Doing interesting research. London: Sage). The iterative review process involved 3 steps: literature search and selection, data extraction, and syntheses to identify boundary assumptions. The dataset included 83 research and practice description articles. Results: Older adults with ARVL were constructed as “at risk” for various adverse outcomes, particularly dependency and self-harm, and as posing risks to others. An epidemiological approach to risk based in assumptions aligned with a technico-scientific perspective was dominant, with risk conceptualized as an embodied, individual-level phenomenon that is to be determined and managed through objective screening and expert monitoring. Implications: Key concerns include a lack of: attention to the tensions created when rehabilitation research and practice attempt to promote independence while simultaneously reducing risk, incorporation of aging adults’ perspectives on risk, and analysis of environmental factors that shape risks. Research that starts by valuing older adults

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

    PubMed

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

    2017-03-01

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

  5. Job stress and behavioral characteristics in relation to coronary heart disease risk among Japanese police officers.

    PubMed

    Shiozaki, Maki; Miyai, Nobuyuki; Morioka, Ikuharu; Utsumi, Miyoko; Hattori, Sonomi; Koike, Hiroaki; Arita, Mikio; Miyashita, Kazuhisa

    2017-08-08

    This study examined the association between job-related behavioral characteristics and the risk of coronary heart diseases (CHD) in Japanese male police officers. Compared to office clerks, police officers exhibited greater age-related increases of the prevalence of CHD risk factors, and a clustering number of CHD risk factors was significantly higher in the group of those over 45 yr of age. Among the police officers, coronary-prone behavior was more frequent than that seen in office clerks. The police officers with coronary-prone behavior tended to engage in shift work and to work overtime more; yet they were less likely to perceive job stress and to express the relevant physical and psychological symptoms than those without coronary-prone behavior. The subjects with such behavioral characteristics had a significantly greater number of CHD risk factors. In a multiple regression analysis, coronary-prone behavior together with age, social support, walking hours per day, and amount of alcohol consumption were selected as significant determinants of a cluster of CHD risk factors. These results suggest that coronary-prone behavior may contribute to the higher prevalence of CHD risk factors in police officers via leading the long working hours and the work-related unfavorable lifestyles, such as alcohol drinking and physical inactivity.

  6. [Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample].

    PubMed

    Trick, Sarah; Jantzer, Vanessa; Haffner, Johann; Parzer, Peter; Resch, Franz

    2016-10-01

    Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample Numerous research studies emphasize parental monitoring as a protective factor for adolescent problem behaviour. The purpose of the study presented was to use Stattin and Kerr's (2000) monitoring subscales for the first time in a German-speaking area and to explore the relations to behaviour problems in an adolescent school sample. The two active monitoring strategies "parental control" and "parental solicitation" as well as "parental knowledge" and "child disclosure" relating to behaviour problems and risk behaviour were examined. A sample of 494 pupils, grades 5, 7 and 9, of German secondary schools and their parents answered questions on "parental knowledge", "control", "solicitation" and "child disclosure". Adolescents also answered the German version of the Strengths and Difficulties Questionnaire (SDQ) and items about risk behaviour like frequency of violence, delinquency, substance abuse, self-injuring behaviour and school absenteeism. Behaviour problems in terms of the SDQ could be predicted sufficiently by "parental knowledge", but for the prediction of risk behaviour, the active parental monitoring strategies were of importance, too. More "parental knowledge", more "control" and less "solicitation" could predict less risk behaviour. Results confirm "parental knowledge" as a general protective factor for problem behaviour. However, they show the importance of "parental control" for adolescent risk behaviour.

  7. Job stress and behavioral characteristics in relation to coronary heart disease risk among Japanese police officers

    PubMed Central

    SHIOZAKI, Maki; MIYAI, Nobuyuki; MORIOKA, Ikuharu; UTSUMI, Miyoko; HATTORI, Sonomi; KOIKE, Hiroaki; ARITA, Mikio; MIYASHITA, Kazuhisa

    2017-01-01

    This study examined the association between job-related behavioral characteristics and the risk of coronary heart diseases (CHD) in Japanese male police officers. Compared to office clerks, police officers exhibited greater age-related increases of the prevalence of CHD risk factors, and a clustering number of CHD risk factors was significantly higher in the group of those over 45 yr of age. Among the police officers, coronary-prone behavior was more frequent than that seen in office clerks. The police officers with coronary-prone behavior tended to engage in shift work and to work overtime more; yet they were less likely to perceive job stress and to express the relevant physical and psychological symptoms than those without coronary-prone behavior. The subjects with such behavioral characteristics had a significantly greater number of CHD risk factors. In a multiple regression analysis, coronary-prone behavior together with age, social support, walking hours per day, and amount of alcohol consumption were selected as significant determinants of a cluster of CHD risk factors. These results suggest that coronary-prone behavior may contribute to the higher prevalence of CHD risk factors in police officers via leading the long working hours and the work-related unfavorable lifestyles, such as alcohol drinking and physical inactivity. PMID:28428501

  8. From Sexual Assault to Sexual Risk: A Relational Pathway?

    PubMed Central

    Wells, Brooke E.; Starks, Tyrel J.; Robel, Erika; Kelly, Brian C.; Parsons, Jeffrey T.; Golub, Sarit A.

    2015-01-01

    Among women and gay and bisexual men, sexual assault is associated with increased rates of sexual risk behavior and negative sexual health outcomes. Although the mechanisms of these effects are potentially myriad, the current analyses examine the role of perceived partner pressure for condomless sex in mediating the association between adult sexual assault (ASA) and recent anal or vaginal sex without a condom. In a sample of 205 young adult women and gay and bisexual men, ASA was indirectly associated with condomless anal and/or vaginal sex via perceptions of partner pressure for condomless sex, χ2(1) = 5.66, p = .02, after controlling for race, age, gender and sexual identity, and relationship status. The elucidation of this relational mechanism points to several potential intervention and prevention strategies that may reduce actual and perceived pressure for sex without a condom, including strategies designed to facilitate the prioritization of health and safety over relational goals and the improvement of partner selection and perceptions of partner pressure. PMID:25944835

  9. From Sexual Assault to Sexual Risk: A Relational Pathway?

    PubMed

    Wells, Brooke E; Starks, Tyrel J; Robel, Erika; Kelly, Brian C; Parsons, Jeffrey T; Golub, Sarit A

    2016-12-01

    Among women and gay and bisexual men, sexual assault is associated with increased rates of sexual risk behavior and negative sexual health outcomes. Although the mechanisms of these effects are potentially myriad, the current analyses examine the role of perceived partner pressure for condomless sex in mediating the association between adult sexual assault (ASA) and recent anal or vaginal sex without a condom. In a sample of 205 young adult women and gay and bisexual men, ASA was indirectly associated with condomless anal and/or vaginal sex via perceptions of partner pressure for condomless sex, χ 2 (1) = 5.66, p = .02, after controlling for race, age, gender and sexual identity, and relationship status. The elucidation of this relational mechanism points to several potential intervention and prevention strategies that may reduce actual and perceived pressure for sex without a condom, including strategies designed to facilitate the prioritization of health and safety over relational goals and the improvement of partner selection and perceptions of partner pressure. © The Author(s) 2015.

  10. [Risk factors for the development of pneumonia in multiple injured patients. Results of a prospective clinical trial].

    PubMed

    Andermahr, J; Hensler, T; Sauerland, S; Greb, A; Helling, H-J; Prokop, A; Neugebauer, E A M; Rehm, K E

    2003-05-01

    Pneumonia is the most common infectious complication in multiple trauma patients. In a prospective clinical cohort study, 266 multiply injured patients were examined for the development of pneumonia. Various risk factors were tested in uni- and multivariate analyses. Three different definitions of pneumonia were used in order to examine how results depended on definition. The incidence of pneumonia was 41%, but varied with definition (30-50%). Injuries to the thorax, head,and abdomen were associated with a significantly increased risk of pneumonia (adjusted relative risk: 1.77, 1.97,and 1.52, respectively).Furthermore, increasing age led to a higher risk of pneumonia. Although the primary analysis revealed a higher pneumonia risk in male patients (adjusted relative risk: 2.23; 95% CI: 1.43-3.05), this result could not be consistently reproduced when using other definitions of pneumonia. Trunk and head injuries and age are proven risk factors for developing posttraumatic pneumonia. The association between male gender and an increased rate of infectious complications remained questionable.

  11. Flux and permanence of risk perceptions: Tourists' perception of the relative and absolute risk for various destinations.

    PubMed

    Wolff, Katharina; Larsen, Svein

    2016-12-01

    The present investigation is a cross-sectional, multi-national, quantitative, and quasi-experimental comparison of tourists' risk perceptions regarding different destinations throughout the past decade. Over 10,000 tourists to Norway from 89 different countries filled in a questionnaire rating the perceived risk for various destinations. Data were collected during 2004, 2010, 2011, 2012, 2013 and 2015 and allow for a comparison of perceived risk across time, place and nationality. Results show that while absolute risk judgments for different destinations fluctuate somewhat over the years, relative risk judgments remain constant. Findings also reveal a "home-is-safer-then-abroad-bias" with tourists consistently perceiving their home country among the safest destinations. The current investigation is rare because it looks at more than one destination at a time. Insights gained from the present findings diverge from what would have been concluded from employing case studies, that is, looking at one destination at a time. © 2016 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  12. Current and Proposed Regulations Related to Minimum Risk Pesticides

    EPA Pesticide Factsheets

    Minimum risk pesticides are exempted from requirements for registration with EPA but are still subject to certain criteria to qualify as minimum risk and may be further regulated by states. See links to the key regulatory citations.

  13. Risk of treatment-related esophageal cancer among breast cancer survivors

    PubMed Central

    Morton, L. M.; Gilbert, E. S.; Hall, P.; Andersson, M.; Joensuu, H.; Vaalavirta, L.; Dores, G. M.; Stovall, M.; Holowaty, E. J.; Lynch, C. F.; Curtis, R. E.; Smith, S. A.; Kleinerman, R. A.; Kaijser, M.; Storm, H. H.; Pukkala, E.; Weathers, R. E.; Linet, M. S.; Rajaraman, P.; Fraumeni, J. F.; Brown, L. M.; van Leeuwen, F. E.; Fossa, S. D.; Johannesen, T. B.; Langmark, F.; Lamart, S.; Travis, L. B.; Aleman, B. M. P.

    2012-01-01

    Background Radiotherapy for breast cancer may expose the esophagus to ionizing radiation, but no study has evaluated esophageal cancer risk after breast cancer associated with radiation dose or systemic therapy use. Design Nested case–control study of esophageal cancer among 289 748 ≥5-year survivors of female breast cancer from five population-based cancer registries (252 cases, 488 individually matched controls), with individualized radiation dosimetry and information abstracted from medical records. Results The largest contributors to esophageal radiation exposure were supraclavicular and internal mammary chain treatments. Esophageal cancer risk increased with increasing radiation dose to the esophageal tumor location (Ptrend < 0.001), with doses of ≥35 Gy associated with an odds ratio (OR) of 8.3 [95% confidence interval (CI) 2.7–28]. Patients with hormonal therapy ≤5 years preceding esophageal cancer diagnosis had lower risk (OR = 0.4, 95% CI 0.2–0.8). Based on few cases, alkylating agent chemotherapy did not appear to affect risk. Our data were consistent with a multiplicative effect of radiation and other esophageal cancer risk factors (e.g. smoking). Conclusions Esophageal cancer is a radiation dose-related complication of radiotherapy for breast cancer, but absolute risk is low. At higher esophageal doses, the risk warrants consideration in radiotherapy risk assessment and long-term follow-up. PMID:22745217

  14. Patient-Reported Health-Related Quality of Life Is a Predictor of Outcomes in Ambulatory Heart Failure Patients Treated With Left Ventricular Assist Device Compared With Medical Management: Results From the ROADMAP Study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management).

    PubMed

    Stehlik, Josef; Estep, Jerry D; Selzman, Craig H; Rogers, Joseph G; Spertus, John A; Shah, Keyur B; Chuang, Joyce; Farrar, David J; Starling, Randall C

    2017-06-01

    The prospective observational ROADMAP study (Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management) demonstrated that ambulatory advanced heart failure patients selected for left ventricular assist device (LVAD) were more likely to be alive at 1 year on original therapy with ≥75-m improvement in 6-minute walk distance compared with patients assigned to optimal medical management. Whether baseline health-related quality of life (hrQoL) resulted in a heterogeneity of this treatment benefit is unknown. Patient-reported hrQoL was assessed with EuroQol questionnaire and visual analogue scale (VAS). We aimed to identify predictors of event-free survival and survival with acceptable hrQoL (VAS≥60). LVAD patients had significant improvement in 3 of 5 EuroQol dimensions ( P <0.05), but no significant changes were observed with optimal medical management. Among patients with baseline VAS<55, survival on original treatment was lower for optimal medical management patients compared with those assigned to LVAD (58±7% versus 82±5%; P =0.004). No such difference was seen if baseline VAS was ≥55 (70±7% versus 75±9%; P =0.79). Survival on original therapy with acceptable quality of life was also more likely with LVAD versus optimal medical management if baseline VAS was <55, whereas outcomes in patients with higher baseline VAS scores were similar regardless of treatment assignment ( P =0.046 for treatment arm and baseline VAS interaction). LVAD therapy resulted in improvement of patient health status in heart failure patients with low self-reported hrQoL, but not in patients with acceptable quality of life at the time of LVAD implantation. Patient-reported hrQoL should be integrated into decision making concerning the use and timing of LVAD therapy in heart failure patients who are symptom limited but remain ambulatory. URL: http://www.ClinicalTrials.gov. Unique identifier: NCT01452802. © 2017 American Heart Association

  15. Clinical risk management in mental health: a qualitative study of main risks and related organizational management practices

    PubMed Central

    2013-01-01

    Background A scientific understanding of clinical risk management (CRM) in mental health care is essential for building safer health systems and for improving patient safety. While evidence on patient safety and CRM in physical health care has increased, there is limited research on these issues in mental health care. This qualitative study provides an overview of the most important clinical risks in mental health and related organizational management practices. Methods We conducted in-depth expert interviews with professionals responsible for CRM in psychiatric hospitals. Interviews were transcribed and analyzed applying qualitative content analysis to thematically sort the identified risks. Results The main concerns for CRM in mental health are a) violence and self-destructive behavior (i.e. protecting patients and staff from other patients, and patients from themselves), b) treatment errors, especially in the process of therapy, and c) risks associated with mental illnesses (e.g. psychosis or depression). This study identified critical differences to CRM in hospitals for physical disorder and challenges specific to CRM in mental health. Firstly, many psychiatric patients do not believe that they are ill and are therefore in hospital against their will. Secondly, staff safety is a much more prominent theme for CRM in mental health care as it is directly related to the specifics of mental illnesses. Conclusions The current study contributes to the understanding of patient safety and raises awareness for CRM in mental health. The mental health specific overview of central risks and related organizational management practices offers a valuable basis for CRM development in mental health and an addition to CRM in general. PMID:23379842

  16. Coffee, caffeine, and risk of completed suicide: results from 3 prospective cohorts of American adults

    PubMed Central

    Lucas, Michel; O’Reilly, Eilis J.; Pan, An; Mirzaei, Fariba; Willett, Walter C.; Okereke, Olivia I.; Ascherio, Alberto

    2014-01-01

    Objective To evaluate the association between coffee and caffeine consumption and suicide risk in three large-scale cohorts of U.S. men and women. Methods We accessed data of 43,599 men enrolled in the Health Professionals Follow-up Study (HPFS, 1988–2008), 73,820 women in the Nurses’ Health Study (NHS, 1992–2008), and 91,005 women in the NHS II (1993–2007). Consumption of caffeine, coffee, and decaffeinated coffee, was assessed every four years by validated food-frequency questionnaires. Deaths from suicide were determined by physician review of death certificates. Multivariate adjusted relative risks (RRs) were estimated with Cox proportional hazard models. Cohort specific RRs were pooled using random-effect models. Results We documented 277 deaths from suicide. Compared to those consuming ≤1 cup/week of caffeinated coffee (≤8 oz/237 ml), the pooled multivariate RR (95% confidence interval [CI]) of suicide was 0.55 (0.38–0.78) for those consuming 2–3 cups/day and 0.47 (0.27–0.81) for those consuming ≥4 cups/day (P trend <0.001). The pooled multivariate RR (95% CI) for suicide was 0.75 (0.63–0.90) for each increment of 2 cups/day of caffeinated coffee and 0.77 (0.63–0.93) for each increment of 300 mg/day of caffeine. Conclusions These results from three large cohorts support an association between caffeine consumption and lower risk of suicide. PMID:23819683

  17. Radiation-related risks of non-cancer outcomes in the atomic bomb survivors.

    PubMed

    Ozasa, K; Takahashi, I; Grant, E J

    2016-06-01

    Risks of non-cancer outcomes after exposure to atomic bomb (A-bomb) radiation have been evaluated among the Life Span Study (LSS) cohort and its subcohort, the Adult Health Study (AHS). Information regarding non-cancer outcomes in the LSS is obtained from death certificates. In the AHS, members undergo clinical examinations biennially to determine their health status. Many AHS studies have been limited to participants attending the clinic over a limited period, and therefore have varying degrees of inferential utility; as such, care is required for comparison with the LSS results. Disease structure of non-cancer diseases in Japan has changed over the long follow-up period since the end of World War II. The health status of the A-bomb survivors may be associated with the hardships of living in a devastated city and impoverished country following the prolonged war effort, in addition to the direct effects of radiation exposure. Radiation-related risk of cardiovascular disease may have increased due to radiation-related increased risk of hypertension and other secondary associations, and the risk of atherosclerotic disorders has also been reported recently. These results should be interpreted with caution because of changes in disease definitions over the follow-up period. The radiation-related risk of non-cancer respiratory diseases also appears to have increased over the follow-up period, but the shapes of the dose-response curves have shown little consistency. © The International Society for Prosthetics and Orthotics.

  18. [Harm related to medical device use - legal and organisational risks].

    PubMed

    Hölscher, U M

    2014-12-01

    The effectiveness of the risk management systems established by medical device manufacturers and health-care facilities is clearly mitigated by European and national legal provisions. Laws, regulations and authorities prevent the systematic exchange of much safety-relevant information. The obligation to report adverse events is suspended for many relevant risks associated with medical device use. Reporting into the vigilance system is of little avail for users. Reporting even may endanger the information provider. The federal fragmentation of the German vigilance system poses a risk for patients. Risk management in health-care facilities without risk policy is dangerously incomplete. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Relative cancer risks of chemical contaminants in the great lakes

    NASA Astrophysics Data System (ADS)

    Bro, Kenneth M.; Sonzogni, William C.; Hanson, Mark E.

    1987-08-01

    Anyone who drinks water or eats fish from the Great Lakes consumes potentially carcinogenic chemicals. In choosing how to respond to such pollution, it is important to put the risks these contaminants pose in perspective. Based on recent measurements of carcinogens in Great Lakes fish and water, calculations of lifetime risks of cancer indicate that consumers of sport fish face cancer risks from Great Lakes contaminants that are several orders of magnitude higher than the risks posed by drinking Great Lakes water. But drinking urban groundwater and breathing urban air may be as hazardous as frequent consumption of sport fish from the Great Lakes. Making such comparisons is difficult because of variation in types and quality of information available and in the methods for estimating risk. Much uncertainty pervades the risk assessment process in such areas as estimating carcinogenic potency and human exposure to contaminants. If risk assessment is to be made more useful, it is important to quantify this uncertainty.

  20. Circadian clock-related genetic risk scores and risk of placental abruption.

    PubMed

    Qiu, Chunfang; Gelaye, Bizu; Denis, Marie; Tadesse, Mahlet G; Luque Fernandez, Miguel Angel; Enquobahrie, Daniel A; Ananth, Cande V; Sanchez, Sixto E; Williams, Michelle A

    2015-12-01

    The circadian clock plays an important role in several aspects of female reproductive biology. Evidence linking circadian clock-related genes to pregnancy outcomes has been inconsistent. We sought to examine whether variations in single nucleotide polymorphisms (SNPs) of circadian clock genes are associated with PA risk. Maternal blood samples were collected from 470 PA case and 473 controls. Genotyping was performed using the Illumina Cardio-MetaboChip platform. We examined 119 SNPs in 13 candidate genes known to control circadian rhythms (e.g., CRY2, ARNTL, and RORA). Univariate and penalized logistic regression models were fit to estimate odds ratios (ORs); and the combined effect of multiple SNPs on PA risk was estimated using a weighted genetic risk score (wGRS). A common SNP in the RORA gene (rs2899663) was associated with a 21% reduced odds of PA (P < 0.05). The odds of PA increased with increasing wGRS (Ptrend < 0.001). The corresponding ORs were 1.00, 1.83, 2.81 and 5.13 across wGRS quartiles. Participants in the highest wGRS quartile had a 5.13-fold (95% confidence interval: 3.21-8.21) higher odds of PA compared to those in the lowest quartile. Although the test for interaction was not significant, the odds of PA was substantially elevated for preeclamptics with the highest wGRS quartile (OR = 14.44, 95%CI: 6.62-31.53) compared to normotensive women in the lowest wGRS quartile. Genetic variants in circadian rhythm genes may be associated with PA risk. Larger studies are needed to corroborate these findings and to further elucidate the pathogenesis of this important obstetrical complication. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Salmonella risk to consumers via pork is related to the Salmonella prevalence in pig feed.

    PubMed

    Rönnqvist, M; Välttilä, V; Ranta, J; Tuominen, P

    2018-05-01

    Pigs are an important source of human infections with Salmonella, one of the most common causes of sporadic gastrointestinal infections and foodborne outbreaks in the European region. Feed has been estimated to be a significant source of Salmonella in piggeries in countries of a low Salmonella prevalence. To estimate Salmonella risk to consumers via the pork production chain, including feed production, a quantitative risk assessment model was constructed. The Salmonella prevalence in feeds and in animals was estimated to be generally low in Finland, but the relative importance of feed as a source of Salmonella in pigs was estimated as potentially high. Discontinuation of the present strict Salmonella control could increase the risk of Salmonella in slaughter pigs and consequent infections in consumers. The increased use of low risk and controlled feed ingredients could result in a consistently lower residual contamination in pigs and help the tracing and control of the sources of infections. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. About some aspects of weather related risks in Spanish Agriculture

    NASA Astrophysics Data System (ADS)

    Anton, J. M.; Tarquis, A. M.; Grau, J. B.; Saa, A.; Diaz, M. C.

    2009-04-01

    aggressive floods in 1500-1800 era, and actual added trends of "climate change" are towards higher temperatures, less water and higher perturbations. These long term risks are rather poorly predictable and will be handled mostly by improvements in agriculture and also by social and economic adaptations, but at shorter delays and specific areas active policies are possible and exist. An agribusiness can set his production plans lowering his global risk. Sometimes it might use prudently some financial instruments, such as "orange juice futures". When using decision making models, some utility functions may consider that severe losses have higher effects than good profits, letting ranges for business margins for insurers to be limited by concurrence at correct levels. Correct availability of credits is necessary for bad periods, and also state policies for rare bad situations, concerning agribusiness survival and also alimentary safety. Insurance products are effective aids for a growing variety of well definite natural risks, such as in cases of hailstorm, that have probabilities of occurrence measurable from previous events data, and a variety of adequate professional models are continuously made for them. Related to Universidad Politecnica de Madrid the CEIGRAM institute has started recently and is involved in agricultural insurance, being connected with insurers through ENESA and AGROMUTUA. That world is active, important, evolving, and is regulated by diverse laws.

  3. Risk-taking related to drug use: an application of the shift-to-risk design.

    PubMed

    Deren, S; Des Jarlais, D C

    1977-01-01

    The utility of the shift-to-risk design for studying the influence of peer groups on drug taking was investigated. Two studies using this design with drug content were conducted, varying the level of information provided about a drug. Subjects were from two college classes consisting of 26 and 28 students. Results indicated that the specification of possible harmful drug effects which are somewhat minimal lead to a significantly greater willingness to recommend trying the drug. In addition, a tendency for a shift-to-caution was found. It was concluded that the shift-to-risk designwas useful for studying decision-making regarding drug use, and that both users and nonusers of drugs should be included in future research.

  4. Lupus-related single nucleotide polymorphisms and risk of diffuse large B-cell lymphoma

    PubMed Central

    Bernatsky, Sasha; Velásquez García, Héctor A; Spinelli, John J; Gaffney, Patrick; Smedby, Karin E; Ramsey-Goldman, Rosalind; Wang, Sophia S; Adami, Hans-Olov; Albanes, Demetrius; Angelucci, Emanuele; Ansell, Stephen M; Asmann, Yan W; Becker, Nikolaus; Benavente, Yolanda; Berndt, Sonja I; Bertrand, Kimberly A; Birmann, Brenda M; Boeing, Heiner; Boffetta, Paolo; Bracci, Paige M; Brennan, Paul; Brooks-Wilson, Angela R; Cerhan, James R; Chanock, Stephen J; Clavel, Jacqueline; Conde, Lucia; Cotenbader, Karen H; Cox, David G; Cozen, Wendy; Crouch, Simon; De Roos, Anneclaire J; de Sanjose, Silvia; Di Lollo, Simonetta; Diver, W Ryan; Dogan, Ahmet; Foretova, Lenka; Ghesquières, Hervé; Giles, Graham G; Glimelius, Bengt; Habermann, Thomas M; Haioun, Corinne; Hartge, Patricia; Hjalgrim, Henrik; Holford, Theodore R; Holly, Elizabeth A; Jackson, Rebecca D; Kaaks, Rudolph; Kane, Eleanor; Kelly, Rachel S; Klein, Robert J; Kraft, Peter; Kricker, Anne; Lan, Qing; Lawrence, Charles; Liebow, Mark; Lightfoot, Tracy; Link, Brian K; Maynadie, Marc; McKay, James; Melbye, Mads; Molina, Thierry J; Monnereau, Alain; Morton, Lindsay M; Nieters, Alexandra; North, Kari E; Novak, Anne J; Offit, Kenneth; Purdue, Mark P; Rais, Marco; Riby, Jacques; Roman, Eve; Rothman, Nathaniel; Salles, Gilles; Severi, Gianluca; Severson, Richard K; Skibola, Christine F; Slager, Susan L; Smith, Alex; Smith, Martyn T; Southey, Melissa C; Staines, Anthony; Teras, Lauren R; Thompson, Carrie A; Tilly, Hervé; Tinker, Lesley F; Tjonneland, Anne; Turner, Jenny; Vajdic, Claire M; Vermeulen, Roel C H; Vijai, Joseph; Vineis, Paolo; Virtamo, Jarmo; Wang, Zhaoming; Weinstein, Stephanie; Witzig, Thomas E; Zelenetz, Andrew; Zeleniuch-Jacquotte, Anne; Zhang, Yawei; Zheng, Tongzhang; Zucca, Mariagrazia; Clarke, Ann E

    2017-01-01

    Objective Determinants of the increased risk of diffuse large B-cell lymphoma (DLBCL) in SLE are unclear. Using data from a recent lymphoma genome-wide association study (GWAS), we assessed whether certain lupus-related single nucleotide polymorphisms (SNPs) were also associated with DLBCL. Methods GWAS data on European Caucasians from the International Lymphoma Epidemiology Consortium (InterLymph) provided a total of 3857 DLBCL cases and 7666 general-population controls. Data were pooled in a random-effects meta-analysis. Results Among the 28 SLE-related SNPs investigated, the two most convincingly associated with risk of DLBCL included the CD40 SLE risk allele rs4810485 on chromosome 20q13 (OR per risk allele=1.09, 95% CI 1.02 to 1.16, p=0.0134), and the HLA SLE risk allele rs1270942 on chromosome 6p21.33 (OR per risk allele=1.17, 95% CI 1.01 to 1.36, p=0.0362). Of additional possible interest were rs2205960 and rs12537284. The rs2205960 SNP, related to a cytokine of the tumour necrosis factor superfamily TNFSF4, was associated with an OR per risk allele of 1.07, 95% CI 1.00 to 1.16, p=0.0549. The OR for the rs12537284 (chromosome 7q32, IRF5 gene) risk allele was 1.08, 95% CI 0.99 to 1.18, p=0.0765. Conclusions These data suggest several plausible genetic links between DLBCL and SLE. PMID:29214033

  5. Lifestyle-related risk factors, smoking status and cardiovascular disease.

    PubMed

    Giudice, Renata; Izzo, Raffaele; Manzi, Maria Virgina; Pagnano, Giampiero; Santoro, Mario; Rao, Maria Assunta Elena; Di Renzo, Gianfranco; De Luca, Nicola; Trimarco, Valentina

