An Integrated Approach for Physical and Cyber Security Risk Assessment: The U.S. Army Corps of Engineers Common Risk Model for Dams

DTIC Science & Technology

2016-07-01

Common Risk Model for Dams ( CRM -D) Methodology,” for the Director, Cost Assessment and Program Evaluation, Office of Secretary of Defense and the...for Dams ( CRM -D), developed by the U.S. Army Corps of Engineers (USACE) in collaboration with the Institute for Defense Analyses (IDA) and the U.S...and cyber security risks across a portfolio of dams, and informing decisions on how to mitigate those risks. The CRM -D can effectively quantify the

Proposals for enhanced health risk assessment and stratification in an integrated care scenario

PubMed Central

Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

2016-01-01

Objectives Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. Settings The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Participants Responsible teams for regional data management in the five ACT regions. Primary and secondary outcome measures We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. Results There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. Conclusions The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require prospective evaluation. PMID:27084274

Systematic Integration of Brain eQTL and GWAS Identifies ZNF323 as a Novel Schizophrenia Risk Gene and Suggests Recent Positive Selection Based on Compensatory Advantage on Pulmonary Function.

PubMed

Luo, Xiong-Jian; Mattheisen, Manuel; Li, Ming; Huang, Liang; Rietschel, Marcella; Børglum, Anders D; Als, Thomas D; van den Oord, Edwin J; Aberg, Karolina A; Mors, Ole; Mortensen, Preben Bo; Luo, Zhenwu; Degenhardt, Franziska; Cichon, Sven; Schulze, Thomas G; Nöthen, Markus M; Su, Bing; Zhao, Zhongming; Gan, Lin; Yao, Yong-Gang

2015-11-01

Genome-wide association studies have identified multiple risk variants and loci that show robust association with schizophrenia. Nevertheless, it remains unclear how these variants confer risk to schizophrenia. In addition, the driving force that maintains the schizophrenia risk variants in human gene pool is poorly understood. To investigate whether expression-associated genetic variants contribute to schizophrenia susceptibility, we systematically integrated brain expression quantitative trait loci and genome-wide association data of schizophrenia using Sherlock, a Bayesian statistical framework. Our analyses identified ZNF323 as a schizophrenia risk gene (P = 2.22×10(-6)). Subsequent analyses confirmed the association of the ZNF323 and its expression-associated single nucleotide polymorphism rs1150711 in independent samples (gene-expression: P = 1.40×10(-6); single-marker meta-analysis in the combined discovery and replication sample comprising 44123 individuals: P = 6.85×10(-10)). We found that the ZNF323 was significantly downregulated in hippocampus and frontal cortex of schizophrenia patients (P = .0038 and P = .0233, respectively). Evidence for pleiotropic effects was detected (association of rs1150711 with lung function and gene expression of ZNF323 in lung: P = 6.62×10(-5) and P = 9.00×10(-5), respectively) with the risk allele (T allele) for schizophrenia acting as protective allele for lung function. Subsequent population genetics analyses suggest that the risk allele (T) of rs1150711 might have undergone recent positive selection in human population. Our findings suggest that the ZNF323 is a schizophrenia susceptibility gene whose expression may influence schizophrenia risk. Our study also illustrates a possible mechanism for maintaining schizophrenia risk variants in the human gene pool. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Friends With Health Benefits: The Long-Term Benefits of Early Peer Social Integration for Blood Pressure and Obesity in Midlife.

PubMed

Cundiff, Jenny M; Matthews, Karen A

2018-05-01

In adults, greater social integration is associated with reduced risk of cardiovascular disease, including hypertension. Social integration earlier in life may be similarly associated with cardiovascular risk. Using a longitudinal sample of 267 Black and White men, we examined whether greater social integration with peers during childhood and adolescence, assessed by parent report, prospectively predicts lower blood pressure and body mass index two decades later in adulthood and whether these effects differ by race, given well-documented racial disparities in hypertension. Boys who were reported by their parents to be more socially integrated with peers evidenced lower blood pressure and body mass index in adulthood, and this effect was not accounted for by body mass index in childhood, childhood socioeconomic status, childhood hostility, childhood physical health, extraversion measured in adolescence, or concurrent adult self-reports of social integration. Results did not differ by race, but analyses were not powered to detect interactions of small effect size.

A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

PubMed Central

Juhnke, Christin; Bethge, Susanne

2016-01-01

Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

Does integration matter? A holistic model for building community resilience in Pakistan.

PubMed

Kanta Kafle, Shesh

2017-01-01

This paper analyses an integrated communitybased risk reduction model adopted by the Pakistan Red Crescent. The paper analyses the model's constructs and definitions, and provides a conceptual framework and a set of practical recommendations for building community resilience. The study uses the process of outcome-based resilience index to assess the effectiveness of the approach. The results indicate that the integrated programming approach is an effective way to build community resilience as it offers a number of tangible and longlasting benefits, including effective and efficient service delivery, local ownership, sustainability of results, and improved local resilience with respect to the shock and stress associated with disaster. The paper also outlines a set of recommendations for the effective and efficient use of the model for building community resilience in Pakistan.

Integrating fire behavior models and geospatial analysis for wildland fire risk assessment and fuel management planning

Treesearch

Alan A. Ager; Nicole M. Vaillant; Mark A. Finney

2011-01-01

Wildland fire risk assessment and fuel management planning on federal lands in the US are complex problems that require state-of-the-art fire behavior modeling and intensive geospatial analyses. Fuel management is a particularly complicated process where the benefits and potential impacts of fuel treatments must be demonstrated in the context of land management goals...

Epidemiologic Analyses of Risk Factors for Bone Loss and Recovery Related to Long-Duration Space Flight

NASA Technical Reports Server (NTRS)

Sibonga, Jean; Amin, Shreyasee

2010-01-01

AIM 1: To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk. compare data from crew members ("observed") with what would be "expected" from Rochester Bone Health Study. AIM 2: To provide a summary of current evidence available on potential risk factors for bone loss, recovery & fracture following long-duration space flight. integrative review of all data pre, in-, and post-flight across disciplines (cardiovascular, nutrition, muscle, etc.) and their relation to bone loss and recovery

Integrative Analyses of De Novo Mutations Provide Deeper Biological Insights into Autism Spectrum Disorder.

PubMed

Takata, Atsushi; Miyake, Noriko; Tsurusaki, Yoshinori; Fukai, Ryoko; Miyatake, Satoko; Koshimizu, Eriko; Kushima, Itaru; Okada, Takashi; Morikawa, Mako; Uno, Yota; Ishizuka, Kanako; Nakamura, Kazuhiko; Tsujii, Masatsugu; Yoshikawa, Takeo; Toyota, Tomoko; Okamoto, Nobuhiko; Hiraki, Yoko; Hashimoto, Ryota; Yasuda, Yuka; Saitoh, Shinji; Ohashi, Kei; Sakai, Yasunari; Ohga, Shouichi; Hara, Toshiro; Kato, Mitsuhiro; Nakamura, Kazuyuki; Ito, Aiko; Seiwa, Chizuru; Shirahata, Emi; Osaka, Hitoshi; Matsumoto, Ayumi; Takeshita, Saoko; Tohyama, Jun; Saikusa, Tomoko; Matsuishi, Toyojiro; Nakamura, Takumi; Tsuboi, Takashi; Kato, Tadafumi; Suzuki, Toshifumi; Saitsu, Hirotomo; Nakashima, Mitsuko; Mizuguchi, Takeshi; Tanaka, Fumiaki; Mori, Norio; Ozaki, Norio; Matsumoto, Naomichi

2018-01-16

Recent studies have established important roles of de novo mutations (DNMs) in autism spectrum disorders (ASDs). Here, we analyze DNMs in 262 ASD probands of Japanese origin and confirm the "de novo paradigm" of ASDs across ethnicities. Based on this consistency, we combine the lists of damaging DNMs in our and published ASD cohorts (total number of trios, 4,244) and perform integrative bioinformatics analyses. Besides replicating the findings of previous studies, our analyses highlight ATP-binding genes and fetal cerebellar/striatal circuits. Analysis of individual genes identified 61 genes enriched for damaging DNMs, including ten genes for which our dataset now contributes to statistical significance. Screening of compounds altering the expression of genes hit by damaging DNMs reveals a global downregulating effect of valproic acid, a known risk factor for ASDs, whereas cardiac glycosides upregulate these genes. Collectively, our integrative approach provides deeper biological and potential medical insights into ASDs. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Estimation of integrated public risks for nonseismic external events affecting the Savannah River Site

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

Durant, W.S.; robinette, R.J.; Kirchner, J.R.

1994-03-01

In essence, this study was envisioned as the ``combination`` of existing accident dose and risk calculations from safety analyses of individual facilities. However, because of the extended time period over which the safety analyses were prepared, calculational assumptions and methodologies differed between the analyses. The scope of this study therefore included the standardization of assumptions and calculations as necessary to insure that the analytical logic was consistent for all the facilities. Each of the nonseismic external events considered in the analyses are addressed in individual sections in this report. In Section 2, extreme straight-line winds are examined. Section 3 addressesmore » tornadoes, and Section 4 addresses other external events [floods, other extreme weather events (lightning, hail, and extremes in temperature or precipitation), vehicle impact, accidents involving adjacent facilities, aircraft impact, and meteorite impact]. Section 5 provides a summary of the general conclusions of the report.« less

Safety analytics for integrating crash frequency and real-time risk modeling for expressways.

PubMed

Wang, Ling; Abdel-Aty, Mohamed; Lee, Jaeyoung

2017-07-01

To find crash contributing factors, there have been numerous crash frequency and real-time safety studies, but such studies have been conducted independently. Until this point, no researcher has simultaneously analyzed crash frequency and real-time crash risk to test whether integrating them could better explain crash occurrence. Therefore, this study aims at integrating crash frequency and real-time safety analyses using expressway data. A Bayesian integrated model and a non-integrated model were built: the integrated model linked the crash frequency and the real-time models by adding the logarithm of the estimated expected crash frequency in the real-time model; the non-integrated model independently estimated the crash frequency and the real-time crash risk. The results showed that the integrated model outperformed the non-integrated model, as it provided much better model results for both the crash frequency and the real-time models. This result indicated that the added component, the logarithm of the expected crash frequency, successfully linked and provided useful information to the two models. This study uncovered few variables that are not typically included in the crash frequency analysis. For example, the average daily standard deviation of speed, which was aggregated based on speed at 1-min intervals, had a positive effect on crash frequency. In conclusion, this study suggested a methodology to improve the crash frequency and real-time models by integrating them, and it might inspire future researchers to understand crash mechanisms better. Copyright © 2017 Elsevier Ltd. All rights reserved.

A combined approach to investigate the toxicity of an industrial landfill's leachate: Chemical analyses, risk assessment and in vitro assays

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

Baderna, D., E-mail: diego.baderna@marionegri.it; Maggioni, S.; Boriani, E.

2011-05-15

Solid wastes constitute an important and emerging problem. Landfills are still one of the most common ways to manage waste disposal. The risk assessment of pollutants from landfills is becoming a major environmental issue in Europe, due to the large number of sites and to the importance of groundwater protection. Furthermore, there is lack of knowledge for the environmental, ecotoxicological and toxicological characteristics of most contaminants contained into landfill leacheates. Understanding leachate composition and creating an integrated strategy for risk assessment are currently needed to correctly face the landfill issues and to make projections on the long-term impacts of amore » landfill, with particular attention to the estimation of possible adverse effects on human health and ecosystem. In the present study, we propose an integrated strategy to evaluate the toxicity of the leachate using chemical analyses, risk assessment guidelines and in vitro assays using the hepatoma HepG2 cells as a model. The approach was applied on a real case study: an industrial waste landfill in northern Italy for which data on the presence of leachate contaminants are available from the last 11 years. Results from our ecological risk models suggest important toxic effects on freshwater fish and small rodents, mainly due to ammonia and inorganic constituents. Our results from in vitro data show an inhibition of cell proliferation by leachate at low doses and cytotoxic effect at high doses after 48 h of exposure. - Research highlights: {yields} We study the toxicity of leachate from a non-hazardous industrial waste landfill. {yields} We perform chemical analyses, risk assessments and in vitro assays on HepG2 cells. {yields} Risk models suggest toxic effects due to ammonia and inorganic constituents. {yields} In vitro assays show that leachate inhibits cell proliferation at low doses. {yields} Leachate can induce cytotoxic effects on HepG2 cells at high doses.« less

Integrated Cryptosporidium Assay To Determine Oocyst Density, Infectivity, and Genotype for Risk Assessment of Source and Reuse Water

PubMed Central

King, Brendon; Fanok, Stella; Phillips, Renae; Swaffer, Brooke

2015-01-01

Cryptosporidium continues to be problematic for the water industry, with risk assessments often indicating that treatment barriers may fail under extreme conditions. However, risk analyses have historically used oocyst densities and not considered either oocyst infectivity or species/genotype, which can result in an overestimation of risk if the oocysts are not human infective. We describe an integrated assay for determining oocyst density, infectivity, and genotype from a single-sample concentrate, an important advance that overcomes the need for processing multiple-grab samples or splitting sample concentrates for separate analyses. The assay incorporates an oocyst recovery control and is compatible with standard primary concentration techniques. Oocysts were purified from primary concentrates using immunomagnetic separation prior to processing by an infectivity assay. Plate-based cell culture was used to detect infectious foci, with a monolayer washing protocol developed to allow recovery and enumeration of oocysts. A simple DNA extraction protocol was developed to allow typing of any wells containing infectious Cryptosporidium. Water samples from a variety of source water and wastewater matrices, including a semirural catchment, wastewater, an aquifer recharge site, and storm water, were analyzed using the assay. Results demonstrate that the assay can reliably determine oocyst densities, infectivity, and genotype from single-grab samples for a variety of water matrices and emphasize the varying nature of Cryptosporidium risk extant throughout source waters and wastewaters. This assay should therefore enable a more comprehensive understanding of Cryptosporidium risk for different water sources, assisting in the selection of appropriate risk mitigation measures. PMID:25769833

Integrated cryptosporidium assay to determine oocyst density, infectivity, and genotype for risk assessment of source and reuse water.

PubMed

King, Brendon; Fanok, Stella; Phillips, Renae; Swaffer, Brooke; Monis, Paul

2015-05-15

Cryptosporidium continues to be problematic for the water industry, with risk assessments often indicating that treatment barriers may fail under extreme conditions. However, risk analyses have historically used oocyst densities and not considered either oocyst infectivity or species/genotype, which can result in an overestimation of risk if the oocysts are not human infective. We describe an integrated assay for determining oocyst density, infectivity, and genotype from a single-sample concentrate, an important advance that overcomes the need for processing multiple-grab samples or splitting sample concentrates for separate analyses. The assay incorporates an oocyst recovery control and is compatible with standard primary concentration techniques. Oocysts were purified from primary concentrates using immunomagnetic separation prior to processing by an infectivity assay. Plate-based cell culture was used to detect infectious foci, with a monolayer washing protocol developed to allow recovery and enumeration of oocysts. A simple DNA extraction protocol was developed to allow typing of any wells containing infectious Cryptosporidium. Water samples from a variety of source water and wastewater matrices, including a semirural catchment, wastewater, an aquifer recharge site, and storm water, were analyzed using the assay. Results demonstrate that the assay can reliably determine oocyst densities, infectivity, and genotype from single-grab samples for a variety of water matrices and emphasize the varying nature of Cryptosporidium risk extant throughout source waters and wastewaters. This assay should therefore enable a more comprehensive understanding of Cryptosporidium risk for different water sources, assisting in the selection of appropriate risk mitigation measures. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Technical guide for applications of gene expression profiling in human health risk assessment of environmental chemicals.