    2012-06-01

    Cardiovascular disease represents one of the most important causes of morbidity and mortality in highly developed countries and is known to be associated with some lifestyle-related risk factors (e.g. alcohol consumption, smoking status, diet, physical activity, bodyweight). There is still incomplete information about their combined effect on cardiovascular risk in hypertensive patients with optimal pharmacological blood pressure control. The objective of this study was to evaluate the correlation of some lifestyle behaviours, using a specific questionnaire, with development of cardiovascular disease in treated hypertensive patients. 617 hypertensive, non-diabetic participants (aged 53.1 ± 7.6 years, 44.9% male; mean age 53.1 ± 7.6 years) free of prevalent cardiovascular disease, cancer, liver cirrhosis and/or failure, chronic kidney disease more than grade 3 (glomerular filtration rate by the Modification of Diet in Renal Disease study <30 mL/min/1.73 m2) were analysed. Metabolic syndrome was defined according to the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Left ventricular hypertrophy was defined when left ventricular mass index was >51 g/m2. Carotid artery atherosclerosis was assessed as an increased intima medial thickness (IMT) by B-mode ultrasonography. IMT values between 0.9 and 1.3 mm were defined as 'thickening' and those >1.3 mm as 'plaque'. Assessment of smoking status, dietary and non-dietary factors was established by administration of a specific questionnaire. In the initial population of examined patients, 288 were smokers and 329 were non-smokers. At baseline, the patients belonging to smoking group were less often overweight than those belonging to the non-smoking group, showing a lower initial body mass index (BMI) [27.54 ± 4.0 vs 28.28 ± 4.3; p < 0.029], lower plasma levels of high-density lipoprotein cholesterol (HDL-C) [48.14 ± 12.6 vs 51.39

  6. ALPK1 genetic regulation and risk in relation to gout

    PubMed Central

    Min-Shan Ko, Albert; Tu, Hung-Pin; Liu, Tze-Tze; Chang, Jan-Gowth; Yuo, Chung-Yee; Chiang, Shang-Lun; Chang, Shun-Jen; Liu, Yu-Fan; Min-Jen Ko, Allen; Lee, Chien-Hung; Lee, Chi-Pin; Chang, Chung-Ming; Tsai, Shih-Feng; Ko, Ying-Chin

    2013-01-01

    Background The present study investigated whether single nucleotide polymorphisms (SNPs) in the alpha-protein kinase 1 (ALPK1) gene are associated with gout in aboriginal and Han Chinese Taiwanese. Methods A total of 1351 aborigines from the community (511 cases and 840 controls) and 511 Han people from hospital (104 cases and 407 controls) were recruited. SNPs in potentially functional regions of the 38 genes within 4q25 were identified and genotypes determined by direct sequencing. Quantitation of blood ALPK1 mRNA expression levels and luciferase assay of gout-associated rs231253 pGL3-SNP constructs cotransfected with hsa-miR-519e were examined. Results We found that ALPK1 gene was the most determinant of gout. Three SNPs of rs11726117 M861T [C], rs231247 [G] and rs231253 [G] were most associated with gout risk [odd ratios (OR) ≥1.44, P ≤ 3.78 × 10−6) in aborigines. A replication set using Han people had risk at rs11726117 and rs231247 (OR ≥1.72, P ≤ 4.08 × 10−3). From pooled analysis (Breslow-Day test, P > 0.33) assuming an additive model, each increasing copy of the risk allele of rs11726117 [C], rs231247 [G] and rs231253 [G] showed significantly elevated OR for gout ≥1.42 (P ≥ 1.53 × 10−6). Consistently, the composite homozygous of linked 3 SNPs (versus wild-type, OR = 1.83, P = 8.21 × 10−4) had strong associations with ALPK1 mRNA expression. Luciferase showed reduced hybridization between hsa-miR-519e and construct carrying gout-associated rs231253 [G] than the wild-type [C] (P = 6.19 × 10−4). Conclusions Our study found that a newly identified ALPK1 gene can effectively interfere with microRNA target recognition and modulates the mRNA expression; and the varying distribution of the implicated SNPs among cases and controls in the two studied populations suggests a significant role in gout susceptibility. PMID:23569188

  7. Incidence and relative risk of hearing disorders in professional musicians

    PubMed Central

    Schink, Tania; Kreutz, Gunter; Busch, Veronika; Pigeot, Iris; Ahrens, Wolfgang

    2014-01-01

    Background Hearing disorders have been associated with occupational exposure to music. Musicians may benefit from non-amplified and low-intensity music, but may also have high risks of music-induced hearing loss. Aims To compare the incidence of hearing loss (HL) and its subentities in professional musicians with that in the general population. Methods We performed a historical cohort study among insurants between 19 and 66 years who were employed subject to social insurance contributions. The study was conducted with data from three German statutory health insurance providers covering the years 2004–2008 with about 7 million insurants. Incidence rates with 95% CIs of HL and the subentities noise-induced hearing loss (NIHL), conductive HL, sensorineural HL, conductive and sensorineural HL, as well as tinnitus were estimated stratified by age, sex and federal state. A Cox regression analysis was conducted to estimate adjusted HRs and two-sided 95% CIs for HL and its subentities. Results More than 3 million insurants were eligible, of whom 2227 were identified as professional musicians (0.07%). During the 4-year observation period, 283 697cases of HL were seen, 238 of them among professional musicians (0.08%), leading to an unadjusted incidence rate ratio of 1.27. The adjusted hazard ratio of musicians was 1.45 (95% CI 1.28 to 1.65) for HL and 3.61 (95% CI 1.81 to 7.20) for NIHL. Conclusions Professional musicians have a high risk of contracting hearing disorders. Use of already available prevention measures should reduce the incidence of HL in professional musicians. PMID:24790053

  8. Age-Related Sensory Impairments and Risk of Cognitive Impairment

    PubMed Central

    Fischer, Mary E; Cruickshanks, Karen J.; Schubert, Carla R; Pinto, Alex A; Carlsson, Cynthia M; Klein, Barbara EK; Klein, Ronald; Tweed, Ted S.

    2016-01-01

    Background/Objectives To evaluate the associations of sensory impairments with the 10-year risk of cognitive impairment. Previous work has primarily focused on the relationship between a single sensory system and cognition. Design The Epidemiology of Hearing Loss Study (EHLS) is a longitudinal, population-based study of aging in the Beaver Dam, WI community. Baseline examinations were conducted in 1993 and follow-up exams have been conducted every 5 years. Setting General community Participants EHLS members without cognitive impairment at EHLS-2 (1998–2000). There were 1,884 participants (mean age = 66.7 years) with complete EHLS-2 sensory data and follow-up information. Measurements Cognitive impairment was a Mini-Mental State Examination score of < 24 or history of dementia or Alzheimer’s disease. Hearing impairment was a pure-tone average of hearing thresholds (0.5, 1, 2 and 4 kHz) of > 25 decibel Hearing Level in either ear. Visual impairment was Pelli-Robson contrast sensitivity of < 1.55 log units in the better eye and olfactory impairment was a San Diego Odor Identification Test score of < 6. Results Hearing, visual, and olfactory impairment were independently associated with cognitive impairment risk [Hearing: Hazard Ratio (HR) = 1.90, 95% Confidence Interval (C.I.) = 1.11, 3.26; Vision: HR = 2.05, 95% C.I. = 1.24, 3.38; Olfaction: HR = 3.92, 95% C.I. = 2.45, 6.26]. However, 85% with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. Conclusion The relationship between sensory impairment and cognitive impairment was not unique to one sensory system suggesting sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging. PMID:27611845

  9. Physical activity volume in relation to risk of atrial fibrillation. A non-linear meta-regression analysis.

    PubMed

    Ricci, Cristian; Gervasi, Federico; Gaeta, Maddalena; Smuts, Cornelius M; Schutte, Aletta E; Leitzmann, Michael F

    2018-05-01

    Background Light physical activity is known to reduce atrial fibrillation risk, whereas moderate to vigorous physical activity may result in an increased risk. However, the question of what volume of physical activity can be considered beneficial remains poorly understood. The scope of the present work was to examine the relation between physical activity volume and atrial fibrillation risk. Design A comprehensive systematic review was performed following the PRISMA guidelines. Methods A non-linear meta-regression considering the amount of energy spent in physical activity was carried out. The first derivative of the non-linear relation between physical activity and atrial fibrillation risk was evaluated to determine the volume of physical activity that carried the minimum atrial fibrillation risk. Results The dose-response analysis of the relation between physical activity and atrial fibrillation risk showed that physical activity at volumes of 5-20 metabolic equivalents per week (MET-h/week) was associated with significant reduction in atrial fibrillation risk (relative risk for 19 MET-h/week = 0.92 (0.87, 0.98). By comparison, physical activity volumes exceeding 20 MET-h/week were unrelated to atrial fibrillation risk (relative risk for 21 MET-h/week = 0.95 (0.88, 1.02). Conclusion These data show a J-shaped relation between physical activity volume and atrial fibrillation risk. Physical activity at volumes of up to 20 MET-h/week is associated with reduced atrial fibrillation risk, whereas volumes exceeding 20 MET-h/week show no relation with risk.

  10. Impaired health-related quality of life and related risk factors among US adults with asthma.

    PubMed

    Pate, Cynthia A; Zahran, Hatice S; Bailey, Cathy M

    2018-04-18

    This study assessed health-related quality of life (HRQoL) and related risk factors among adults with asthma in the United States. Using the 2015 Behavioral Risk Factor Surveillance System (BRFSS), we examined the association between four domains of impaired HRQoL and selected explanatory factors. A BRFSS sample of 39,321 adults with asthma was used in this study. We examined the association between fair/poor health, ≥ 14 mentally unhealthy days, ≥ 14 physically unhealthy days, and ≥ 14 days of activity limitation and selected explanatory variables (sex, race/ethnicity, age, annual household income, healthcare coverage, physical activity, smoking status, body mass index (BMI), having a coexisting disease, and being diagnosed with depression) using multivariable logistic regression models. Income, physical activity status, smoking status, coexisting diseases, and depression were strongly associated with all HRQoL domains. Blacks had significantly less ≥ 14 physically unhealthy days (23.4%; aPR = 0.82 [95% confidence interval (CI): 0.72, 0.92]) and ≥ 14 days of activity limitation (18.3%; aPR = 0.81 [0.70, 0.94]) and Hispanics had significantly more fair/poor health (38.4%; aPR = 1.31 [1.18, 1.45]) than whites. Underweight and obese had significantly more fair/poor health, and underweight significantly more ≥ 14 physically unhealthy days, compared with normal weight. Adults aged 55 years or older had significantly less ≥ 14 mentally unhealthy days than adults 18-24 years. Multiple factors were associated with impaired HRQoL. Providing strategies to address potential risk factors such as low income, physically inactive, smoker, and obese or underweight should be considered to improve HRQoL among adults with asthma.

  11. Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE.

    PubMed

    Mavaddat, Nasim; Peock, Susan; Frost, Debra; Ellis, Steve; Platte, Radka; Fineberg, Elena; Evans, D Gareth; Izatt, Louise; Eeles, Rosalind A; Adlard, Julian; Davidson, Rosemarie; Eccles, Diana; Cole, Trevor; Cook, Jackie; Brewer, Carole; Tischkowitz, Marc; Douglas, Fiona; Hodgson, Shirley; Walker, Lisa; Porteous, Mary E; Morrison, Patrick J; Side, Lucy E; Kennedy, M John; Houghton, Catherine; Donaldson, Alan; Rogers, Mark T; Dorkins, Huw; Miedzybrodzka, Zosia; Gregory, Helen; Eason, Jacqueline; Barwell, Julian; McCann, Emma; Murray, Alex; Antoniou, Antonis C; Easton, Douglas F

    2013-06-05

    Reliable estimates of cancer risk are critical for guiding management of BRCA1 and BRCA2 mutation carriers. The aims of this study were to derive penetrance estimates for breast cancer, ovarian cancer, and contralateral breast cancer in a prospective series of mutation carriers and to assess how these risks are modified by common breast cancer susceptibility alleles. Prospective cancer risks were estimated using a cohort of 978 BRCA1 and 909 BRCA2 carriers from the United Kingdom. Nine hundred eighty-eight women had no breast or ovarian cancer diagnosis at baseline, 1509 women were unaffected by ovarian cancer, and 651 had been diagnosed with unilateral breast cancer. Cumulative risks were obtained using Kaplan-Meier estimates. Associations between cancer risk and covariables of interest were evaluated using Cox regression. All statistical tests were two-sided. The average cumulative risks by age 70 years for BRCA1 carriers were estimated to be 60% (95% confidence interval [CI] = 44% to 75%) for breast cancer, 59% (95% CI = 43% to 76%) for ovarian cancer, and 83% (95% CI = 69% to 94%) for contralateral breast cancer. For BRCA2 carriers, the corresponding risks were 55% (95% CI = 41% to 70%) for breast cancer, 16.5% (95% CI = 7.5% to 34%) for ovarian cancer, and 62% (95% CI = 44% to 79.5%) for contralateral breast cancer. BRCA2 carriers in the highest tertile of risk, defined by the joint genotype distribution of seven single nucleotide polymorphisms associated with breast cancer risk, were at statistically significantly higher risk of developing breast cancer than those in the lowest tertile (hazard ratio = 4.1, 95% CI = 1.2 to 14.5; P = .02). Prospective risk estimates confirm that BRCA1 and BRCA2 carriers are at high risk of developing breast, ovarian, and contralateral breast cancer. Our results confirm findings from retrospective studies that common breast cancer susceptibility alleles in combination are predictive of breast cancer risk for BRCA2 carriers.

  12. Oxidative Stress, Obesity, and Breast Cancer Risk: Results From the Shanghai Women's Health Study

    PubMed Central

    Dai, Qi; Gao, Yu-Tang; Shu, Xiao-Ou; Yang, Gong; Milne, Ginger; Cai, Qiuyin; Wen, Wanqing; Rothman, Nathaniel; Cai, Hui; Li, Honglan; Xiang, Yongbing; Chow, Wong-Ho; Zheng, Wei

    2009-01-01

    Purpose Increased reactive oxygen species may exhaust the antioxidant capability of human defense systems, leading to oxidative stress and cancer development. Urinary F2-isoprostanes, secondary end products of lipid peroxidation, are more accurate markers of oxidative stress than other available biomarkers. No prospective study has investigated whether levels of 15-F2t-isoprostane (15-F2t-IsoP) and its metabolite 2,3-dinor-5,6-dihydro-15-F2t-IsoP (15-F2t-IsoPM) are related to breast cancer risk. Patients and Methods We conducted a nested case-control study within the Shanghai Women's Health Study, a population-based cohort study of 74,942 Chinese women between 40 and 70 years of age. Prediagnostic urinary 15-F2t-IsoP and 15-F2t-IsoPM were measured by gas chromatography mass spectrometry for 436 breast cancer cases and 852 individually matched controls. Results Urinary excretion of isoprostanes was not significantly different between cases and controls. However, among overweight women, levels of isoprostanes were positively associated with breast cancer risk, which became stronger with increasing body mass index (BMI). Among women with a BMI ≥ 29, the odds ratio (OR) increased to 10.27 (95% CI, 2.41 to 43.80) for the highest compared with the lowest tertile of 15-F2t-IsoPM (P for trend = .003; P for interaction = .0004). In contrast, 15-F2t-IsoP and 15-F2t-IsoPM were inversely associated with breast cancer risk among nonoverweight women. Among women with a BMI ≤ 23, breast cancer risk was reduced with increasing 15-F2t-IsoP levels in a dose-response manner (P for trend = .006), with an OR of 0.46 (95% CI, 0.26 to 0.80) for the highest tertile versus the lowest (P for interaction = .006). Conclusion Our results suggest that the role of oxidative stress in breast cancer development may depend on adiposity. PMID:19380446

  13. Differences in substance-related risk behavior between dual and triple diagnosed severely mentally ill adults.

    PubMed

    Hampton, Michelle Decoux; Chafetz, Linda; Portillo, Carmen

    2012-02-01

    OBJECTIVES: The purpose of this study was to determine if differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. METHODS: This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of HIV/HCV. RESULTS: When compared to the dual diagnosis group, subjects with triple diagnoses were four times more likely to have engaged in IDU (p=.001) and 2.6 times more likely to use amphetamines (p=.05). They also reported using more types of substances over the lifetime (p<.0001). But with regard to other risk behaviors such as alcohol use to intoxication and cocaine/crack use, there were no significant differences. CONCLUSION: Though many substance-related risk behaviors occurred in both groups, adults with triple diagnoses were more likely to engage in IDU, amphetamine use, and to use more types of substances over the lifetime. This information has the potential to inform interventions that might prevent/reduce substance-related risk in this population.

  14. Differences in substance-related risk behavior between dual and triple diagnosed severely mentally ill adults

    PubMed Central

    Hampton, Michelle DeCoux; Chafetz, Linda; Portillo, Carmen

    2011-01-01

    Objectives The purpose of this study was to determine if differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. Methods This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of HIV/HCV. Results When compared to the dual diagnosis group, subjects with triple diagnoses were four times more likely to have engaged in IDU (p=.001) and 2.6 times more likely to use amphetamines (p=.05). They also reported using more types of substances over the lifetime (p<.0001). But with regard to other risk behaviors such as alcohol use to intoxication and cocaine/crack use, there were no significant differences. Conclusion Though many substance-related risk behaviors occurred in both groups, adults with triple diagnoses were more likely to engage in IDU, amphetamine use, and to use more types of substances over the lifetime. This information has the potential to inform interventions that might prevent/reduce substance-related risk in this population. PMID:22582086

  15. Socioeconomic indicators of heat-related health risk supplemented with remotely sensed data

    PubMed Central

    Johnson, Daniel P; Wilson, Jeffrey S; Luber, George C

    2009-01-01

    Background Extreme heat events are the number one cause of weather-related fatalities in the United States. The current system of alert for extreme heat events does not take into account intra-urban spatial variation in risk. The purpose of this study is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature derived from thermal remote sensing data. Results Comparison of logistic regression models indicates that supplementing known sociodemographic risk factors with remote sensing estimates of land surface temperature improves the delineation of intra-urban variations in risk from extreme heat events. Conclusion Thermal remote sensing data can be utilized to improve understanding of intra-urban variations in risk from extreme heat. The refinement of current risk assessment systems could increase the likelihood of survival during extreme heat events and assist emergency personnel in the delivery of vital resources during such disasters. PMID:19835578

  16. Urban-Hazard Risk Analysis: Mapping of Heat-Related Risks in the Elderly in Major Italian Cities

    PubMed Central

    Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

    2015-01-01

    Background Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Objectives Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥65). Methods A long time-series (2001–2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using “Crichton’s Risk Triangle” hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). Results The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. Conclusions This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public

  17. Risk of Epithelial Ovarian Cancer in Relation to Benign Ovarian Conditions and Ovarian Surgery

    PubMed Central

    Rossing, Mary Anne; Cushing-Haugen, Kara L.; Wicklund, Kristine G.; Doherty, Jennifer A.; Weiss, Noel S.

    2009-01-01

    Objective Some forms of ovarian neoplasms may be preventable through the removal of precursor lesions. We assessed risk associated with a prior diagnosis of, and ovarian surgery following, ovarian cysts and endometriosis, with a focus on characterizing risk among tumor subgroups. Methods Information was collected during in-person interviews with 812 women with ovarian cancer diagnosed in western Washington State from 2002–2005 and 1,313 population-based controls. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results The risk of a borderline mucinous ovarian tumor associated with a history of an ovarian cyst was increased (OR=1.7, 95% CI 1.0–2.8) but did not vary notably according to receipt of subsequent ovarian surgery. While risk of invasive epithelial ovarian cancer was slightly increased among women with a cyst who had no subsequent ovarian surgery, it was reduced when a cyst diagnosis was followed by surgery (OR= 0.6, 95% CI 0.4–0.9). This reduction in risk was most evident for serous invasive tumors. Women with a history of endometriosis had a three-fold increased risk of endometrioid and clear cell invasive tumors, with a lesser risk increase among women who underwent subsequent ovarian surgery. Conclusions Our results suggest differences in the relation of ovarian cysts and endometriosis with risk of specific subtypes of ovarian cancer, as well as the possibility that ovarian surgery in women with these conditions may lower the risk of invasive disease. PMID:18704718

  18. Ethnicity-related variation in breast cancer risk factors.

    PubMed

    Bernstein, Leslie; Teal, Cayla R; Joslyn, Sue; Wilson, Jerome

    2003-01-01

    A variety of factors are predictors of breast cancer risk. However, the studies conducted to establish these risk factors have rarely included African American women. The few studies with sufficient numbers of African-American women suggest that risk factors for breast cancer among African-American women are similar to those of white women. Although risk factors may be similar for African-American and white women, differences in the prevalence of risk factors may explain the differences in patterns of incidence. The authors reviewed the epidemiologic studies of breast cancer among African-American women and identified resources with information regarding the prevalence of risk factors among African American and white women. Considerable variation exists in the studies of breast cancer risk factors among African American women. Because few studies have included sufficient numbers of African-American women, no firm conclusions can be drawn regarding whether risk estimates for African American women differ from those of white women. Estimates of the prevalence of breast cancer risk factors indicate that African American and white women differ in terms of their ages at menarche, menstrual cycle patterns, birth rates, lactation histories, patterns of oral contraceptive use, levels of obesity, frequency of menopausal hormone use, physical activity patterns, and alcohol intake. The risk factor profile of African-American women appears to differ from that of white women. This may explain in part, the higher incidence rates for African Americans before age 45 years and the lower incidence rates at older ages. Discussions of these data at a workshop highlighted the need for future research on breast cancer risk among African Americans. This research should acknowledge the heterogeneous heritage, cultural beliefs, and cultural knowledge of African-American women. Studies conducted in collaboration with the African-American community of women and with the breast cancer

  19. HIV-related risk perception among female sex workers in Nigeria

    PubMed Central

    Ankomah, Augustine; Omoregie, Godpower; Akinyemi, Zacch; Anyanti, Jennifer; Ladipo, Olaronke; Adebayo, Samson

    2011-01-01

    Background Over one-third of sex workers in Nigeria are infected with human immunodeficiency virus (HIV), yet there is a lack of understanding of sex workers’ own perception of sexual risk-taking. Applying the theory of cognitive dissonance, this paper examined the personal HIV risk perception of brothel-based sex workers. Methods The study is based on 24 focus group discussions held among brothel-based sex workers in four geographically and culturally dispersed cities in Nigeria. Results It was found that sex workers underestimated their risk of infection and rationalized, defended, or justified their behaviors, a typical psychological response to worry, threat, and anxiety arising from the apparent discrepancies between beliefs and behaviors. To reduce dissonance, many sex workers had a strong belief in fatalism, predestination, and faith-based invulnerability to HIV infection. Many believed that one will not die of acquired immune deficiency syndrome if it is not ordained by God. The sex workers also had a high level of HIV-related stigma. Conclusion From these findings, most sex workers considered risk reduction and in particular condom use as far beyond their control or even unnecessary, as a result of their strong beliefs in fatalism and predestination. Therefore, one critical area of intervention is the need to assist sex workers to develop accurate means of assessing their personal vulnerability and self-appraisal of HIV-related risk. PMID:22096411

  20. Reminders of cancer risk and pain catastrophizing: relationships with cancer worry and perceived risk in women with a first-degree relative with breast cancer.

    PubMed

    Whitney, Colette A; Dorfman, Caroline S; Shelby, Rebecca A; Keefe, Francis J; Gandhi, Vicky; Somers, Tamara J

    2018-04-20

    First-degree relatives of women with breast cancer may experience increased worry or perceived risk when faced with reminders of their own cancer risk. Worry and risk reminders may include physical symptoms (e.g., persistent breast pain) and caregiving experiences. Women who engage in pain catastrophizing may be particularly likely to experience increased distress when risk reminders are present. We examined the degree to which persistent breast pain and experience as a cancer caregiver were related to cancer worry and perceived risk in first-degree relatives of women with breast cancer (N = 85) and how catastrophic thoughts about breast pain could impact these relationships. There was a significant interaction between persistent breast pain and pain catastrophizing in predicting cancer worry (p = .03); among women who engaged in pain catastrophizing, cancer worry remained high even in the absence of breast pain. Pain catastrophizing also moderated the relationships between caregiving involvement and cancer worry (p = .003) and perceived risk (p = .03). As the degree of caregiving responsibility increased, cancer worry and perceived risk increased for women who engaged in pain catastrophizing; levels of cancer worry and perceived risk remained low and stable for women who did not engage in pain catastrophizing regardless of caregiving experience. The results suggest that first-degree relatives of breast cancer survivors who engage in pain catastrophizing may experience greater cancer worry and perceived risk and may benefit from interventions aimed at reducing catastrophic thoughts about pain.

  1. Several anthropometric measurements and breast cancer risk: results of the E3N cohort study.

    PubMed

    Tehard, B; Clavel-Chapelon, F

    2006-01-01

    To investigate the association between various anthropometric characteristics and breast cancer. Longitudinal prospective cohort study. Follow-up between 1995 and 2000. In total, 69 116 women (age: 45-70 years; mean follow-up: 3.6 years), 275 premenopausal and 860 postmenopausal incident invasive breast cancers. Self-reported height, weight, breast, thorax, waist and hip circumferences and calculated body mass index (BMI) and waist-to-hip ratio (WHR) at baseline. A slight increase in risk with increasing height was found. Weight, BMI, thorax and waist circumferences and WHR were negatively related to breast cancer risk among premenopausal women. The relationships became non significant after additional adjustment for BMI. An increased risk of premenopausal breast cancer with an android body shape (WHR>0.87) might possibly be confined to obese women. Among postmenopausal women, all anthropometric measurements of corpulence were positively associated with breast cancer risk but became non significant after additional adjustment for BMI. No difference in risk of postmenopausal breast cancer according to HRT use was observed. The study confirmed that adiposity was negatively associated to premenopausal breast cancer risk and positively associated to postmenopausal breast cancer risk. Further studies will be needed to specify clearly the association between WHR and breast cancer risk, particularly before menopause.

  2. Trends in the knowledge, attitudes and practices of travel risk groups towards prevention of malaria: results from the Dutch Schiphol Airport Survey 2002 to 2009

    PubMed Central

    2012-01-01

    Background Previous studies investigating the travellers’ knowledge, attitudes and practices (KAP) profile indicated an important educational need among those travelling to risk destinations. Initiatives to improve such education should target all groups of travellers, including business travellers, those visiting friends and relatives (VFRs), and elderly travellers. Methods In the years 2002 to 2009, a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study trends in KAP of travel risk groups towards prevention of malaria. The risk groups last-minute travellers, solo-travellers, business travellers, VFRs and elderly travellers were specifically studied. Results A total of 3,045 respondents were included in the survey. Travellers to destinations with a high risk for malaria had significantly more accurate risk perceptions (knowledge) than travellers to low-risk destinations. The relative risk for malaria in travellers to high-risk destinations was probably mitigated by higher protection rates against malaria as compared with travellers to low risk destinations. There were no significant differences in intended risk-taking behaviour. Trend analyses showed a significant change over time in attitude towards more risk-avoiding behaviour and towards higher protection rates against malaria in travellers to high-risk destinations. The KAP profile of last-minute travellers substantially increased their relative risk for malaria, which contrasts to the slight increase in relative risk of solo travellers, business travellers and VFRs for malaria. Conclusions The results of this sequential cohort survey in Dutch travellers suggest an annual 1.8% increase in protection rates against malaria coinciding with an annual 2.5% decrease in intended risk-seeking behaviour. This improvement may reflect the continuous efforts of travel health advice providers to create awareness and to propagate safe and healthy travel. The KAP profile of last

  3. Family history of breast cancer increases the risk of prostate cancer: results from the EPICAP study.

    PubMed

    Lamy, Pierre-Jean; Trétarre, Brigitte; Rebillard, Xavier; Sanchez, Marie; Cénée, Sylvie; Ménégaux, Florence

    2018-05-04

    Familial aggregation is now well established with an increased risk of prostate cancer in patients with a family history of prostate cancer in first degree relatives. The aim of this paper was to investigate the role of family history of cancer in first degree relatives in prostate cancer risk. As expected, a family history of prostate cancer in first-degree relatives was more frequent in cases than in controls (OR 3.10, 95% CI 2.32-4.15). A family history of early BCa (before age 50) in first-degree relatives was more frequent in cases than in controls (OR 1.79, 95% CI 1.09-2.94) with higher risk of aggressive PCa. The association was more pronounced for BCa in daughters (OR 15.26 95% CI 1.95-120). In summary, a family history of BCa in first degree relatives before age 50 may increases the risk of PCa with higher Gleason score. This finding could suggest a specific prostate surveillance and/or genetic counselling for men who present such familial history. EPIdemiological study of Prostate CAncer (EPICAP) is a population-based case-control study specifically designed to investigate the role of environmental and genetic factors in prostate cancer. Detailed information on family history of cancer in first degree relatives (parents, brothers and sisters, children) was collected as well as the age of occurrence and the localization of each cancer. Overall, 819 cases and 879 controls have been included.

  4. [Interpersonal relations as a source of risk of mobbing in the local police].