PubMed

Bourdon-Lacombe, Julie A; Moffat, Ivy D; Deveau, Michelle; Husain, Mainul; Auerbach, Scott; Krewski, Daniel; Thomas, Russell S; Bushel, Pierre R; Williams, Andrew; Yauk, Carole L

2015-07-01

Toxicogenomics promises to be an important part of future human health risk assessment of environmental chemicals. The application of gene expression profiles (e.g., for hazard identification, chemical prioritization, chemical grouping, mode of action discovery, and quantitative analysis of response) is growing in the literature, but their use in formal risk assessment by regulatory agencies is relatively infrequent. Although additional validations for specific applications are required, gene expression data can be of immediate use for increasing confidence in chemical evaluations. We believe that a primary reason for the current lack of integration is the limited practical guidance available for risk assessment specialists with limited experience in genomics. The present manuscript provides basic information on gene expression profiling, along with guidance on evaluating the quality of genomic experiments and data, and interpretation of results presented in the form of heat maps, pathway analyses and other common approaches. Moreover, potential ways to integrate information from gene expression experiments into current risk assessment are presented using published studies as examples. The primary objective of this work is to facilitate integration of gene expression data into human health risk assessments of environmental chemicals. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

A New View of Radiation-Induced Cancer: Integrating Short- and Long-Term Processes. Part II: Second Cancer Risk Estimation

NASA Technical Reports Server (NTRS)

Shuryak, Igor; Brenner, David J.; Hahnfeldt, Philip; Hlatky, Lynn; Sachs, Rainer K.

2009-01-01

As the number of cancer survivors grows, prediction of radiotherapy-induced second cancer risks becomes increasingly important. Because the latency period for solid tumors is long, the risks of recently introduced radiotherapy protocols are not yet directly measurable. In the accompanying article, we presented a new biologically based mathematical model, which, in principle, can estimate second cancer risks for any protocol. The novelty of the model is that it integrates, into a single formalism, mechanistic analyses of pre-malignant cell dynamics on two different time scales: short-term during radiotherapy and recovery; long-term during the entire life span. Here, we apply the model to nine solid cancer types (stomach, lung, colon, rectal, pancreatic, bladder, breast, central nervous system, and thyroid) using data on radiotherapy-induced second malignancies, on Japanese atomic bomb survivors, and on background US cancer incidence. Potentially, the model can be incorporated into radiotherapy treatment planning algorithms, adding second cancer risk as an optimization criterion.

A new view of radiation-induced cancer: integrating short- and long-term processes. Part II: second cancer risk estimation.

PubMed

Shuryak, Igor; Hahnfeldt, Philip; Hlatky, Lynn; Sachs, Rainer K; Brenner, David J

2009-08-01

As the number of cancer survivors grows, prediction of radiotherapy-induced second cancer risks becomes increasingly important. Because the latency period for solid tumors is long, the risks of recently introduced radiotherapy protocols are not yet directly measurable. In the accompanying article, we presented a new biologically based mathematical model, which, in principle, can estimate second cancer risks for any protocol. The novelty of the model is that it integrates, into a single formalism, mechanistic analyses of pre-malignant cell dynamics on two different time scales: short-term during radiotherapy and recovery; long-term during the entire life span. Here, we apply the model to nine solid cancer types (stomach, lung, colon, rectal, pancreatic, bladder, breast, central nervous system, and thyroid) using data on radiotherapy-induced second malignancies, on Japanese atomic bomb survivors, and on background US cancer incidence. Potentially, the model can be incorporated into radiotherapy treatment planning algorithms, adding second cancer risk as an optimization criterion.

Proposals for enhanced health risk assessment and stratification in an integrated care scenario.

PubMed

Dueñas-Espín, Ivan; Vela, Emili; Pauws, Steffen; Bescos, Cristina; Cano, Isaac; Cleries, Montserrat; Contel, Joan Carles; de Manuel Keenoy, Esteban; Garcia-Aymerich, Judith; Gomez-Cabrero, David; Kaye, Rachelle; Lahr, Maarten M H; Lluch-Ariet, Magí; Moharra, Montserrat; Monterde, David; Mora, Joana; Nalin, Marco; Pavlickova, Andrea; Piera, Jordi; Ponce, Sara; Santaeugenia, Sebastià; Schonenberg, Helen; Störk, Stefan; Tegner, Jesper; Velickovski, Filip; Westerteicher, Christoph; Roca, Josep

2016-04-15

Population-based health risk assessment and stratification are considered highly relevant for large-scale implementation of integrated care by facilitating services design and case identification. The principal objective of the study was to analyse five health-risk assessment strategies and health indicators used in the five regions participating in the Advancing Care Coordination and Telehealth Deployment (ACT) programme (http://www.act-programme.eu). The second purpose was to elaborate on strategies toward enhanced health risk predictive modelling in the clinical scenario. The five ACT regions: Scotland (UK), Basque Country (ES), Catalonia (ES), Lombardy (I) and Groningen (NL). Responsible teams for regional data management in the five ACT regions. We characterised and compared risk assessment strategies among ACT regions by analysing operational health risk predictive modelling tools for population-based stratification, as well as available health indicators at regional level. The analysis of the risk assessment tool deployed in Catalonia in 2015 (GMAs, Adjusted Morbidity Groups) was used as a basis to propose how population-based analytics could contribute to clinical risk prediction. There was consensus on the need for a population health approach to generate health risk predictive modelling. However, this strategy was fully in place only in two ACT regions: Basque Country and Catalonia. We found marked differences among regions in health risk predictive modelling tools and health indicators, and identified key factors constraining their comparability. The research proposes means to overcome current limitations and the use of population-based health risk prediction for enhanced clinical risk assessment. The results indicate the need for further efforts to improve both comparability and flexibility of current population-based health risk predictive modelling approaches. Applicability and impact of the proposals for enhanced clinical risk assessment require prospective evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Integrated frameworks for assessing and managing health risks in the context of managed aquifer recharge with river water.

PubMed

Assmuth, Timo; Simola, Antti; Pitkänen, Tarja; Lyytimäki, Jari; Huttula, Timo

2016-01-01

Integrated assessment and management of water resources for the supply of potable water is increasingly important in light of projected water scarcity in many parts of the world. This article develops frameworks for regional-level waterborne human health risk assessment of chemical and microbiological contamination to aid water management, incorporating economic aspects of health risks. Managed aquifer recharge with surface water from a river in Southern Finland is used as an illustrative case. With a starting point in watershed governance, stakeholder concerns, and value-at-risk concepts, we merge common methods for integrative health risk analysis of contaminants to describe risks and impacts dynamically and broadly. This involves structuring analyses along the risk chain: sources-releases-environmental transport and fate-exposures-health effects-socio-economic impacts-management responses. Risks attributed to contaminants are embedded in other risks, such as contaminants from other sources, and related to benefits from improved water quality. A set of models along this risk chain in the case is presented. Fundamental issues in the assessment are identified, including 1) framing of risks, scenarios, and choices; 2) interaction of models and empirical information; 3) time dimension; 4) distributions of risks and benefits; and 5) uncertainties about risks and controls. We find that all these combine objective and subjective aspects, and involve value judgments and policy choices. We conclude with proposals for overcoming conceptual and functional divides and lock-ins to improve modeling, assessment, and management of complex water supply schemes, especially by reflective solution-oriented interdisciplinary and multi-actor deliberation. © 2015 SETAC.

Identification and Evaluation of Integration and Cross Cutting Issues Across HRP Risks

NASA Technical Reports Server (NTRS)

Steinberg, S. L.; Shelhamer, Mark

2015-01-01

The HRP Integrated Research Plan contains the research plans for the 32 risks requiring research to characterize and mitigate. These risks to human health and performance in spaceflight are identified by evidence and each one focuses on a single aspect of human physiology or performance. They are further categorized by aspects of the spaceflight environment, such as altered gravity or space radiation, that that play a major role in their likelihood and consequence. From its inception the "integrate" in the Research Plan has denoted the integrated nature of risks to human health and performance, the connectedness of physiological systems within the human body regardless of the spaceflight environment, and the integrated response of the human body to the spaceflight environment. Common characteristics of the spaceflight environment include altered gravity, atmospheres and light/dark cycles, space radiation, isolation, noise, and periods of high or low workload. Long term exposure to this unique environment produces a suite of physiological effects such as stress; vision, neurocognitive and anthropometric changes; circadian misalignment; fluid shifts, deconditioning; immune dysregulation; and altered nutritional requirements. Matrix diagraming was used to systematically identify, analyze and rate the many-to-many relationships between environmental characteristics and the suite of physiological effects. It was also to identify patterns in the relationships of common physiological effects to each other. Analyses of patterns or relationships in these diagrams help to identify issues that cut across multiple risks. Cross cutting issues benefit from a multidisciplinary approach that synthesizes concepts or data from two or more disciplines to identify and characterize risk factors or develop countermeasures relevant to multiple risks. They also help to illuminate possible problem areas that may arise when a countermeasure impacts risks other than those which it was developed to mitigate, or identify groupings of physiological changes that are likely to occur that may impact the overall risk posture.

Rocket engine system reliability analyses using probabilistic and fuzzy logic techniques

NASA Technical Reports Server (NTRS)

Hardy, Terry L.; Rapp, Douglas C.

1994-01-01

The reliability of rocket engine systems was analyzed by using probabilistic and fuzzy logic techniques. Fault trees were developed for integrated modular engine (IME) and discrete engine systems, and then were used with the two techniques to quantify reliability. The IRRAS (Integrated Reliability and Risk Analysis System) computer code, developed for the U.S. Nuclear Regulatory Commission, was used for the probabilistic analyses, and FUZZYFTA (Fuzzy Fault Tree Analysis), a code developed at NASA Lewis Research Center, was used for the fuzzy logic analyses. Although both techniques provided estimates of the reliability of the IME and discrete systems, probabilistic techniques emphasized uncertainty resulting from randomness in the system whereas fuzzy logic techniques emphasized uncertainty resulting from vagueness in the system. Because uncertainty can have both random and vague components, both techniques were found to be useful tools in the analysis of rocket engine system reliability.

UNCERTAINTY AND SENSITIVITY ANALYSES FOR INTEGRATED HUMAN HEALTH AND ECOLOGICAL RISK ASSESSMENT OF HAZARDOUS WASTE DISPOSAL

EPA Science Inventory

While there is a high potential for exposure of humans and ecosystems to chemicals released from hazardous waste sites, the degree to which this potential is realized is often uncertain. Conceptually divided among parameter, model, and modeler uncertainties imparted during simula...

GLOBAL ASSESSMENT OF WASTEWATER IRRIGATION: UNDERSTANDING HEALTH RISKS AND CONTRIBUTIONS TO FOOD SECURITY USING AN ENVIRONMENTAL SYSTEMS APPROACH

EPA Science Inventory

This research will quantify the extent of de facto reuse of untreated wastewater at the global scale. Through the integration of multiple existing spatial data sources, this project will produce rigorous analyses assessing the relationship between wastewater irrigation, hea...

A refined ecological risk assessment for California red-legged frog, Delta smelt, and California tiger salamander exposed to malathion.

PubMed

Clemow, Yvonne H; Manning, Gillian E; Breton, Roger L; Winchell, Michael F; Padilla, Lauren; Rodney, Sara I; Hanzas, John P; Estes, Tammara L; Budreski, Katherine; Toth, Brent N; Hill, Katie L; Priest, Colleen D; Teed, R Scott; Knopper, Loren D; Moore, Dwayne Rj; Stone, Christopher T; Whatling, Paul

2018-03-01

The California red-legged frog (CRLF), Delta smelt (DS), and California tiger salamander (CTS) are 3 species listed under the United States Federal Endangered Species Act (ESA), all of which inhabit aquatic ecosystems in California. The US Environmental Protection Agency (USEPA) has conducted deterministic screening-level risk assessments for these species potentially exposed to malathion, an organophosphorus insecticide and acaricide. Results from our screening-level analyses identified potential risk of direct effects to DS as well as indirect effects to all 3 species via reduction in prey. Accordingly, for those species and scenarios in which risk was identified at the screening level, we conducted a refined probabilistic risk assessment for CRLF, DS, and CTS. The refined ecological risk assessment (ERA) was conducted using best available data and approaches, as recommended by the 2013 National Research Council (NRC) report "Assessing Risks to Endangered and Threatened Species from Pesticides." Refined aquatic exposure models including the Pesticide Root Zone Model (PRZM), the Vegetative Filter Strip Modeling System (VFSMOD), the Variable Volume Water Model (VVWM), the Exposure Analysis Modeling System (EXAMS), and the Soil and Water Assessment Tool (SWAT) were used to generate estimated exposure concentrations (EECs) for malathion based on worst-case scenarios in California. Refined effects analyses involved developing concentration-response curves for fish and species sensitivity distributions (SSDs) for fish and aquatic invertebrates. Quantitative risk curves, field and mesocosm studies, surface-water monitoring data, and incident reports were considered in a weight-of-evidence approach. Currently, labeled uses of malathion are not expected to result in direct effects to CRLF, DS or CTS, or indirect effects due to effects on fish and invertebrate prey. Integr Environ Assess Manag 2018;14:224-239. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Risk Acceptance Personality Paradigm: How We View What We Don't Know We Don't Know

NASA Technical Reports Server (NTRS)

Massie, Michael J.; Morris, A. Terry

2011-01-01

The purpose of integrated hazard analyses, probabilistic risk assessments, failure modes and effects analyses, fault trees and many other similar tools is to give managers of a program some idea of the risks associated with their program. All risk tools establish a set of undesired events and then try to evaluate the risk to the program by assessing the severity of the undesired event and the likelihood of that event occurring. Some tools provide qualitative results, some provide quantitative results and some do both. However, in the end the program manager and his/her team must decide which risks are acceptable and which are not. Even with a wide array of analysis tools available, risk acceptance is often a controversial and difficult decision making process. And yet, today's space exploration programs are moving toward more risk based design approaches. Thus, risk identification and good risk assessment is becoming even more vital to the engineering development process. This paper explores how known and unknown information influences risk-based decisions by looking at how the various parts of our personalities are affected by what they know and what they don't know. This paper then offers some criteria for consideration when making risk-based decisions.

Selection of first-line therapy in multiple sclerosis using risk-benefit decision analysis.

PubMed

Bargiela, David; Bianchi, Matthew T; Westover, M Brandon; Chibnik, Lori B; Healy, Brian C; De Jager, Philip L; Xia, Zongqi

2017-02-14

To integrate long-term measures of disease-modifying drug efficacy and risk to guide selection of first-line treatment of multiple sclerosis. We created a Markov decision model to evaluate disability worsening and progressive multifocal leukoencephalopathy (PML) risk in patients receiving natalizumab (NTZ), fingolimod (FGL), or glatiramer acetate (GA) over 30 years. Leveraging publicly available data, we integrated treatment utility, disability worsening, and risk of PML into quality-adjusted life-years (QALYs). We performed sensitivity analyses varying PML risk, mortality and morbidity, and relative risk of disease worsening across clinically relevant ranges. Over the entire reported range of NTZ-associated PML risk, NTZ as first-line therapy is predicted to provide a greater net benefit (15.06 QALYs) than FGL (13.99 QALYs) or GA (12.71 QALYs) treatment over 30 years, after accounting for loss of QALYs due to PML or death (resulting from all causes). NTZ treatment is associated with delayed worsening to an Expanded Disability Status Scale score ≥6.0 vs FGL or GA (22.7, 17.0, and 12.4 years, respectively). Compared to untreated patients, NTZ-treated patients have a greater relative risk of death in the early years of treatment that varies according to PML risk profile. NTZ as a first-line treatment is associated with the highest net benefit across full ranges of PML risk, mortality, and morbidity compared to FGL or GA. Integrated modeling of long-term treatment risks and benefits informs stratified clinical decision-making and can support patient counseling on selection of first-line treatment options. © 2017 American Academy of Neurology.