    PubMed

    Segurado Torres, Almudena; Agulló Tomás, Esteban; Rodríguez Suárez, Julio; Agulló Tomás, Ma Silveria; Boada i Grau, Joan; Medina Centeno, Raúl

    2008-11-01

    Social relations in the workplace are one of the main sources of risk for the onset of mobbing. In this work, we analyzed, through the perceived social climate, the influence of interpersonal relations on the characterization of the processes of mobbing, in a sample of local police (N = 235). In particular, the policemen and women's opinions of the quality of the personal relations among the group members and the treatment they receive from the command posts were assessed. The results of the study show that the development of guidelines of social interaction based on discrimination and abuse of authority are predicting variables of mobbing in this group.

  5. Development and Validation of a Video Measure for Assessing Women’s Risk Perception for Alcohol-Related Sexual Assault

    PubMed Central

    Parks, Kathleen A.; Levonyan-Radloff, Kristine; Dearing, Ronda L.; Hequembourg, Amy; Testa, Maria

    2016-01-01

    Objective Using an iterative process, a series of three video scenarios were developed for use as a standardized measure for assessing women’s perception of risks for alcohol-related sexual assault (SA). The videos included ambiguous and clear behavioral and environmental risk cues. Method Focus group discussions with young, female heavy drinkers (N = 42) were used to develop three videos at different risk levels (low, moderate, and high) in Study 1. Realism, reliability, and validity of the videos were assessed using multiple methods in Studies 2 and 3. One hundred-four women were used to compare differences in risk perception across the video risk level in Study 2. In Study 3 (N = 60), we assessed women’s perceptions of the low and high risk videos under conditions of no alcohol and alcohol. Results The realism and reliability of the videos were good. Women who viewed the low risk video compared to women who viewed the moderate and high risk videos perceived less risk for SA. We found an interaction between alcohol and risk perception such that, women in the alcohol condition were less likely to perceive risk when watching the high risk video. Conclusions As the video risk level increased, women’s perception of risk increased. These findings provide convergent evidence for the validity of the video measure. Given the limited number of standardized scenarios for assessing risk perception for sexual assault, our findings suggest that these videos may provide a needed standardized measure. PMID:27747131

  6. Contributions of polygenic risk for obesity to PTSD-related metabolic syndrome and cortical thickness.

    PubMed

    Wolf, Erika J; Miller, Danielle R; Logue, Mark W; Sumner, Jennifer; Stoop, Tawni B; Leritz, Elizabeth C; Hayes, Jasmeet P; Stone, Annjanette; Schichman, Steven A; McGlinchey, Regina E; Milberg, William P; Miller, Mark W

    2017-10-01

    Research suggests that posttraumatic stress disorder (PTSD) is associated with metabolic syndrome (MetS) and that PTSD-associated MetS is related to decreased cortical thickness. However, the role of genetic factors in these associations is unclear. This study evaluated contributions of polygenic obesity risk and PTSD to MetS and of MetS and polygenic obesity risk to cortical thickness. 196 white, non-Hispanic veterans of the wars in Iraq and Afghanistan underwent clinical diagnostic interviews, physiological assessments, and genome-wide genotyping; 168 also completed magnetic resonance imaging scans. Polygenic risk scores (PRSs) for obesity were calculated from results of a prior genome-wide association study (Speliotes et al., 2010) and PTSD and MetS severity factor scores were obtained. Obesity PRS (β=0.15, p=0.009) and PTSD (β=0.17, p=0.005) predicted MetS and interacted such that the association between PTSD and MetS was stronger in individuals with greater polygenic obesity risk (β=0.13, p=0.02). Whole-brain vertex-wise analyses suggested that obesity PRS interacted with MetS to predict decreased cortical thickness in left rostral middle frontal gyrus (β=-0.40, p<0.001). Results suggest that PTSD, genetic variability, and MetS are related in a transactional fashion wherein obesity genetic risk increases stress-related metabolic pathology, and compounds the ill health effects of MetS on the brain. Genetic proclivity towards MetS should be considered in PTSD patients when prescribing psychotropic medications with adverse metabolic profiles. Results are consistent with a growing literature suggestive of PTSD-related accelerated aging. Published by Elsevier Inc.

  7. Exploration of health risks related to air pollution and temperature in three Latin American cities.

    PubMed

    Romero-Lankao, Patricia; Qin, Hua; Borbor-Cordova, Mercy

    2013-04-01

    This paper explores whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities. Our results show the association between air pollution levels and socioeconomic vulnerabilities did not always correlate within the study cities. Furthermore, the spatial differences in socioeconomic vulnerabilities within cities do not necessarily correspond with the spatial distribution of health impacts. The present study improves our understanding of the multifaceted nature of health risks and vulnerabilities associated with global environmental change. The findings suggest that health risks from atmospheric conditions and pollutants exist without boundaries or social distinctions, even exhibiting characteristics of a boomerang effect (i.e., affecting rich and poor alike) on a smaller scale such as areas within urban regions. We used human mortality, a severe impact, to measure health risks from air pollution and extreme temperatures. Public health data of better quality (e.g., morbidity, hospital visits) are needed for future research to advance our understanding of the nature of health risks related to climate hazards. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Suicide risk in relation to air pollen counts: a study based on data from Danish registers

    PubMed Central

    Qin, Ping; Waltoft, Berit L; Mortensen, Preben B; Postolache, Teodor T

    2013-01-01

    Objectives Since the well-observed spring peak of suicide incidents coincides with the peak of seasonal aeroallergens as tree-pollen, we want to document an association between suicide and pollen exposure with empirical data from Denmark. Design Ecological time series study. Setting Data on suicide incidents, air pollen counts and meteorological status were retrieved from Danish registries. Participants 13 700 suicide incidents over 1304 consecutive weeks were obtained from two large areas covering 2.86 million residents. Primary and secondary outcome measures Risk of suicide associated with pollen concentration was assessed using a time series Poisson-generalised additive model. Results We noted a significant association between suicide risk and air pollen counts. A change of pollen counts levels from 0 to ‘10–<30’ grains/m3 air was associated with a relative risk of 1.064, that is, a 6.4% increase in weekly number of suicides in the population, and from 0 to ‘30–100’ grains, a relative risk of 1.132. The observed association remained significant after controlling for effects of region, calendar time, temperature, cloud cover and humidity. Meanwhile, we observed a significant sex difference that suicide risk in men started to rise when there was a small increase of air pollen, while the risk in women started to rise until pollen grains reached a certain level. High levels of pollen had slightly stronger effect on risk of suicide in individuals with mood disorder than those without the disorder. Conclusions The observed association between suicide risk and air pollen counts supports the hypothesis that aeroallergens, acting as immune triggers, may precipitate suicide. PMID:23793651

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

    PubMed

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

    2017-02-15

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

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

    PubMed Central

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

    2017-01-01

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

  11. Dietary intake of nitrate relative to antioxidant vitamin in relation to breast cancer risk: a case-control study.

    PubMed

    Yang, Yoon Jung; Hwang, Se Hee; Kim, Hyun Ja; Nam, Seok-Jin; Kong, Gu; Kim, Mi Kyung

    2010-01-01

    Nitrate is a precursor in the endogenous formation of N-nitroso compounds, which are potent animal carcinogens, whereas antioxidant vitamins have been suggested to protect against carcinogenesis. Interestingly, nitrate and antioxidant vitamins stem from the same dietary sources. We investigated whether the intake of nitrate relative to antioxidant vitamins is associated with the risk of breast cancer. A total of 362 breast cancer cases were matched to the 362 controls by age and menopausal status. Dietary intake was assessed using a quantitative food frequency questionnaire with 121 food items by trained interviewers. The nitrate to antioxidant vitamin consumption ratio was then calculated. Conditional logistic regression analysis was used to obtain odds ratios (ORs) and corresponding 95% confidence intervals (CI). Mean intakes of nitrate for cases and controls were 421 mg/day and 424 mg/day, respectively. Intakes of nitrate, nitrate/beta-carotene, nitrate/vitamin C, and nitrate/vitamin E were not associated with breast cancer risk. However, higher breast cancer risk was observed with higher intake of nitrate/folate (OR = 2.03, 95% CI = 1.16-3.54, P for trend = 0.052). Our results suggest that lowering the ratio of nitrate to folate intake may be effective in reducing breast cancer risk.

  12. Practice-Based Research Network Infrastructure Design for Institutional Review Board Risk Assessment and Generalizability of Clinical Results.

    PubMed

    Curro, Frederick; Thompson, Van P; Naftolin, Frederick; Grill, Ashley; Vena, Don; Terracio, Louis; Hashimoto, Mariko; Buchholz, Matthew; McKinstry, Andrea; Cannon, Diane; Alfano, Vincent; Gooden, Thalia; Vernillo, Anthony; Czeisler, Elan

    2013-01-01

    Data from clinical studies generated by Practice Based Research Networks should be generalizable to the profession. For nationally representative data a broad recruitment of practitioners may pose added risks to IRB's. Infrastructure must assure data integrity while minimizing risk to assure that the clinical results are generalizable. The PEARL Network is an interdisciplinary dental/medical PBRN conducting a broad range of clinical studies. The infrastructure is designed to support the principles of Good Clinical Practice (GCP) and create a data audit trail to ensure data integrity for generalizability. As the PBRN concept becomes of greater interest, membership may expand beyond the local community, and the issue of geography versus risk management becomes of concern to the IRB. The PEARL Network describes how it resolves many of the issues related to recruiting on a National basis while maintaining study compliance to ensure patient safety and minimize risk to the IRB.

  13. Probability and predictors of relapse to smoking: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

    PubMed Central

    García-Rodríguez, Olaya; Secades-Villa, Roberto; Flórez-Salamanca, Ludwing; Okuda, Mayumi; Liu, Shang-Min; Blanco, Carlos

    2013-01-01

    Background The goal of this study was to estimate rates of relapse to smoking in the community and to identify predictors of relapse. Methods Data were drawn from the Waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Logistic regression analyses were used to estimate the probability of relapse at Wave 2 among individuals who were abstinent at Wave 1 given length of abstinence as well as the presence of several sociodemographic, psychopathologic and substance use-related variables at Wave 1. Results The risk for relapse among individuals who had been abstinent for 12 months or less at the baseline assessment was above 50%. Among individuals who had been abstinent for over a year, risk of relapse decreased hyperbolically as a function of time, and stabilized around 10% after 30 years of abstinence. Although several sociodemographic, psychopathologic and tobacco-related variables predicted relapse in univariate analyses, only younger age at cessation and shorter duration of abstinence independently predicted risk of relapse in multivariable analyses. Conclusions The first year after a quit attempt constitutes the period of highest risk for relapse. Although the risk for relapse decreases over time, it never fully disappears. Furthermore, younger age at smoking cessation also increases the risk for relapse. This information may help develop more targeted and effective relapse prevention programs. PMID:23570817

  14. Children of alcoholics in Spain: from risk to pathology. Results from the ALFIL program.

    PubMed

    Díaz, Rosa; Gual, Antoni; García, Montse; Arnau, Jaume; Pascual, Francisco; Cañuelo, Bartolomé; Rubio, Gabriel; de Dios, Yolanda; Fernández-Eire, M Carmen; Valdés, Raquel; Garbayo, Isabel

    2008-01-01

    To identify the possible risk factors and negative outcomes associated with parental alcoholism. A secondary aim was to determine the influence of the family density of alcoholism on children of alcoholics' (COAs) psychological functioning. A multisite epidemiological study was conducted in 8 Spanish cities, recruiting a total sample of 371 COAs (whose parents were in contact with alcohol treatment centers and accepted to participate in this study) and 147 controls (from schools in the same localities as COAs). Both groups were 6-17 years old and received a comprehensive evaluation of mental disorders (no symptoms, subclinical symptoms or clinical diagnosis for each disorder; according to DSM-IV criteria); alcohol and other substance use (none, occasional, regular and risky consumption); school achievement (low, middle and high) and other academic performance indicators (WISC-R Information and Arithmetic subtests, school support activities and failed subjects and courses). Lastly, several cognitive functions were measured by the WISC-R Similarities, Block Design and Digit Symbol subtests, the Toulouse-Piéron test and the Stroop test. Logistic regression methods were used to compare both groups and a linear regression model was used to determine the influence of the family density of alcoholism. The following confounding variables were controlled for: age, gender, socio-economic status and family cohesion. Children of alcoholics' were twice as likely as controls to present subclinical symptoms and four times more likely than controls to have a definite diagnosis of any mental disorder. More specifically, COAs had a significantly higher risk than controls of attention deficit disorder/hyperactivity, depression, phobias, enuresis and tics. COAs also tended to have more symptoms of generalized anxiety disorder. COAs had worse results on all the cognitive tests used and their risk of low school achievement was nine times higher than that of controls. Family density of

  15. Parental Predictions and Perceptions Regarding Long-Term Childhood Obesity-Related Health Risks

    PubMed Central

    Wright, Davene R.; Lozano, Paula; Dawson-Hahn, Elizabeth; Christakis, Dimitri A.; Haaland, Wren; Basu, Anirban

    2016-01-01

    Objectives To assess how parents perceive long-term risks for developing obesity-related chronic health conditions. Methods A web-based nationally representative survey was administered to 502 U.S. parents with a 5–12 year old child. Parents reported whether their child was most likely to be at a healthy weight or overweight, and the probability that their child would develop hypertension, heart disease, depression, or type 2 diabetes in adulthood. Responses of parents of children with overweight and obesity were compared to those of healthy weight children using multivariate models. Results The survey had an overall response rate of 39.2%. The mean (SD) unadjusted parent predicted health risks were 15.4% (17.7%), 11.2% (14.7%), 12.5% (16.2%), and 12.1% (16.1%) for hypertension, heart disease, depression, and diabetes, respectively. Despite under-perceiving their child’s current BMI class, parents of children with obesity estimate their children to be at greater risk for obesity-related health conditions than parents of healthy weight children by 5–6 percentage points. Having a family history of a chronic disease, higher quality of care, and older parent age were also significant predictors of estimating higher risk probabilities. Conclusions Despite evidence that parents of overweight children may not perceive these children as being overweight, parents unexpectedly estimate greater future risk of weight-related health conditions for these children. Focusing communication about weight on screening for and reducing the risk of weight-related diseases may prove useful in engaging parents and children in weight management PMID:26875508

  16. Exploration-Related Research on ISS: Connecting Science Results to Future Missions

    NASA Technical Reports Server (NTRS)

    Rhatigan, Jennifer L.; Robinson, Julie A.; Sawin, Charles F.

    2005-01-01

    In January, 2004, the U.S. President announced The Vision for Space Exploration, and charged the National Aeronautics and Space Administration (NASA) with using the International Space Station (ISS) for research and technology targeted at supporting U.S. space exploration goals. This paper describes: What we have learned from the first four years of research on ISS relative to the exploration mission; The on-going research being conducted in this regard; and Our current understanding of the major exploration mission risks that the ISS can be used to address. Specifically, we discuss research carried out on the ISS to determine the mechanisms by which human health is affected on long-duration missions, and to develop countermeasures to protect humans from the space environment. These bioastronautics experiments are key enablers of future long duration human exploration missions. We also discuss how targeted technological developments can enable mission design trade studies. We discuss the relationship between the ultimate number of human test subjects available on the ISS to the quality and quantity of scientific insight that can be used to reduce health risks to future explorers. We discuss the results of NASA's efforts over the past year to realign the ISS research programs to support a product-driven portfolio that is directed towards reducing the major risks of exploration missions. The fundamental challenge to science on ISS is completing experiments that answer key questions in time to shape design decisions for future exploration. In this context, exploration relevant research must do more than be conceptually connected to design decisions - it must become a part of the mission design process.

  17. Risk management perspective for climate service development - Results from a study on Finnish organizations

    NASA Astrophysics Data System (ADS)

    Harjanne, Atte; Haavisto, Riina; Tuomenvirta, Heikki; Gregow, Hilppa

    2017-10-01

    Weather, climate and climate change can cause significant risks to businesses and public administration. However, understanding these processes can also create opportunities. Information can help to manage these risks and opportunities, but in order to do so, it must be in line with how risk management and decision making works. To better understand how climate risks and opportunities are reflected in different organizational processes and what types of information is needed and used, we conducted a study on the perceptions and management of weather and climate risks in Finnish organizations and on their use of weather and climate information. In addition, we collected feedback on how the existing climate information tools should be developed. Data on climate risk management was collected in an online survey and in one full-day workshop. The survey was aimed to the Finnish public and private organizations who use weather and climate data and altogether 118 responses were collected. The workshop consisted of two parts: weather and climate risk management processes in general and the development of the current information tools to further address user needs.

    We found that climate risk management in organizations is quite diverse and often de-centralized and that external experts are considered the most useful sources of information. Consequently, users emphasize the need for networks of expertise and sector-specific information tools. Creating such services requires input and information sharing from the user side as well. Better temporal and spatial accuracy is naturally asked for, but users also stressed the need for transparency when it comes to communicating uncertainties, and the availability and up-to-datedness of information. Our results illustrate that weather and climate risks compete and blend in with other risks and changes perceived by the organizations and supporting information is sought from different types of sources. Thus the design and

  18. Relation between risk of falling and postural sway complexity in diabetes.

    PubMed

    Morrison, S; Colberg, S R; Parson, H K; Vinik, A I

    2012-04-01

    For older individuals with diabetes, any decline in balance control can be especially problematic since it is often a precursor to an increased risk of falling. This study was designed to evaluate differences in postural motion dynamics and falls risk for older individuals with type 2 diabetes (T2DM) classified as fallers/non-fallers and, to assess what impact exercise has on balance and falls risk. The results demonstrated that the risk of falling is greater for those older individuals with multiple risk factors including diabetes and a previous falls history. The postural motion features of the high-risk individuals (T2DM-fallers) were also different, being characterized by increased variability and complexity, increased AP-ML coupling, less overall COP motion and increased velocity. One suggestion is that these individuals evoked a stiffening strategy during the more challenging postural tasks. Following training, a decline in falls risk was observed for all groups, with this effect being most pronounced for the T2DM-fallers. Interestingly, the COP motion of this group became more similar to controls, exhibiting decreased complexity and variability, and decreased velocity. The reciprocal changes in COP complexity support the broader view that age/disease-related changes in physiological complexity are bi-directional. Overall, these results show that, even for older T2DM individuals at greater risk of falling, targeted interventions can positively enhance their postural dynamics. Further, the finding that the pattern of postural motion variability and complexity was altered highlights that a decline in physiological complexity may not always be negatively associated with aging and/or disease. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Explaining Behavior Change after Genetic Testing: The Problem of Collinearity between Test Results and Risk Estimates

    PubMed Central

    Fanshawe, Thomas R.; Prevost, A. Toby; Roberts, J. Scott; Green, Robert C.; Armstrong, David; Marteau, Theresa M.

    2010-01-01

    This paper explores whether and how the behavioral impact of genotype disclosure can be disentangled from the impact of numerical risk estimates generated by genetic tests. Secondary data analyses are presented from a randomized controlled trial of 162 first-degree relatives of Alzheimer’s disease (AD) patients. Each participant received a lifetime risk estimate of AD. Control group estimates were based on age, gender, family history, and assumed ε4-negative apolipoprotein E (APOE) genotype; intervention group estimates were based upon the first three variables plus true APOE genotype, which was also disclosed. AD-specific self-reported behavior change (diet, exercise, and medication use) was assessed at 12 months. Behavior change was significantly more likely with increasing risk estimates, and also more likely, but not significantly so, in ε4-positive intervention group participants (53% changed behavior) than in control group participants (31%). Intervention group participants receiving ε4-negative genotype feedback (24% changed behavior) and control group participants had similar rates of behavior change and risk estimates, the latter allowing assessment of the independent effects of genotype disclosure. However, collinearity between risk estimates and ε4-positive genotypes, which engender high-risk estimates, prevented assessment of the independent effect of the disclosure of an ε4 genotype. Novel study designs are proposed to determine whether genotype disclosure has an impact upon behavior beyond that of numerical risk estimates. PMID:18666860

  20. Explaining behavior change after genetic testing: the problem of collinearity between test results and risk estimates.

    PubMed

    Fanshawe, Thomas R; Prevost, A Toby; Roberts, J Scott; Green, Robert C; Armstrong, David; Marteau, Theresa M

    2008-09-01

    This paper explores whether and how the behavioral impact of genotype disclosure can be disentangled from the impact of numerical risk estimates generated by genetic tests. Secondary data analyses are presented from a randomized controlled trial of 162 first-degree relatives of Alzheimer's disease (AD) patients. Each participant received a lifetime risk estimate of AD. Control group estimates were based on age, gender, family history, and assumed epsilon4-negative apolipoprotein E (APOE) genotype; intervention group estimates were based upon the first three variables plus true APOE genotype, which was also disclosed. AD-specific self-reported behavior change (diet, exercise, and medication use) was assessed at 12 months. Behavior change was significantly more likely with increasing risk estimates, and also more likely, but not significantly so, in epsilon4-positive intervention group participants (53% changed behavior) than in control group participants (31%). Intervention group participants receiving epsilon4-negative genotype feedback (24% changed behavior) and control group participants had similar rates of behavior change and risk estimates, the latter allowing assessment of the independent effects of genotype disclosure. However, collinearity between risk estimates and epsilon4-positive genotypes, which engender high-risk estimates, prevented assessment of the independent effect of the disclosure of an epsilon4 genotype. Novel study designs are proposed to determine whether genotype disclosure has an impact upon behavior beyond that of numerical risk estimates.

  1. Cross-Strait Economic Relations: Opportunities Outweigh Risks

    DTIC Science & Technology

    2004-04-01

    Risks 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7... Risks Paradoxically, the economic relationship between China and Taiwan is thriving even as long-simmering tensions between the governments have...economics and security, the disadvantages to Taiwan of increased trade with and investment in China are arguably outweighed by the advantages. Cross

  2. Duty-related trauma exposure in 911 telecommunicators: considering the risk for posttraumatic stress.

    PubMed

    Pierce, Heather; Lilly, Michelle M

    2012-04-01

    Peritraumatic distress may increase the risk for posttraumatic stress disorder (PTSD) in police officers. Much less is known about emotional reactions and PTSD symptomatology in 911 telecommunicators. The current study assessed duty-related exposure to potentially traumatic calls, peritraumatic distress, and PTSD symptomatology in a cross-sectional, convenience sample of 171 telecommunicators. Results showed that telecommunicators reported high levels of peritraumatic distress and a moderate, positive relationship was found between peritraumatic distress and PTSD symptom severity (r = .34). The results suggest that 911 telecommunicators are exposed to duty-related trauma that may lead to the development of PTSD, and that direct, physical exposure to trauma may not be necessary to increase risk for PTSD in this population. Copyright © 2012 International Society for Traumatic Stress Studies.

  3. The risk of cataract in relation to metal arc welding.

    PubMed

    Slagor, Rebekka Michaelsen; La Cour, Morten; Bonde, Jens Peter

    2016-09-01

    There are indications that solar ultraviolet radiation (UVR) increases the risk of cataract, but there is only circumstantial evidence that metal welding, an important occupational source of UVR exposure, is a risk factor. The objective of this study is to unravel if metal welding increases the risk of cataract. We compared the risk of being diagnosed with cataract from 1987-2012 in a historic cohort of 4288 male metal arc welders against a reference group comprised of Danish skilled and unskilled male workers with similar age distribution. For the welders' cohort, information on welding was collected from questionnaires and, for both cohorts, information about cataract diagnosis and operation was gathered from Danish national registers. Using Cox regression analysis, the hazard ratio (HR) for cataract diagnosis and/or operation was calculated in the follow-up period adjusted for baseline data regarding age, diabetes, and social group. There were 266 welders and 29 007 referents with a diagnosis and/or operation for cataract. The unadjusted HR for cataract comparing ever-welders with referents was 1.07 [95% confidence interval (95% CI) 0.95-1.21] and the adjusted HR was 1.08 (95% CI 0.95-1.22). Age and diabetes were as expected strong risk factors. We found no increased risk of developing cataract among Danish metal welders who worked with arc welding from 1950-1985. This may be attributed to the effectiveness of personal safety equipment.

  4. Sex-Related Differences in Neural Activity during Risk Taking: An fMRI Study

    PubMed Central

    Chan, Chetwyn C. H.; Leung, Ada W. S.; Fox, Peter T.; Gao, Jia-Hong

    2009-01-01

    This study explored sex effects on the process of risk-taking. We observed that the female participants (n = 10) showed stronger activation in the right insula and bilateral orbitofrontal cortex (OFC) than did the male participants (n = 12) while they were performing in the Risky-Gains task. The female participants also showed stronger activations in the precentral, postcentral, and paracentral regions after receiving punishment feedback. In addition, the strength of neural activity in the insula correlated with the rate of risky behaviors for the female participants but not for the male participants. Similarly, the percent signal changes in the right OFC correlated negatively with the rate of selecting risky choices for the female group. These findings strongly suggest a sex-related influence modulating brain activity during risk-taking tasks. When taking the same level of risk, relative to men, women tend to engage in more neural processing involving the insula and the OFC to update and valuate possible uncertainty associated with risk-taking decision making. These results are consistent with the value-based decision-making model and offer insights into the possible neural mechanisms underlying the different risk-taking attitudes of men and women. PMID:18842666

  5. Use of Aspirin and Other Nonsteroidal Antiinflammatory Medications in Relation to Prostate Cancer Risk

    PubMed Central

    Salinas, Claudia A.; Kwon, Erika M.; FitzGerald, Liesel M.; Feng, Ziding; Nelson, Peter S.; Ostrander, Elaine A.; Peters, Ulrike; Stanford, Janet L.

    2010-01-01

    Recent interest has focused on the role that inflammation may play in the development of prostate cancer and whether use of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs) affects risk. In a population-based case-control study designed to investigate the relation between these medications and prostate cancer risk, detailed exposure data were analyzed from 1,001 cases diagnosed with prostate cancer between January 1, 2002, and December 31, 2005, and 942 age-matched controls from King County, Washington. A significant 21% reduction in the risk of prostate cancer was observed among current users of aspirin compared with nonusers (95% confidence interval (CI): 0.65, 0.96). Long-term use of aspirin (>5 years: odds ratio = 0.76, 95% CI: 0.61, 0.96) and daily use of low-dose aspirin (odds ratio = 0.71, 95% CI: 0.56, 0.90) were also associated with decreased risk. There was no evidence that the association with aspirin use varied by disease aggressiveness, but there was effect modification (Pinteraction = 0.02) with a genetic variant in prostaglandin-endoperoxide synthase 2 (PTGS2) (rs12042763). Prostate cancer risk was not related to use of either nonaspirin NSAIDs or acetaminophen. These results contribute further evidence that aspirin may have chemopreventive activity against prostate cancer and highlight the need for additional research. PMID:20688905

  6. The Inverse Relation Between Risks and Benefits: The Role of Affect and Expertise.

    PubMed

    Sokolowska, Joanna; Sleboda, Patrycja

    2015-07-01

    Although risk and benefits of risky activities are positively correlated in the real world, empirical results indicate that people perceive them as negatively correlated. The common explanation is that confounding benefits and losses stems from affect. In this article, we address the issue that has not been clearly established in studies on the affect heuristic: to what extent boundary conditions, such as judgments' generality and expertise, influence the presence of the inverse relation in judgments of hazards. These conditions were examined in four studies in which respondents evaluated general or specific benefits and risks of "affect-rich" and "affect-poor" hazards (ranging from investments to applications of stem cell research). In line with previous research, affect is defined as good or bad feelings integral to a stimulus. In contrast to previous research, affect is considered as related both to personal feelings and to social controversies associated with a hazard. Expertise is related to personal knowledge (laypersons vs. experts) as well as to objective knowledge (targets well vs. poorly known to science). The direct comparison of the input from personal and objective ignorance into the inverse relation has not been investigated previously. It was found that affect invoked by a hazard guides general but not specific judgments of its benefits and risks. Technical expertise helps to avoid simplified evaluations of consequences as long as they are well known to science. For new, poorly understood hazards (e.g., stem cell research), expertise does not protect from the perception of the inverse relation between benefits and risks. © 2015 Society for Risk Analysis.

  7. Public knowledge and perception of geo-hydrological risk in Calabria (southern Italy): preliminary results

    NASA Astrophysics Data System (ADS)

    Antronico, Loredana; Coscarelli, Roberto; De Pascale, Francesco

    2017-04-01

    The analysis of risk perception is a fundamental tool to strengthen public awareness and knowledge that are directly linked to the way people perceive disaster risk. By means of a quantitative research method (structured interviews), a survey to acquire information on knowledge, communication and perception of natural hazard by the population was led with main reference to landslides and floods. With these aims, a questionnaire including about 50 queries was elaborated with the following main objectives: i) the state of knowledge about landslides and flood phenomena of the people living or working in the survey area; ii) the ability of the population in responding to emergency situations related to such phenomena and the background coming from past events; iii) the trust of the population towards administrators. Moreover, the communication between citizens and Local Authorities when a catastrophic event occurs was evaluated. The survey was carried out on an area of Tyrrhenian seacoast of Calabria (southern Italy) where a set of mountain front alluvial fans develops along the narrow coastal plain. In the study area, a series of rainfall events in the years 2009, 2010, and 2011 have induced several debris flows, hyperconcentrated flows and inundations that threatened the population and mainly caused damage to private buildings and infrastructures located on the alluvial fans. Three municipalities were selected in the study area, where the proposed questionnaire was submitted face-to-face to 300 residents using a judgment sampling procedure. The preliminary results of the survey are alarming: citizens don't have a good communication with local institutions. In addition, the majority of respondents think that landslides and floods are caused by "man-made actions". They indicated "illegal building", "poor land-management practices" and "lack of interest of local administrators" as the main factors that have the most influence in the occurrence of landslides and

  8. Relations among Affect, Abstinence Motivation and Confidence, and Daily Smoking Lapse Risk

    PubMed Central

    Minami, Haruka; Yeh, Vivian M.; Bold, Krysten W.; Chapman, Gretchen B.; McCarthy, Danielle E.

    2016-01-01

    Aims This study tested the hypothesis that changes in momentary affect, abstinence motivation, and confidence would predict lapse risk over the next 12–24 hours using Ecological Momentary Assessment (EMA) data from smokers attempting to quit smoking. Method 103 adult, daily, treatment-seeking smokers recorded their momentary affect, motivation to quit, abstinence confidence, and smoking behaviors in near real time with multiple EMA reports per day using electronic diaries post-quit. Results Multilevel models indicated that initial levels of negative affect were associated with smoking, even after controlling for earlier smoking status, and that short-term increases in negative affect predicted lapses up to 12, but not 24, hours later. Positive affect had significant effects on subsequent abstinence confidence, but not motivation to quit. High levels of motivation appeared to reduce increases in lapse risk that occur over hours while momentary changes in confidence did not predict lapse risk over 12 hours. Conclusion Negative affect had short-lived effects on lapse risk, whereas higher levels of motivation protected against the risk of lapsing that accumulates over hours. An increase in positive affect was associated with greater confidence to quit, but such changes in confidence did not reduce short-term lapse risk, contrary to expectations. Relations observed among affect, cognitions, and lapse seem to depend critically on the timing of assessments. PMID:24955665

  9. Within and between Individual Variability of Exposure to Work-Related Musculoskeletal Disorder Risk Factors.

    PubMed

    Zare, Mohsen; Sagot, Jean-Claude; Roquelaure, Yves

    2018-05-17

    Industrial companies indicate a tendency to eliminate variations in operator strategies, particularly following implementation of the lean principle. Companies believe when the operators perform the same prescribed tasks, they have to execute them in the same manner (completing the same gestures and being exposed to the same risk factors). They attempt to achieve better product quality by standardizing and reducing operational leeway. However, operators adjust and modify ways of performing tasks to balance between their abilities and the requirements of the job. This study aims to investigate the variability of exposure to physical risk factors within and between operators when executing the same prescribed tasks. The Ergonomic Standard method was used to evaluate two workstations. Seven operators were observed thirty times between repeated cycle times at those workstations. The results revealed the variability of exposure to risk factors between and within operators in the repeated execution of the same tasks. Individual characteristics and operators' strategies might generate the variability of exposure to risk factors that may be an opportunity to reduce the risks of work-related musculoskeletal disorders (WR-MSDs). However, sometimes operators' strategies may cause overexposure to risk factors; operators most often adopt such strategies to undertake their tasks while reducing the workload.

  10. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... 153 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment; Proposed Rule #0;#0;Federal Register / Vol. 76 , No. 136 / Friday, July 15, 2011...] RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk...

  11. 7 CFR 331.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Registration and related security risk assessments... AGENTS AND TOXINS § 331.7 Registration and related security risk assessments. (a) Unless exempted under... be approved by the Administrator or the HHS Secretary based on a security risk assessment by the...

  12. 9 CFR 121.7 - Registration and related security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Registration and related security risk..., USE, AND TRANSFER OF SELECT AGENTS AND TOXINS § 121.7 Registration and related security risk... Administrator or the HHS Secretary based on a security risk assessment by the Attorney General: (i) The...

  13. 78 FR 69267 - Defense Federal Acquisition Regulation Supplement: Requirements Relating to Supply Chain Risk...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... Regulation Supplement: Requirements Relating to Supply Chain Risk (DFARS Case 2012-D050) AGENCY: Defense... for FY 2013. This interim rule allows DoD to consider the impact of supply chain risk in specified... Information Relating to Supply Chain Risk,'' as amended by section 806 of the NDAA for FY 2013 (Pub. L. 112...

  14. How Primary Care Providers Talk to Patients about Genome Sequencing Results: Risk, Rationale, and Recommendation.

    PubMed

    Vassy, Jason L; Davis, J Kelly; Kirby, Christine; Richardson, Ian J; Green, Robert C; McGuire, Amy L; Ubel, Peter A

    2018-06-01

    Genomics will play an increasingly prominent role in clinical medicine. To describe how primary care physicians (PCPs) discuss and make clinical recommendations about genome sequencing results. Qualitative analysis. PCPs and their generally healthy patients undergoing genome sequencing. Patients received clinical genome reports that included four categories of results: monogenic disease risk variants (if present), carrier status, five pharmacogenetics results, and polygenic risk estimates for eight cardiometabolic traits. Patients' office visits with their PCPs were audio-recorded, and summative content analysis was used to describe how PCPs discussed genomic results. For each genomic result discussed in 48 PCP-patient visits, we identified a "take-home" message (recommendation), categorized as continuing current management, further treatment, further evaluation, behavior change, remembering for future care, or sharing with family members. We analyzed how PCPs came to each recommendation by identifying 1) how they described the risk or importance of the given result and 2) the rationale they gave for translating that risk into a specific recommendation. Quantitative analysis showed that continuing current management was the most commonly coded recommendation across results overall (492/749, 66%) and for each individual result type except monogenic disease risk results. Pharmacogenetics was the most common result type to prompt a recommendation to remember for future care (94/119, 79%); carrier status was the most common type prompting a recommendation to share with family members (45/54, 83%); and polygenic results were the most common type prompting a behavior change recommendation (55/58, 95%). One-fifth of recommendation codes associated with monogenic results were for further evaluation (6/24, 25%). Rationales for these recommendations included patient context, family context, and scientific/clinical limitations of sequencing. PCPs distinguish substantive

  15. Risk of alcohol dependence: prevalence, related problems and socioeconomic factors.

    PubMed

    Martins-Oliveira, Juliana Gabrielle; Jorge, Kelly Oliva; Ferreira, Raquel Conceição; Ferreira, Efigênia Ferreira E; Vale, Míriam Pimenta; Zarzar, Patrícia Maria

    2016-01-01

    The present study evaluated the possible alcohol dependence and related problems among adolescents and determined possible associations with socioeconomic factors and gender. A cross-sectional study was conducted with a representative sample of 936 adolescents aged 15 to 19 years enrolled at public and private schools in the city of Belo Horizonte, Brazil. Data related to alcohol consumption and associated problems were collected using the Alcohol Use Disorder Identification Test (AUDIT). The Social Vulnerability Index (SVI), mother's schooling and type of school were used to assess socioeconomic factors. Statistical analysis involved the chi-square test (p < 0.05) and Poisson regression. The prevalence of possible dependence was 16.4%, 52.1% reported concern of a family member regarding the adolescent's alcohol consumption. Female adolescents were less likely to exhibit possible dependence in comparison to males. Participants with living in a low vulnerability area were more likely to consume alcohol in comparison to those living in underprivileged areas. The results of the present study demonstrate that possible dependence was significantly associated with the male gender and low social vulnerability.

  16. Police-related experiences and HIV risk among female sex workers in Andhra Pradesh, India.

    PubMed

    Erausquin, Jennifer Toller; Reed, Elizabeth; Blankenship, Kim M

    2011-12-01

    Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police-FSW interactions to reduce HIV vulnerability among FSWs.

  17. Police-Related Experiences and HIV Risk Among Female Sex Workers in Andhra Pradesh, India

    PubMed Central

    Reed, Elizabeth; Blankenship, Kim M.

    2011-01-01

    Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police–FSW interactions to reduce HIV vulnerability among FSWs. PMID:22043036

  18. When performance and risk taking are related: Working for rewards is related to risk taking when the value of rewards is presented briefly.

    PubMed

    Veling, Harm; Bijleveld, Erik

    2015-12-01

    Valuable monetary rewards can boost human performance on various effortful tasks even when the value of the rewards is presented too briefly to allow for strategic decision making. However, the mechanism by which briefly-presented reward information influences performance has remained unclear. One possibility is that performance after briefly-presented reward information is primarily boosted via activation of the dopamine reward system, whereas performance after very visible reward information is driven more by strategic processes. To examine this hypothesis, we first presented participants with a task in which they could earn rewards of relatively low (1 cent) or high (10 cents) value, and the value information was presented either briefly (17 ms) or for an extended duration (300 ms). Furthermore, responsiveness of the dopamine system was indirectly estimated with a measure of risk taking, the Balloon Analogue Risk Task (BART). Results showed that performance after high- compared to low-value rewards was indeed related to the BART scores only when reward information was presented briefly. These results are suggestive of the possibility that brief presentation of reward information boosts performance directly via activating the dopamine system, whereas extended presentation of reward information leads to more strategic reward-driven behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Adiposity and breast cancer risk in postmenopausal women: Results from the UK Biobank prospective cohort.

    PubMed

    Guo, Wenji; Key, Timothy J; Reeves, Gillian K

    2018-03-23

    Body size is an important modifiable risk factor for postmenopausal breast cancer. However, it remains unclear whether direct measures of fat mass are better indicators of risk than anthropometric measures, or whether central adiposity may contribute to risk beyond overall adiposity. We analyzed data from 162,691 postmenopausal women in UK Biobank followed from 2006 to 2014. Body size was measured by trained technicians. Multivariable-adjusted Cox regression was used to estimate relative risks. Analyses were stratified by age at recruitment, region and socioeconomic status, and adjusted for family history of breast cancer, age at menarche, age at first birth, parity, age at menopause, previous hormone replacement therapy use, smoking, alcohol intake, height, physical activity and ethnicity. We observed 2,913 incident invasive breast cancers during a mean 5.7 years of follow-up. There was a continuous increase in risk of postmenopausal breast cancer with increasing adiposity, across all measures. The point estimate, comparing women in the top (median 37.6 kg) to bottom (median 17.6 kg) quartile of body fat mass was 1.70 (95% confidence interval 1.52-1.90). The magnitudes of the associations between per SD increase in BMI and body fat mass with breast cancer risk were similar, suggesting impedance measures of fat were not substantially better indicators of risk than anthropometric measures. After adjusting for body fat mass, the associations between anthropometric measures of central adiposity and breast cancer risk were attenuated. The magnitude of risk, across all measures of adiposity, was greater in women who had been postmenopausal for 12 or more years. © 2018 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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

    PubMed

    Hill, S Y

    2000-01-01

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

  1. Association of vitamin C with the risk of age-related cataract: a meta-analysis.

    PubMed

    Wei, Lin; Liang, Ge; Cai, Chunmei; Lv, Jin

    2016-05-01

    Whether vitamin C is a protective factor for age-related cataract remains unclear. Thus, we conducted a meta-analysis to summarize the evidence from epidemiological studies of vitamin C and the risk of age-related cataract. Pertinent studies were identified by searching in PubMed and in Webscience. The random effect model was used to combine the results. Meta-regression and subgroups analyses were used to explore potential sources of between-study heterogeneity. Publication bias was estimated using Egger's regression asymmetry test. Finally, 15 articles with 20 studies for vitamin C intake and eight articles with 10 studies for serum ascorbate were included in this meta-analysis. The relative risk (RR) and 95% confidence interval of cataract for the highest versus the lowest category of vitamin C intake was 0.814 (0.707-0.938), and the associations were significant in America and Asia. Significant association of cataract risk with highest versus the lowest category of serum ascorbate was found in general [0.704 (0.564-0.879)]. Inverse associations were also found between serum ascorbate and nuclear cataract and posterior subcapsular cataract. Higher vitamin C intake and serum ascorbate might be inversely associated with risk of cataract. Vitamin C intake should be advocated for the primary prevention of cataract. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  2. Risk of disordered eating attitudes and its relation to mental health among university students in ASEAN.

    PubMed

    Pengpid, Supa; Peltzer, Karl

    2018-06-01

    Since there is a lack of information on eating disorders attitudes in Association of Southeast Asian Nations (ASEAN), the aim of this study was to explore the prevalence of eating disorder attitude and its relation to mental distress among university student populations in Indonesia, Malaysia, Myanmar, Thailand and Vietnam. A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate university students that were randomly recruited. The Eating Attitudes Test (EAT-26) was utilized to determine the prevalence of disordered eating attitudes. The sample included 3148 university students, with a mean age of 20.5 years, SD = 1.6. Using the EAT-26, 11.5% of the students across all countries were classified as being at risk for an eating disorder, ranging from below 10% in Indonesia, Thailand and Vietnam to 13.8% in Malaysia and 20.6% in Myanmar. In multivariable logistic regression analysis, sociodemographic factors (wealthier subjective economic status, and living in a lower middle income country), underweight and overweight body weight perception, psychological factors (depression symptoms and pathological internet use), and being obese were associated with eating disorder risk. Relatively high rates of eating disorder risk were found. This result calls for increased awareness, understanding of eating disorders and related risk factors and interventions in university students in ASEAN. Level V, descriptive cross-sectional survey.

  3. Social Networking Technology Use and Engagement in HIV Related Risk and Protective Behaviors among Homeless Youth

    PubMed Central

    Barman-Adhikari, Anamika; Rice, Eric; Bender, Kimberly; Lengnick-Hall, Rebecca; Yoshioka-Maxwell, Amanda; Rhoades, Harmony

    2016-01-01

    Preliminary studies with homeless youth find surprisingly pervasive social media use and suggest youths’ online interactions may be associated with their HIV-related risk and protective behaviors. As homeless youth are transient and difficult to engage in place-based services, social media may represent a novel venue for intervention. A critical first step in intervention development is gaining greater understanding of how homeless youth use social media especially as it relates to whom they connect to and around what topics. Given the salience of Social Networking Sites in the lives of these otherwise difficult to reach adolescents, and their potential to disseminate prevention interventions, this study assessed associations between online social networking technology use and HIV risk behaviors among homeless youth in Los Angeles, California. Homeless youth ages 13 through 24 (N=1046) were recruited through three drop-in centers and surveyed about their social media use and self-reported HIV-related risk behaviors. Results suggest that social media use is widely prevalent among this population, and the content of these online interactions is associated with whether or not they engage in risk or protective behaviors. Implications for interventions and further research are discussed. PMID:27337044

  4. Risk perception by healthcare professionals related to drug use during pregnancy: a Swiss survey.

    PubMed

    Csajka, Chantal; Jaquet, Aurélie; Winterfeld, Ursula; Meyer, Yvonne; Einarson, Adrienne; Panchaud, Alice

    2014-03-07

    Healthcare professionals' (HCPs') perception of risk associated with drug use in pregnancy may have an impact on the pharmacological treatment of some women. The aim of this study was to examine this risk perception in a sample of Swiss HCPs with a special focus on their knowledge and use of available specialised information sources. An online, French and German, questionnaire was e-mailed to 7,136 members of four Swiss professional societies (gynaecologists, paediatricians, midwives and pharmacists). The questionnaire was designed (a) to collect demographic characteristics, (b) to evaluate the frequency of use of several specialised sources of information on drugs in pregnancy in their daily practice, and (c) to examine the perception of risk associated with drug use during pregnancy. A total of 1,310 questionnaires were collected (response rate of 18.4%). More than 80% of the respondent HCPs use the Swiss Drug Reference Book (Compendium) to assess the risk associated with drugs during pregnancy and are not aware of available specialised information sources (books, websites or information centres). Despite some disparities between HPCs, the risk related to drug intake was overall highly misperceived. Blinded reading of three product monographs in the Compendium was associated with an overestimated perception of risk (e.g., after reading the "paracetamol" monograph, 38% of the participants stated they would probably not advise the use of this drug to a pregnant patient). Overall, an overestimation of the risk associated with drug use during pregnancy has been observed in our sample of HCPs, which might be related to the underuse of specialised information source among other factors. These findings evidenced the need for increased training for HCPs in order to optimise medication use during pregnancy. Further studies are needed to confirm these results and identify causes.

  5. Risk Profiles for Endometriosis in Japanese Women: Results From a Repeated Survey of Self-Reports

    PubMed Central

    Yasui, Toshiyuki; Hayashi, Kunihiko; Nagai, Kazue; Mizunuma, Hideki; Kubota, Toshiro; Lee, Jung-Su; Suzuki, Shosuke

    2015-01-01

    Background The prevalence and risk factors for endometriosis may differ according to diagnosis methodologies, such as study populations and diagnostic accuracy. We examined risk profiles in imaging-diagnosed endometriosis with and without surgical confirmation in a large population of Japanese women, as well as the differences in risk profiles of endometriosis based on history of infertility. Methods Questionnaires that included items on sites of endometriosis determined by imaging techniques and surgical procedure were mailed to 1025 women who self-reported endometriosis in a baseline survey of the Japan Nurses’ Health Study (n = 15 019). Results Two hundred and ten women had surgically confirmed endometriosis (Group A), 120 had imaging-diagnosed endometriosis without a surgical procedure (Group B), and 264 had adenomyosis (Group C). A short menstrual cycle at 18–22 years of age and cigarette smoking at 30 years of age were associated with significantly increased risk of endometriosis (Group A plus Group B), while older age was associated with risk of adenomyosis (Group C). In women with a history of infertility, a short menstrual cycle was associated with a significantly increased risk of endometriosis in both Group A and Group B, but risk profiles of endometriosis were different between Group A and Group B in women without a history of infertility. Conclusions Women with surgically confirmed endometriosis and those with imaging-diagnosed endometriosis without surgery have basically common risk profiles, but these risk profiles are different from those with adenomyosis. The presence of a history of infertility should be taken into consideration for evaluation of risk profiles. PMID:25716280

  6. Relations between early family risk, children’s behavioral regulation, and academic achievement

    PubMed Central

    Sektnan, Michaella; McClelland, Megan M.; Acock, Alan; Morrison, Frederick J.

    2010-01-01

    This study examined relations among early family risk, children’s behavioral regulation at 54 months and kindergarten, and academic achievement in first grade using data on 1,298 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Family risk was indexed by ethnic minority status, low maternal education, low average family income from 1 – 54 months, and high maternal depressive symptoms from 1 - 54 months. Results of structural equation modeling indicated that minority status, low maternal education, and low family income had significant negative effects on reading, math, and vocabulary achievement in first grade. Modest indirect effects were also found from ethnicity, maternal education, and maternal depressive symptoms, through 54-month and kindergarten behavioral regulation to first-grade achievement. Discussion focuses on the importance of behavioral regulation for school success especially for children facing early risk. PMID:20953343

  7. Colorectal cancer screening: results of a 5-year program in asymptomatic subjects at increased risk.

    PubMed

    Pezzoli, A; Matarese, V; Rubini, M; Simoni, M; Caravelli, G C; Stockbrugger, R; Cifalà, V; Boccia, S; Feo, C; Simone, L; Trevisani, L; Liboni, A; Gullini, S

    2007-01-01

    The province of Ferrara has one of the highest incidences of colorectal cancer (CRC) in Italy. In January 2000, we set up a colonoscopy screening program focussing on first-degree relatives of CRC patients. We now report the results 5 years after the beginning of the project. SCREENEES AND METHODS: In October 1999, we started a campaign stressing the usefulness of colonoscopy for the first-degree relatives of CRC patients. Subjects included in the screening program were aged between 45 and 75 years with at least one first-degree relative affected by CRC. They were invited to an interview where a physician suggested colonoscopy as a screening option. In 5 years, 776 subjects were interviewed and 733 (94.4%) agreed to an endoscopic examination (M/F:375/401; mean age 55 years): 562 colonoscopies were performed. Adenomas and cancers were found in 122 (21.7%) and 12 (2.1%) subjects, respectively. Histological examination in 181 persons with lesions (32.8%) showed (most serious lesion quoted) 47 hyperplastic polyps (26% of all lesions), 2 serrated adenomas (1.1%), 68 tubular adenomas (48%), 24 tubulovillous adenomas (13.3%), 9 adenomas with high grade dysplasia (5%) and 12 adenocarcinomas (6.6%). The majority of the cancers were at an early stage (8 Dukes A and 3 Dukes B). Sedation was used in only 42 colonoscopies (7.5%). A colonoscopy-based screening in this selected high-risk population is feasible. Even without sedation subjects readily agreed to the endoscopic procedure. We identified a significant number of advanced neoplasms and cancers at an early stage suggesting that this could be a useful tool in early identification of CRC.

  8. Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors.

    PubMed

    Liu, Gao; Fu, Zhi-Qing; Zhu, Ping; Li, Shi-Jun

    2015-06-01

    Central venous catheterization (CVC)-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases (6.17%) of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization (P<0.01) and that in internal jugular vein catheterization (P<0.05). No statistically significant difference was found between femoral vein catheterization and internal jugular vein catheterization (P<0.05). Previous venous thrombosis history (P<0.01), high lactate dehydrogenase level (P<0.01), low high-density lipoprotein (HDL) level (P<0.05), and low albumin level (P<0.05) were found as risk factors or predictors of CVC-related venous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

  9. The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers

    PubMed Central

    2013-01-01

    Objectives To identify work-related musculoskeletal symptoms and any associated work-related risk factors, focusing on structural labor factors among hotel workers. Methods A total of 1,016 hotel workers (620 men and 396 women) were analyzed. The questionnaire surveyed participants’ socio-demographics, health-related behaviors, job-related factors, and work-related musculoskeletal symptoms. Work-related musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. All analyses were stratified by gender, and multiple logistic regression modeling was used to determine associations between work-related musculoskeletal symptoms and work-related risk factors. Results The risk of developing work-related musculoskeletal symptoms was 1.9 times higher among male workers in the kitchen department than males in the room department (OR = 1.92, 95% CI = 1.03-3.79), and 2.5 times higher among male workers with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.52, 95% CI = 1.57-4.04). All of the aforementioned cases demonstrated a statistically significant association with work-related musculoskeletal symptoms. Moreover, the risk of developing work-related musculoskeletal symptoms was 3.3 times higher among female workers aged between 30 and 34 than those aged 24 or younger (OR = 3.32, 95% CI = 1.56-7.04); 0.3 times higher among females in the back office department than those in the room department (OR = 0.34, 95% CI = 0.12-0.91); 1.6 times higher among females on shift schedules than those who were not (OR = 1.60, 95% CI = 1.02-2.59); 1.8 times higher among females who performed more intensive work than those who performed less intensive work (OR = 1.88, 95% CI = 1.17-3.02), and; 2.1 times higher among females with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.17, 95% CI = 1.34-3.50). All of the aforementioned cases also displayed a statistically significant association with work-related

  10. Potential microbial risk factors related to soil amendments and irrigation water of potato crops.

    PubMed

    Selma, M V; Allende, A; López-Gálvez, F; Elizaquível, P; Aznar, R; Gil, M I

    2007-12-01

    This study assesses the potential microbial risk factors related to the use of soil amendments and irrigation water on potato crops, cultivated in one traditional and two intensive farms during two harvest seasons. The natural microbiota and potentially pathogenic micro-organisms were evaluated in the soil amendment, irrigation water, soil and produce. Uncomposted amendments and residual and creek water samples showed the highest microbial counts. The microbial load of potatoes harvested in spring was similar among the tested farms despite the diverse microbial levels of Listeria spp. and faecal coliforms in the potential risk sources. However, differences in total coliform load of potato were found between farms cultivated in the autumn. Immunochromatographic rapid tests and the BAM's reference method (Bacteriological Analytical Manual; AOAC International) were used to detect Escherichia coli O157:H7 from the potential risk sources and produce. Confirmation of the positive results by polymerase chain reaction procedures showed that the immunochromatographic assay was not reliable as it led to false-positive results. The potentially pathogenic micro-organisms of soil amendment, irrigation water and soil samples changed with the harvest seasons and the use of different agricultural practices. However, the microbial load of the produce was not always influenced by these risk sources. Improvements in environmental sample preparation are needed to avoid interferences in the use of immunochromatographic rapid tests. The potential microbial risk sources of fresh produce should be regularly controlled using reliable detection methods to guarantee their microbial safety.

  11. A prospective study of gait related risk factors for exercise-related lower leg pain.

    PubMed

    Willems, T M; De Clercq, D; Delbaere, K; Vanderstraeten, G; De Cock, A; Witvrouw, E

    2006-01-01

    The purpose of this study was to determine prospectively gait related risk factors for exercise-related lower leg pain (ERLLP) in 400 physical education students. Static lower leg alignment was determined, and 3D gait kinematics combined with plantar pressure profiles were collected. After this evaluation, all sports injuries were registered by the same sports physician during the duration of the study. Forty six subjects developed ERLLP and 29 of them developed bilateral symptoms thus giving 75 symptomatic lower legs. Bilateral lower legs of 167 subjects who developed no injuries in the lower extremities served as controls. Cox regression analysis revealed that subjects who developed ERLLP had an altered running pattern before the injury compared to the controls and included (1) a significantly more central heel-strike, (2) a significantly increased pronation, accompanied with more pressure underneath the medial side of the foot, and (3) a significantly more lateral roll-off. These findings suggest that altered biomechanics play a role in the genesis of ERLLP and thus should be considered in prevention and rehabilitation.

  12. Assessment of credit risk based on fuzzy relations

    NASA Astrophysics Data System (ADS)

    Tsabadze, Teimuraz

    2017-06-01

    The purpose of this paper is to develop a new approach for an assessment of the credit risk to corporate borrowers. There are different models for borrowers' risk assessment. These models are divided into two groups: statistical and theoretical. When assessing the credit risk for corporate borrowers, statistical model is unacceptable due to the lack of sufficiently large history of defaults. At the same time, we cannot use some theoretical models due to the lack of stock exchange. In those cases, when studying a particular borrower given that statistical base does not exist, the decision-making process is always of expert nature. The paper describes a new approach that may be used in group decision-making. An example of the application of the proposed approach is given.

  13. Stratospheric controlled perturbation experiment (SCoPEx): overview, status, and results from related laboratory experiments

    NASA Astrophysics Data System (ADS)

    Keith, D.; Dykema, J. A.; Keutsch, F. N.

    2017-12-01

    Stratospheric Controlled Perturbation Experiment (SCoPEx), is a scientific experiment to advance understanding of stratospheric aerosols. It aims to make quantitative measurements of aerosol microphysics and atmospheric chemistry to improve large-scale models used to assess the risks and benefits of solar geoengineering. A perturbative experiment requires: (a) means to create a well-mixed, small perturbed volume, and (b) observation of time evolution of chemistry and aerosols in the volume. SCoPEx will used a propelled balloon gondola containing all instruments and drive system. The propeller wake forms a well-mixed volume (roughly 1 km long and 100 meters in diameter) that serves as an experimental `beaker' into which aerosols (e.g., < 1 kg of 0.3 µm radius CaCO3 particles) at can be injected; while, the propellers allow the gondola to move at speeds up to 3 m/sec relative to the local air mass driving the gondola back forth through the volume to measure properties of the perturbed air mass. This presentation will provide an overview of the experiment including (a) a systems engineering perspective from high-level scientific questions through instrument selection, mission design, and proposed operations and data analysis; (b) instruments, include current status of integration testing; (c) payload engineering including structure, power and mass budget, etc; (d) results from CFD simulation of propeller wake and simulation of chemistry and aerosol microphysics; and finally (e) proposed concept of operations and schedule. We will also provide an overview of the plans for governance including management of health safety and environmental risks, transparency, public engagement, and larger questions about governance of solar geoengineering experiments. Finally, we will briefly present results of laboratory experiments of the interaction of chemical such as ClONO2 and HCl on particle surfaces relevant for stratospheric solar geoengineering.