[Sport as a profession: medical and social aspects].

PubMed

Izmerov, N F

2011-01-01

The author analyses possible use of methods and achievements of industrial medicine in solving problems of acme in sports. The article covers theoretic, methodologic and practical basis for possible integration of industrial medicine and sports medicine. Mechanisms of such interdisciplinary integration include current legal basis, scientific research (mostly, concept of occupational risk, norm and pathology concept, doctrine of preventive medicine, etc), practical experience accumulated in this country and abroad. Some aspects of public health preservation in contemporary Russia are also tackled.

Integrated Research on the Development of Global Climate Risk Management Strategies - Framework and Initial Results of the Research Project ICA-RUS

NASA Astrophysics Data System (ADS)

Emori, Seita; Takahashi, Kiyoshi; Yamagata, Yoshiki; Oki, Taikan; Mori, Shunsuke; Fujigaki, Yuko

2013-04-01

With the aim of proposing strategies of global climate risk management, we have launched a five-year research project called ICA-RUS (Integrated Climate Assessment - Risks, Uncertainties and Society). In this project with the phrase "risk management" in its title, we aspire for a comprehensive assessment of climate change risks, explicit consideration of uncertainties, utilization of best available information, and consideration of every possible conditions and options. We also regard the problem as one of decision-making at the human level, which involves social value judgments and adapts to future changes in circumstances. The ICA-RUS project consists of the following five themes: 1) Synthesis of global climate risk management strategies, 2) Optimization of land, water and ecosystem uses for climate risk management, 3) Identification and analysis of critical climate risks, 4) Evaluation of climate risk management options under technological, social and economic uncertainties and 5) Interactions between scientific and social rationalities in climate risk management (see also: http://www.nies.go.jp/ica-rus/en/). For the integration of quantitative knowledge of climate change risks and responses, we apply a tool named AIM/Impact [Policy], which consists of an energy-economic model, a simplified climate model and impact projection modules. At the same time, in order to make use of qualitative knowledge as well, we hold monthly project meetings for the discussion of risk management strategies and publish annual reports based on the quantitative and qualitative information. To enhance the comprehensiveness of the analyses, we maintain an inventory of risks and risk management options. The inventory is revised iteratively through interactive meetings with stakeholders such as policymakers, government officials and industrial representatives.

Sisters in hereditary breast and ovarian cancer families: communal coping, social integration, and psychological well-being.

PubMed

Koehly, Laura M; Peters, June A; Kuhn, Natalia; Hoskins, Lindsey; Letocha, Anne; Kenen, Regina; Loud, Jennifer; Greene, Mark H

2008-08-01

We investigated the association between psychological distress and indices of social integration and communal coping among sisters from hereditary breast and ovarian cancer (HBOC) families. Sixty-five sisters from 31 HBOC families completed the Brief Symptom Inventory-18 and the Colored Eco-Genetic Relationship Map, which identified members of participants' social support networks. Hierarchical linear models were used for all analyses to account for the clustering of sisters within families. Intra-family correlation coefficients suggested that sisters shared perceptions of breast cancer risk and worry, but not ovarian cancer risk and worry. Further, sisters demonstrated shared levels of anxiety and somatization, but not depressive symptoms. Communal coping indices quantifying shared support resources were negatively related to anxiety and somatization. The number of persons with whom cancer risk information was shared exhibited a positive trend with somatization. Social integration, as measured by the size of participants' emotional support network, was negatively associated with anxiety. Lower depression scores were observed among participants with more persons playing multiple support roles and fewer persons providing tangible assistance. Understanding how support relationships impact well-being among persons adjusting to HBOC risk, and the particular role of family in that process, will facilitate developing appropriate management approaches to help cancer-prone families adjust to their cancer risk.

Space Shuttle Propulsion Systems Plume Modeling and Simulation for the Lift-Off Computational Fluid Dynamics Model

NASA Technical Reports Server (NTRS)

Strutzenberg, L. L.; Dougherty, N. S.; Liever, P. A.; West, J. S.; Smith, S. D.

2007-01-01

This paper details advances being made in the development of Reynolds-Averaged Navier-Stokes numerical simulation tools, models, and methods for the integrated Space Shuttle Vehicle at launch. The conceptual model and modeling approach described includes the development of multiple computational models to appropriately analyze the potential debris transport for critical debris sources at Lift-Off. The conceptual model described herein involves the integration of propulsion analysis for the nozzle/plume flow with the overall 3D vehicle flowfield at Lift-Off. Debris Transport Analyses are being performed using the Shuttle Lift-Off models to assess the risk to the vehicle from Lift-Off debris and appropriately prioritized mitigation of potential debris sources to continue to reduce vehicle risk. These integrated simulations are being used to evaluate plume-induced debris environments where the multi-plume interactions with the launch facility can potentially accelerate debris particles toward the vehicle.

Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men.

PubMed

Jeffries, William L; Marks, Gary; Lauby, Jennifer; Murrill, Christopher S; Millett, Gregorio A

2013-05-01

We investigated whether the experience of homophobic events increases the odds of engaging in unprotected anal intercourse (UAI) among black men who have sex with men (MSM) and whether social integration level buffered the association. Participants (N = 1,154) reported homophobic events experienced in the past 12 months. Social integration measures included social support, closeness with family members and friends, attachment to the black gay community, openness about sexuality within religious communities, and MSM social network size. Logistic regression analyses indicated that experiencing homophobia was associated with (1) UAI among men not previously diagnosed with HIV and (2) sexual HIV transmission risk behavior among men who knew they were HIV-infected. None of the social integration measures buffered these associations. Homophobia may promote acquisition and transmission of HIV infection among black MSM. Interventions are needed to reduce homophobia experienced by black MSM.

Meta-dimensional data integration identifies critical pathways for susceptibility, tumorigenesis and progression of endometrial cancer.

PubMed

Wei, Runmin; De Vivo, Immaculata; Huang, Sijia; Zhu, Xun; Risch, Harvey; Moore, Jason H; Yu, Herbert; Garmire, Lana X

2016-08-23

Endometrial Cancer (EC) is one of the most common female cancers. Genome-wide association studies (GWAS) have been investigated to identify genetic polymorphisms that are predictive of EC risks. Here we utilized a meta-dimensional integrative approach to seek genetically susceptible pathways that may be associated with tumorigenesis and progression of EC. We analyzed GWAS data obtained from Connecticut Endometrial Cancer Study (CECS) and identified the top 20 EC susceptible pathways. To further verify the significance of top 20 EC susceptible pathways, we conducted pathway-level multi-omics analyses using EC exome-Seq, RNA-Seq and survival data, all based on The Cancer Genome Atlas (TCGA) samples. We measured the overall consistent rankings of these pathways in all four data types. Some well-studied pathways, such as p53 signaling and cell cycle pathways, show consistently high rankings across different analyses. Additionally, other cell signaling pathways (e.g. IGF-1/mTOR, rac-1 and IL-5 pathway), genetic information processing pathway (e.g. homologous recombination) and metabolism pathway (e.g. sphingolipid metabolism) are also highly associated with EC risks, diagnosis and prognosis. In conclusion, the meta-dimensional integration of EC cohorts has suggested some common pathways that may be associated from predisposition, tumorigenesis to progression.

[The socio-hygienic monitoring as an integral system for health risk assessment and risk management at the regional level].

PubMed

Kuzmin, S V; Gurvich, V B; Dikonskaya, O V; Malykh, O L; Yarushin, S V; Romanov, S V; Kornilkov, A S

2013-01-01

The information and analytical framework for the introduction of health risk assessment and risk management methodologies in the Sverdlovsk Region is the system of socio-hygienic monitoring. Techniques of risk management that take into account the choice of most cost-effective and efficient actions for improvement of the sanitary and epidemiologic situation at the level of the region, municipality, or a business entity of the Russian Federation, have been developed and proposed. To assess the efficiency of planning and activities for health risk management common method approaches and economic methods of "cost-effectiveness" and "cost-benefit" analyses provided in method recommendations and introduced in the Russian Federation are applied.

Robust approaches to quantification of margin and uncertainty for sparse data

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

Hund, Lauren; Schroeder, Benjamin B.; Rumsey, Kelin

Characterizing the tails of probability distributions plays a key role in quantification of margins and uncertainties (QMU), where the goal is characterization of low probability, high consequence events based on continuous measures of performance. When data are collected using physical experimentation, probability distributions are typically fit using statistical methods based on the collected data, and these parametric distributional assumptions are often used to extrapolate about the extreme tail behavior of the underlying probability distribution. In this project, we character- ize the risk associated with such tail extrapolation. Specifically, we conducted a scaling study to demonstrate the large magnitude of themore » risk; then, we developed new methods for communicat- ing risk associated with tail extrapolation from unvalidated statistical models; lastly, we proposed a Bayesian data-integration framework to mitigate tail extrapolation risk through integrating ad- ditional information. We conclude that decision-making using QMU is a complex process that cannot be achieved using statistical analyses alone.« less

Engendering development and disasters.

PubMed

Bradshaw, Sarah

2015-01-01

Over the last two decades the different impacts of disasters on women and men have been acknowledged, leading to calls to integrate gender into disaster risk reduction and response. This paper explores how evolving understandings of ways of integrating gender into development have influenced this process, critically analysing contemporary initiatives to 'engender' development that see the inclusion of women for both efficiency and equality gains. It has been argued that this has resulted in a 'feminisation of responsibility' that can reinforce rather than challenge gender relations. The construction of women affected by disasters as both an at-risk group and as a means to reduce risk suggests similar processes of feminisation. The paper argues that if disaster risk reduction initiatives are to reduce women's vulnerability, they need to focus explicitly on the root causes of this vulnerability and design programmes that specifically focus on reducing gender inequalities by challenging unequal gendered power relations. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

An interdisciplinary approach to volcanic risk reduction under conditions of uncertainty: a case study of Tristan da Cunha

NASA Astrophysics Data System (ADS)

Hicks, A.; Barclay, J.; Simmons, P.; Loughlin, S.

2014-07-01

The uncertainty brought about by intermittent volcanic activity is fairly common at volcanoes worldwide. While better knowledge of any one volcano's behavioural characteristics has the potential to reduce this uncertainty, the subsequent reduction of risk from volcanic threats is only realised if that knowledge is pertinent to stakeholders and effectively communicated to inform good decision making. Success requires integration of methods, skills and expertise across disciplinary boundaries. This research project develops and trials a novel interdisciplinary approach to volcanic risk reduction on the remote volcanic island of Tristan da Cunha (South Atlantic). For the first time, volcanological techniques, probabilistic decision support and social scientific methods were integrated in a single study. New data were produced that (1) established no spatio-temporal pattern to recent volcanic activity; (2) quantified the high degree of scientific uncertainty around future eruptive scenarios; (3) analysed the physical vulnerability of the community as a consequence of their geographical isolation and exposure to volcanic hazards; (4) evaluated social and cultural influences on vulnerability and resilience; and (5) evaluated the effectiveness of a scenario planning approach, both as a method for integrating the different strands of the research and as a way of enabling on-island decision makers to take ownership of risk identification and management, and capacity building within their community. The paper provides empirical evidence of the value of an innovative interdisciplinary framework for reducing volcanic risk. It also provides evidence for the strength that comes from integrating social and physical sciences with the development of effective, tailored engagement and communication strategies in volcanic risk reduction.

Cash plus care: social protection cumulatively mitigates HIV-risk behaviour among adolescents in South Africa.

PubMed

Cluver, Lucie D; Orkin, F Mark; Boyes, Mark E; Sherr, Lorraine

2014-07-01

It is not known whether cumulative 'cash plus care' interventions can reduce adolescent HIV-infection risks in sub-Saharan Africa. This study investigated whether parental AIDS and other environmental adversities increase adolescent HIV-risk behaviour and whether social protection provision of 'cash' or integrated 'cash plus care' reduces HIV-risk behaviour. A prospective observational study with random sampling (<2.5% baseline refusal, 1-year follow-up, 96.8% retention). Three thousand five hundred and fifteen 10-18 year-olds (56.7% girls) were interviewed in South Africa between 2009-2010 and 2011-2012. All homes with a resident adolescent were sampled, within randomly selected census areas in two urban and two rural districts in two provinces. Measures included potential environmental risks (e.g. parental HIV/AIDS, poverty), social protection: receipt of cash/food support (e.g. child grants, school feeding), care (e.g. positive parenting) and HIV-risk behaviours (e.g. unprotected sex). Analyses used logistic regression. Cash alone was associated with reduced HIV risk for girls [odds ratio (OR) 0.63; 95% confidence interval (95% CI) 0.44-0.91, P = 0.02] but not for boys. Integrated cash plus care was associated with halved HIV-risk behaviour incidence for both sexes (girls OR 0.55; 95% CI 0.35-0.85, P = 0.007; boys OR 0.50; 95% CI 0.31-0.82, P = 0.005), compared with no support and controlling for confounders. Follow-up HIV-risk behaviour was reduced from 41 to 15% for girls and from 42 to 17% for boys. Girls in AIDS-affected families and informal-dwelling boys had higher HIV-risk behaviour, but were less likely to access integrated social protection. Integrated cash plus care reduces male and female adolescent HIV-risk behaviours. Increasing adolescent access to social protection may be an effective HIV prevention strategy in Sub-Saharan Africa.

Migration at early age from a high to a lower coronary heart disease risk country lowers the risk of subclinical atherosclerosis in middle-aged men.

PubMed

Jartti, L; Rönnemaa, T; Raitakari, O T; Hedlund, E; Hammar, N; Lassila, R; Marniemi, J; Koskenvuo, M; Kaprio, J

2009-03-01

Study of migrants offers a natural model to assess environmental risk of coronary heart disease (CHD) in countries differing in CHD occurrence. In Sweden, CHD risk has been markedly lower than in Finland from where a large migration occurred in the 1970s. To study the structural and functional markers of subclinical atherosclerosis in twin pairs discordant for migration with the main focus on age at migration, length of residence and integration into Swedish society after migration from a high to a lower CHD risk country. Carotid intima-media thickness (IMT) and brachial artery endothelial function (EF) were assessed with high-resolution ultrasound and a set of cardiovascular, socio-economic and psychosocial risk factors were estimated in 76 middle-aged male twin pairs discordant for migration from Finland to Sweden. Men who had migrated in adolescence had lower IMT values compared with their co-twins living in Finland (0.665 +/- 0.114 vs. 0.802 +/- 0.167 mm, P = 0.009). Also men who integrated well to Swedish society had lower (0.720 +/- 0.154 vs. 0.799 +/- 0.207 mm, P = 0.013) IMT values than their twin brothers living in Finland. Associations between IMT and migration age and between IMT and integration remained significant in multivariate analyses of several CHD risk factors. The intrapair difference in IMT was significantly associated with immigration age and integration (ANOVA, P = 0.0082), the difference being greatest among pairs where the brother living in Sweden had migrated at early age and integrated well to Swedish society. EF was better in men who had migrated to Sweden before the age of 21 years, but not later, compared with their co-twins in Finland (6.4 +/- 4.6% vs. 3.8 +/- 3.6%, P = 0.025). Migration at an early age and good integration are beneficial to vascular health associated with moving from a high to a lower CHD risk country, suggesting that an environment-sensitive period influences atherogenesis before adulthood.