  14. Relative Peripheral Refractive Error and the Risk of Onset and Progression of Myopia in Children

    PubMed Central

    Sinnott, Loraine T.; Mitchell, G. Lynn; Jones-Jordan, Lisa A.; Moeschberger, Melvin L.; Cotter, Susan A.; Kleinstein, Robert N.; Manny, Ruth E.; Twelker, J. Daniel; Zadnik, Karla

    2011-01-01

    Purpose. To investigate whether relative peripheral hyperopia is a risk factor for either the onset of myopia in children or the rate of myopic progression. Methods. The risk of myopia onset was assessed in 2043 nonmyopic third-grade children (mean age ± SD = 8.8 ± 0.52 years) participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study between 1995 and 2007, 324 of whom became myopic by the eighth grade. Progression analyses used data from 774 myopic children in grades 1 to 8. Foveal and relative peripheral refractive error 30° in the nasal visual field was measured annually by using cycloplegic autorefraction. Axial length was measured by A-scan ultrasonography. Results. The association between more hyperopic relative peripheral refractive error in the third grade and the risk of the onset of myopia by the eighth grade varied by ethnic group (Asian children odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.06–2.30; African-American children OR = 0.75, 95% CI = 0.58–0.96; Hispanics, Native Americans, and whites showed no significant association). Myopia progression was greater per diopter of more hyperopic relative peripheral refractive error, but only by a small amount (−0.024 D per year; P = 0.02). Axial elongation was unrelated to the average relative peripheral refractive error (P = 0.77), regardless of ethnicity. Conclusions. Relative peripheral hyperopia appears to exert little consistent influence on the risk of the onset of myopic refractive error, on the rate of myopia progression, or on axial elongation. PMID:20739476

  15. Mild cool air--a risk factor for asthma exacerbations: results of a retrospective study.

    PubMed

    Saxena, Tarun; Maheshwari, Sanjiv; Saxen, Manjari

    2011-10-01

    Worldwide incidence of bronchial asthma is on rise. Infections either viral or bacterial and various environmental factors are considered as major risk factors for exacerbations in various studies. Despite of awareness and preventive strategies to risk factors, exacerbations largely remain uncontrolled, therefore the study was planned to review the existing risk factors and to find out some other risk factor/factors which could help us in understanding the other causes of exacerbations. The study was done in Ajmer, the central part of Rajasthan state, India, at Mittal Hospital & Research Centre and J. L. N. Medical college hospital by collecting data for the period of four years (January 2006 - December 2009). Monthly record of 300 regular cases of bronchial asthma was taken. This record included symptoms, history of exposure to various risk factors, and PEFR. Environmental data was also collected. On the basis of record monthly attack rate was calculated. RESULTS/OBSERVATIONS: Maximum attack rate (> 90%) was found in October, November (early winter) and February and March (spring) during all the four years studied except in October 2009. A common precipitant present during these months was mild cool air (environmental temperature of 23-27 degrees c). Attack rate was very less above and below of this temperature. No clear association was present with any other known precipitants. It is concluded that inhalation of mild coolair (23-27 degrees c) may be an important risk factor besides other risk factors for asthma exacerbation.

  16. Modifying pro-drug risk factors in adolescents: results from project ALERT.

    PubMed

    Ghosh-Dastidar, Bonnie; Longshore, Douglas L; Ellickson, Phyllis L; McCaffrey, Daniel F

    2004-06-01

    The objective of this study was to evaluate the impact of a revised state-of-the-art drug prevention program, Project ALERT, on risk factors for drug use in mostly rural midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to treatment or control conditions. Treatment-group students received 11 lessons in Grade 7 and 3 more in Grade 8. Effects for 4276 eighth graders were assessed 18 months after baseline. Results indicate that Project ALERT had statistically significant effects on all the targeted risk factors associated with cigarette and marijuana use and more modest gains with the pro-alcohol risk factors. The program helped adolescents at low, moderate, and high risk for future use, with the effect sizes typically stronger for the low- and moderate-risk groups. Thus, school-based drug prevention programs can lower risk factors that correlate with drug use, help low- to high-risk adolescents, and be effective in diverse school environments.

  17. Family history of cardiovascular disease (CVD), perceived CVD risk, and health-related behavior: A review of the literature

    PubMed Central

    Imes, Christopher C.; Lewis, Frances Marcus

    2012-01-01

    Background Over 82 million Americans have one or more forms of cardiovascular disease (CVD), accounting for 32.8% of all deaths in the United States. Although the evidence for the familial aggregation of CVD is strong, the relationship between family history (FH) of CVD, perceived risk for CVD and their relationship to health-related behavior is poorly understood. Objective The objective of this article is to review and summarize the published research on the relationship between a FH of CVD, an individual’s perceived risk, and health-related behavior in order to make recommendations for clinical practice and future research. Methods A literature search was conducted using PubMed, CINAHL Plus, and PsycINFO to identify articles that examined the relationship between a FH of CVD, perceived CVD risk, and health-promoting behaviors. A total of 263 unique articles were reviewed. Two hundred thirty-eight were excluded, resulting in a total of 25 articles included in the paper. Results There was a positive relationship between a reported FH of CVD and perceived risk. However, the relationship between a FH of CVD and health-related behavior change and perceived risk and behavior change was inconsistent. Conclusions A person’s awareness of their FH of CVD or their own risk for CVD is not a sufficient predictor of changes in their health-related behavior. Future studies are needed to better explain the processes by which perceived CVD risk or FH of CVD can be used to affect health-related behavior changes. It appears that both FH and perceived personal risk for CVD are necessary but not sufficient conditions to change health-related behavior in high-risk populations. Future studies should also test interventions that help individuals with a FH of CVD attribute increased personal risk to themselves for developing CVD, while providing lifestyle management options to minimize their risk. PMID:23321782

  18. HIV risk perception and distribution of HIV risk among African, Caribbean and other Black people in a Canadian city: mixed methods results from the BLACCH study

    PubMed Central

    2013-01-01

    Background African, Caribbean and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about the epidemiology of HIV risk in this population. This paper helps fill the knowledge gap by: presenting service providers’ and ACB people’s perceptions about HIV risk in ACB populations; describing the distribution of HIV risk behaviours among ACB people according to markers of social status and position; and comparing results from these two analyses. Methods The Black, African and Caribbean Canadian Health (BLACCH) Study is a mixed methods study that used semi-structured interviews and a cross-sectional quantitative questionnaire to collect information about HIV and health from 188 ACB people in London, Ontario, Canada. Qualitative content analysis was used to identify interview themes, and weighted bivariate statistical analyses were performed on the quantitative data. Behaviours related to HIV risk were stratified by sex, poverty status, immigration experience and employment status. Results Community members perceived that they were at low risk for HIV and mainly focused on sexual risks. They called for more information about HIV in Canada and culturally appropriate HIV services. Service providers cited marital infidelity and cultural and religious attitudes about condoms as barriers to women protecting themselves. They mentioned cultural norms, beliefs about masculinity and underrepresentation of heterosexual ACB men at AIDS service organizations as barriers to men protecting themselves. There were few statistically significant differences in risk behaviours reported by men and women. Those living in poverty were more likely to abstain from sex (p = 0.006) and use condoms (p = 0.027) in the past year. Those living in Canada longer reported higher prevalences of forced sex (p < 0.001), mixing alcohol or drugs with sex (p = 0.001) and past STI diagnoses (p = 0.032). Stable employment was associated with

  19. Mobile phone use and glioma risk: comparison of epidemiological study results with incidence trends in the United States

    PubMed Central

    Rajaraman, P; Curtis, R E; Devesa, S S; Inskip, P D; Check, D P; Linet, M S

    2012-01-01

    Objective In view of mobile phone exposure being classified as a possible human carcinogen by the International Agency for Research on Cancer (IARC), we determined the compatibility of two recent reports of glioma risk (forming the basis of the IARC’s classification) with observed incidence trends in the United States. Design Comparison of observed rates with projected rates of glioma incidence for 1997-2008. We estimated projected rates by combining relative risks reported in the 2010 Interphone study and a 2011 Swedish study by Hardell and colleagues with rates adjusted for age, registry, and sex; data for mobile phone use; and various latency periods. Setting US population based data for glioma incidence in 1992-2008, from 12 registries in the Surveillance, Epidemiology, and End Results (SEER) programme (Atlanta, Detroit, Los Angeles, San Francisco, San Jose-Monterey, Seattle, rural Georgia, Connecticut, Hawaii, Iowa, New Mexico, and Utah). Participants Data for 24 813 non-Hispanic white people diagnosed with glioma at age 18 years or older. Results Age specific incidence rates of glioma remained generally constant in 1992-2008 (−0.02% change per year, 95% confidence interval −0.28% to 0.25%), a period coinciding with a substantial increase in mobile phone use from close to 0% to almost 100% of the US population. If phone use was associated with glioma risk, we expected glioma incidence rates to be higher than those observed, even with a latency period of 10 years and low relative risks (1.5). Based on relative risks of glioma by tumour latency and cumulative hours of phone use in the Swedish study, predicted rates should have been at least 40% higher than observed rates in 2008. However, predicted glioma rates based on the small proportion of highly exposed people in the Interphone study could be consistent with the observed data. Results remained valid if we used either non-regular users or low users of mobile phones as the baseline category, and if we

  20. Cancer risk in relation to serum copper levels.

    PubMed

    Coates, R J; Weiss, N S; Daling, J R; Rettmer, R L; Warnick, G R

    1989-08-01

    A nested, matched case-control study was conducted to assess the relationship between serum levels of copper and the subsequent risk of cancer. One hundred thirty-three cases of cancer were identified during 1974-1984 among 5000 members of a northwest Washington State employee cohort from whom serum specimens had been previously obtained and stored. Two hundred forty-one controls were selected at random from the cohort and were matched to the cases on the basis of age, sex, race, and date of blood draw. Serum copper levels were measured by atomic absorption spectrometry. Risk of a subsequent diagnosis of cancer was positively associated with serum copper levels, but only among those cases diagnosed within 4 years of the time the serum specimens were collected. Among cases diagnosed more than 4 years after specimen collection, there was no consistent association between serum copper levels and risk. Adjustment for age, sex, race, occupational status, cigarette smoking, family history of cancer, alcohol consumption, and, among females, use of exogenous hormones had no appreciable effect on these relationships. The findings suggest that the presence of cancer may increase serum copper levels several years prior to its diagnosis. They are less supportive of the hypothesis that serum copper levels affect cancer risk.

  1. Genetic Variants Related to Height and Risk of Atrial Fibrillation

    PubMed Central

    Rosenberg, Michael A.; Kaplan, Robert C.; Siscovick, David S.; Psaty, Bruce M.; Heckbert, Susan R.; Newton-Cheh, Christopher; Mukamal, Kenneth J.

    2014-01-01

    Increased height is a known independent risk factor for atrial fibrillation (AF). However, whether genetic determinants of height influence risk is uncertain. In this candidate gene study, we examined the association of 209 height-associated single-nucleotide polymorphisms (SNPs) with incident AF in 3,309 persons of European descent from the Cardiovascular Health Study, a prospective cohort study of older adults (aged ≥65 years) enrolled in 1989–1990. After a median follow-up period of 13.2 years, 879 participants developed incident AF. The height-associated SNPs together explained approximately 10% of the variation in height (P = 6.0 × 10−8). Using an unweighted genetic height score, we found a nonsignificant association with risk of AF (per allele, hazard ratio = 1.01, 95% confidence interval: 1.00, 1.02; P = 0.06). In weighted analyses, we found that genetically predicted height was strongly associated with AF risk (per 10 cm, hazard ratio = 1.30, 95% confidence interval: 1.03, 1.64; P = 0.03). Importantly, for all models, the inclusion of actual height completely attenuated the genetic height effect. Finally, we identified 1 nonsynonymous SNP (rs1046934) that was independently associated with AF and may warrant future study. In conclusion, we found that genetic determinants of height appear to increase the risk of AF, primarily via height itself. This approach of examining SNPs associated with an intermediate phenotype should be considered as a method for identifying novel genetic targets. PMID:24944287

  2. Alcohol-related aggression during the college years: theories, risk factors and policy implications.

    PubMed

    Giancola, Peter R

    2002-03-01

    The purpose of this article is to present an overview of the research literature on alcohol-related aggression with a focus on college students. Data from both survey studies and experimental laboratory investigations conducted on college students are reviewed. Various methodological approaches to studying the alcohol-aggression relation, and their associated limitations, are then presented and discussed. The literature indicates that alcohol consumption facilitates aggressive behavior and increases the risk of being the victim of a violent act, particularly in heavy drinkers. Results from these studies are then placed into a context by reviewing 12 influential theories of aggression and alcohol-related aggression. On the basis of these theories and empirical data, a preliminary risk profile is presented to help identify which factors are likely to be important in predicting who will and who will not become aggressive after drinking alcohol. Although much research is still needed to elucidate the intricate causes of alcohol-related aggression, current prevention efforts might focus on modifying key risk factors such as poor cognitive functioning and inaccurate expectations about the effects of alcohol. Other prevention efforts directed specifically at college students might focus on helping them to identify risky situations that might facilitate the expression of intoxicated aggression.

  3. Work-Related Stress Risk Assessment in Italy: A Methodological Proposal Adapted to Regulatory Guidelines

    PubMed Central

    Persechino, Benedetta; Valenti, Antonio; Ronchetti, Matteo; Rondinone, Bruna Maria; Di Tecco, Cristina; Vitali, Sara; Iavicoli, Sergio

    2013-01-01

    Background Work-related stress is one of the major causes of occupational ill health. In line with the regulatory framework on occupational health and safety (OSH), adequate models for assessing and managing risk need to be identified so as to minimize the impact of this stress not only on workers' health, but also on productivity. Methods After close analysis of the Italian and European reference regulatory framework and work-related stress assessment and management models used in some European countries, we adopted the UK Health and Safety Executive's (HSE) Management Standards (MS) approach, adapting it to the Italian context in order to provide a suitable methodological proposal for Italy. Results We have developed a work-related stress risk assessment strategy, meeting regulatory requirements, now available on a specific web platform that includes software, tutorials, and other tools to assist companies in their assessments. Conclusion This methodological proposal is new on the Italian work-related stress risk assessment scene. Besides providing an evaluation approach using scientifically validated instruments, it ensures the active participation of occupational health professionals in each company. The assessment tools provided enable companies not only to comply with the law, but also to contribute to a database for monitoring and assessment and give access to a reserved area for data analysis and comparisons. PMID:23961332

  4. [Risk assessment of work-related stress: the case of a public administration].

    PubMed

    Loi, Michela; Bellò, Benedetta; Mattana, Veronica

    2015-01-01

    The paper describes a case study of work related stress assessment in a public administration, based on an objective methodology (Romano, 2009). The Ispes1 forms (2010) have been used to perform the assessment. They have been filled during some focus group in which 45 workers have been involved, divided into 7 homogeneous groups relying on their department, back-office vs front-office typology of work and the office collocation. According to the Grounded Theory perspective, through the content analysis three further risk factors arose, comparing to the Ispesl forms, such as: (a) the quality of communication, (b) the relationship among and with leaders and colleagues, (c) the presence of discriminatory behaviours. Hence, on the basis of the results, mostly for a deeper analysis of work related stress assessment in a public administration, we suggest to consider these further risk factors.

  5. Childhood Adversity and Cumulative Life Stress: Risk Factors for Cancer-Related Fatigue.

    PubMed

    Bower, Julienne E; Crosswell, Alexandra D; Slavich, George M

    2014-01-01

    Fatigue is a common symptom in healthy and clinical populations, including cancer survivors. However, risk factors for cancer-related fatigue have not been identified. On the basis of research linking stress with other fatigue-related disorders, we tested the hypothesis that stress exposure during childhood and throughout the life span would be associated with fatigue in breast cancer survivors. Stress exposure was assessed using the Stress and Adversity Inventory, a novel computer-based instrument that assesses for 96 types of acute and chronic stressors that may affect health. Results showed that breast cancer survivors with persistent fatigue reported significantly higher levels of cumulative lifetime stress exposure, including more stressful experiences in childhood and in adulthood, compared to a control group of nonfatigued survivors. These findings identify a novel risk factor for fatigue in the growing population of cancer survivors and suggest targets for treatment.

  6. Childhood Adversity and Cumulative Life Stress: Risk Factors for Cancer-Related Fatigue

    PubMed Central

    Bower, Julienne E.; Crosswell, Alexandra D.; Slavich, George M.

    2013-01-01

    Fatigue is a common symptom in healthy and clinical populations, including cancer survivors. However, risk factors for cancer-related fatigue have not been identified. On the basis of research linking stress with other fatigue-related disorders, we tested the hypothesis that stress exposure during childhood and throughout the life span would be associated with fatigue in breast cancer survivors. Stress exposure was assessed using the Stress and Adversity Inventory, a novel computer-based instrument that assesses for 96 types of acute and chronic stressors that may affect health. Results showed that breast cancer survivors with persistent fatigue reported significantly higher levels of cumulative lifetime stress exposure, including more stressful experiences in childhood and in adulthood, compared to a control group of nonfatigued survivors. These findings identify a novel risk factor for fatigue in the growing population of cancer survivors and suggest targets for treatment. PMID:24377083

  7. Type 2 Diabetes Mellitus Screening and Risk Factors Using Decision Tree: Results of Data Mining.

    PubMed

    Habibi, Shafi; Ahmadi, Maryam; Alizadeh, Somayeh

    2015-03-18

    The aim of this study was to examine a predictive model using features related to the diabetes type 2 risk factors. The data were obtained from a database in a diabetes control system in Tabriz, Iran. The data included all people referred for diabetes screening between 2009 and 2011. The features considered as "Inputs" were: age, sex, systolic and diastolic blood pressure, family history of diabetes, and body mass index (BMI). Moreover, we used diagnosis as "Class". We applied the "Decision Tree" technique and "J48" algorithm in the WEKA (3.6.10 version) software to develop the model. After data preprocessing and preparation, we used 22,398 records for data mining. The model precision to identify patients was 0.717. The age factor was placed in the root node of the tree as a result of higher information gain. The ROC curve indicates the model function in identification of patients and those individuals who are healthy. The curve indicates high capability of the model, especially in identification of the healthy persons. We developed a model using the decision tree for screening T2DM which did not require laboratory tests for T2DM diagnosis.

  8. Trunk kinematics and fall risk of older adults: translating biomechanical results to the clinic.

    PubMed

    Grabiner, Mark D; Donovan, Stephanie; Bareither, Mary Lou; Marone, Jane R; Hamstra-Wright, Karrie; Gatts, Strawberry; Troy, Karen L

    2008-04-01

    This paper reviews some of our experiences over nearly 15 years of trying to determine modifiable factors that contribute to the high incidence of fall by older adults. As part of our approach, we have subjected healthy young and older adults to very large postural disturbances during locomotion, in the form of trips and slips, to which rapid compensatory responses have been necessary to avoid falling. For both trips and slips, the ability to limit trunk motion has consistently discriminated older adults who fall from both younger adults and older adults who have been able to avoid falling. We have shown that the ability to limit trunk motion can be rapidly acquired, or learned, by older adults as a result of task-specific training. The learned motor skill has demonstrated short-term retention and has been shown to effectively decrease fall-risk due to trips. Collectively, we believe the works strongly suggests that the traditional exercise-based fall-prevention and whole-body, task-specific training can synergize to reduce falls and fall-related injury in older adults.

  9. Dietary compound score and risk of age-related macular degeneration in the Age-Related Eye Disease Study

    USDA-ARS?s Scientific Manuscript database

    Purpose: Because foods provide many nutrients, which may interact with each other to modify risk for multifactorial diseases such as age-related macular degeneration (AMD), we sought to develop a composite scoring system to summarize the combined effect of multiple dietary nutrients on AMD risk. Th...

  10. Prevalence of Abnormal Papanicolaou Test Results and Related Factors among Women Living in Zanjan, Iran.

    PubMed

    Maleki, Azam; Ahmadnia, Elahe; Avazeh, Azar; Mazloomzadeh, Saeideh; Molaei, Behnaz; Jalilvand, Ahmad

    2015-01-01

    Currently, a comprehensive program for screening and early detection of cervical cancer does not exist in Iran. This study aimed to determine the prevalence of abnormal Papanicolaou (Pap) smears and some related factors among women living in Zanjan, Iran. This cross-sectional study was conducted in 2012 in Zanjan on 4274 married women aged 20-65 years. The study participants were selected through two-stage cluster sampling. After obtaining written consent, demographic and fertility questionnaires were completed. Samples from cervix were obtained through a standard method using the Rover Cervex- Brush. Evaluation and interpretation of the samples were reported using the Bethesda 2001 method. Data were statistically analyzed using chi-square and logistic regression models. Most inflammatory changes in the samples were mild (37.4%). Abnormal atypical changes in the epithelial cells were found in 4.04%. The highest percentage of abnormal changes in the epithelial cells was atypical squamous cells of undetermined significance (ASCUS) (1.9%). Abnormal results of Pap smear was significantly and independently associated with age, papillomavirus infection, and lack of awareness about Pap smear tests. Given the high prevalence of inflammatory and precancerous changes in this study, compared to other studies in Iran and other Muslim countries, and the effect of demographic variables and individual factors on abnormal results, increasing the awareness of women and their families regarding the risk factors for cervical cancer, preventive measures such as screening, and timely treatment seem necessary.

  11. Anthropometric and hormonal risk factors for male breast cancer: male breast cancer pooling project results.

    PubMed

    Brinton, Louise A; Cook, Michael B; McCormack, Valerie; Johnson, Kenneth C; Olsson, Håkan; Casagrande, John T; Cooke, Rosie; Falk, Roni T; Gapstur, Susan M; Gaudet, Mia M; Gaziano, J Michael; Gkiokas, Georgios; Guénel, Pascal; Henderson, Brian E; Hollenbeck, Albert; Hsing, Ann W; Kolonel, Laurence N; Isaacs, Claudine; Lubin, Jay H; Michels, Karin B; Negri, Eva; Parisi, Dominick; Petridou, Eleni Th; Pike, Malcolm C; Riboli, Elio; Sesso, Howard D; Snyder, Kirk; Swerdlow, Anthony J; Trichopoulos, Dimitrios; Ursin, Giske; van den Brandt, Piet A; Van Den Eeden, Stephen K; Weiderpass, Elisabete; Willett, Walter C; Ewertz, Marianne; Thomas, David B

    2014-03-01

    The etiology of male breast cancer is poorly understood, partly because of its relative rarity. Although genetic factors are involved, less is known regarding the role of anthropometric and hormonally related risk factors. In the Male Breast Cancer Pooling Project, a consortium of 11 case-control and 10 cohort investigations involving 2405 case patients (n = 1190 from case-control and n = 1215 from cohort studies) and 52013 control subjects, individual participant data were harmonized and pooled. Unconditional logistic regression generated study design-specific (case-control/cohort) odds ratios (ORs) and 95% confidence intervals (CIs), with exposure estimates combined using fixed effects meta-analysis. All statistical tests were two-sided. Risk was statistically significantly associated with weight (highest/lowest tertile: OR = 1.36; 95% CI = 1.18 to 1.57), height (OR = 1.18; 95% CI = 1.01 to 1.38), and body mass index (BMI; OR = 1.30; 95% CI = 1.12 to 1.51), with evidence that recent rather than distant BMI was the strongest predictor. Klinefelter syndrome (OR = 24.7; 95% CI = 8.94 to 68.4) and gynecomastia (OR = 9.78; 95% CI = 7.52 to 12.7) were also statistically significantly associated with risk, relations that were independent of BMI. Diabetes also emerged as an independent risk factor (OR = 1.19; 95% CI = 1.04 to 1.37). There were also suggestive relations with cryptorchidism (OR = 2.18; 95% CI = 0.96 to 4.94) and orchitis (OR = 1.43; 95% CI = 1.02 to 1.99). Although age at onset of puberty and histories of infertility were unrelated to risk, never having had children was statistically significantly related (OR = 1.29; 95% CI = 1.01 to 1.66). Among individuals diagnosed at older ages, a history of fractures was statistically significantly related (OR = 1.41; 95% CI = 1.07 to 1.86). Consistent findings across case-control and cohort investigations, complemented by pooled analyses, indicated important roles for anthropometric and hormonal risk factors in the

  12. Genetic variants primarily associated with type 2 diabetes are related to coronary artery disease risk

    PubMed Central

    Jansen, Henning; Loley, Christina; Lieb, Wolfgang; Pencina, Michael J; Nelson, Christopher P; Kathiresan, Sekar; Peloso, Gina M; Voight, Benjamin F; Reilly, Muredach P; Assimes, Themistocles L; Boerwinkle, Eric; Hengstenberg, Christian; Laaksonen, Reijo; McPherson, Ruth; Roberts, Robert; Thorsteinsdottir, Unnur; Peters, Annette; Gieger, Christian; Rawal, Rajesh; Thompson, John R; König, Inke R; Vasan, Ramachandran S; Erdmann, Jeanette; Samani, Nilesh J; Schunkert, Heribert

    2015-01-01

    Background The mechanisms underlying the association between diabetes and coronary artery disease (CAD) risk are unclear. We aimed to assess this association by studying genetic variants that have been shown to associate with type 2 diabetes (T2DM). If the association between diabetes and CAD is causal, we expected to observe an association of these variants with CAD as well. Methods and Results We studied all genetic variants currently known to be associated with T2DM at a genome-wide significant level (p<5*10−8) in CARDIoGRAM, a genome-wide data-set of CAD including 22,233 CAD cases and 64,762 controls. Out of the 44 published T2DM SNPs 10 were significantly associated with CAD in CARDIoGRAM (OR>1, p<0.05), more than expected by chance (p=5.0*10−5). Considering all 44 SNPs, the average CAD risk observed per individual T2DM risk allele was 1.0076 (95% confidence interval (CI), 0.9973–1.0180). Such average risk increase was significantly lower than the increase expected based on i) the published effects of the SNPs on T2DM risk and ii) the effect of T2DM on CAD risk as observed in the Framingham Heart Study, which suggested a risk of 1.067 per allele (p=7.2*10−10 vs. the observed effect). Studying two risk scores based on risk alleles of the diabetes SNPs, one score using individual level data in 9856 subjects, and the second score on average effects of reported beta-coefficients from the entire CARDIoGRAM data-set, we again observed a significant - yet smaller than expected - association with CAD. Conclusions Our data indicate that an association between type 2 diabetes related SNPs and CAD exists. However, the effects on CAD risk appear to be by far lower than what would be expected based on the effects of risk alleles on T2DM and the effect of T2DM on CAD in the epidemiological setting. PMID:26074316

  13. Mobile phone use and glioma risk: comparison of epidemiological study results with incidence trends in the United States.