Risk adjustment alternatives in paying for behavioral health care under Medicaid.

PubMed Central

Ettner, S L; Frank, R G; McGuire, T G; Hermann, R C

2001-01-01

OBJECTIVE: To compare the performance of various risk adjustment models in behavioral health applications such as setting mental health and substance abuse (MH/SA) capitation payments or overall capitation payments for populations including MH/SA users. DATA SOURCES/STUDY DESIGN: The 1991-93 administrative data from the Michigan Medicaid program were used. We compared mean absolute prediction error for several risk adjustment models and simulated the profits and losses that behavioral health care carve outs and integrated health plans would experience under risk adjustment if they enrolled beneficiaries with a history of MH/SA problems. Models included basic demographic adjustment, Adjusted Diagnostic Groups, Hierarchical Condition Categories, and specifications designed for behavioral health. PRINCIPAL FINDINGS: Differences in predictive ability among risk adjustment models were small and generally insignificant. Specifications based on relatively few MH/SA diagnostic categories did as well as or better than models controlling for additional variables such as medical diagnoses at predicting MH/SA expenditures among adults. Simulation analyses revealed that among both adults and minors considerable scope remained for behavioral health care carve outs to make profits or losses after risk adjustment based on differential enrollment of severely ill patients. Similarly, integrated health plans have strong financial incentives to avoid MH/SA users even after adjustment. CONCLUSIONS: Current risk adjustment methodologies do not eliminate the financial incentives for integrated health plans and behavioral health care carve-out plans to avoid high-utilizing patients with psychiatric disorders. PMID:11508640

Depression in Europe: does migrant integration have mental health payoffs? A cross-national comparison of 20 European countries.

PubMed

Levecque, Katia; Van Rossem, Ronan

2015-01-01

Objectives. Depression is a leading cause of ill health and disability. As migrants form an increasing group in Europe, already making up about 8.7% of the population in 2010, knowledge on migrant-related inequalities in depression is of main public health interest. In this study, we first assess whether migrants in Europe are at higher risk for depression compared to the native population. Second, we assess whether the association between migration and depression is dependent on different forms of migrant integration. Migrant integration is looked at both from the individual and from the national level. Design. Hierarchical linear regression analyses based on data for 20 countries in the European Social Survey 2006/2007 (N = 37,076 individuals aged 15 or more). Depression is measured using the center for Epidemiologic Depression Scale. We consider migrant integration over time (first- and second-generation migrants, differentiated according to European Union (EU) or non-EU origin), barriers to integration (low educational level, financial difficulties, being out of the labor market, ethnic minority status, discrimination), and the host country environment (national migrant integration policy). Controls are gender, age, partner relationship, social support, and welfare state regime. Results. Natives and second-generation migrants do not differ significantly in their risk profile for depression. First-generation migrants show higher levels of depression, with those born outside of Europe to be the worst off. This higher risk for depression is not attributable to ethnic minority status but is mainly due to experienced barriers to socioeconomic integration and processes of discrimination. A country's national policy on migrant integration shows not to soften the depressing effect of being a first-generation migrant nor does it have indirect beneficial health effects by reducing barriers to integration. Conclusion. In Europe, first-generation EU and non-EU migrants experience higher levels of depression. Second-generation migrants and natives show similar risk profiles.

Concepts to Support HRP Integration Using Publications and Modeling

NASA Technical Reports Server (NTRS)

Mindock, J.; Lumpkins, S.; Shelhamer, M.

2014-01-01

Initial efforts are underway to enhance the Human Research Program (HRP)'s identification and support of potential cross-disciplinary scientific collaborations. To increase the emphasis on integration in HRP's science portfolio management, concepts are being explored through the development of a set of tools. These tools are intended to enable modeling, analysis, and visualization of the state of the human system in the spaceflight environment; HRP's current understanding of that state with an indication of uncertainties; and how that state changes due to HRP programmatic progress and design reference mission definitions. In this talk, we will discuss proof-of-concept work performed using a subset of publications captured in the HRP publications database. The publications were tagged in the database with words representing factors influencing health and performance in spaceflight, as well as with words representing the risks HRP research is reducing. Analysis was performed on the publication tag data to identify relationships between factors and between risks. Network representations were then created as one type of visualization of these relationships. This enables future analyses of the structure of the networks based on results from network theory. Such analyses can provide insights into HRP's current human system knowledge state as informed by the publication data. The network structure analyses can also elucidate potential improvements by identifying network connections to establish or strengthen for maximized information flow. The relationships identified in the publication data were subsequently used as inputs to a model captured in the Systems Modeling Language (SysML), which functions as a repository for relationship information to be gleaned from multiple sources. Example network visualization outputs from a simple SysML model were then also created to compare to the visualizations based on the publication data only. We will also discuss ideas for building upon this proof-of-concept work to further support an integrated approach to human spaceflight risk reduction.

Coupling the Biophysical and Social Dimensions of Wildfire Risk to Improve Wildfire Mitigation Planning.

PubMed

Ager, Alan A; Kline, Jeffrey D; Fischer, A Paige

2015-08-01

We describe recent advances in biophysical and social aspects of risk and their potential combined contribution to improve mitigation planning on fire-prone landscapes. The methods and tools provide an improved method for defining the spatial extent of wildfire risk to communities compared to current planning processes. They also propose an expanded role for social science to improve understanding of community-wide risk perceptions and to predict property owners' capacities and willingness to mitigate risk by treating hazardous fuels and reducing the susceptibility of dwellings. In particular, we identify spatial scale mismatches in wildfire mitigation planning and their potential adverse impact on risk mitigation goals. Studies in other fire-prone regions suggest that these scale mismatches are widespread and contribute to continued wildfire dwelling losses. We discuss how risk perceptions and behavior contribute to scale mismatches and how they can be minimized through integrated analyses of landscape wildfire transmission and social factors that describe the potential for collaboration among landowners and land management agencies. These concepts are then used to outline an integrated socioecological planning framework to identify optimal strategies for local community risk mitigation and improve landscape-scale prioritization of fuel management investments by government entities. © 2015 Society for Risk Analysis.

Social integration of Latin-American immigrants in Spain: the influence of the community context.

PubMed

Fuente, Asur; Herrero, Juan

2012-11-01

The main goal of this study is to analyze the degree to which several community elements such as insecurity, discrimination and informal community support might have an influence on the social integration of Latin-American immigrants, a group at risk of social exclusion in Spain. Multivariate linear regression analyses results showed that informal community support is positively related to social integration whereas insecurity is negatively related. The statistical relationship between discrimination and social integration disappears once levels of informal community support are taken into account. A better understanding of the factors that either promote or inhibit the social integration progress of immigrant population is important to orientate public policies and intervention programs that contribute to the adaptation of this population to the host society.

Integration of Multilocus Genetic Risk into the Default Mode Network Longitudinal Trajectory during the Alzheimer's Disease Process.

PubMed

Su, Fan; Shu, Hao; Ye, Qing; Xie, Chunming; Yuan, Baoyu; Zhang, Zhijun; Bai, Feng

2017-01-01

The aim of the study was to investigate the cognitive significance of the changes in default mode network (DMN) during the process of Alzheimer's disease (AD) and the genetic basis that drives the alteration. Eighty-seven subjects with mild cognitive impairment (MCI) and 131 healthy controls (HC) were employed at baseline, and they had the genetic risk scores (GRS) based on the GWAS-validated AD-related top loci. Eleven MCIs who converted to AD (c-MCIs), 32 subjects who remained stable (nc-MCIs), and 56 HCs participated in the follow-up analyses after an average of 35 months. Decreased functional connectivity (FC) within temporal cortex was identified for MCIs at baseline, which was partially determined by the GRS; moreover, compensations may occur within the frontal-parietal brain to maintain relatively intact cognition. During the follow-ups, c-MCIs exhibited more FC declines within the prefrontal-parietal lobes and parahippocampal gyrus/hippocampus than the HCs and nc-MCIs. The GRS did not significantly vary among the three groups, whereas associations were identified at risky alleles and FC declines in all AD spectra. Interestingly, the influence of APOEɛ4 varied as the disease progressed; APOEɛ4 was associated with longitudinal FC decreases only for HCs in the single variance-based analyses and deteriorated DMN integration in nc-MCIs by combining the effects of other loci. However, the GRS without APOEɛ4 predicted FC decline for converters. It is suggested that the integration of multilocus genetic risk predicted the longitudinal trajectory of DMN and may be used as a clinical strategy to track AD progression.

A combined approach to investigate the toxicity of an industrial landfill's leachate: chemical analyses, risk assessment and in vitro assays.

PubMed

Baderna, D; Maggioni, S; Boriani, E; Gemma, S; Molteni, M; Lombardo, A; Colombo, A; Bordonali, S; Rotella, G; Lodi, M; Benfenati, E

2011-05-01

Solid wastes constitute an important and emerging problem. Landfills are still one of the most common ways to manage waste disposal. The risk assessment of pollutants from landfills is becoming a major environmental issue in Europe, due to the large number of sites and to the importance of groundwater protection. Furthermore, there is lack of knowledge for the environmental, ecotoxicological and toxicological characteristics of most contaminants contained into landfill leacheates. Understanding leachate composition and creating an integrated strategy for risk assessment are currently needed to correctly face the landfill issues and to make projections on the long-term impacts of a landfill, with particular attention to the estimation of possible adverse effects on human health and ecosystem. In the present study, we propose an integrated strategy to evaluate the toxicity of the leachate using chemical analyses, risk assessment guidelines and in vitro assays using the hepatoma HepG2 cells as a model. The approach was applied on a real case study: an industrial waste landfill in northern Italy for which data on the presence of leachate contaminants are available from the last 11 years. Results from our ecological risk models suggest important toxic effects on freshwater fish and small rodents, mainly due to ammonia and inorganic constituents. Our results from in vitro data show an inhibition of cell proliferation by leachate at low doses and cytotoxic effect at high doses after 48 h of exposure. Copyright © 2011 Elsevier Inc. All rights reserved.

Marital status integration and suicide: A meta-analysis and meta-regression.

PubMed

Kyung-Sook, Woo; SangSoo, Shin; Sangjin, Shin; Young-Jeon, Shin

2018-01-01

Marital status is an index of the phenomenon of social integration within social structures and has long been identified as an important predictor suicide. However, previous meta-analyses have focused only on a particular marital status, or not sufficiently explored moderators. A meta-analysis of observational studies was conducted to explore the relationships between marital status and suicide and to understand the important moderating factors in this association. Electronic databases were searched to identify studies conducted between January 1, 2000 and June 30, 2016. We performed a meta-analysis, subgroup analysis, and meta-regression of 170 suicide risk estimates from 36 publications. Using random effects model with adjustment for covariates, the study found that the suicide risk for non-married versus married was OR = 1.92 (95% CI: 1.75-2.12). The suicide risk was higher for non-married individuals aged <65 years than for those aged ≥65 years, and higher for men than for women. According to the results of stratified analysis by gender, non-married men exhibited a greater risk of suicide than their married counterparts in all sub-analyses, but women aged 65 years or older showed no significant association between marital status and suicide. The suicide risk in divorced individuals was higher than for non-married individuals in both men and women. The meta-regression showed that gender, age, and sample size affected between-study variation. The results of the study indicated that non-married individuals have an aggregate higher suicide risk than married ones. In addition, gender and age were confirmed as important moderating factors in the relationship between marital status and suicide. Copyright © 2017 Elsevier Ltd. All rights reserved.

Overview of EVA PRA for TPS Repair for Hubble Space Telescope Servicing Mission

NASA Technical Reports Server (NTRS)

Bigler, Mark; Duncan, Gary; Roeschel, Eduardo; Canga, Michael

2010-01-01

Following the Columbia accident in 2003, NASA developed techniques to repair the Thermal Protection System (TPS) in the event of damage to the TPS as one of several actions to reduce the risk to future flights from ascent debris, micro-meteoroid and/or orbital debris (MMOD). Other actions to help reduce the risk include improved inspection techniques, reduced shedding of debris from the External Tank and ability to rescue the crew with a launch on need vehicle. For the Hubble Space Telescope (HST) Servicing Mission the crew rescue capability was limited by the inability to safe haven on the International Space Station (ISS), resulting in a greater reliance on the repair capability. Therefore it was desirable to have an idea of the risk associated with conducting a repair, where the repair would have to be conducted using an Extra-Vehicular Activity (EVA). Previously, focused analyses had been conducted to quantify the risk associated with certain aspects of an EVA, for example the EVA Mobility Unit (EMU) or Space Suit; however, the analyses were somewhat limited in scope. A complete integrated model of an EVA which could quantify the risk associated with all of the major components of an EVA had never been done before. It was desired to have a complete integrated model to be able to assess the risks associated with an EVA to support the Space Shuttle Program (SSP) in making risk informed decisions. In the case of the HST Servicing Mission, this model was developed to assess specifically the risks associated with performing a TPS repair EVA. This paper provides an overview of the model that was developed to support the HST mission in the event of TPS damage. The HST Servicing Mission was successfully completed on May 24th 2009 with no critical TPS damage; therefore the model was not required for real-time mission support. However, it laid the foundation upon which future EVA quantitative risk assessments could be based.

A pilot systematic genomic comparison of recurrence risks of hepatitis B virus-associated hepatocellular carcinoma with low- and high-degree liver fibrosis.

PubMed

Yoo, Seungyeul; Wang, Wenhui; Wang, Qin; Fiel, M Isabel; Lee, Eunjee; Hiotis, Spiros P; Zhu, Jun

2017-12-07

Chronic hepatitis B virus (HBV) infection leads to liver fibrosis, which is a major risk factor in hepatocellular carcinoma (HCC) and an independent risk factor of recurrence after HCC tumor resection. The HBV genome can be inserted into the human genome, and chronic inflammation may trigger somatic mutations. However, how HBV integration and other genomic changes contribute to the risk of tumor recurrence with regards to the different degree of liver fibrosis is not clearly understood. We sequenced mRNAs of 21 pairs of tumor and distant non-neoplastic liver tissues of HBV-HCC patients and performed comprehensive genomic analyses of our RNAseq data and public available HBV-HCC sequencing data. We developed a robust pipeline for sensitively identifying HBV integration sites based on sequencing data. Simulations showed that our method outperformed existing methods. Applying it to our data, 374 and 106 HBV host genes were identified in non-neoplastic liver and tumor tissues, respectively. When applying it to other RNA sequencing datasets, consistently more HBV integrations were identified in non-neoplastic liver than in tumor tissues. HBV host genes identified in non-neoplastic liver samples significantly overlapped with known tumor suppressor genes. More significant enrichment of tumor suppressor genes was observed among HBV host genes identified from patients with tumor recurrence, indicating the potential risk of tumor recurrence driven by HBV integration in non-neoplastic liver tissues. We also compared SNPs of each sample with SNPs in a cancer census database and inferred samples' pathogenic SNP loads. Pathogenic SNP loads in non-neoplastic liver tissues were consistently higher than those in normal liver tissues. Additionally, HBV host genes identified in non-neoplastic liver tissues significantly overlapped with pathogenic somatic mutations, suggesting that HBV integration and somatic mutations targeting the same set of genes are important to tumorigenesis. HBV integrations and pathogenic mutations showed distinct patterns between low and high liver fibrosis patients with regards to tumor recurrence. The results suggest that HBV integrations and pathogenic SNPs in non-neoplastic tissues are important for tumorigenesis and different recurrence risk models are needed for patients with low and high degrees of liver fibrosis.

Risk Factors as Major Determinants of Resilience: A Replication Study.

PubMed

Eshel, Yohanan; Kimhi, Shaul; Lahad, Mooli; Leykin, Dmitry; Goroshit, Marina

2018-03-16

The present study was conducted in the context of current concerns about replication in psychological research. It claims that risk factors should be regarded as an integral part of the definition of individual resilience, which should be defined in terms of the balance between individual strength or protective factors, and individual vulnerability or risk factors (IND-SVR). Five independent samples, including 3457 Israeli participants, were employed to determine the effects of resilience promoting and resilience suppressing variables on the IND-SVR index of resilience, and on its two components: recovery from adversity, and distress symptoms. Five path analyses were employed for determining the role of distress symptoms as a measure of psychological resilience, as compared to other indices of this resilience. Results indicated the major role of risk factors (distress symptoms) as an integral component of resilience. This role was generally replicated in the five investigated samples. Risk factors are legitimate, valid, and useful parts of the definition of psychological resilience. Resilience research has shifted away from studying individual risk factors to investigating the process through which individuals overcome the hardships they experience. The present data seem to suggest that this shift should be reexamined.

An Approach to Risk-Based Design Incorporating Damage Tolerance Analyses

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Glaessgen, Edward H.; Sleight, David W.

2002-01-01

Incorporating risk-based design as an integral part of spacecraft development is becoming more and more common. Assessment of uncertainties associated with design parameters and environmental aspects such as loading provides increased knowledge of the design and its performance. Results of such studies can contribute to mitigating risk through a system-level assessment. Understanding the risk of an event occurring, the probability of its occurrence, and the consequences of its occurrence can lead to robust, reliable designs. This paper describes an approach to risk-based structural design incorporating damage-tolerance analysis. The application of this approach to a candidate Earth-entry vehicle is described. The emphasis of the paper is on describing an approach for establishing damage-tolerant structural response inputs to a system-level probabilistic risk assessment.

System safety in Stirling engine development

NASA Technical Reports Server (NTRS)

Bankaitis, H.

1981-01-01

The DOE/NASA Stirling Engine Project Office has required that contractors make safety considerations an integral part of all phases of the Stirling engine development program. As an integral part of each engine design subtask, analyses are evolved to determine possible modes of failure. The accepted system safety analysis techniques (Fault Tree, FMEA, Hazards Analysis, etc.) are applied in various degrees of extent at the system, subsystem and component levels. The primary objectives are to identify critical failure areas, to enable removal of susceptibility to such failures or their effects from the system and to minimize risk.

True versus perturbed forest inventory plot locations for modeling: a simulation study

Treesearch

John W. Coulston; Kurt H. Riitters; Ronald E. McRoberts; William D. Smith

2006-01-01

USDA Forest Service Forest Inventory and Analysis plot information is widely used for timber inventories, forest health assessments, and environmental risk analyses. With few exceptions, true plot locations are not revealed; the plot coordinates are manipulated to obscure the location of field plots and thereby preserve plot integrity. The influence of perturbed plot...

Scientific developments ISFD3

USGS Publications Warehouse

Schropp, M.H.I.; Soong, T.W.

2006-01-01

Highlights, trends, and consensus from the 63 papers submitted to the Scientific Developments theme of the Third International Symposium on Flood Defence (ISFD) are presented. Realizing that absolute protection against flooding can never be guaranteed, trends in flood management have shifted: (1) from flood protection to flood-risk management, (2) from reinforcing structural protection to lowering flood levels, and (3) to sustainable management through integrated problem solving. Improved understanding of watershed responses, climate changes, applications of GIS and remote-sensing technologies, and advanced analytical tools appeared to be the driving forces for renewing flood-risk management strategies. Technical competence in integrating analytical tools to form the basin wide management systems are demonstrated by several large, transnation models. However, analyses from social-economic-environmental points of view are found lag in general. ?? 2006 Taylor & Francis Group.

Sisters in hereditary breast and ovarian cancer families: communal coping, social integration, and psychological well-being†

PubMed Central

Koehly, Laura M.; Peters, June A.; Kuhn, Natalia; Hoskins, Lindsey; Letocha, Anne; Kenen, Regina; Loud, Jennifer; Greene, Mark H.

2011-01-01

Objective We investigated the association between psychological distress and indices of social integration and communal coping among sisters from hereditary breast and ovarian cancer (HBOC) families. Sample and methods Sixty-five sisters from 31 HBOC families completed the Brief Symptom Inventory-18 and the Colored Eco-Genetic Relationship Map, which identified members of participants’ social support networks. Hierarchical linear models were used for all analyses to account for the clustering of sisters within families. Results Intra-family correlation coefficients suggested that sisters shared perceptions of breast cancer risk and worry, but not ovarian cancer risk and worry. Further, sisters demonstrated shared levels of anxiety and somatization, but not depressive symptoms. Communal coping indices quantifying shared support resources were negatively related to anxiety and somatization. The number of persons with whom cancer risk information was shared exhibited a positive trend with somatization. Social integration, as measured by the size of participants’ emotional support network, was negatively associated with anxiety. Lower depression scores were observed among participants with more persons playing multiple support roles and fewer persons providing tangible assistance. Conclusion Understanding how support relationships impact well-being among persons adjusting to HBOC risk, and the particular role of family in that process, will facilitate developing appropriate management approaches to help cancer-prone families adjust to their cancer risk. Published in 2008 by John Wiley & Sons Ltd. PMID:18688790

Quasi-Static Probabilistic Structural Analyses Process and Criteria

NASA Technical Reports Server (NTRS)

Goldberg, B.; Verderaime, V.

1999-01-01

Current deterministic structural methods are easily applied to substructures and components, and analysts have built great design insights and confidence in them over the years. However, deterministic methods cannot support systems risk analyses, and it was recently reported that deterministic treatment of statistical data is inconsistent with error propagation laws that can result in unevenly conservative structural predictions. Assuming non-nal distributions and using statistical data formats throughout prevailing stress deterministic processes lead to a safety factor in statistical format, which integrated into the safety index, provides a safety factor and first order reliability relationship. The embedded safety factor in the safety index expression allows a historically based risk to be determined and verified over a variety of quasi-static metallic substructures consistent with the traditional safety factor methods and NASA Std. 5001 criteria.

Community integration outcomes of people with spinal cord injury and multiple matched controls: A pilot study.

PubMed

Callaway, Libby; Enticott, Joanne; Farnworth, Louise; McDonald, Rachael; Migliorini, Christine; Willer, Barry

2017-06-01

Australia's National Disability Insurance Scheme (NDIS) is designed to influence home, social and economic participation for Scheme participants. Given the major disability reform underway, this pilot study aimed to: (i) examine community integration outcomes of people with spinal cord injury (SCI); (ii) compare findings with multiple matched controls and (iii) consider findings within the context of Australia's NDIS. Setting: Victoria, Australia. Matched analysis (people with and without SCI). Community Integration Questionnaire (CIQ). n = 40 adults with SCI (M age = 52.8 years; 61% male; 77% traumatic SCI). Matched analyses from each SCI subject aged <70 years (n = 31) with four CIQ normative data subjects (from n = 1927) was undertaken, with key demographic variables matched (age range, gender, living location and living situation). Risk of low CIQ score as a function of SCI was also examined using conditional Poisson regression. With key demographic variables held constant, small to medium effect sizes were found in favour of the normative sample, with statistically significant differences in home (ρ = 0.003) and productivity integration (ρ = 0.02). Relative risk of low home integration was significant in the SCI cohort (conditional RR (95% CI) = 3.1 (1.5-6.3), ρ = 0.001). Relative risk of low CIQ total, social integration and productivity scores did not reach significance. This cohort of SCI participants was less integrated into home and productive occupations than matched norms, holding implications for planning and allocation of supports to influence outcomes within an NDIS. Further research is necessary to understand community integration outcomes in larger matched samples. © 2016 Occupational Therapy Australia.

Application of a generic bow-tie based risk analysis framework on risk management of sea ports and offshore terminals.

PubMed

Mokhtari, Kambiz; Ren, Jun; Roberts, Charles; Wang, Jin

2011-08-30

Ports and offshore terminals are critical infrastructure resources and play key roles in the transportation of goods and people. With more than 80 percent of international trade by volume being carried out by sea, ports and offshore terminals are vital for seaborne trade and international commerce. Furthermore in today's uncertain and complex environment there is a need to analyse the participated risk factors in order to prioritise protective measures in these critically logistics infrastructures. As a result of this study is carried out to support the risk assessment phase of the proposed Risk Management (RM) framework used for the purpose of sea ports and offshore terminals operations and management (PTOM). This has been fulfilled by integration of a generic bow-tie based risk analysis framework into the risk assessment phase as a backbone of the phase. For this reason Fault Tree Analysis (FTA) and Event Tree Analysis (ETA) are used to analyse the risk factors associated within the PTOM. This process will eventually help the port professionals and port risk managers to investigate the identified risk factors more in detail. In order to deal with vagueness of the data Fuzzy Set Theory (FST) and possibility approach are used to overcome the disadvantages of the conventional probability based approaches. Copyright © 2011 Elsevier B.V. All rights reserved.

A PROgramme of Lifestyle Intervention in Families for Cardiovascular risk reduction (PROLIFIC Study): design and rationale of a family based randomized controlled trial in individuals with family history of premature coronary heart disease.

PubMed

Jeemon, Panniyammakal; Harikrishnan, S; Sanjay, G; Sivasubramonian, Sivasankaran; Lekha, T R; Padmanabhan, Sandosh; Tandon, Nikhil; Prabhakaran, Dorairaj

2017-01-05

Recognizing patterns of coronary heart disease (CHD) risk in families helps to identify and target individuals who may have the most to gain from preventive interventions. The overall goal of the study is to test the effectiveness and sustainability of an integrated care model for managing cardiovascular risk in high risk families. The proposed care model targets the structural and environmental conditions that predispose high risk families to development of CHD through the following interventions: 1) screening for cardiovascular risk factors, 2) providing lifestyle interventions 3) providing a framework for linkage to appropriate primary health care facility, and 4) active follow-up of intervention adherence. Initially, a formative qualitative research component will gather information on understanding of diseases, barriers to care, specific components of the intervention package and feedback on the intervention. Then a cluster randomized controlled trial involving 740 families comprising 1480 participants will be conducted to determine whether the package of interventions (integrated care model) is effective in reducing or preventing the progression of CHD risk factors and risk factor clustering in families. The sustainability and scalability of this intervention will be assessed through economic (cost-effectiveness analyses) and qualitative evaluation (process outcomes) to estimate value and acceptability. Scalability is informed by cost-effectiveness and acceptability of the integrated cardiovascular risk reduction approach. Knowledge generated from this trial has the potential to significantly affect new programmatic policy and clinical guidelines that will lead to improvements in cardiovascular health in India. NCT02771873, registered in May 2016 ( https://clinicaltrials.gov/ct2/show/results/NCT02771873 ).

Use of GIS in visualization of work-related health problems

PubMed Central

Delaunay, M.; Van der Westhuizen, H.; Godard, V.; Agius, R.; Le Barbier, M.; Godderis, L.

2015-01-01

Background Occupational health and safety (OHS) information is often complex, diverse and unstructured and suffers from a lack of integration which usually precludes any systemic insight of the situation. Aims To analyse to what extent the use of geographical information systems (GISs) can help to integrate, analyse and present OHS data in a comprehensive and communicable way relevant for surveillance purposes. Methods We first developed a ‘macro-approach’ (from national to local level), mapping data related to economic activity (denominator of active workers displayed by activity sectors), as well as work-related ill-health (numerators of workers suffering from work-related ill-health). The latter data are composed of compensated occupational diseases on the one hand and work-related diseases investigated by specialized clinics on the other hand. Then, a ‘micro-approach’ was worked out, integrating at a plant level, using computer-aided drawing, occupational risks data and OHS surveillance data (e.g. use of medication and sickness absence data). Results At the macro-level, microelectronics companies and workers were mapped at different scales. For the first time, we were able to compare, up to the enterprise level, complementary data showing different pictures of work-related ill-health, allowing a better understanding of OH issues in this sector. At the micro-level, new information arose from the integration of risk assessment data and medical data. Conclusions This work illustrates to what extent GIS is a promising tool in the OHS field, and discusses related challenges (technical, ethical, biases and interpretation) and research perspectives. PMID:26503981

Integration of care for hypertension and diabetes: a scoping review assessing the evidence from systematic reviews and evaluating reporting.

PubMed

Yiu, Kristy C; Rohwer, Anke; Young, Taryn

2018-06-20

With the rise in pre-mature mortality rate from non-communicable disease (NCD), there is a need for evidence-based interventions. We evaluated existing systematic reviews on effectiveness of integration of healthcare services, in particular with focus on delivery of care designed to improve health and process outcomes in people with multi-morbidity, where at least one of the conditions was diabetes or hypertension. We searched MEDLINE, EMBASE, Cochrane Library, and Health Evidence to November 8, 2016 and consulted experts. One review author screened titles, abstracts and two review authors independently screened short listed full-texts and selected reviews for inclusion. We considered systematic reviews evaluating integration of care, compared to usual care, for people with multi-morbidity. One review author extracted data and another author verified it. Two review authors independently evaluated risk of bias using ROBIS and AMSTAR. Inter-rater reliability was analysed for ROBIS and AMSTAR using Cohen's kappa and percent agreement. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used to assess reporting. We identified five systematic reviews on integration of care. Four reviews focused on comorbid diabetes and depression and two covered hypertension and comorbidities of cardiovascular disease, depression, or diabetes. Interventions were poorly described. The health outcomes evaluated included risk of all-cause mortality, measures of depression, cholesterol levels, HbA1c levels, effect of depression on HbA1c levels, symptom improvement, systolic blood pressure, and hypertension control. Process outcomes included access and utilisation of healthcare services, costs, and quality of care. Overall, three reviews had a low and medium risk of bias according to ROBIS and AMSTAR respectively, while two reviews had high risk of bias as judged by both ROBIS and AMSTAR. Findings have demonstrated that collaborative care in general resulted in better health and process outcomes when compared to usual care for both depression and diabetes and hypertension and diabetes. Several knowledge gaps were identified on integration of care for comorbidities with diabetes and/or hypertension: limited research on this topic for hypertension, limited reviews that included primary studies based in low-middle income countries, and limited reviews on collaborative care for communicable and NCDs.