    PubMed

    Little, M P; Rajaraman, P; Curtis, R E; Devesa, S S; Inskip, P D; Check, D P; Linet, M S

    2012-03-08

    In view of mobile phone exposure being classified as a possible human carcinogen by the International Agency for Research on Cancer (IARC), we determined the compatibility of two recent reports of glioma risk (forming the basis of the IARC's classification) with observed incidence trends in the United States. Comparison of observed rates with projected rates of glioma incidence for 1997-2008. We estimated projected rates by combining relative risks reported in the 2010 Interphone study and a 2011 Swedish study by Hardell and colleagues with rates adjusted for age, registry, and sex; data for mobile phone use; and various latency periods. US population based data for glioma incidence in 1992-2008, from 12 registries in the Surveillance, Epidemiology, and End Results (SEER) programme (Atlanta, Detroit, Los Angeles, San Francisco, San Jose-Monterey, Seattle, rural Georgia, Connecticut, Hawaii, Iowa, New Mexico, and Utah). Data for 24,813 non-Hispanic white people diagnosed with glioma at age 18 years or older. Age specific incidence rates of glioma remained generally constant in 1992-2008 (-0.02% change per year, 95% confidence interval -0.28% to 0.25%), a period coinciding with a substantial increase in mobile phone use from close to 0% to almost 100% of the US population. If phone use was associated with glioma risk, we expected glioma incidence rates to be higher than those observed, even with a latency period of 10 years and low relative risks (1.5). Based on relative risks of glioma by tumour latency and cumulative hours of phone use in the Swedish study, predicted rates should have been at least 40% higher than observed rates in 2008. However, predicted glioma rates based on the small proportion of highly exposed people in the Interphone study could be consistent with the observed data. Results remained valid if we used either non-regular users or low users of mobile phones as the baseline category, and if we constrained relative risks to be more than 1. Raised

  14. Shorter telomere length increases age-related tumor risks in von Hippel-Lindau disease patients.

    PubMed

    Wang, Jiang-Yi; Peng, Shuang-He; Ning, Xiang-Hui; Li, Teng; Liu, Sheng-Jie; Liu, Jia-Yuan; Hong, Bao-An; Qi, Nie-Nie; Peng, Xiang; Zhou, Bo-Wen; Zhang, Jiu-Feng; Cai, Lin; Gong, Kan

    2017-09-01

    Von Hippel-Lindau (VHL) disease is a rare autosomal dominant cancer syndrome caused by alterations of VHL gene. Patients are predisposed to develop pheochromocytomas and solid or cystic tumors of the central nervous system, kidney, pancreas, and retina. Remarkable phenotypic heterogeneity exits in organ involvement and tumor onset age between and within VHL families. However, no reliable markers have been found to predict the age-related tumor risks in VHL patients. A large Chinese cohort composed of 300 VHL patients and 92 healthy family controls was enrolled in our study. Blood relative telomere length was measured in 184 patients and all the controls available for genomic DNA samples. Age-related risks for the five major VHL-associated tumors were evaluated using Kaplan-Meier plots and Cox regression analysis. Differences in clinical phenotype were observed between Chinese cohort and the United Kingdom cohort. VHL patients showed significantly shorter telomere length than healthy family controls(P = 0.0183), and a positive correlation was found between telomere length and onset age of the five major tumors, respectively. Moreover, patients in the shorter telomere group (age-adjusted telomere length ≤ 0.44) suffered higher age-related risks for VHL-associated central nervous system hemangioblastomas (HR: 1.879, P = 0.004), renal cell carcinoma (HR: 2.126, P = 0.002) and pancreatic cyst and neuroendocrine tumors (HR: 2.093, P = 0.001). These results indicate that blood shorter telomere length is a new biomarker for age-related tumor risks in VHL patients, which will be crucial to genetic counseling and future research about the role of telomere shortening in the pathogenesis of VHL-associated tumors. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  15. Rural-to-urban migration and risk of hypertension: longitudinal results of the PERU MIGRANT study

    PubMed Central

    Bernabe-Ortiz, A; Sanchez, J F; Carrillo-Larco, R M; Gilman, R H; Poterico, J A; Quispe, R; Smeeth, L; Miranda, J J

    2017-01-01

    Urbanization can be detrimental to health in populations due to changes in dietary and physical activity patterns. The aim of this study was to determine the effect of migration on the incidence of hypertension. Participants of the PERU MIGRANT study, that is, rural, urban and rural-to-urban migrants, were re-evaluated after 5 years after baseline assessment. The outcome was incidence of hypertension; and the exposures were study group and other well-known risk factors. Incidence rates, relative risks (RRs) and population attributable fractions (PAFs) were calculated. At baseline, 201 (20.4%), 589 (59.5%) and 199 (20.1%) participants were rural, rural-to-urban migrant and urban subjects, respectively. Overall mean age was 47.9 (s.d.±12.0) years, and 522 (52.9%) were female. Hypertension prevalence at baseline was 16.0% (95% confidence interval (CI) 13.7–18.3), being more common in urban group; whereas pre-hypertension was more prevalent in rural participants (P<0.001). Follow-up rate at 5 years was 94%, 895 participants were re-assessed and 33 (3.3%) deaths were recorded. Overall incidence of hypertension was 1.73 (95%CI 1.36–2.20) per 100 person-years. In multivariable model and compared with the urban group, rural group had a greater risk of developing hypertension (RR 3.58; 95%CI 1.42–9.06). PAFs showed high waist circumference as the leading risk factor for the hypertension development in rural (19.1%), migrant (27.9%) and urban (45.8%) participants. Subjects from rural areas are at higher risk of developing hypertension relative to rural–urban migrant or urban groups. Central obesity was the leading risk factor for hypertension incidence in the three population groups. PMID:26865219

  16. Dyslexia risk gene relates to representation of sound in the auditory brainstem.

    PubMed

    Neef, Nicole E; Müller, Bent; Liebig, Johanna; Schaadt, Gesa; Grigutsch, Maren; Gunter, Thomas C; Wilcke, Arndt; Kirsten, Holger; Skeide, Michael A; Kraft, Indra; Kraus, Nina; Emmrich, Frank; Brauer, Jens; Boltze, Johannes; Friederici, Angela D

    2017-04-01

    Dyslexia is a reading disorder with strong associations with KIAA0319 and DCDC2. Both genes play a functional role in spike time precision of neurons. Strikingly, poor readers show an imprecise encoding of fast transients of speech in the auditory brainstem. Whether dyslexia risk genes are related to the quality of sound encoding in the auditory brainstem remains to be investigated. Here, we quantified the response consistency of speech-evoked brainstem responses to the acoustically presented syllable [da] in 159 genotyped, literate and preliterate children. When controlling for age, sex, familial risk and intelligence, partial correlation analyses associated a higher dyslexia risk loading with KIAA0319 with noisier responses. In contrast, a higher risk loading with DCDC2 was associated with a trend towards more stable responses. These results suggest that unstable representation of sound, and thus, reduced neural discrimination ability of stop consonants, occurred in genotypes carrying a higher amount of KIAA0319 risk alleles. Current data provide the first evidence that the dyslexia-associated gene KIAA0319 can alter brainstem responses and impair phoneme processing in the auditory brainstem. This brain-gene relationship provides insight into the complex relationships between phenotype and genotype thereby improving the understanding of the dyslexia-inherent complex multifactorial condition. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Racial Discrimination and HIV-related Risk Behaviors in Southeast Louisiana

    PubMed Central

    Kaplan, Kathryn C.; Hormes, Julia M.; Wallace, Maeve; Rountree, Michele; Theall, Katherine P.

    2016-01-01

    Objectives We examined the relationship between cumulative experiences of racial discrimination and HIV-related risk taking, and whether these relationships are mediated through alcohol use among African Americans in semi-rural southeast Louisiana. Methods Participants (N = 214) reported on experiences of discrimination, HIV sexual risk-taking, history of sexually transmitted infection (STI), and health behaviors including alcohol use in the previous 90 days. Experiences of discrimination (scaled both by frequency of occurrence and situational counts) as a predictor of a sexual risk composite score as well as a history of STI was assessed using multivariate linear and logistic regression, respectively, including tests for mediation by alcohol use. Results Discrimination was common in this cohort, with respondents confirming their experience on average 7 of the 9 potential situations and on more than 34 separate occasions. After adjustment, discrimination was significantly associated with increasing sexual risk-taking and lifetime history of STI when measured either by frequency of occurrence or number of situations, although there was no evidence that these relationships were mediated through alcohol use. Conclusions Cumulative experiences of discrimination may play a significant role in sexual risk behavior and consequently increase vulnerability to HIV and other STIs. PMID:26685822

  18. Worldwide Prevalence of Human Papillomavirus and Relative Risk of Prostate Cancer: A Meta-analysis

    PubMed Central

    Yang, Lin; Xie, Shuanghua; Feng, Xiaoshuang; Chen, Yuheng; Zheng, Tongzhang; Dai, Min; Ke Zhou, Cindy; Hu, Zhibin; Li, Ni; Hang, Dong

    2015-01-01

    Despite the increasing number of studies conducted recently to evaluate the association between HPV infections and the risk of prostate cancer, the results remain inconclusive. Furthermore, the prevalence and distribution of overall and individual HPV types worldwide in prostate cancer has not been reported until now. Therefore, we estimated the prevalence of HPV in prostate cancer by pooling data of 46 studies with 4919 prostate cancer cases, taking into account the heterogeneity of major related parameters, including study region, specimen type, HPV DNA source, detection method, publication calendar period and Gleason score. Moreover, we tested the association of HPV infections with prostate cancer risks by a meta-analysis of 26 tissue-based case-control studies. We found that the prevalence of HPV infection was 18.93% (95% CI = 17.84–20.05%) in prostate cancer cases, and most of which were high-risk HPV types (17.73%, 95% CI = 16.52–18.99%). The prevalence varied by region, PCR primers used, publication calendar period and Gleason score. Our study also showed a significantly increased risk of prostate cancer with the positivity of overall HPV detected in prostate tissues (OR = 1.79, 95% CI = 1.29–2.49) and revealed the geographic variation of association strength (P < 0.001). In conclusion, HPV infections may contribute to the risk of prostate cancer. PMID:26441160

  19. Work-related violence against security guards--who is most at risk?

    PubMed

    Leino, Tuula; Selin, Risto; Summala, Heikki; Virtanen, Marianna

    2011-01-01

    Studies on violence in the work of security guards are largely lacking. This study is unique in that it focuses on security guards (n=1,010) in Finland, and assesses the different forms, prevalence, and risk factors of the work-related violence they often face. Information to a survey instrument was obtained by first interviewing 30 volunteers. Then we made a cross-sectional mailed survey that was sent to a randomized group of 2,000 security guards. The response rate was 52. We found the prevalence of verbal aggression, threats of assault, and physical acts against security guards at least once a month to be 39%, 19%, and 15% respectively. As regards risk factors and who is most at risk, our results show that male gender, young age, low work experience, late working hours, and time pressure were associated with all three forms of work-related violence. Unlike other forms of violence, verbal aggression was highly prevalent outside the metropolitan area and directed towards both more and less experienced security guards. In prevention policies for violence, it is important to identify high-risk groups such as those who have less work experience.

  20. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners.

    PubMed

    Thijs, Y; De Clercq, D; Roosen, P; Witvrouw, E

    2008-06-01

    To determine prospectively gait-related intrinsic risk factors for patellofemoral pain (PFP) in a population of novice recreational runners. Prospective cohort study. 102 novice recreational runners (89 women) with no history of knee or lower leg complaints. The standing foot posture of the subjects was examined and plantar pressure measurements during running were collected. The subjects then participated in a 10-week "start to run" programme. During this period all sports injuries were registered by a sports medicine physician. The relationship between the standing foot posture and PFP was investigated and gait-related intrinsic risk factors for PFP were determined. The 17 runners who developed PFP exerted a significantly higher vertical peak force underneath the lateral heel and metatarsals 2 and 3. Logistic regression analysis showed that a significantly higher vertical peak force underneath the second metatarsal and shorter time to the vertical peak force underneath the lateral heel were predictors for PFP. No significant evidence was found for an association between an excessively pronated or supinated foot posture and the development of PFP. The findings suggest that an excessive impact shock during heel strike and at the propulsion phase of running may contribute to an increased risk of developing PFP. The hypothesis that persons at risk for PFP show an altered static foot posture in comparison with non-afflicted persons is not supported by the results of this study.

  1. The Effect of HIV-Related Immunosuppression on the Risk of Tuberculosis Transmission to Household Contacts

    PubMed Central

    Huang, Chuan-Chin; Tchetgen, Eric Tchetgen; Becerra, Mercedes C.; Cohen, Ted; Hughes, Katherine C.; Zhang, Zibiao; Calderon, Roger; Yataco, Rosa; Contreras, Carmen; Galea, Jerome; Lecca, Leonid; Murray, Megan

    2014-01-01

    Background. Coinfection with human immunodeficiency virus (HIV) may modify the risk of transmitting tuberculosis. Some previous investigations suggest that patients coinfected with HIV and tuberculosis are less likely to transmit infection, whereas others do not support this conclusion. Here, we estimated the relative risk of tuberculosis transmission from coinfected patients compared to HIV-negative patients with tuberculosis. Methods. Between September 2009 and August 2012, we identified and enrolled 4841 household contacts of 1608 patients with drug-sensitive tuberculosis in Lima, Peru. We assessed the HIV status and CD4 counts of index patients, as well as other risk factors for infection specific to the index patient, the household, and the exposed individuals. Contacts underwent tuberculin skin testing to determine tuberculosis infection status. Results. After adjusting for covariates, we found that household contacts of HIV-infected tuberculosis patients with a CD4 count ≤250 cells/µL were less likely to be infected with tuberculosis (risk ratio = 0.49 [95% confidence interval, .24–.96]) than the contacts of HIV-negative tuberculosis patients. No children younger than 15 years who were exposed to HIV-positive patients with a CD4 count ≤250 cells/µL were infected with tuberculosis, compared to 22% of those exposed to non-HIV-infected patients. There was no significant difference in the risk of infection between contacts of HIV-infected index patients with CD4 counts >250 cells/µL and contacts of index patients who were not HIV-infected. Conclusions. We found a reduced risk of tuberculosis infection among the household contacts of patients with active tuberculosis who had advanced HIV-related immunosuppression, suggesting reduced transmission from these index patients. PMID:24368620

  2. Disclosure of genetics research results after the death of the patient participant: a qualitative study of the impact on relatives.

    PubMed

    Ormondroyd, E; Moynihan, C; Watson, M; Foster, C; Davolls, S; Ardern-Jones, A; Eeles, R

    2007-08-01

    When a gene mutation is identified in a research study following the death of the study participant, it is not clear whether such information should be made available to relatives. We report here an evaluation of the impact on relatives of being informed of study results that detected pathogenic BRCA2 mutations in a male relative, now deceased, who had early onset (under the age of 55) prostate cancer. The breast and ovarian cancer risk was unknown to the living relatives. Qualitative analysis of interviews with thirteen relatives indicated that those who had a higher risk perception, resulting from an awareness of cancer family history or experiential knowledge of cancer in their family, tended to adjust more easily to the results. All participants believed that genetics research results of clinical significance should be fed back to relatives. Those who were fully aware of the BRCA2 results and implications for themselves felt they had benefited from the information, irrespective of whether or not they had elected for genetic testing, because of the consequent availability of surveillance programs. Initial anxiety upon learning about the BRCA2 result was alleviated by genetic counselling. Factors influencing those who have not engaged with the information included scepticism related to the relative who attempted to inform them, young age and fear of cancer. Those who had not sought genetic counselling did not attempt further dissemination, and some were not undergoing regular screening. Implications for informed consent in genetics research programs, and the requirement for genetic counselling when research results are disclosed, are discussed.

  3. Work and diet-related risk factors of cardiovascular diseases: comparison of two occupational groups

    PubMed Central

    2010-01-01

    Background Although work related risk factors associated with Cardiovascular Diseases (CD) have been well researched, there is no detailed knowledge regarding disparate occupational groups each with a different risk exposition. Therefore, two occupational groups (chefs and office workers) were compared with a focus on nutritional and psychosocial factors. Methods Two groups of subjects were tested for work and diet-related risks of CD (45 chefs and 48 office workers). The groups matched both for gender (male) and age (30 to 45 years). The study included a medical check-up, bioelectrical impedance analysis as well as an evaluation of questionnaires on health, nutritional behaviour and coping capacity. In addition, volunteers were required to compile a 7-day-dietary-record and collect their urine 24 h prior to their check-up. Blood samples drawn were analysed for glucose and lipid metabolism, homocysteine, vitamin B12, folic acid; C-reactive protein, uric acid, red blood cell fatty acids, plant sterols, antioxidative capacity and oxidative stress. Results On average, the chefs showed one risk factor more compared to the office workers. The most frequent risk factors in both groups included overweight/obesity (chef group [CG]: 62.2%; office group [OG]: 58.3%) and elevated TC (CG: 62.2%; OG: 43.8%]. Moreover, although the chefs often had higher CRP-concentrations (40.0%), more office workers suffered from hypertension (37.5%). Chefs showed significant higher concentrations of saturated fatty acids and oleic acid, whereas docosahexaenoic acid, Omega-6- and trans fatty acids were found more frequently in the red blood cell membranes of office workers. While there were no significant differences in analysed plant sterols between the two occupational groups, 7,8-dihydro-8-oxo-2'-deoxyguanosine was significantly increased in office workers. Concerning the work-related psychosocial factors, the chefs were characterised by a stronger subjective importance of work, a greater

  4. Respiratory Health Symptoms among Schoolchildren in Relation to Possible Food-Related Risk and Protective Factors.

    PubMed

    Wright, Caradee Y; Nkosi, Vusumuzi; Wichmann, Janine

    2018-03-13

    Respiratory health outcomes are among the top five causes of child morbidity and mortality around the world. We aimed to investigate possible food-related risk and protective factors for respiratory health outcomes in children. Structured questionnaires completed by primary caregivers of 10-year old children were used to collect information on demographics, socio-economic status, house characteristics and child respiratory health status. Upper (URIs) and Lower (LRIs) respiratory illnesses comprised hay fever, and wheezing, asthma and bronchitis, respectively. Eight hundred questionnaires were distributed, 648 retrieved and 420 completed in full (52.5% response rate). The hay fever 6-month prevalence was 22.4% and wheezing had the highest 6-month prevalence among the LRIs (13.8%). The majority of children ate vegetables (75.5%), fruit (69.3%) and chicken or fish (81.7%) regularly. Nearly half of the children (45.5%) regularly ate processed food. Eating processed food regularly was statistical significantly associated with wheeze (Adjusted Odds Ratio (OR) = 2.65; 95% CI: 1.38-5.08), hay fever (OR = 1.62; 95% CI: 1.09-2.64) and bronchitis (OR = 1.27; 95% CI: 1.06-2.56). The study found an association between regular consumption of processed foods and wheeze, hay fever and bronchitis among 10 year old children. The regular consumption of processed food plays a role in adverse respiratory health effects among children and healthy eating is emphasized.

  5. Understanding the Relationships Between Inspection Results and Risk of Foodborne Illness in Restaurants.

    PubMed

    Lee, Petrona; Hedberg, Craig W

    2016-10-01

    Restaurants are important settings for foodborne disease outbreaks and consumers are increasingly using restaurant inspection results to guide decisions about where to eat. Although public posting of inspection results may lead to improved sanitary practices in the restaurant, the relationship between inspection results and risk of foodborne illness appears to be pathogen specific. To further examine the relationship between inspection results and the risk of foodborne disease outbreaks, we evaluated results of routine inspections conducted in multiple restaurants in a chain (Chain A) that was associated with a large Salmonella outbreak in Illinois. Inspection results were collected from 106 Chain A establishments in eight counties. Forty-six outbreak-associated cases were linked to 23 of these Chain A restaurants. There were no significant differences between the outbreak and nonoutbreak restaurants for overall demerit points or for the number of demerit points attributed to hand washing or cross-contamination. Our analyses strongly suggest that the outbreak resulted from consumption of a contaminated fresh produce item without further amplification within individual restaurants. Inspections at these facilities would be unlikely to detect or predict the foodborne illness outbreak because there are no Food Code items in place to stop the introduction of contaminated food from an otherwise approved commercial food source. The results of our study suggest that the agent and food item pairing and route of transmission must be taken into consideration to improve our understanding of the relationship between inspection results and the risk of foodborne illness in restaurants.

  6. Chronic and Acute Relational Risk Factors for Dating Aggression in Adolescence and Young Adulthood

    PubMed Central

    Furman, Wyndol

    2016-01-01

    Dating aggression is a prevalent and costly public health concern. Using a relational risk framework, this study examined acute and chronic relational risk factors (negative interactions, jealousy, support, & relationship satisfaction) and their effects on physical and psychological dating aggression. The study also examined the interaction between chronic and acute risk, allowing us to assess how changes in acute risk have differing effects depending on whether the individual is typically at higher chronic risk. A sample of 200 youth (100 female) completed seven waves of data, which spanned nine years from middle adolescence to young adulthood (M age at Wave 1 = 15.83). Using hierarchical linear modeling, analyses revealed both acute (within-person) and chronic (between-person) levels in jealousy, negative interactions, and relationship satisfaction, were associated with physical and psychological dating aggression. Significant interactions between chronic and acute risk emerged in predicting physical aggression for negative interactions, jealousy, and relationship satisfaction such that those with higher levels of chronic risk are more vulnerable to increases in acute risk. These interactions between chronic and acute risk indicate that risk is not static, and dating aggression is particularly likely to occur at certain times for youth at high risk for dating aggression. Such periods of increased risk may provide opportunities for interventions to be particularly effective in preventing dating aggression or its consequences. Taken together, these findings provide support for the role of relational risk factors for dating aggression. They also underscore the importance of considering risk dynamically. PMID:26832727

  7. Chronic and Acute Relational Risk Factors for Dating Aggression in Adolescence and Young Adulthood.

    PubMed

    Collibee, Charlene; Furman, Wyndol

    2016-04-01

    Dating aggression is a prevalent and costly public health concern. Using a relational risk framework, this study examined acute and chronic relational risk factors (negative interactions, jealousy, support, and relationship satisfaction) and their effects on physical and psychological dating aggression. The study also examined the interaction between chronic and acute risk, allowing us to assess how changes in acute risk have differing effects depending on whether the individual is typically at higher chronic risk. A sample of 200 youth (100 female) completed seven waves of data, which spanned 9 years from middle adolescence to young adulthood (M age at Wave 1 = 15.83). Using hierarchical linear modeling, analyses revealed both acute (within-person) and chronic (between-person) levels in jealousy, negative interactions, and relationship satisfaction, were associated with physical and psychological dating aggression. Significant interactions between chronic and acute risk emerged in predicting physical aggression for negative interactions, jealousy, and relationship satisfaction such that those with higher levels of chronic risk are more vulnerable to increases in acute risk. These interactions between chronic and acute risk indicate that risk is not static, and dating aggression is particularly likely to occur at certain times for youth at high risk for dating aggression. Such periods of increased risk may provide opportunities for interventions to be particularly effective in preventing dating aggression or its consequences. Taken together, these findings provide support for the role of relational risk factors for dating aggression. They also underscore the importance of considering risk dynamically.

  8. TERT rs2736098 polymorphism and cancer risk: results of a meta-analysis.

    PubMed

    Qi, Hao-Yu; Zou, Peng; Zhao, Lin; Zhu, Jue; Gu, Ai-Hua

    2012-01-01

    Several studies have demonstrated associations between the TERT rs2736098 single nucleotide polymorphisms (SNPs) and susceptibility to cancer development. However, there are conflicting results. A systematic meta-analysis was therefore performed to establish the cancer risk associated with the polymorphism. In this meta-analysis, a total of 6 case-control studies, including 5,567 cases and 6,191 controls, were included. Crude odds ratios with 95% confidence intervals were used to assess the strength of associations in several genetic models. Our results showed no association reaching the level of statistical significance for overall risk. Interestingly, in the stratified analyses (subdivided by ethnicity), significantly increased risks were found in the Asian subgroup which indicates the TERT rs2736098 polymorphism may have controversial involvement in cancer susceptibility. Overall, this meta-analysis indicates that the TERT rs2736098 polymorphism may have little involvement in cancer susceptibility.

  9. Linking parent perceptions of children's weight to early coronary risk factors: results from the CARDIAC Project.

    PubMed

    Stabler, M E; Cottrell, L; Lilly, C

    2014-01-01

    Obesity is a public health threat because of the increasing prevalence in childhood and its causal relationship to the leading cause of death in America, heart disease. Detecting early signs of cardiovascular disease (CVD) risk factors in children and appropriately intervening to reverse the unhealthy trajectory associated with childhood obesity is of great importance. The objective of this study is to observe parental perception of their child's body mass index (BMI) and find associations between inaccurately estimated children and CVD risk factors. This study analyzed the association between 147 rural fifth grade students' lipid profiles and parents' self-reported survey who participated in the 2008-2011 Coronary Artery Risk Detection in Appalachian Communities study. After controlling for covariates, underestimated children were more likely to have higher log-transformed triglyceride and systolic blood pressure values and overestimated children were more likely to have lower systolic blood pressure. Underestimating a child's BMI is associated with coronary risk-related factors, while overestimating a child's BMI is associate with a protective CVD marker. A follow-up study examining the development of CVD risk factors in children of parents who inaccurately estimate their BMI would help clarify this relationship. Knowledge of how parental perceptions directly influence higher lipid levels in children could have an impact on public health efforts in the fight against childhood obesity in rural environments.

  10. Dietary magnesium intake and the risk of diabetes in the Japanese community: results from the Takayama study.

    PubMed

    Konishi, Kie; Wada, Keiko; Tamura, Takashi; Tsuji, Michiko; Kawachi, Toshiaki; Nagata, Chisato

    2017-03-01

    Several experimental studies showed that magnesium intake improved insulin resistance and glucose uptake in diabetes patients. However, epidemiological studies on the association between magnesium intake and diabetes risk have yielded inconsistent results. We investigated whether magnesium intake is related to the risk of developing diabetes in a population-based cohort study in Japan. Study subjects were participants in the Takayama study. A total of 13,525 residents in Takayama City, Japan, responded to a self-administered questionnaire in 1992 and to a follow-up questionnaire seeking information about diabetes in 2002. Magnesium and other nutrient intakes were estimated from a validated food frequency questionnaire administered at the baseline. During a follow-up of 10 years, 438 subjects reported diabetes newly diagnosed by physician. Compared with women in the low quartile of magnesium intake, women in the high quartile were at a significantly reduced risk of diabetes (HR 0.50; 95 % CI 0.30-0.84; P-trend 0.005) after adjustments for covariates. In men, there was no association between magnesium intake and the risk of diabetes. These results suggest that diets with a high intake of magnesium may decrease the risk of diabetes in women.

  11. Distribution of concussion related symptoms after whiplash injury in risk strata.

    PubMed

    Kasch, Helge; Jensen, Troels S

    2017-12-29

    Background/aims The presence and severity of concussion related symptoms after acute whiplash injury are debatable. In this study we examine the distribution and development of the burden of concussion related symptoms in whiplash patients. Methods Consecutively 141 acute whiplash patients and 40 ankle injured controls were recruited from emergency units and were examined after 1 week, 1, 3, 6, 12 months obtaining neck/head VAS score, number-of-non-painful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, strength and duration of neck muscles. Risk factors derived (reduced CROM, intense neckpain/headache, multiple non-pain complaints) were applied in a Risk Assessment Score and divided into 7 risk-strata (refer Kasch et al., Spine 2011). After 1 week and 6 months whiplash patients fulfilled the Rivermead Oxford Head Injury questionnaire (10 items, score from 0 = no change to 4 = very marked change, Danish Version, total score range from 0 to 40). Results 138 acute whiplash patients fulfilled the Rivermead Oxford Head Injury questionnaire after 1 week and 111 after 6 months. The distribution was markedly different in the risk strata, in stratum 7 the sum score was a factor 10 higher than stratum 1 after 1 week (Kruskal-Wallis, p < 1.4 × 10-7) and remained high 6 months after injury (p < 0.05). Conclusion Mild concussion symptoms do not necessarily reflect eventual concussion, but are found after injuries with no direct head trauma and amnesia e.g. whiplash injuries. The Risk Assessment Score fits nicely with the burden of concussion related symptoms after whiplash injury.

  12. Vegetables- and antioxidant-related nutrients, genetic susceptibility, and non-Hodgkin lymphoma risk

    PubMed Central

    Kelemen, Linda E.; Wang, Sophia S.; Lim, Unhee; Cozen, Wendy; Schenk, Maryjean; Hartge, Patricia; Li, Yan; Rothman, Nathaniel; Davis, Scott; Chanock, Stephen J.; Ward, Mary H.

    2009-01-01

    Genetic susceptibility to DNA oxidation, carcinogen metabolism, and altered DNA repair may increase non-Hodgkin lymphoma (NHL) risk, whereas vegetables-and antioxidant-related nutrients may decrease risk. We evaluated the interaction of a priori-defined dietary factors with 28 polymorphisms in these metabolic pathways. Incident cases (n = 1,141) were identified during 1998–2000 from four cancer registries and frequency-matched to population-based controls (n = 949). We estimated diet-gene joint effects using two-phase semi-parametric maximum-likelihood methods, which utilized genotype data from all subjects as well as 371 cases and 311 controls with available diet information. Adjusted odds ratios (95% confidence intervals) were lower among common allele carriers with higher dietary intakes. For the GSTM3 3-base insertion and higher total vegetable intake, the risk was 0.56 (0.35–0.92, p interaction = 0.03); for GSTP1 A114V and higher cruciferous vegetable intake, the risk was 0.52 (0.34–0.81, p interaction = 0.02); for OGG1 S326C and higher daily zinc intake, the risk was 0.71 (0.47–1.08, p interaction = 0.04) and for XRCC3 T241M and higher green leafy vegetable intake, the risk was 0.63 (0.41–0.97, p interaction = 0.03). Calculation of the false positive report probability determined a high likelihood of falsely positive associations. Although most associations have not been examined previously with NHL, our results suggest the examined polymorphisms are not modifiers of the association between vegetable and zinc intakes and NHL risk. PMID:18204928

  13. Dietary Fat, Fiber, and Carbohydrate Intake in Relation to Risk of Endometrial Cancer

    PubMed Central

    Cui, Xiaohui; Rosner, Bernard; Willett, Walter C; Hankinson, Susan E

    2011-01-01

    Background Macronutrients such as fat and fiber have been hypothesized to play a role in the etiology of endometrial cancer. Methods To investigate these associations, the authors analyzed data from the Nurses’ Health Study (NHS). From 1980 to 2006, 669 invasive adenocarcinoma cases were identified over 1.3 million person-years of follow-up. Dietary intake was assessed in 1980 and updated every 2–4 years. Cox proportional hazard models were used to calculate relative risks (RRs), controlling for total energy and other risk factors. Results Overall, the authors found no significant associations between most dietary factors and endometrial cancer risk. Total fat was associated with a borderline significant decreased risk (top vs. bottom quintile RR=0.78; 95% confidence interval [CI]=0.60, 0.99; Ptrend=0.18). Findings for animal fat were similar. No inverse associations between dietary fibers and cancer risk were observed. Cereal fiber was modestly positively associated with risk (top vs. bottom quintile RR=1.38, 95%CI=1.07, 1.79; Ptrend = 0.05). The inverse association with animal fat intake and a positive association with carbohydrate intake were observed among premenopausal but not among postmenopausal women. Conclusions In this large prospective study, no overall association was observed between dietary fat, fiber, or carbohydrates with endometrial cancer risk, although several of the relationships may vary by menopausal status. Impact Dietary fat and fiber intake do not appear to play a major role in endometrial cancer etiology overall. However, further evaluation of these associations, particularly in premenopausal women, is needed. PMID:21393567

  14. Teen Sleep and Suicidality: Results from the Youth Risk Behavior Surveys of 2007 and 2009

    PubMed Central

    Fitzgerald, Caris T.; Messias, Erick; Buysse, Daniel J.