Mapping the spatio-temporal risk of lead exposure in apex species for more effective mitigation

PubMed Central

Mateo-Tomás, Patricia; Olea, Pedro P.; Jiménez-Moreno, María; Camarero, Pablo R.; Sánchez-Barbudo, Inés S.; Rodríguez Martín-Doimeadios, Rosa C.; Mateo, Rafael

2016-01-01

Effective mitigation of the risks posed by environmental contaminants for ecosystem integrity and human health requires knowing their sources and spatio-temporal distribution. We analysed the exposure to lead (Pb) in griffon vulture Gyps fulvus—an apex species valuable as biomonitoring sentinel. We determined vultures' lead exposure and its main sources by combining isotope signatures and modelling analyses of 691 bird blood samples collected over 5 years. We made yearlong spatially explicit predictions of the species risk of lead exposure. Our results highlight elevated lead exposure of griffon vultures (i.e. 44.9% of the studied population, approximately 15% of the European, showed lead blood levels more than 200 ng ml−1) partly owing to environmental lead (e.g. geological sources). These exposures to environmental lead of geological sources increased in those vultures exposed to point sources (e.g. lead-based ammunition). These spatial models and pollutant risk maps are powerful tools that identify areas of wildlife exposure to potentially harmful sources of lead that could affect ecosystem and human health. PMID:27466455

Cumulative risk assessment for combined health effects from chemical and nonchemical stressors.

PubMed

Sexton, Ken; Linder, Stephen H

2011-12-01

Cumulative risk assessment is a science policy tool for organizing and analyzing information to examine, characterize, and possibly quantify combined threats from multiple environmental stressors. We briefly survey the state of the art regarding cumulative risk assessment, emphasizing challenges and complexities of moving beyond the current focus on chemical mixtures to incorporate nonchemical stressors, such as poverty and discrimination, into the assessment paradigm. Theoretical frameworks for integrating nonchemical stressors into cumulative risk assessments are discussed, the impact of geospatial issues on interpreting results of statistical analyses is described, and four assessment methods are used to illustrate the diversity of current approaches. Prospects for future progress depend on adequate research support as well as development and verification of appropriate analytic frameworks.

Cumulative Risk Assessment for Combined Health Effects From Chemical and Nonchemical Stressors

PubMed Central

Linder, Stephen H.

2011-01-01

Cumulative risk assessment is a science policy tool for organizing and analyzing information to examine, characterize, and possibly quantify combined threats from multiple environmental stressors. We briefly survey the state of the art regarding cumulative risk assessment, emphasizing challenges and complexities of moving beyond the current focus on chemical mixtures to incorporate nonchemical stressors, such as poverty and discrimination, into the assessment paradigm. Theoretical frameworks for integrating nonchemical stressors into cumulative risk assessments are discussed, the impact of geospatial issues on interpreting results of statistical analyses is described, and four assessment methods are used to illustrate the diversity of current approaches. Prospects for future progress depend on adequate research support as well as development and verification of appropriate analytic frameworks. PMID:21551386

Impact of a cis-associated gene expression SNP on chromosome 20q11.22 on bipolar disorder susceptibility, hippocampal structure and cognitive performance.

PubMed

Li, Ming; Luo, Xiong-jian; Landén, Mikael; Bergen, Sarah E; Hultman, Christina M; Li, Xiao; Zhang, Wen; Yao, Yong-Gang; Zhang, Chen; Liu, Jiewei; Mattheisen, Manuel; Cichon, Sven; Mühleisen, Thomas W; Degenhardt, Franziska A; Nöthen, Markus M; Schulze, Thomas G; Grigoroiu-Serbanescu, Maria; Li, Hao; Fuller, Chris K; Chen, Chunhui; Dong, Qi; Chen, Chuansheng; Jamain, Stéphane; Leboyer, Marion; Bellivier, Frank; Etain, Bruno; Kahn, Jean-Pierre; Henry, Chantal; Preisig, Martin; Kutalik, Zoltán; Castelao, Enrique; Wright, Adam; Mitchell, Philip B; Fullerton, Janice M; Schofield, Peter R; Montgomery, Grant W; Medland, Sarah E; Gordon, Scott D; Martin, Nicholas G; Rietschel, Marcella; Liu, Chunyu; Kleinman, Joel E; Hyde, Thomas M; Weinberger, Daniel R; Su, Bing

2016-02-01

Bipolar disorder is a highly heritable polygenic disorder. Recent enrichment analyses suggest that there may be true risk variants for bipolar disorder in the expression quantitative trait loci (eQTL) in the brain. We sought to assess the impact of eQTL variants on bipolar disorder risk by combining data from both bipolar disorder genome-wide association studies (GWAS) and brain eQTL. To detect single nucleotide polymorphisms (SNPs) that influence expression levels of genes associated with bipolar disorder, we jointly analysed data from a bipolar disorder GWAS (7481 cases and 9250 controls) and a genome-wide brain (cortical) eQTL (193 healthy controls) using a Bayesian statistical method, with independent follow-up replications. The identified risk SNP was then further tested for association with hippocampal volume (n = 5775) and cognitive performance (n = 342) among healthy individuals. Integrative analysis revealed a significant association between a brain eQTL rs6088662 on chromosome 20q11.22 and bipolar disorder (log Bayes factor = 5.48; bipolar disorder P = 5.85 × 10(-5)). Follow-up studies across multiple independent samples confirmed the association of the risk SNP (rs6088662) with gene expression and bipolar disorder susceptibility (P = 3.54 × 10(-8)). Further exploratory analysis revealed that rs6088662 is also associated with hippocampal volume and cognitive performance in healthy individuals. Our findings suggest that 20q11.22 is likely a risk region for bipolar disorder; they also highlight the informative value of integrating functional annotation of genetic variants for gene expression in advancing our understanding of the biological basis underlying complex disorders, such as bipolar disorder. © The Royal College of Psychiatrists 2016.

Seat Integrated and Conventional Restraints: A Study of Crash Injury/Fatality Rates in Rollovers

PubMed Central

Padmanaban, Jeya; Burnett, Roger A.

2008-01-01

This study used police-reported motor vehicle crash data from eleven states to determine ejection, fatality, and fatal/serious injury risks for belted drivers in vehicles with conventional seatbelts compared to belted drivers in vehicles with seat integrated restraint systems (SIRS). Risks were compared for 11,159 belted drivers involved in single- or multiple-vehicle rollover crashes. Simple driver ejection (partial and complete), fatality, and injury rates were derived, and logistic regression analyses were used to determine relative contribution of factors (including event calendar year, vehicle age, driver age/gender/alcohol use) that significantly influence the likelihood of fatality and fatal/serious injury to belted drivers in rollovers. Results show no statistically significant difference in driver ejection, fatality, or fatal/serious injury rates between vehicles with conventional belts and vehicles with SIRS. PMID:19026243

Introduction of a conceptual model for integrating the MMPI-2-RF into HCR-20V3 violence risk assessments and associations between the MMPI-2-RF and institutional violence.

PubMed

Tarescavage, Anthony M; Glassmire, David M; Burchett, Danielle

2016-12-01

Reflecting the need to prevent violence, structured professional judgment assessment tools have been developed specifically to assess the likelihood of future violence. These tools typically integrate data from clinical interviews and collateral records to assist in the conceptualization of violence risk, but objective psychological testing may also be useful in completing the instruments. The authors describe the advantages of using the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in this manner with the Historical Clinical Management-20 Version 3 (HCR-20 V3 ). Accordingly, they have 2 purposes. First, they sought to identify conceptual links between the constructs measured by the tools and introduce a model to integrate MMPI-2-RF findings into an HCR-20 V3 risk assessment. Second, although the authors did not have collateral HCR-20 V3 ratings, they sought to examine associations between the MMPI-2-RF scales and future violence in a sample of 303 psychiatric patients (233 males, 70 females) adjudicated as not guilty by reason of insanity. The authors found that the MMPI-2-RF scales demonstrated significant, meaningful associations with a count of future violent acts at the hospital. The largest associations involved scales measuring emotional dysregulation and externalizing dysfunction. These associations were qualified by relative risk ratio analyses indicating that patients producing elevations on these scales were at 1.5 to 2.5 times greater risk of future violence than those without elevations. Overall, the findings indicated that most MMPI-2-RF scales conceptually linked to the HCR-20 V3 risk factors were associated with future violence. In light of these findings, the authors discuss recommendations for integrating the MMPI-2-RF when interpreting HCR-20 V3 risk factors. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Ethical Risk Management Education in Engineering: A Systematic Review.

PubMed

Guntzburger, Yoann; Pauchant, Thierry C; Tanguy, Philippe A

2017-04-01

Risk management is certainly one of the most important professional responsibilities of an engineer. As such, this activity needs to be combined with complex ethical reflections, and this requirement should therefore be explicitly integrated in engineering education. In this article, we analyse how this nexus between ethics and risk management is expressed in the engineering education research literature. It was done by reviewing 135 articles published between 1980 and March 1, 2016. These articles have been selected from 21 major journals that specialize in engineering education, engineering ethics and ethics education. Our review suggests that risk management is mostly used as an anecdote or an example when addressing ethics issues in engineering education. Further, it is perceived as an ethical duty or requirement, achieved through rational and technical methods. However, a small number of publications do offer some critical analyses of ethics education in engineering and their implications for ethical risk and safety management. Therefore, we argue in this article that the link between risk management and ethics should be further developed in engineering education in order to promote the progressive change toward more socially and environmentally responsible engineering practices. Several research trends and issues are also identified and discussed in order to support the engineering education community in this project.

Estimating community health needs against a Triple Aim background: What can we learn from current predictive risk models?

PubMed

Elissen, Arianne M J; Struijs, Jeroen N; Baan, Caroline A; Ruwaard, Dirk

2015-05-01

To support providers and commissioners in accurately assessing their local populations' health needs, this study produces an overview of Dutch predictive risk models for health care, focusing specifically on the type, combination and relevance of included determinants for achieving the Triple Aim (improved health, better care experience, and lower costs). We conducted a mixed-methods study combining document analyses, interviews and a Delphi study. Predictive risk models were identified based on a web search and expert input. Participating in the study were Dutch experts in predictive risk modelling (interviews; n=11) and experts in healthcare delivery, insurance and/or funding methodology (Delphi panel; n=15). Ten predictive risk models were analysed, comprising 17 unique determinants. Twelve were considered relevant by experts for estimating community health needs. Although some compositional similarities were identified between models, the combination and operationalisation of determinants varied considerably. Existing predictive risk models provide a good starting point, but optimally balancing resources and targeting interventions on the community level will likely require a more holistic approach to health needs assessment. Development of additional determinants, such as measures of people's lifestyle and social network, may require policies pushing the integration of routine data from different (healthcare) sources. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Integrated Geothermal-CO2 Storage Reservoirs: FY1 Final Report

DOE Data Explorer

Buscheck, Thomas A.

2012-01-01

The purpose of phase 1 is to determine the feasibility of integrating geologic CO2 storage (GCS) with geothermal energy production. Phase 1 includes reservoir analyses to determine injector/producer well schemes that balance the generation of economically useful flow rates at the producers with the need to manage reservoir overpressure to reduce the risks associated with overpressure, such as induced seismicity and CO2 leakage to overlying aquifers. This submittal contains input and output files of the reservoir model analyses. A reservoir-model "index-html" file was sent in a previous submittal to organize the reservoir-model input and output files according to sections of the FY1 Final Report to which they pertain. The recipient should save the file: Reservoir-models-inputs-outputs-index.html in the same directory that the files: Section2.1.*.tar.gz files are saved in.

Marine water quality under climate change conditions/scenarios

NASA Astrophysics Data System (ADS)

Rizzi, Jonathan; Torresan, Silvia; Critto, Andrea; Zabeo, Alex; Brigolin, Daniele; Carniel, Sandro; Pastres, Roberto; Marcomini, Antonio

2016-04-01

The increase of sea temperature and the changes in marine currents are generating impacts on coastal waters such as changes in water biogeochemical and physical parameters (e.g. primary production, pH, salinity) leading to progressive degradation of the marine environment. With the main aim of analysing the potential impacts of climate change on coastal water quality, a Regional Risk Assessment (RRA) methodology was developed and applied to coastal marine waters of the North Adriatic (i.e. coastal water bodies of the Veneto and Friuli Venezia Giulia regions, Italy). RRA integrates the outputs of regional models providing information on macronutrients (i.e. dissolved inorganic nitrogen e reactive phosphorus), dissolved oxygen, pH, salinity and temperature, etc., under future climate change scenarios with site-specific environmental and socio-economic indicators (e.g. biotic index, presence and extension of seagrasses, presence of aquaculture). The presented approach uses Geographic Information Systems to manage, analyse, and visualize data and employs Multi-Criteria Decision Analysis for the integration of stakeholders preferences and experts judgments into the evaluation process. RRA outputs are hazard, exposure, vulnerability, risk and damage maps useful for the identification and prioritization of hot-spot areas and vulnerable targets in the considered region. Therefore, the main aim of this contribution is to apply the RRA methodology to integrate, visualize, and rank according to spatial distribution, physical and chemical data concerning the coastal waters of the North Adriatic Sea in order to predict possible changes of the actual water quality.

A "weight of evidence" approach for the integration of environmental "triad" data to assess ecological risk and biological vulnerability.

PubMed

Dagnino, Alessandro; Sforzini, Susanna; Dondero, Francesco; Fenoglio, Stefano; Bona, Elisa; Jensen, John; Viarengo, Aldo

2008-07-01

A new Expert Decision Support System (EDSS) that can integrate Triad data for assessing environmental risk and biological vulnerability at contaminated sites has been developed. Starting with ecosystem relevance, the EDSS assigns different weights to the results obtained from Triad disciplines. The following parameters have been employed: 1) chemical soil analyses (revealing the presence of potentially dangerous substances), 2) ecotoxicological bioassays (utilizing classical endpoints such as survival and reproduction rates), 3) biomarkers (showing sublethal pollutant effects), and 4) ecological parameters (assessing changes in community structure and functions). For each Triad discipline, the EDSS compares the data obtained at the studied field sites with reference values and calculates different 0-1 indexes (e.g., Chemical Risk Index, Ecotoxicological Risk Index, and Ecological Risk Index). The EDSS output consists of 3 indexes: 1) Environmental Risk index (EnvRI), quantifying the levels of biological damage at population-community level, 2) Biological Vulnerability Index (BVI), assessing the potential threats to biological equilibriums, and 3) Genotoxicity Index (GTI), screening genotoxicity effects. The EDSS has been applied in the integration of a battery of Triad data obtained during the European Union-funded Life Intervention in the Fraschetta Area (LINFA) project, which has been carried out in order to estimate the potential risk from soils of a highly anthropized area (Alessandria, Italy) mainly impacted by deposition of atmospheric pollutants. Results obtained during 4 seasonal sampling campaigns (2004-2005) show maximum values of EnvRI in sites A and B (characterized by industrial releases) and lower levels in site D (affected by vehicular traffic emissions). All 3 potentially polluted sites have shown high levels of BVI and GTI, suggesting a general change from reference conditions (site C).

Use of GIS in visualization of work-related health problems.

PubMed

Delaunay, M; Van der Westhuizen, H; Godard, V; Agius, R; Le Barbier, M; Godderis, L; Bonneterre, V

2015-11-01

Occupational health and safety (OHS) information is often complex, diverse and unstructured and suffers from a lack of integration which usually precludes any systemic insight of the situation. To analyse to what extent the use of geographical information systems (GISs) can help to integrate, analyse and present OHS data in a comprehensive and communicable way relevant for surveillance purposes. We first developed a 'macro-approach' (from national to local level), mapping data related to economic activity (denominator of active workers displayed by activity sectors), as well as work-related ill-health (numerators of workers suffering from work-related ill-health). The latter data are composed of compensated occupational diseases on the one hand and work-related diseases investigated by specialized clinics on the other hand. Then, a 'micro-approach' was worked out, integrating at a plant level, using computer-aided drawing, occupational risks data and OHS surveillance data (e.g. use of medication and sickness absence data). At the macro-level, microelectronics companies and workers were mapped at different scales. For the first time, we were able to compare, up to the enterprise level, complementary data showing different pictures of work-related ill-health, allowing a better understanding of OH issues in this sector. At the micro-level, new information arose from the integration of risk assessment data and medical data. This work illustrates to what extent GIS is a promising tool in the OHS field, and discusses related challenges (technical, ethical, biases and interpretation) and research perspectives. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Embedding Scientific Integrity and Ethics into the Scientific Process and Research Data Lifecycle

NASA Astrophysics Data System (ADS)

Gundersen, L. C.

2016-12-01

Predicting climate change, developing resources sustainably, and mitigating natural hazard risk are complex interdisciplinary challenges in the geosciences that require the integration of data and knowledge from disparate disciplines and scales. This kind of interdisciplinary science can only thrive if scientific communities work together and adhere to common standards of scientific integrity, ethics, data management, curation, and sharing. Science and data without integrity and ethics can erode the very fabric of the scientific enterprise and potentially harm society and the planet. Inaccurate risk analyses of natural hazards can lead to poor choices in construction, insurance, and emergency response. Incorrect assessment of mineral resources can bankrupt a company, destroy a local economy, and contaminate an ecosystem. This paper presents key ethics and integrity questions paired with the major components of the research data life cycle. The questions can be used by the researcher during the scientific process to help ensure the integrity and ethics of their research and adherence to sound data management practice. Questions include considerations for open, collaborative science, which is fundamentally changing the responsibility of scientists regarding data sharing and reproducibility. The publication of primary data, methods, models, software, and workflows must become a norm of science. There are also questions that prompt the scientist to think about the benefit of their work to society; ensuring equity, respect, and fairness in working with others; and always striving for honesty, excellence, and transparency.

Uncertainty and risk in wildland fire management: a review.

PubMed

Thompson, Matthew P; Calkin, Dave E

2011-08-01

Wildland fire management is subject to manifold sources of uncertainty. Beyond the unpredictability of wildfire behavior, uncertainty stems from inaccurate/missing data, limited resource value measures to guide prioritization across fires and resources at risk, and an incomplete scientific understanding of ecological response to fire, of fire behavior response to treatments, and of spatiotemporal dynamics involving disturbance regimes and climate change. This work attempts to systematically align sources of uncertainty with the most appropriate decision support methodologies, in order to facilitate cost-effective, risk-based wildfire planning efforts. We review the state of wildfire risk assessment and management, with a specific focus on uncertainties challenging implementation of integrated risk assessments that consider a suite of human and ecological values. Recent advances in wildfire simulation and geospatial mapping of highly valued resources have enabled robust risk-based analyses to inform planning across a variety of scales, although improvements are needed in fire behavior and ignition occurrence models. A key remaining challenge is a better characterization of non-market resources at risk, both in terms of their response to fire and how society values those resources. Our findings echo earlier literature identifying wildfire effects analysis and value uncertainty as the primary challenges to integrated wildfire risk assessment and wildfire management. We stress the importance of identifying and characterizing uncertainties in order to better quantify and manage them. Leveraging the most appropriate decision support tools can facilitate wildfire risk assessment and ideally improve decision-making. Published by Elsevier Ltd.

Predicting aggressive behaviour in acute forensic mental health units: A re-examination of the dynamic appraisal of situational aggression's predictive validity.

PubMed

Maguire, Tessa; Daffern, Michael; Bowe, Steven J; McKenna, Brian

2017-10-01

In the present study, we explored the predictive validity of the Dynamic Appraisal of Situational Aggression (DASA) assessment tool in male (n = 30) and female (n = 30) patients admitted to the acute units of a forensic mental health hospital. We also tested the psychometric properties of the original DASA bands and novel risk bands. The first 60 days of each patient's file was reviewed to identify daily DASA scores and subsequent risk-related nursing interventions and aggressive behaviour within the following 24 hours. Risk assessments, followed by documented nursing interventions, were removed to preserve the integrity of the risk-assessment analysis. Receiver-operator characteristics were used to test the predictive accuracy of the DASA, and generalized estimating equations (GEE) were used to account for repeated risk assessments, which occurs when analysing short-term risk-assessment data. The results revealed modest predictive validity for males and females. GEE analyses suggested the need to adjust the DASA risk bands to the following (with associated odds ratios (OR) for aggressive behaviour): 0 = low risk; 1, 2, 3 = moderate-risk OR, 4.70 (95% confidence interval (CI): 2.84-7.80); and 4, 5, 6, 7 = high-risk OR, 16.13 (95% CI: 9.71-26.78). The adjusted DASA risk bands could assist nurses by prompting violence-prevention interventions when the level of risk is elevated. © 2017 Australian College of Mental Health Nurses Inc.

Database assessment of CMIP5 and hydrological models to determine flood risk areas

NASA Astrophysics Data System (ADS)

Limlahapun, Ponthip; Fukui, Hiromichi

2016-11-01

Solutions for water-related disasters may not be solved with a single scientific method. Based on this premise, we involved logic conceptions, associate sequential result amongst models, and database applications attempting to analyse historical and future scenarios in the context of flooding. The three main models used in this study are (1) the fifth phase of the Coupled Model Intercomparison Project (CMIP5) to derive precipitation; (2) the Integrated Flood Analysis System (IFAS) to extract amount of discharge; and (3) the Hydrologic Engineering Center (HEC) model to generate inundated areas. This research notably focused on integrating data regardless of system-design complexity, and database approaches are significantly flexible, manageable, and well-supported for system data transfer, which makes them suitable for monitoring a flood. The outcome of flood map together with real-time stream data can help local communities identify areas at-risk of flooding in advance.

Integrated genetic and epigenetic prediction of coronary heart disease in the Framingham Heart Study.

PubMed

Dogan, Meeshanthini V; Grumbach, Isabella M; Michaelson, Jacob J; Philibert, Robert A

2018-01-01

An improved method for detecting coronary heart disease (CHD) could have substantial clinical impact. Building on the idea that systemic effects of CHD risk factors are a conglomeration of genetic and environmental factors, we use machine learning techniques and integrate genetic, epigenetic and phenotype data from the Framingham Heart Study to build and test a Random Forest classification model for symptomatic CHD. Our classifier was trained on n = 1,545 individuals and consisted of four DNA methylation sites, two SNPs, age and gender. The methylation sites and SNPs were selected during the training phase. The final trained model was then tested on n = 142 individuals. The test data comprised of individuals removed based on relatedness to those in the training dataset. This integrated classifier was capable of classifying symptomatic CHD status of those in the test set with an accuracy, sensitivity and specificity of 78%, 0.75 and 0.80, respectively. In contrast, a model using only conventional CHD risk factors as predictors had an accuracy and sensitivity of only 65% and 0.42, respectively, but with a specificity of 0.89 in the test set. Regression analyses of the methylation signatures illustrate our ability to map these signatures to known risk factors in CHD pathogenesis. These results demonstrate the capability of an integrated approach to effectively model symptomatic CHD status. These results also suggest that future studies of biomaterial collected from longitudinally informative cohorts that are specifically characterized for cardiac disease at follow-up could lead to the introduction of sensitive, readily employable integrated genetic-epigenetic algorithms for predicting onset of future symptomatic CHD.

Integrating Climate Change Adaptation into Disaster Risk Reduction in Urban Contexts: Perceptions and Practice

PubMed Central

Rivera, Claudia

2014-01-01

This paper analyses the perceptions of disaster risk reduction (DRR) practitioners concerning the on-going integration of climate change adaptation (CCA) into their practices in urban contexts in Nicaragua. Understanding their perceptions is important as this will provide information on how this integration can be improved. Exploring the perceptions of practitioners in Nicaragua is important as the country has a long history of disasters, and practitioners have been developing the current DRR planning framework for more than a decade. The analysis is based on semi-structured interviews designed to collect information about practitioners’ understanding of: (a) CCA, (b) the current level of integration of CCA into DRR and urban planning, (c) the opportunities and constraints of this integration, and (d) the potential to adapt cities to climate change. The results revealed that practitioners’ perception is that the integration of CCA into their practice is at an early stage, and that they need to improve their understanding of CCA in terms of a development issue. Three main constraints on improved integration were identified: (a) a recognized lack of understanding of CCA, (b) insufficient guidance on how to integrate it, and (c) the limited opportunities to integrate it into urban planning due to a lack of instruments and capacity in this field. Three opportunities were also identified: (a) practitioners’ awareness of the need to integrate CCA into their practices, (b) the robust structure of the DRR planning framework in the country, which provides a suitable channel for facilitating integration, and (c) the fact that CCA is receiving more attention and financial and technical support from the international community. PMID:24475365

Literature review of baseline study for risk analysis - the landfill leachate case.

PubMed

Butt, T E; Gouda, H M; Baloch, M I; Paul, P; Javadi, A A; Alam, A

2014-02-01

There is growing awareness and public concern about environmental impacts of waste management and disposal. Environmental policy instruments have been strengthened and associated governmental programmes have increased in recent years, resulting in high level strategies for waste management. Risk assessment is now an essential tool in the prioritisation of environmental and human health protection. However, regulators need to compare the full range of risks on a sound and consistent basis. Comparing risks from such diverse sources poses a significant challenge, and traditional hazard and risk assessments are no longer sufficient. Consideration now needs to be given to a much wider range of factors if risk assessment is to be used as an aid to more integrated decision-making process. For this purpose, baseline study - the foundation of risk assessment - can play a crucial role. To date limited research has been conducted on the need, parameters, requirements, and constituents of baseline study particularly in the context of how, why, and what information is to be collated in order to render risk assessments more appropriately integrated and complete. To establish the 'state-of-the-art' of baseline study, this paper comprehensively reviews the literature regarding environmental risk assessment in general terms, and then proceeds to review work that is specifically related to landfills and landfill leachate, thereby identifying knowledge gaps and shortfall areas. This review concludes that a holistic baseline study procedure for waste disposal sites, which risk assessors could use for carrying out risk analyses specifically for landfill leachate, does not as yet exist. © 2013.

Engineering Risk Assessment of Space Thruster Challenge Problem

NASA Technical Reports Server (NTRS)

Mathias, Donovan L.; Mattenberger, Christopher J.; Go, Susie

2014-01-01

The Engineering Risk Assessment (ERA) team at NASA Ames Research Center utilizes dynamic models with linked physics-of-failure analyses to produce quantitative risk assessments of space exploration missions. This paper applies the ERA approach to the baseline and extended versions of the PSAM Space Thruster Challenge Problem, which investigates mission risk for a deep space ion propulsion system with time-varying thruster requirements and operations schedules. The dynamic mission is modeled using a combination of discrete and continuous-time reliability elements within the commercially available GoldSim software. Loss-of-mission (LOM) probability results are generated via Monte Carlo sampling performed by the integrated model. Model convergence studies are presented to illustrate the sensitivity of integrated LOM results to the number of Monte Carlo trials. A deterministic risk model was also built for the three baseline and extended missions using the Ames Reliability Tool (ART), and results are compared to the simulation results to evaluate the relative importance of mission dynamics. The ART model did a reasonable job of matching the simulation models for the baseline case, while a hybrid approach using offline dynamic models was required for the extended missions. This study highlighted that state-of-the-art techniques can adequately adapt to a range of dynamic problems.

Integrating population dynamics into mapping human exposure to seismic hazard

NASA Astrophysics Data System (ADS)

Freire, S.; Aubrecht, C.

2012-11-01

Disaster risk is not fully characterized without taking into account vulnerability and population exposure. Assessment of earthquake risk in urban areas would benefit from considering the variation of population distribution at more detailed spatial and temporal scales, and from a more explicit integration of this improved demographic data with existing seismic hazard maps. In the present work, "intelligent" dasymetric mapping is used to model population dynamics at high spatial resolution in order to benefit the analysis of spatio-temporal exposure to earthquake hazard in a metropolitan area. These night- and daytime-specific population densities are then classified and combined with seismic intensity levels to derive new spatially-explicit four-class-composite maps of human exposure. The presented approach enables a more thorough assessment of population exposure to earthquake hazard. Results show that there are significantly more people potentially at risk in the daytime period, demonstrating the shifting nature of population exposure in the daily cycle and the need to move beyond conventional residence-based demographic data sources to improve risk analyses. The proposed fine-scale maps of human exposure to seismic intensity are mainly aimed at benefiting visualization and communication of earthquake risk, but can be valuable in all phases of the disaster management process where knowledge of population densities is relevant for decision-making.

Risk, Resiliency, and Coping in National Guard Families

DTIC Science & Technology

2015-10-01

especially as it relates to resiliency. We set out to collect both quantitative survey data and qualitative interview data from one infantry battalion...date, we have collected predeployment (Time 1) and postdeployment (Time 2) survey data from service members and their spouse/significant other or parent...post-deployment surveys and have integrated this data with pre- deployment data and running analyses that will be a focus dissemination of the

Can cognitive behavioural therapy based strategies be integrated into physiotherapy for the prevention of chronic low back pain? A systematic review.

PubMed

Brunner, Emanuel; De Herdt, Amber; Minguet, Philippe; Baldew, Se-Sergio; Probst, Michel

2013-01-01

The primary purpose was to detect randomized controlled trials investigating cognitive behaviour therapy-based (CBT) treatments applied in acute/sub-acute low back pain (LBP). The secondary purpose was to analyse the methodological properties of the included studies, and to identify theory-based treatment strategies that are applicable for physiotherapists. A systematic literature search was conducted using four databases. Risk of bias of included studies was assessed and the methodological properties summarized. In addition, content and treatment theory of detected CBT-based strategies were systematically analysed and classified into three distinctive concepts of CBT: operant, cognitive and respondent treatment. Finally, applicability of treatment strategies in physiotherapy practice was discussed. Eight studies were included in the present systematic review. Half of the studies suffered from high risk of bias, and study characteristics varied in all domains of methodology, particularly in terms of treatment design and outcome measures. Graded activity, an operant treatment approach based on principles of operant conditioning, was identified as a CBT-based strategy with traceable theoretical justification that can be applied by physiotherapists. Operant conditioning can be integrated in ambulant physiotherapy practice and is a promising CBT-based strategy for the prevention of chronic LBP.

Rehabilitation and Flood Management Planning in a Steep, Boulder-Bedded Stream

NASA Astrophysics Data System (ADS)

Caruso, Brian S.; Downs, Peter W.

2007-08-01

This study demonstrates the integration of rehabilitation and flood management planning in a steep, boulder-bedded stream in a coastal urban catchment on the South Island of New Zealand. The Water of Leith, the primary stream flowing through the city of Dunedin, is used as a case study. The catchment is steep, with a short time of concentration and rapid hydrologic response, and the lower stream reaches are highly channelized with floodplain encroachment, a high potential for debris flows, significant flood risks, and severely degraded aquatic habitat. Because the objectives for rehabilitation and flood management in urban catchments are often conflicting, a number of types of analyses at both the catchment and the reach scales and careful planning with stakeholder consultation were needed for successful rehabilitation efforts. This included modeling and analysis of catchment hydrology, fluvial geomorphologic assessment, analysis of water quality and aquatic ecology, hydraulic modeling and flood risk evaluation, detailed feasibility studies, and preliminary design to optimize multiple rehabilitation and flood management objectives. The study showed that all of these analyses were needed for integrated rehabilitation and flood management and that some incremental improvements in stream ecological health, aesthetics, and public recreational opportunities could be achieved in this challenging environment. These methods should be considered in a range of types of stream rehabilitation projects.