    2011-01-01

    Study Objectives: Suicide in the adolescent population is a tragic and preventable cause of death. Previous studies have confirmed both long and short total sleep times (TSTs) are associated with suicidal ideation in the adult population. We hypothesized that both long and short TSTs are risk factors for serious suicide attempt in the adolescent population as well. Methods: We tested this hypothesis using the Youth Risk Behavior Surveys from 2007 and 2009, which consist of school-based, nationally representative samples (N = 12,154 for 2007, N = 14,782 for 2009). Logistic regression models were used to assess the relationship between suicidality and sleep after adjusting for confounders including age, sex, race/ethnicity, feelings of sadness, and substance abuse. Results: Of the total sample, roughly 15% reported suicidal ideation, 10% planned suicide, 5% attempted and 2% reported an attempt requiring treatment. Teens who reported sleeping ≤ 5 or ≥ 10 h had a significantly higher risk for suicidality compared to those with a TST of 8 h. The largest odds ratios were found among the most severe forms of suicidality (attempt requiring treatment) with an odds ratio of 5.9 for a TST ≤ 4 h and 4.7 for a TST ≥ 10 h. Conclusion: Both short and long TSTs are risk factors for suicidality among teens and extremes in TST may indicate more serious suicidality. Self-reported sleep duration may be a useful screening question for suicide risk. Future studies should examine whether sleep duration is a causal and/or modifiable risk factor for suicidality in teens. Citation: Fitzgerald CT; Messias E; Buysse DJ. Teen sleep and suicidality: results from the youth risk behavior surveys of 2007 and 2009. J Clin Sleep Med 2011;7(4):351-356. PMID:21897771

  15. Cardiometabolic Risk Clustering in Spinal Cord Injury: Results of Exploratory Factor Analysis

    PubMed Central

    2013-01-01

    Background: Evidence suggests an elevated prevalence of cardiometabolic risks among persons with spinal cord injury (SCI); however, the unique clustering of risk factors in this population has not been fully explored. Objective: The purpose of this study was to describe unique clustering of cardiometabolic risk factors differentiated by level of injury. Methods: One hundred twenty-one subjects (mean 37 ± 12 years; range, 18–73) with chronic C5 to T12 motor complete SCI were studied. Assessments included medical histories, anthropometrics and blood pressure, and fasting serum lipids, glucose, insulin, and hemoglobin A1c (HbA1c). Results: The most common cardiometabolic risk factors were overweight/obesity, high levels of low-density lipoprotein (LDL-C), and low levels of high-density lipoprotein (HDL-C). Risk clustering was found in 76.9% of the population. Exploratory principal component factor analysis using varimax rotation revealed a 3–factor model in persons with paraplegia (65.4% variance) and a 4–factor solution in persons with tetraplegia (73.3% variance). The differences between groups were emphasized by the varied composition of the extracted factors: Lipid Profile A (total cholesterol [TC] and LDL-C), Body Mass-Hypertension Profile (body mass index [BMI], systolic blood pressure [SBP], and fasting insulin [FI]); Glycemic Profile (fasting glucose and HbA1c), and Lipid Profile B (TG and HDL-C). BMI and SBP formed a separate factor only in persons with tetraplegia. Conclusions: Although the majority of the population with SCI has risk clustering, the composition of the risk clusters may be dependent on level of injury, based on a factor analysis group comparison. This is clinically plausible and relevant as tetraplegics tend to be hypo- to normotensive and more sedentary, resulting in lower HDL-C and a greater propensity toward impaired carbohydrate metabolism. PMID:23960702

  16. Avalanche risk assessment - a multi-temporal approach, results from Galtür, Austria

    NASA Astrophysics Data System (ADS)

    Keiler, M.; Sailer, R.; Jörg, P.; Weber, C.; Fuchs, S.; Zischg, A.; Sauermoser, S.

    2006-07-01

    Snow avalanches pose a threat to settlements and infrastructure in alpine environments. Due to the catastrophic events in recent years, the public is more aware of this phenomenon. Alpine settlements have always been confronted with natural hazards, but changes in land use and in dealing with avalanche hazards lead to an altering perception of this threat. In this study, a multi-temporal risk assessment is presented for three avalanche tracks in the municipality of Galtür, Austria. Changes in avalanche risk as well as changes in the risk-influencing factors (process behaviour, values at risk (buildings) and vulnerability) between 1950 and 2000 are quantified. An additional focus is put on the interconnection between these factors and their influence on the resulting risk. The avalanche processes were calculated using different simulation models (SAMOS as well as ELBA+). For each avalanche track, different scenarios were calculated according to the development of mitigation measures. The focus of the study was on a multi-temporal risk assessment; consequently the used models could be replaced with other snow avalanche models providing the same functionalities. The monetary values of buildings were estimated using the volume of the buildings and average prices per cubic meter. The changing size of the buildings over time was inferred from construction plans. The vulnerability of the buildings is understood as a degree of loss to a given element within the area affected by natural hazards. A vulnerability function for different construction types of buildings that depends on avalanche pressure was used to assess the degree of loss. No general risk trend could be determined for the studied avalanche tracks. Due to the high complexity of the variations in risk, small changes of one of several influencing factors can cause considerable differences in the resulting risk. This multi-temporal approach leads to better understanding of the today's risk by identifying the

  17. Non-steroidal Anti-inflammatory Drugs and Cancer Risk in Women: Results from the Women’s Health Initiative

    PubMed Central

    Brasky, Theodore M.; Liu, Jingmin; White, Emily; Peters, Ulrike; Potter, John D.; Walter, Roland B.; Baik, Christina S.; Lane, Dorothy S.; Manson, JoAnn E.; Vitolins, Mara Z.; Allison, Matthew A.; Tang, Jean Y.; Wactawski-Wende, Jean

    2017-01-01

    The use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with reduced risks of cancers at several sites in some studies; however, we recently reported no association between their use and total cancer risk in women in a prospective study. Here we examine the association between NSAIDs and total and site-specific cancer incidence in the large, prospective Women’s Health Initiative (WHI). 129,013 women were recruited to participate in the WHI at 40 US clinical centers from 1993 to 1998 and followed prospectively. After 9.7 years of follow-up, 12,998 incident, first primary, invasive cancers were diagnosed. NSAID use was systematically collected at study visits. We used Cox proportional hazards regression models to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations between NSAIDs use and total and site-specific cancer risk. Relative to non-use, consistent use (i.e., use at baseline and year 3 of follow-up) of any NSAID was not associated with total cancer risk (HR 1.00, 95% CI: 0.94–1.06). Results for individual NSAIDs were similar to the aggregate measure. In site-specific analyses, NSAIDs were associated with reduced risks of colorectal cancer, ovarian cancer, and melanoma. Our study confirms a chemopreventive benefit for colorectal cancer in women and gives preliminary evidence for a reduction of the risk of some rarer cancers. NSAIDs’ benefit on cancer risk was limited to specific sites and not evident when total cancer risk was examined. This information may be of importance when NSAIDs are considered as chemopreventive agents. PMID:24599876

  18. TERRORIST PROTECTION PLANNING USING A RELATIVE RISK REDUCTION APPROACH, SESSION VIII: TECHNOLOGY FORUM FOCUS GROUPS.

    SciTech Connect

    INDUSI,J.P.

    2003-06-16

    Since the events of 9/11, there have been considerable concerns and associated efforts to prevent or respond to acts of terrorism. Very often we hear calls to reduce the threat from or correct vulnerabilities to various terrorist acts. Others fall victim to anxiety over potential scenarios with the gravest of consequences involving hundreds of thousands of casualties. The problem is complicated by the fact that planners have limited, albeit in some cases significant, resources and less than perfect intelligence on potential terrorist plans. However, valuable resources must be used prudently to reduce the overall risk to the nation. A systematicmore » approach to this process of asset allocation is to reduce the overall risk and not just an individual element of risk such as vulnerabilities. Hence, we define risk as a function of three variables: the threat (the likelihood and scenario of the terrorist act), the vulnerability (the vulnerability of potential targets to the threat), and the consequences (health and safety, economic, etc.) resulting from a successful terrorist scenario. Both the vulnerability and consequences from a postulated adversary scenario can be reasonably well estimated. However, the threat likelihood and scenarios are much more difficult to estimate. A possible path forward is to develop scenarios for each potential target in question using experts from many disciplines. This should yield a finite but large number of target-scenario pairs. The vulnerabilities and consequences for each are estimated and then ranked relative to one another. The resulting relative risk ranking will have targets near the top of the ranking for which the threat is estimated to be more likely, the vulnerability greatest, and the consequences the most grave. In the absence of perfect intelligence, this may be the best we can do.« less

  19. Low density lipoprotein receptor related protein-1 and 6 gene variants and ischemic stroke risk

    PubMed Central

    Harriott, Andrea M.; Heckman, Michael G.; Rayaprolu, Sruti; Soto-Ortolaza, Alexandra I.; Diehl, Nancy N.; Kanekiyo, Takahisa; Liu, Chia-Chen; Bu, Guojun; Malik, Rainer; Cole, John W.; Meschia, James F.; Ross, Owen A.

    2015-01-01

    Background Low density lipoprotein receptor related proteins-1 and 6 have been implicated in cerebral ischemia. In addition, genetic variation in LRP1 and LRP6 has been linked with various factors that are related to risk of ischemic stroke. The aim of this study was to examine the association of LRP1 and LRP6 gene variants with risk of ischemic stroke as part of the Ischemic Stroke Genetics Study (ISGS). Methods We included a Caucasian series (434 stroke patients, 319 controls) and an African American series (161 stroke patients, 116 controls). Fourteen LRP6 variants and 3 LRP1 variants were genotyped and assessed for association with ischemic stroke. Results In the Caucasian series, significant associations with ischemic stroke were observed for LRP6 rs2075241 (OR:0.42, P=0.023), rs2302685 (OR:0.44, P=0.049), rs7975614 (OR: 0.07, P=0.017), rs10492120 (OR: 0.62, P=0.036), and rs10743980 (OR: 0.66, P=0.037). Risk of ischemic stroke was significantly lower for carriers of any of these five protective LRP6 variants (24.0% of subjects) compared to non-carriers (OR:0.57, P=0.003). The protective association for LRP6 rs2075241 was observed at a similar magnitude across ischemic stroke subtypes, while the effects of rs23022685, rs10492120, and rs10743980 were most apparent for cardioembolic and large vessel stroke. In the African American series, LRP1 rs11172113 was associated with an increased risk of stroke (OR:1.89, P=0.006). Conclusions The results of our preliminary study provide evidence that LRP6 and LRP1 variants may be associated with risk of ischemic stroke. Validation in larger studies is warranted. PMID:26031789

  20. Travel and biologic therapy: travel-related infection risk, vaccine response and recommendations.

    PubMed

    Hall, Victoria; Johnson, Douglas; Torresi, Joseph

    2018-01-01

    Biologic therapy has revolutionized the management of refractory chronic autoimmune and auto-inflammatory disease, as well as several malignancies, providing rapid symptomatic relief and/or disease remission. Patients receiving biologic therapies have an improved quality of life, facilitating travel to exotic destinations and potentially placing them at risk of a range of infections. For each biologic agent, we review associated travel-related infection risk and expected travel vaccine response and effectiveness. A PUBMED search [vaccination OR vaccine] AND/OR ['specific vaccine'] AND/OR [immunology OR immune response OR response] AND [biologic OR biological OR biologic agent] was performed. A review of the literature was performed in order to develop recommendations on vaccination for patients in receipt of biologic therapy travelling to high-risk travel destinations. There is a paucity of literature in this area, however, it is apparent that travel-related infection risk is increased in patients on biologic therapy and when illness occurs they are at a higher risk of complication and hospitalization. Patients in receipt of biologic agents are deemed as having a high level of immunosuppression-live vaccines, including the yellow fever vaccine, are contraindicated. Inactivated vaccines are considered safe; however, vaccine response can be attenuated by the patient's biologic therapy, thereby resulting in reduced vaccine effectiveness and protection. Best practice requires a collaborative approach between the patient's primary healthcare physician, relevant specialist and travel medicine expert, who should all be familiar with the immunosuppressive and immunomodulatory effects resulting from the biologic therapies. Timing of vaccines should be carefully planned, and if possible, vaccination provided well before established immunosuppression.

  1. People at High Risk of Developing Flu-Related Complications

    MedlinePlus

    ... UPDATE: Parotitis and Influenza FAQ Parotitis and Influenza Algorithm: Interpreting Influenza Testing Results When Influenza is Circulating Algorithm: Interpreting Influenza Testing Results When Influenza is NOT ...

  2. Population Modeling of Modified Risk Tobacco Products Accounting for Smoking Reduction and Gradual Transitions of Relative Risk.

    PubMed

    Poland, Bill; Teischinger, Florian

    2017-11-01

    As suggested by the Food and Drug Administration (FDA) Modified Risk Tobacco Product (MRTP) Applications Draft Guidance, we developed a statistical model based on public data to explore the effect on population mortality of an MRTP resulting in reduced conventional cigarette smoking. Many cigarette smokers who try an MRTP persist as dual users while smoking fewer conventional cigarettes per day (CPD). Lower-CPD smokers have lower mortality risk based on large cohort studies. However, with little data on the effect of smoking reduction on mortality, predictive modeling is needed. We generalize prior assumptions of gradual, exponential decay of Excess Risk (ER) of death, relative to never-smokers, after quitting or reducing CPD. The same age-dependent slopes are applied to all transitions, including initiation to conventional cigarettes and to a second product (MRTP). A Monte Carlo simulation model generates random individual product use histories, including CPD, to project cumulative deaths through 2060 in a population with versus without the MRTP. Transitions are modeled to and from dual use, which affects CPD and cigarette quit rates, and to MRTP use only. Results in a hypothetical scenario showed high sensitivity of long-run mortality to CPD reduction levels and moderate sensitivity to ER transition rates. Models to project population effects of an MRTP should account for possible mortality effects of reduced smoking among dual users. In addition, studies should follow dual-user CPD histories and quit rates over long time periods to clarify long-term usage patterns and thereby improve health impact projections. We simulated mortality effects of a hypothetical MRTP accounting for cigarette smoking reduction by smokers who add MRTP use. Data on relative mortality risk versus CPD suggest that this reduction may have a substantial effect on mortality rates, unaccounted for in other models. This effect is weighed with additional hypothetical effects in an example.

  3. INTERPRETATION OF SPLP RESULTS FOR ASSESSING RISK TO GROUNDWATER FROM LAND-APPLIED GRANULAR WASTE

    EPA Science Inventory

    Scientists and engineers often rely on results from the synthetic precipitation leaching procedure (SPLP) to assess the risk of groundwater contamination posed by the land application of granular solid wastes. The concentrations of pollutants in SPLP leachate can be measured and ...

  4. Wisconsin Youth Risk Behavior and HIV/AIDS Prevention Education: Survey Results, 1991. Bulletin No. 93253.

    ERIC Educational Resources Information Center

    Wagener, Judy; Nehls-Lowe, Barbara

    This report contains data from the 1991 Youth Risk Behavior Survey, administered to 1,440 high school students throughout Wisconsin. Included are data on the prevalence of injuries; drug use; sexual behaviors; dietary behaviors; and physical activity. The results revealed that over 80% of students rarely or never wear bicycle helmets and 50%…

  5. Results for Learning Report 2014-15: Basic Education at Risk

    ERIC Educational Resources Information Center

    Bernard, Jean-Marc; Amelewonou, Kokou; Bonnet, Gabrielle; Rubiano-Matulevich, Eliana; Soman, Kouassi; Sonnenberg, Krystyna

    2014-01-01

    The 2014/2015 Results for Learning Report: Basic Education at Risk examines the progress achieved by Global Partnership for Education (GPE) partner developing countries over the period 2008-2012. Universal primary education has never been so close, yet there are still 58 million children of primary school age who do not go to school around the…

  6. Risk factors for severe intimate partner violence and violence-related injuries among women in India.

    PubMed

    Sabri, Bushra; Renner, Lynette M; Stockman, Jamila K; Mittal, Mona; Decker, Michele R

    2014-01-01

    Relying on an ecological framework, we examined risk factors for severe physical intimate partner violence (IPV) and related injuries among a nationally representative sample of women (N = 67,226) in India. Data for this cross-sectional study were derived from the 2005-2006 India National Family Health Survey, a nationally representative household-based health surveillance system. Logistic regression analyses were used to generate the study findings. We found that factors related to severe physical IPV and injuries included low or no education, low socioeconomic status, rural residence, greater number of children, and separated or divorced marital status. Husbands' problem drinking, jealousy, suspicion, control, and emotionally and sexually abusive behaviors were also related to an increased likelihood of women experiencing severe IPV and injuries. Other factors included women's exposure to domestic violence in childhood, perpetration of IPV, and adherence to social norms that accept husbands' violence. Practitioners may use these findings to identify women at high risk of being victimized by severe IPV or injuries for prevention and intervention strategies. Policies and programs that focus on empowering abused women and holding perpetrators accountable may protect women at risk for severe IPV or injuries that may result in death.

  7. Relative risk estimation of Chikungunya disease in Malaysia: An analysis based on Poisson-gamma model

    NASA Astrophysics Data System (ADS)

    Samat, N. A.; Ma'arof, S. H. Mohd Imam

    2015-05-01

    Disease mapping is a method to display the geographical distribution of disease occurrence, which generally involves the usage and interpretation of a map to show the incidence of certain diseases. Relative risk (RR) estimation is one of the most important issues in disease mapping. This paper begins by providing a brief overview of Chikungunya disease. This is followed by a review of the classical model used in disease mapping, based on the standardized morbidity ratio (SMR), which we then apply to our Chikungunya data. We then fit an extension of the classical model, which we refer to as a Poisson-Gamma model, when prior distributions for the relative risks are assumed known. Both results are displayed and compared using maps and we reveal a smoother map with fewer extremes values of estimated relative risk. The extensions of this paper will consider other methods that are relevant to overcome the drawbacks of the existing methods, in order to inform and direct government strategy for monitoring and controlling Chikungunya disease.

  8. Neural mechanisms regulating different forms of risk-related decision-making: Insights from animal models.

    PubMed

    Orsini, Caitlin A; Moorman, David E; Young, Jared W; Setlow, Barry; Floresco, Stan B

    2015-11-01

    Over the past 20 years there has been a growing interest in the neural underpinnings of cost/benefit decision-making. Recent studies with animal models have made considerable advances in our understanding of how different prefrontal, striatal, limbic and monoaminergic circuits interact to promote efficient risk/reward decision-making, and how dysfunction in these circuits underlies aberrant decision-making observed in numerous psychiatric disorders. This review will highlight recent findings from studies exploring these questions using a variety of behavioral assays, as well as molecular, pharmacological, neurophysiological, and translational approaches. We begin with a discussion of how neural systems related to decision subcomponents may interact to generate more complex decisions involving risk and uncertainty. This is followed by an overview of interactions between prefrontal-amygdala-dopamine and habenular circuits in regulating choice between certain and uncertain rewards and how different modes of dopamine transmission may contribute to these processes. These data will be compared with results from other studies investigating the contribution of some of these systems to guiding decision-making related to rewards vs. punishment. Lastly, we provide a brief summary of impairments in risk-related decision-making associated with psychiatric disorders, highlighting recent translational studies in laboratory animals. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed Central

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

    2015-01-01

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

  10. Work and diet-related risk factors of cardiovascular diseases: comparison of two occupational groups.

    PubMed

    Hartung, Danielle; Stadeler, Martina; Grieshaber, Romano; Keller, Sylvia; Jahreis, Gerhard

    2010-03-22

    aspiration and enhanced efforts at perfectionism at their workplace. The chefs in the study bear a higher risk of CD compared to the office-workers. Although, CD is not exclusively a result of workplace-conditions, study results show that work-related influences can not be ignored. Thus, prevention of CD may be an important task attributable to occupational physicians.

  11. Management strategies, early results, benefits, and risk factors of laparoscopic repair of perforated peptic ulcer.

    PubMed

    Lunevicius, Raimundas; Morkevicius, Matas

    2005-10-01

    The primary goal of this study was to describe epidemiology and management strategies of the perforated duodenal ulcer, as well as the most common methods of laparoscopic perforated duodenal ulcer repair. The secondary goal was to demonstrate the value of prospective and retrospective studies regarding the early results of surgery and the risk factors. The tertiary goal was to emphasize the benefits of this operation, and the fourth goal was to clarify the possible risk factors associated with laparoscopic repair of the duodenal ulcer. The Medline/Pubmed database was used. Review was done after evaluation of 96 retrieved full-text articles. Thirteen prospective and twelve retrospective studies were selected, grouped, and summarized. The spectrum of the retrospective studies' results are as follows: median overall morbidity rate 10.5 %, median conversion rate 7%, median hospital stay 7 days, and median postoperative mortality rate 0%. The following is the spectrum of results of the prospective studies: median overall morbidity rate was slightly less (6%); the median conversion rate was higher (15%); the median hospital stay was shorter (5 days) and the postoperative mortality was higher (3%). The risk factors identified were the same. Shock, delayed presentation (> 24 hours), confounding medical condition, age > 70 years, poor laparoscopic expertise, ASA III-IV, and Boey score should be considered preoperative laparoscopic repair risk factors. Each of these factors independently should qualify as a criterion for open repair due to higher intraoperative risks as well as postoperative morbidity. Inadequate ulcer localization, large perforation size (defined by some as > 6 mm diameter, and by others as > 10 mm), and ulcers with friable edges are also considered as conversion risk factors.

  12. Perception of Risk and Terrorism-Related Behavior Change: Dual Influences of Probabilistic Reasoning and Reality Testing.

    PubMed

    Denovan, Andrew; Dagnall, Neil; Drinkwater, Kenneth; Parker, Andrew; Clough, Peter

    2017-01-01

    The present study assessed the degree to which probabilistic reasoning performance and thinking style influenced perception of risk and self-reported levels of terrorism-related behavior change. A sample of 263 respondents, recruited via convenience sampling, completed a series of measures comprising probabilistic reasoning tasks (perception of randomness, base rate, probability, and conjunction fallacy), the Reality Testing subscale of the Inventory of Personality Organization (IPO-RT), the Domain-Specific Risk-Taking Scale, and a terrorism-related behavior change scale. Structural equation modeling examined three progressive models. Firstly, the Independence Model assumed that probabilistic reasoning, perception of risk and reality testing independently predicted terrorism-related behavior change. Secondly, the Mediation Model supposed that probabilistic reasoning and reality testing correlated, and indirectly predicted terrorism-related behavior change through perception of risk. Lastly, the Dual-Influence Model proposed that probabilistic reasoning indirectly predicted terrorism-related behavior change via perception of risk, independent of reality testing. Results indicated that performance on probabilistic reasoning tasks most strongly predicted perception of risk, and preference for an intuitive thinking style (measured by the IPO-RT) best explained terrorism-related behavior change. The combination of perception of risk with probabilistic reasoning ability in the Dual-Influence Model enhanced the predictive power of the analytical-rational route, with conjunction fallacy having a significant indirect effect on terrorism-related behavior change via perception of risk. The Dual-Influence Model possessed superior fit and reported similar predictive relations between intuitive-experiential and analytical-rational routes and terrorism-related behavior change. The discussion critically examines these findings in relation to dual-processing frameworks. This

  13. Perception of Risk and Terrorism-Related Behavior Change: Dual Influences of Probabilistic Reasoning and Reality Testing

    PubMed Central

    Denovan, Andrew; Dagnall, Neil; Drinkwater, Kenneth; Parker, Andrew; Clough, Peter

    2017-01-01

    The present study assessed the degree to which probabilistic reasoning performance and thinking style influenced perception of risk and self-reported levels of terrorism-related behavior change. A sample of 263 respondents, recruited via convenience sampling, completed a series of measures comprising probabilistic reasoning tasks (perception of randomness, base rate, probability, and conjunction fallacy), the Reality Testing subscale of the Inventory of Personality Organization (IPO-RT), the Domain-Specific Risk-Taking Scale, and a terrorism-related behavior change scale. Structural equation modeling examined three progressive models. Firstly, the Independence Model assumed that probabilistic reasoning, perception of risk and reality testing independently predicted terrorism-related behavior change. Secondly, the Mediation Model supposed that probabilistic reasoning and reality testing correlated, and indirectly predicted terrorism-related behavior change through perception of risk. Lastly, the Dual-Influence Model proposed that probabilistic reasoning indirectly predicted terrorism-related behavior change via perception of risk, independent of reality testing. Results indicated that performance on probabilistic reasoning tasks most strongly predicted perception of risk, and preference for an intuitive thinking style (measured by the IPO-RT) best explained terrorism-related behavior change. The combination of perception of risk with probabilistic reasoning ability in the Dual-Influence Model enhanced the predictive power of the analytical-rational route, with conjunction fallacy having a significant indirect effect on terrorism-related behavior change via perception of risk. The Dual-Influence Model possessed superior fit and reported similar predictive relations between intuitive-experiential and analytical-rational routes and terrorism-related behavior change. The discussion critically examines these findings in relation to dual-processing frameworks. This

  14. Early Adolescents' Perceptions of Relative Risk from 10 Societal and Environmental Hazards.

    ERIC Educational Resources Information Center

    Riechard, Donald E.; McGarrity, Jean

    1994-01-01

    In this exploratory study, perceptions of relative risk held by 120 early adolescents (11-14 years) were examined for 10 hazards: wild animals, fire, nuclear energy, pollution, storms, war, car accidents, people, no food, and drugs. Dissonance was found between perceptions of risk and computed risk associated with factual data. (LZ)

  15. Human health risk assessment related to cyanotoxins exposure.

    PubMed

    Funari, Enzo; Testai, Emanuela

    2008-01-01

    This review focuses on the risk assessment associated with human exposure to cyanotoxins, secondary metabolites of an ubiquitous group of photosynthetic procariota. Cyanobacteria occur especially in eutrophic inland and coastal surface waters, where under favorable conditions they attain high densities and may form blooms and scums. Cyanotoxins can be grouped according to their biological effects into hepatotoxins, neurotoxins, cytotoxins, and toxins with irritating potential, also acting on the gastrointestinal system. The chemical and toxicological properties of the main cyanotoxins, relevant for the evaluation of possible risks for human health, are presented. Humans may be exposed to cyanotoxins via several routes, with the oral one being by far the most important, occurring by ingesting contaminated drinking water, food, some dietary supplements, or water during recreational activities. Acute and short-term toxic effects have been associated in humans with exposure to high levels of cyanotoxins in drinking and bathing waters. However, the chronic exposure to low cyanotoxin levels remains a critical issue. This article identifies the actual risky exposure scenarios, provides toxicologically derived reference values, and discusses open issues and research needs.

  16. [Doping: health risks and relation to addictive behaviors].

    PubMed

    Siri, Françoise; Roques, Bernard P

    2003-11-01

    The paper presents the health hazards of the major doping substances and raises some questions about the relationship between doping and addictive behavior. Current definitions of doping and addictive behavior are examined. The paper's goal is: 1- to assess the risks of neurotoxicity and overall toxicity of doping substances: stimulants, narcotics (seldom used as doping substances), and hormones, and assess their addictive potential; 2- to present available data on drug-dependent patients with a record of early prolonged and intensive physical activity or athletic practice. Some doping substances present high risks for health at large doses, but usually low addictive potential and neurotoxicity. Dependency on doping substances and drift towards dependency to addictive drugs, if any, are therefore determined by genetic and environmental factors. A significant susceptibility to drug dependence has been observed in some cases of very intensive and competitive practice. Over-representation of intensive and competitive athletic antecedents among some drug-dependent patients could be accounted for in either of two ways. On the first account, the causal factor is a sensation-seeking character trait, with a likely genetic component, which predisposes the individual to the use of drugs or doping substances, as the opportunities arise. On the second account, the sudden interruption of intensive practice, and of the associated organic stress and hypersensitization of the hedonic pathway, creates a weaning syndrome and leads to the search for relief through drugs. Further exploration of this hypothesis is called for.

  17. Quantitative relations between risk, return and firm size

    NASA Astrophysics Data System (ADS)

    Podobnik, B.; Horvatic, D.; Petersen, A. M.; Stanley, H. E.

    2009-03-01

    We analyze —for a large set of stocks comprising four financial indices— the annual logarithmic growth rate R and the firm size, quantified by the market capitalization MC. For the Nasdaq Composite and the New York Stock Exchange Composite we find that the probability density functions of growth rates are Laplace ones in the broad central region, where the standard deviation σ(R), as a measure of risk, decreases with the MC as a power law σ(R)~(MC)- β. For both the Nasdaq Composite and the S&P 500, we find that the average growth rate langRrang decreases faster than σ(R) with MC, implying that the return-to-risk ratio langRrang/σ(R) also decreases with MC. For the S&P 500, langRrang and langRrang/σ(R) also follow power laws. For a 20-year time horizon, for the Nasdaq Composite we find that σ(R) vs. MC exhibits a functional form called a volatility smile, while for the NYSE Composite, we find power law stability between σ(r) and MC.

  18. Prediagnostic Sex Steroid Hormones in Relation to Male Breast Cancer Risk

    PubMed Central

    Brinton, Louise A.; Key, Tim J.; Kolonel, Laurence N.; Michels, Karin B.; Sesso, Howard D.; Ursin, Giske; Van Den Eeden, Stephen K.; Wood, Shannon N.; Falk, Roni T.; Parisi, Dominick; Guillemette, Chantal; Caron, Patrick; Turcotte, Véronique; Habel, Laurel A.; Isaacs, Claudine J.; Riboli, Elio; Weiderpass, Elisabete; Cook, Michael B.

    2015-01-01

    Purpose Although previous studies have implicated a variety of hormone-related risk factors in the etiology of male breast cancers, no previous studies have examined the effects of endogenous hormones. Patients and Methods Within the Male Breast Cancer Pooling Project, an international consortium comprising 21 case-control and cohort investigations, a subset of seven prospective cohort studies were able to contribute prediagnostic serum or plasma samples for hormone quantitation. Using a nested case-control design, multivariable unconditional logistic regression analyses estimated odds ratios and 95% CIs for associations between male breast cancer risk and 11 individual estrogens and androgens, as well as selected ratios of these analytes. Results Data from 101 cases and 217 matched controls were analyzed. After adjustment for age and date of blood draw, race, and body mass index, androgens were found to be largely unrelated to risk, but circulating estradiol levels showed a significant association. Men in the highest quartile had an odds ratio of 2.47 (95% CI, 1.10 to 5.58) compared with those in the lowest quartile (trend P = .06). Assessment of estradiol as a ratio to various individual androgens or sum of androgens showed no further enhancement of risk. These relations were not significantly modified by either age or body mass index, although estradiol was slightly more strongly related to breast cancers occurring among younger (age < 67 years) than older men. Conclusion Our results support the notion of an important role for estradiol in the etiology of male breast cancers, similar to female breast cancers. PMID:25964249

  19. Fracture risk in hepatitis C virus infected persons: results from the DANVIR cohort study.

    PubMed

    Hansen, Ann-Brit Eg; Omland, Lars Haukali; Krarup, Henrik; Obel, Niels

    2014-07-01

    The association between Hepatitis C virus (HCV)-infection and fracture risk is not well characterized. We compared fracture risk between HCV-seropositive (HCV-exposed) patients and the general population and between patients with cleared and chronic HCV-infection. Outcome measures were time to first fracture at any site, time to first low-energy and first non-low-energy (other) fracture in 12,013 HCV-exposed patients from the DANVIR cohort compared with a general population control cohort (n=60,065) matched by sex and age. Within DANVIR, 4500 patients with chronic HCV-infection and 2656 patients with cleared HCV-infection were studied. Compared with population controls, HCV-exposed patients had increased overall risk of fracture [adjusted incidence rate ratio (aIRR) 2.15, 95% Confidence Interval (CI) 2.03-2.28], increased risk of low-energy fracture (aIRR 2.13, 95% CI: 1.93-2.35) and of other fracture (aIRR 2.18, 95% CI: 2.02-2.34). Compared with cleared HCV-infection, chronic HCV-infection was not associated with increased risk of fracture at any site (aIRR 1.08, 95% CI: 0.97-1.20), or other fracture (aIRR 1.04, 95% CI: 0.91-1.19). The aIRR for low-energy fracture was 1.20 (95% CI: 0.99-1.44). HCV-exposed patients had increased risk of all fracture types. In contrast, overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection, although chronic HCV-infection might be associated with a small excess risk of low-energy fractures. Our study suggests that fracture risk in HCV-infected patients is multi-factorial and mainly determined by lifestyle-related factors associated with HCV-exposure. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  20. First Approximations of Prescribed Fire Risks Relative to Other Management Techniques Used on Private Lands.

    PubMed

    Twidwell, Dirac; Wonkka, Carissa L; Sindelar, Michael T; Weir, John R

    2015-01-01

    Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands.

  1. First Approximations of Prescribed Fire Risks Relative to Other Management Techniques Used on Private Lands

    PubMed Central

    Twidwell, Dirac; Wonkka, Carissa L.; Sindelar, Michael T.; Weir, John R.

    2015-01-01

    Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1) a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2) a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3) an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related) equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands. PMID:26465329

  2. Male breast cancer incidence and mortality risk in the Japanese atomic bomb survivors – Differences in excess relative and absolute risk from female breast cancer

    DOE PAGES

    Little, Mark P.; McElvenny, Damien M.

    2016-06-10

    There are well-known associations of ionizing radiation with female breast cancer, and emerging evidence also for male breast cancer. In the UK, female breast cancer following occupational radiation exposure is among that set of cancers eligible for state compensation and consideration is currently being given to an extension to include male breast cancer. The objectives here, compare radiation-associated excess relative and absolute risks of male and female breast cancers. Breast cancer incidence and mortality data in the Japanese atomic-bomb survivors were analyzed using relative and absolute risk models via Poisson regression. As a result, we observed significant ( p≤ 0.01)more » dose-related excess risk for male breast cancer incidence and mortality. For incidence and mortality data, there are approximate 15-fold and 5- fold elevations, respectively, of relative risk for male compared with female breast cancer incidence, the former borderline significant (p = 0.050). In contrast, for incidence and mortality data there are approximate 20-fold and 10-fold elevations, respectively, of female absolute risk compared with male, both statistically significant (p < 0.001). There are no indications of differences between the sexes in age/time-since-exposure/age-at-exposure modifications to the relative or absolute excess risk. The probability of causation of male breast cancer following radiation exposure exceeds by at least 5-fold that of many other malignancies. In conclusion, there is evidence of much higher radiation-associated relative risk for male than for female breast cancer, although absolute excess risks for males are much less than for females. However, the small number of male cases and deaths suggests a degree of caution in interpretation of this finding.« less

  3. Male breast cancer incidence and mortality risk in the Japanese atomic bomb survivors – Differences in excess relative and absolute risk from female breast cancer

    SciTech Connect

    Little, Mark P.; McElvenny, Damien M.

    There are well-known associations of ionizing radiation with female breast cancer, and emerging evidence also for male breast cancer. In the UK, female breast cancer following occupational radiation exposure is among that set of cancers eligible for state compensation and consideration is currently being given to an extension to include male breast cancer. The objectives here, compare radiation-associated excess relative and absolute risks of male and female breast cancers. Breast cancer incidence and mortality data in the Japanese atomic-bomb survivors were analyzed using relative and absolute risk models via Poisson regression. As a result, we observed significant ( p≤ 0.01)more » dose-related excess risk for male breast cancer incidence and mortality. For incidence and mortality data, there are approximate 15-fold and 5- fold elevations, respectively, of relative risk for male compared with female breast cancer incidence, the former borderline significant (p = 0.050). In contrast, for incidence and mortality data there are approximate 20-fold and 10-fold elevations, respectively, of female absolute risk compared with male, both statistically significant (p < 0.001). There are no indications of differences between the sexes in age/time-since-exposure/age-at-exposure modifications to the relative or absolute excess risk. The probability of causation of male breast cancer following radiation exposure exceeds by at least 5-fold that of many other malignancies. In conclusion, there is evidence of much higher radiation-associated relative risk for male than for female breast cancer, although absolute excess risks for males are much less than for females. However, the small number of male cases and deaths suggests a degree of caution in interpretation of this finding.« less

  4. Quantitative assessment of current and future risks related rainfall in processing tomato in the Guadiana river basin (SW Spain)

    NASA Astrophysics Data System (ADS)

    Castañeda-Vera, Alba; Garrido, Alberto; Ruiz-Ramos, Margarita; Sánchez-Sánchez, Enrique; Inés Mínguez, M.

    2013-04-01

    An extension of risk coverages in the insurance policies for processing tomato, mainly related to rainfall events, has resulted in an important increase in claims. This suggests that damages related to extreme or ill-timed showers have been underestimated in previous years. An estimation of damages related to rainfall in the last thirty years and the impact of climate change in the risk related to rainfall in processing tomato crops in the Guadiana river basin (SW Spain) were studied through a risk index. First, the risk index was defined with temperature and relative humidity thresholds related to different damage magnitudes. Then, this index was applied to current climate and to future climate scenarios in nine weather stations representative of the studied area to determine the trends in losses related to extreme or inopportune rainfall events. Thresholds of temperature and relative humidity were obtained from cross-checking agricultural insurance records and meteorological data from local weather stations (REDAREX, http://sw-aperos.juntaex.es/redarex). To consider longer time series, the reanalysis database ERA-INTERIM (Dee et al., 2011) was used. Simulated climate was obtained from the European Project ENSEMBLES (http://www.ensembles-eu.org/). Trends in climatic risk were analysed by applying the risk index to three sets of data defining current climate (1980-2010), mid-future climate (2010-2040) and long-term future climate (2040-2070). An algorithm to choose the surrounding cell that minimizes the temperature and precipitation climatic biases and maximizes seasonal correlation when comparing ENSEMBLES regional climate model simulations and observed climate was applied before index calculation. The results show the trends in frequency and magnitude of the risk of suffering damages related to rainfall events. The methodology decreased the uncertainty on risk levels. Results contribute to detect the periods during the growing season with larger risk of damage

  5. Relative risk of probabilistic category learning deficits in patients with schizophrenia and their siblings

    PubMed Central

    Weickert, Thomas W.; Goldberg, Terry E.; Egan, Michael F.; Apud, Jose A.; Meeter, Martijn; Myers, Catherine E.; Gluck, Mark A; Weinberger, Daniel R.

    2010-01-01

    Background While patients with schizophrenia display an overall probabilistic category learning performance deficit, the extent to which this deficit occurs in unaffected siblings of patients with schizophrenia is unknown. There are also discrepant findings regarding probabilistic category learning acquisition rate and performance in patients with schizophrenia. Methods A probabilistic category learning test was administered to 108 patients with schizophrenia, 82 unaffected siblings, and 121 healthy participants. Results Patients with schizophrenia displayed significant differences from their unaffected siblings and healthy participants with respect to probabilistic category learning acquisition rates. Although siblings on the whole failed to differ from healthy participants on strategy and quantitative indices of overall performance and learning acquisition, application of a revised learning criterion enabling classification into good and poor learners based on individual learning curves revealed significant differences between percentages of sibling and healthy poor learners: healthy (13.2%), siblings (34.1%), patients (48.1%), yielding a moderate relative risk. Conclusions These results clarify previous discrepant findings pertaining to probabilistic category learning acquisition rate in schizophrenia and provide the first evidence for the relative risk of probabilistic category learning abnormalities in unaffected siblings of patients with schizophrenia, supporting genetic underpinnings of probabilistic category learning deficits in schizophrenia. These findings also raise questions regarding the contribution of antipsychotic medication to the probabilistic category learning deficit in schizophrenia. The distinction between good and poor learning may be used to inform genetic studies designed to detect schizophrenia risk alleles. PMID:20172502

  6. Risk for excessive alcohol use and drinking-related problems in college student athletes

    PubMed Central

    Yusko, David A.; Buckman, Jennifer F.; White, Helene R.; Pandina, Robert J.

    2008-01-01

    There is compelling evidence that college student athletes engage in frequent episodes of heavy drinking and are prone to negative consequences resulting from such use. This study sought to identify risk and protective factors associated with student-athlete drinking and determine if student-athlete risk factors differed from those of non-athletes. Athletes compared to non-athletes reported more exaggerated perceptions of peer heavy drinking and lower sensation seeking and coping and enhancement motives for drinking, suggesting a risk profile distinct from non-athletes. In the overall sample, higher sensation seeking, overestimation of peer heavy drinking, non-use of protective behaviors while drinking, and higher enhancement and coping drinking motives were associated with greater frequency of heavy episodic drinking and more negative drinking consequences. In athletes compared to non-athletes, sensation seeking was more strongly associated with heavy episodic drinking and drinking to cope was more strongly associated with negative alcohol-related consequences. Overall, the results suggest that already proven brief intervention strategies, with minor adaptations related to the roles of sensation seeking and drinking to cope, may be helpful for student athletes. PMID:18752900

  7. Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon.

    PubMed

    Salameh, Pascale; Chahine, Mirna; Hallit, Souheil; Farah, Rita; Zeidan, Rouba Karen; Asmar, Roland; Hosseiny, Hassan

    2018-04-01

    Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

  8. Mediation by Peer Violence Victimization of Sexual Orientation Disparities in Cancer-Related Tobacco, Alcohol, and Sexual Risk Behaviors: Pooled Youth Risk Behavior Surveys

    PubMed Central

    Corliss, Heather L.; Everett, Bethany G.; Russell, Stephen T.; Buchting, Francisco O.; Birkett, Michelle A

    2014-01-01

    Objectives. We examined the role of adolescent peer violence victimization (PVV) in sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors. Methods. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex sexual attraction, partners, or identity as sexual minority and the remainder as heterosexual. We had 4 indicators of tobacco and alcohol use and 4 of sexual risk and 2 PVV factors: victimization at school and carrying weapons. We stratified associations by gender and race/ethnicity. Results. PVV was related to disparities in cancer-related risk behaviors of substance use and sexual risk, with odds ratios (ORs) of 1.3 (95% confidence interval [CI] = 1.03, 1.6) to 11.3 (95% CI = 6.2, 20.8), and to being a sexual minority, with ORs of 1.4 (95% CI = 1.1, 1.9) to 5.6 (95% CI = 3.5, 8.9). PVV mediated sexual orientation disparities in substance use and sexual risk behaviors. Findings were pronounced for adolescent girls and Asian/Pacific Islanders. Conclusions. Interventions are needed to reduce PVV in schools as a way to reduce sexual orientation disparities in cancer risk across the life span. PMID:24825215

  9. Whole Grain Consumption and Risk of Ischemic Stroke: Results From 2 Prospective Cohort Studies.

    PubMed

    Juan, Juan; Liu, Gang; Willett, Walter C; Hu, Frank B; Rexrode, Kathryn M; Sun, Qi

    2017-12-01

    Higher intake of whole grains may exert cardiometabolic benefits, although findings on stroke risk are inconclusive. The potentially differential effects of individual whole grain foods on ischemic stroke have not been examined. We analyzed whole grain consumption in relation to ischemic stroke among 71 750 women from the Nurses' Health Study and 42 823 men from the Health Professionals Follow-up Study who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline (1984 and 1986, respectively) through 2010 using a Cox proportional hazards model. Validated semiquantitative food frequency questionnaires were used to assess consumption of whole grain intake, including whole grain cold breakfast cereal, dark bread, oatmeal, brown rice, popcorn, bran, and germ. Self-reported incident cases of ischemic stroke were confirmed through medical record review. During 2 820 128 person-years of follow-up in the 2 cohorts, 2458 cases of ischemic stroke were identified and confirmed. Intake of total whole grains was not associated with risk of ischemic stroke after adjustment for covariates: the pooled hazard ratio (95% confidence interval) comparing extreme intake levels was 1.04 (0.91-1.19). However, intake of whole grain cold breakfast cereal and total bran was inversely associated with ischemic stroke after multivariate adjustment: the pooled hazard ratios (95% confidence intervals) were 0.88 (0.80-0.96; P trend =0.008) and 0.89 (0.79-1.00; P trend =0.004), respectively. Other whole grain foods were not associated with a lower risk of ischemic stroke. Although overall consumption of whole grains was not associated with lower risk of ischemic stroke, greater consumption of whole grain cold breakfast cereal and bran was significantly associated with a lower risk of ischemic stroke. More studies are needed to replicate these associations between individual whole grain foods and risk of ischemic stroke among other populations. © 2017 American Heart

  10. Patient Protection and Affordable Care Act; standards related to reinsurance, risk corridors, and risk adjustment. Final rule.

    PubMed

    2012-03-23

    This final rule implements standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. These programs will mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and the Affordable Insurance Exchanges ("Exchanges") are implemented, starting in 2014. The transitional State-based reinsurance program serves to reduce uncertainty by sharing risk in the individual market through making payments for high claims costs for enrollees. The temporary Federally administered risk corridors program serves to protect against uncertainty in rate setting by qualified health plans sharing risk in losses and gains with the Federal government. The permanent State-based risk adjustment program provides payments to health insurance issuers that disproportionately attract high-risk populations (such as individuals with chronic conditions).

  11. Literature review of visual representation of the results of benefit-risk assessments of medicinal products.

    PubMed

    Hallgreen, Christine E; Mt-Isa, Shahrul; Lieftucht, Alfons; Phillips, Lawrence D; Hughes, Diana; Talbot, Susan; Asiimwe, Alex; Downey, Gerald; Genov, Georgy; Hermann, Richard; Noel, Rebecca; Peters, Ruth; Micaleff, Alain; Tzoulaki, Ioanna; Ashby, Deborah

    2016-03-01

    The PROTECT Benefit-Risk group is dedicated to research in methods for continuous benefit-risk monitoring of medicines, including the presentation of the results, with a particular emphasis on graphical methods. A comprehensive review was performed to identify visuals used for medical risk and benefit-risk communication. The identified visual displays were grouped into visual types, and each visual type was appraised based on five criteria: intended audience, intended message, knowledge required to understand the visual, unintentional messages that may be derived from the visual and missing information that may be needed to understand the visual. Sixty-six examples of visual formats were identified from the literature and classified into 14 visual types. We found that there is not one single visual format that is consistently superior to others for the communication of benefit-risk information. In addition, we found that most of the drawbacks found in the visual formats could be considered general to visual communication, although some appear more relevant to specific formats and should be considered when creating visuals for different audiences depending on the exact message to be communicated. We have arrived at recommendations for the use of visual displays for benefit-risk communication. The recommendation refers to the creation of visuals. We outline four criteria to determine audience-visual compatibility and consider these to be a key task in creating any visual. Next we propose specific visual formats of interest, to be explored further for their ability to address nine different types of benefit-risk analysis information. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Cardiometabolic risk clustering in spinal cord injury: results of exploratory factor analysis.

    PubMed

    Libin, Alexander; Tinsley, Emily A; Nash, Mark S; Mendez, Armando J; Burns, Patricia; Elrod, Matt; Hamm, Larry F; Groah, Suzanne L

    2013-01-01

    Evidence suggests an elevated prevalence of cardiometabolic risks among persons with spinal cord injury (SCI); however, the unique clustering of risk factors in this population has not been fully explored. The purpose of this study was to describe unique clustering of cardiometabolic risk factors differentiated by level of injury. One hundred twenty-one subjects (mean 37 ± 12 years; range, 18-73) with chronic C5 to T12 motor complete SCI were studied. Assessments included medical histories, anthropometrics and blood pressure, and fasting serum lipids, glucose, insulin, and hemoglobin A1c (HbA1c). The most common cardiometabolic risk factors were overweight/obesity, high levels of low-density lipoprotein (LDL-C), and low levels of high-density lipoprotein (HDL-C). Risk clustering was found in 76.9% of the population. Exploratory principal component factor analysis using varimax rotation revealed a 3-factor model in persons with paraplegia (65.4% variance) and a 4-factor solution in persons with tetraplegia (73.3% variance). The differences between groups were emphasized by the varied composition of the extracted factors: Lipid Profile A (total cholesterol [TC] and LDL-C), Body Mass-Hypertension Profile (body mass index [BMI], systolic blood pressure [SBP], and fasting insulin [FI]); Glycemic Profile (fasting glucose and HbA1c), and Lipid Profile B (TG and HDL-C). BMI and SBP formed a separate factor only in persons with tetraplegia. Although the majority of the population with SCI has risk clustering, the composition of the risk clusters may be dependent on level of injury, based on a factor analysis group comparison. This is clinically plausible and relevant as tetraplegics tend to be hypo- to normotensive and more sedentary, resulting in lower HDL-C and a greater propensity toward impaired carbohydrate metabolism.

  13. What is worse? A hierarchy of family-related risk factors predicting alcohol use in adolescence.

    PubMed

    Kuntsche, Emmanuel N; Kuendig, Hervé

    2006-01-01

    The aim of the present study was to determine if family structure, perception of excessive drinking in the family, and family bonding hold a graduated importance in predicting adolescent alcohol use and their association with peers who drink excessively. Three nested linear structural models were calculated separately for frequent and excessive drinking, based on a sample of 3,127 eighth and ninth graders in Switzerland (mean age 15.3, SD 0.8) surveyed in spring 2002 in the context of the "Health Behavior in School-Aged Children (HBSC)" study. The results confirm that the perception of excessive drinking in the family is more closely related to both frequent and excessive drinking than family structure, and family bonding is more closely related than drinking perception. Adjusting for both socio-demographic variables and the association with peers who drink excessively only slightly changed the results. To predict an association with the latter, family structure was more important than the perception of drinking, but family bonding remained the predominant predictor. The results stress the graduated importance of family-related risk factors: by listening to their children's worries, by spending their free time with them, and by providing help when needed, parents might have the possibility to actively minimize the risk of frequent and excessive drinking regardless of whether they are frequent excessive drinkers or live without a partner.

  14. ALPK1 genetic regulation and risk in relation to gout.

    PubMed

    Ko, Albert Min-Shan; Tu, Hung-Pin; Liu, Tze-Tze; Chang, Jan-Gowth; Yuo, Chung-Yee; Chiang, Shang-Lun; Chang, Shun-Jen; Liu, Yu-Fan; Ko, Allen Min-Jen; Lee, Chien-Hung; Lee, Chi-Pin; Chang, Chung-Ming; Tsai, Shih-Feng; Ko, Ying-Chin

    2013-04-01

    The present study investigated whether single nucleotide polymorphisms (SNPs) in the alpha-protein kinase 1 (ALPK1) gene are associated with gout in aboriginal and Han Chinese Taiwanese. A total of 1351 aborigines from the community (511 cases and 840 controls) and 511 Han people from hospital (104 cases and 407 controls) were recruited. SNPs in potentially functional regions of the 38 genes within 4q25 were identified and genotypes determined by direct sequencing. Quantitation of blood ALPK1 mRNA expression levels and luciferase assay of gout-associated rs231253 pGL3-SNP constructs cotransfected with hsa-miR-519e were examined. We found that ALPK1 gene was the most determinant of gout. Three SNPs of rs11726117 M861T [C], rs231247 [G] and rs231253 [G] were most associated with gout risk [odd ratios (OR) ≥1.44, P ≤ 3.78 × 10(-6)) in aborigines. A replication set using Han people had risk at rs11726117 and rs231247 (OR ≥1.72, P ≤ 4.08 × 10(-3)). From pooled analysis (Breslow-Day test, P > 0.33) assuming an additive model, each increasing copy of the risk allele of rs11726117 [C], rs231247 [G] and rs231253 [G] showed significantly elevated OR for gout ≥1.42 (P ≥ 1.53 × 10(-6)). Consistently, the composite homozygous of linked 3 SNPs (versus wild-type, OR = 1.83, P = 8.21 × 10(-4)) had strong associations with ALPK1 mRNA expression. Luciferase showed reduced hybridization between hsa-miR-519e and construct carrying gout-associated rs231253 [G] than the wild-type [C] (P = 6.19 × 10(-4)). Our study found that a newly identified ALPK1 gene can effectively interfere with microRNA target recognition and modulates the mRNA expression; and the varying distribution of the implicated SNPs among cases and controls in the two studied populations suggests a significant role in gout susceptibility.

  15. A framework for estimating radiation-related cancer risks in Japan from the 2011 Fukushima nuclear accident.

    PubMed

    Walsh, L; Zhang, W; Shore, R E; Auvinen, A; Laurier, D; Wakeford, R; Jacob, P; Gent, N; Anspaugh, L R; Schüz, J; Kesminiene, A; van Deventer, E; Tritscher, A; del Rosarion Pérez, M

    2014-11-01

    We present here a methodology for health risk assessment adopted by the World Health Organization that provides a framework for estimating risks from the Fukushima nuclear accident after the March 11, 2011 Japanese major earthquake and tsunami. Substantial attention has been given to the possible health risks associated with human exposure to radiation from damaged reactors at the Fukushima Daiichi nuclear power station. Cumulative doses were estimated and applied for each post-accident year of life, based on a reference level of exposure during the first year after the earthquake. A lifetime cumulative dose of twice the first year dose was estimated for the primary radionuclide contaminants ((134)Cs and (137)Cs) and are based on Chernobyl data, relative abundances of cesium isotopes, and cleanup efforts. Risks for particularly radiosensitive cancer sites (leukemia, thyroid and breast cancer), as well as the combined risk for all solid cancers were considered. The male and female cumulative risks of cancer incidence attributed to radiation doses from the accident, for those exposed at various ages, were estimated in terms of the lifetime attributable risk (LAR). Calculations of LAR were based on recent Japanese population statistics for cancer incidence and current radiation risk models from the Life Span Study of Japanese A-bomb survivors. Cancer risks over an initial period of 15 years after first exposure were also considered. LAR results were also given as a percentage of the lifetime baseline risk (i.e., the cancer risk in the absence of radiation exposure from the accident). The LAR results were based on either a reference first year dose (10 mGy) or a reference lifetime dose (20 mGy) so that risk assessment may be applied for relocated and non-relocated members of the public, as well as for adult male emergency workers. The results show that the major contribution to LAR from the reference lifetime dose comes from the first year dose. For a dose of 10 mGy in

  16. BRCA1/2 Test Results Impact Risk Management Attitudes, Intentions and Uptake

    PubMed Central

    O’Neill, Suzanne C.; Valdimarsdottir, Heiddis B.; DeMarco, Tiffani A.; Peshkin, Beth N.; Graves, Kristi D.; Brown, Karen; Hurley, Karen E.; Isaacs, Claudine; Hecker, Sharon; Schwartz, Marc D.

    2011-01-01

    BACKGROUND Women who receive positive or uninformative BRCA1/2 test results face a number of decisions about how to manage their cancer risk. The purpose of this study was to prospectively examine the effect of receiving a positive vs. uninformative BRCA1/2 genetic test result on the perceived pros and cons of risk-reducing mastectomy (RRM) and risk-reducing oophorectomy (RRO) and breast cancer screening. We further examined how perceived pros and cons of surgery predict intention for and uptake of surgery. METHODS 308 women (146 positive, 162 uninformative) were included in RRM and breast cancer screening analyses. 276 women were included in RRO analyses. Participants completed questionnaires at pre-disclosure baseline and 1-, 6-and 12-months post-disclosure. We used linear multiple regression to assess whether test result contributed to change in pros and cons and logistic regression to predict intentions and surgery uptake. RESULTS Receipt of a positive BRCA1/2 test result predicted stronger pros for RRM and RRO (Ps < .001), but not perceived cons of RRM and RRO. Pros of surgery predicted RRM and RRO intentions in carriers and RRO intentions in uninformatives. Cons predicted RRM intentions in carriers. Pros and cons predicted carriers’ RRO uptake in the year after testing (Ps < .001). CONCLUSIONS Receipt of BRCA1/2 mutation test results impacts how carriers see the positive aspects of RRO and RRM and their surgical intentions. Both the positive and negative aspects predict uptake of surgery. PMID:20383578

  17. Maternal Discourse, Attachment-Related Risk, and Current Risk Factors: Associations with Maternal Parenting Behavior during Foster Care Visits

    ERIC Educational Resources Information Center

    Schoppe-Sullivan, Sarah J.; Mangelsdorf, Sarah C.; Haight, Wendy L.; Black, James E.; Sokolowski, Margaret Szewczyk; Giorgio, Grace; Tata, Lakshmi

    2007-01-01

    This study examined relations among mothers' discourse about experiences in their families of origin and with child protective services (CPS), attachment-related and current risk factors, and the quality of mothers' parenting behavior with their young children during supervised visits. Twenty-nine 2- to 6-year-old children in foster care and their…

  18. External cephalic version-related risks: a meta-analysis.

    PubMed

    Grootscholten, Kim; Kok, Marjolein; Oei, S Guid; Mol, Ben W J; van der Post, Joris A

    2008-11-01

    To systematically review the literature on external cephalic version-related complications and to assess if the outcome of a version attempt is related to complications. In March 2007 we searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies reporting on complications from an external cephalic version attempt for singleton breech pregnancies after 36 weeks of pregnancy were selected. We calculated odds ratios (ORs) from studies that reported both on complications as well as on the position of the fetus immediately after the procedure. We found 84 studies, reporting on 12,955 version attempts that reported on external cephalic version-related complications. The pooled complication rate was 6.1% (95% CI 4.7-7.8), 0.24% for serious complications (95% confidence interval [CI] 0.17-0.34) and 0.35% for emergency cesarean deliveries (95% CI 0.26-0.47). Complications were not related to external cephalic version outcome (OR 1.2 (95% CI 0.93-1.7). External cephalic version is a safe procedure. Complications are not related to the fetal position after external cephalic version.

  19. Blood and body fluid exposure risks among health care workers: results from the Duke Health and Safety Surveillance System.

    PubMed

    Dement, John M; Epling, Carol; Ostbye, Truls; Pompeii, Lisa A; Hunt, Debra L

    2004-12-01

    Health care workers (HCWs) are at risk of exposures to human blood and body fluids (BBF). Needlestick injuries and splashes place HCWs at risk for numerous blood-borne infections including human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). Utilizing a new comprehensive occupational health surveillance system, the objective of this research was to better define the BBF exposure ri