CHANGES SDSS: the development of a Spatial Decision Support System for analysing changing hydro-meteorological risk

NASA Astrophysics Data System (ADS)

van Westen, Cees; Bakker, Wim; Zhang, Kaixi; Jäger, Stefan; Assmann, Andre; Kass, Steve; Andrejchenko, Vera; Olyazadeh, Roya; Berlin, Julian; Cristal, Irina

2014-05-01

Within the framework of the EU FP7 Marie Curie Project CHANGES (www.changes-itn.eu) and the EU FP7 Copernicus project INCREO (http://www.increo-fp7.eu) a spatial decision support system is under development with the aim to analyse the effect of risk reduction planning alternatives on reducing the risk now and in the future, and support decision makers in selecting the best alternatives. The Spatial Decision Support System will be composed of a number of integrated components. The Risk Assessment component allows to carry out spatial risk analysis, with different degrees of complexity, ranging from simple exposure (overlay of hazard and assets maps) to quantitative analysis (using different hazard types, temporal scenarios and vulnerability curves) resulting into risk curves. The platform does not include a component to calculate hazard maps, and existing hazard maps are used as input data for the risk component. The second component of the SDSS is a risk reduction planning component, which forms the core of the platform. This component includes the definition of risk reduction alternatives (related to disaster response planning, risk reduction measures and spatial planning) and links back to the risk assessment module to calculate the new level of risk if the measure is implemented, and a cost-benefit (or cost-effectiveness/ Spatial Multi Criteria Evaluation) component to compare the alternatives and make decision on the optimal one. The third component of the SDSS is a temporal scenario component, which allows to define future scenarios in terms of climate change, land use change and population change, and the time periods for which these scenarios will be made. The component doesn't generate these scenarios but uses input maps for the effect of the scenarios on the hazard and assets maps. The last component is a communication and visualization component, which can compare scenarios and alternatives, not only in the form of maps, but also in other forms (risk curves, tables, graphs). The envisaged users of the platform are organizations involved in planning of risk reduction measures, and that have staff capable of visualizing and analysing spatial data at a municipal scale.

Integrated flash flood vulnerability assessment: Insights from East Attica, Greece

NASA Astrophysics Data System (ADS)

Karagiorgos, Konstantinos; Thaler, Thomas; Heiser, Micha; Hübl, Johannes; Fuchs, Sven

2016-10-01

In the framework of flood risk assessment, vulnerability is a key concept to assess the susceptibility of elements at risk. Besides the increasing amount of studies on flash floods available, in-depth information on vulnerability in Mediterranean countries was missing so far. Moreover, current approaches in vulnerability research are driven by a divide between social scientists who tend to view vulnerability as representing a set of socio-economic factors, and natural scientists who view vulnerability in terms of the degree of loss to an element at risk. Further, vulnerability studies in response to flash flood processes are rarely answered in the literature. In order to close this gap, this paper implemented an integrated vulnerability approach focusing on residential buildings exposed to flash floods in Greece. In general, both physical and social vulnerability was comparable low, which is interpreted as a result from (a) specific building regulations in Greece as well as general design principles leading to less structural susceptibility of elements at risk exposed, and (b) relatively low economic losses leading to less social vulnerability of citizens exposed. The population show high risk awareness and coping capacity to response to natural hazards event and in the same time the impact of the events are quite low, because of the already high use of local protection measures. The low vulnerability score for East Attica can be attributed especially to the low physical vulnerability and the moderate socio-economic well-being of the area. The consequence is to focus risk management strategies mainly in the reduction of the social vulnerability. By analysing both physical and social vulnerability an attempt was made to bridge the gap between scholars from sciences and humanities, and to integrate the results of the analysis into the broader vulnerability context.

Further Confirmation of Germline Glioma Risk Variant rs78378222 in TP53 and Its Implication in Tumor Tissues via Integrative Analysis of TCGA Data

PubMed Central

Wang, Zhaoming; Rajaraman, Preetha; Melin, Beatrice S.; Chung, Charles C.; Zhang, Weijia; McKean-Cowdin, Roberta; Michaud, Dominique; Yeager, Meredith; Ahlbom, Anders; Albanes, Demetrius; Andersson, Ulrika; Beane Freeman, Laura E.; Buring, Julie E.; Butler, Mary Ann; Carreón, Tania; Feychting, Maria; Gapstur, Susan M.; Gaziano, J. Michael; Giles, Graham G.; Hallmans, Goran; Henriksson, Roger; Hoffman-Bolton, Judith; Inskip, Peter D.; Kitahara, Cari M.; Le Marchand, Loic; Linet, Martha S.; Li, Shengchao; Peters, Ulrike; Purdue, Mark P.; Rothman, Nathaniel; Ruder, Avima M.; Sesso, Howard D.; Severi, Gianluca; Stampfer, Meir; Stevens, Victoria L.; Visvanathan, Kala; Wang, Sophia S.; White, Emily; Zeleniuch-Jacquotte, Anne; Hoover, Robert; Fraumeni, Joseph F.; Chatterjee, Nilanjan; Hartge, Patricia; Chanock, Stephen J.

2016-01-01

We confirmed strong association of rs78378222:A>C (per allele odds ratio [OR] = 3.14; P = 6.48 × 10−11), a germline rare single-nucleotide polymorphism (SNP) in TP53, via imputation of a genome-wide association study of glioma (1,856 cases and 4,955 controls). We subsequently performed integrative analyses on the Cancer Genome Atlas (TCGA) data for GBM (glioblastoma multiforme) and LUAD (lung adenocarcinoma). Based on SNP data, we imputed genotypes for rs78378222 and selected individuals carrying rare risk allele (C). Using RNA sequencing data, we observed aberrant transcripts with ~3 kb longer than normal for those individuals. Using exome sequencing data, we further showed that loss of haplotype carrying common protective allele (A) occurred somatically in GBM but not in LUAD. Our bioinformatic analysis suggests rare risk allele (C) disrupts mRNA termination, and an allelic loss of a genomic region harboring common protective allele (A) occurs during tumor initiation or progression for glioma. PMID:25907361

Aortic stiffness is associated with white matter integrity in patients with type 1 diabetes.

PubMed

Tjeerdema, Nathanja; Van Schinkel, Linda D; Westenberg, Jos J; Van Elderen, Saskia G; Van Buchem, Mark A; Smit, Johannes W; Van der Grond, Jeroen; De Roos, Albert

2014-09-01

To assess the association between aortic pulse wave velocity (PWV) as a marker of arterial stiffness and diffusion tensor imaging of brain white matter integrity in patients with type 1 diabetes using advanced magnetic resonance imaging (MRI) technology. Forty-one patients with type 1 diabetes (23 men, mean age 44 ± 12 years, mean diabetes duration 24 ± 13 years) were included. Aortic PWV was assessed using through-plane velocity-encoded MRI. Brain diffusion tensor imaging (DTI) measurements were performed on 3-T MRI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated for white and grey matter integrity. Pearson correlation and multivariable linear regression analyses including cardiovascular risk factors as covariates were assessed. Multivariable linear regression analyses revealed that aortic PWV is independently associated with white matter integrity FA (β = -0.777, p = 0.008) in patients with type 1 diabetes. This effect was independent of age, gender, mean arterial pressure, body mass index, smoking, duration of diabetes and glycated haemoglobin levels. Aortic PWV was not significantly related to grey matter integrity. Our data suggest that aortic stiffness is independently associated with reduced white matter integrity in patients with type 1 diabetes. Aortic stiffness is associated with brain injury. Aortic stiffness exposes small vessels to high pressure fluctuations and flow. Aortic stiffness is associated with microvascular brain injury in diabetes. This suggests a vascular contribution to early subtle microstructural deficits.

Prefrontal gray matter volume mediates genetic risks for obesity.

PubMed

Opel, N; Redlich, R; Kaehler, C; Grotegerd, D; Dohm, K; Heindel, W; Kugel, H; Thalamuthu, A; Koutsouleris, N; Arolt, V; Teuber, A; Wersching, H; Baune, B T; Berger, K; Dannlowski, U

2017-05-01

Genetic and neuroimaging research has identified neurobiological correlates of obesity. However, evidence for an integrated model of genetic risk and brain structural alterations in the pathophysiology of obesity is still absent. Here we investigated the relationship between polygenic risk for obesity, gray matter structure and body mass index (BMI) by the use of univariate and multivariate analyses in two large, independent cohorts (n=330 and n=347). Higher BMI and higher polygenic risk for obesity were significantly associated with medial prefrontal gray matter decrease, and prefrontal gray matter was further shown to significantly mediate the effect of polygenic risk for obesity on BMI in both samples. Building on this, the successful individualized prediction of BMI by means of multivariate pattern classification algorithms trained on whole-brain imaging data and external validations in the second cohort points to potential clinical applications of this imaging trait marker.

Stochastic Generation of Spatiotemporal Rainfall Events for Flood Risk Assessment

NASA Astrophysics Data System (ADS)

Diederen, D.; Liu, Y.; Gouldby, B.; Diermanse, F.

2017-12-01

Current flood risk analyses that only consider peaks of hydrometeorological forcing variables have limitations regarding their representation of reality. Simplistic assumptions regarding antecedent conditions are required, often different sources of flooding are considered in isolation, and the complex temporal and spatial evolution of the events is not considered. Mid-latitude storms, governed by large scale climatic conditions, often exhibit a high degree of temporal dependency, for example. For sustainable flood risk management, that accounts appropriately for climate change, it is desirable for flood risk analyses to reflect reality more appropriately. Analysis of risk mitigation measures and comparison of their relative performance is therefore likely to be more robust and lead to improved solutions. We provide a new framework for the provision of boundary conditions to flood risk analyses that more appropriately reflects reality. The boundary conditions capture the temporal dependencies of complex storms whilst preserving the extreme values and associated spatial dependencies. We demonstrate the application of this framework to generate a synthetic rainfall events time series boundary condition set from reanalysis rainfall data (CFSR) on the continental scale. We define spatiotemporal clusters of rainfall as events, extract hydrological parameters for each event, generate synthetic parameter sets with a multivariate distribution with a focus on the joint tail probability [Heffernan and Tawn, 2004], and finally create synthetic events from the generated synthetic parameters. We highlight the stochastic integration of (a) spatiotemporal features, e.g. event occurrence intensity over space-time, or time to previous event, which we use for the spatial placement and sequencing of the synthetic events, and (b) value-specific parameters, e.g. peak intensity and event extent. We contrast this to more traditional approaches to highlight the significant improvements in terms of representing the reality of extreme flood events.

Integrative analyses of leprosy susceptibility genes indicate a common autoimmune profile.

PubMed

Zhang, Deng-Feng; Wang, Dong; Li, Yu-Ye; Yao, Yong-Gang

2016-04-01

Leprosy is an ancient chronic infection in the skin and peripheral nerves caused by Mycobacterium leprae. The development of leprosy depends on genetic background and the immune status of the host. However, there is no systematic view focusing on the biological pathways, interaction networks and overall expression pattern of leprosy-related immune and genetic factors. To identify the hub genes in the center of leprosy genetic network and to provide an insight into immune and genetic factors contributing to leprosy. We retrieved all reported leprosy-related genes and performed integrative analyses covering gene expression profiling, pathway analysis, protein-protein interaction network, and evolutionary analyses. A list of 123 differentially expressed leprosy related genes, which were enriched in activation and regulation of immune response, was obtained in our analyses. Cross-disorder analysis showed that the list of leprosy susceptibility genes was largely shared by typical autoimmune diseases such as lupus erythematosus and arthritis, suggesting that similar pathways might be affected in leprosy and autoimmune diseases. Protein-protein interaction (PPI) and positive selection analyses revealed a co-evolution network of leprosy risk genes. Our analyses showed that leprosy associated genes constituted a co-evolution network and might undergo positive selection driven by M. leprae. We suggested that leprosy may be a kind of autoimmune disease and the development of leprosy is a matter of defect or over-activation of body immunity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Delivering integrated HAZUS-MH flood loss analyses and flood inundation maps over the Web.

PubMed

Hearn, Paul P; Longenecker, Herbert E; Aguinaldo, John J; Rahav, Ami N

2013-01-01

Catastrophic flooding is responsible for more loss of life and damages to property than any other natural hazard. Recently developed flood inundation mapping technologies make it possible to view the extent and depth of flooding on the land surface over the Internet; however, by themselves these technologies are unable to provide estimates of losses to property and infrastructure. The Federal Emergency Management Agency's (FEMA's) HAZUS-MH software is extensively used to conduct flood loss analyses in the United States, providing a nationwide database of population and infrastructure at risk. Unfortunately, HAZUS-MH requires a dedicated Geographic Information System (GIS) workstation and a trained operator, and analyses are not adapted for convenient delivery over the Web. This article describes a cooperative effort by the US Geological Survey (USGS) and FEMA to make HAZUS-MH output GIS and Web compatible and to integrate these data with digital flood inundation maps in USGS's newly developed Inundation Mapping Web Portal. By running the computationally intensive HAZUS-MH flood analyses offline and converting the output to a Web-GIS compatible format, detailed estimates of flood losses can now be delivered to anyone with Internet access, thus dramatically increasing the availability of these forecasts to local emergency planners and first responders.

Delivering integrated HAZUS-MH flood loss analyses and flood inundation maps over the Web

USGS Publications Warehouse

Hearn,, Paul P.; Longenecker, Herbert E.; Aguinaldo, John J.; Rahav, Ami N.

2013-01-01

Catastrophic flooding is responsible for more loss of life and damages to property than any other natural hazard. Recently developed flood inundation mapping technologies make it possible to view the extent and depth of flooding on the land surface over the Internet; however, by themselves these technologies are unable to provide estimates of losses to property and infrastructure. The Federal Emergency Management Agency’s (FEMA's) HAZUS-MH software is extensively used to conduct flood loss analyses in the United States, providing a nationwide database of population and infrastructure at risk. Unfortunately, HAZUS-MH requires a dedicated Geographic Information System (GIS) workstation and a trained operator, and analyses are not adapted for convenient delivery over the Web. This article describes a cooperative effort by the US Geological Survey (USGS) and FEMA to make HAZUS-MH output GIS and Web compatible and to integrate these data with digital flood inundation maps in USGS’s newly developed Inundation Mapping Web Portal. By running the computationally intensive HAZUS-MH flood analyses offline and converting the output to a Web-GIS compatible format, detailed estimates of flood losses can now be delivered to anyone with Internet access, thus dramatically increasing the availability of these forecasts to local emergency planners and first responders.

From event analysis to global lessons: disaster forensics for building resilience

NASA Astrophysics Data System (ADS)

Keating, Adriana; Venkateswaran, Kanmani; Szoenyi, Michael; MacClune, Karen; Mechler, Reinhard

2016-07-01

With unprecedented growth in disaster risk, there is an urgent need for enhanced learning and understanding of disasters, particularly in relation to the trends in drivers of increasing risk. Building on the disaster forensics field, we introduce the post-event review capability (PERC) methodology for systematically and holistically analysing disaster events, and identifying actionable recommendations. PERC responds to a need for learning about the successes and failures in disaster risk management and resilience, and uncovers the underlying drivers of increasing risk. We draw generalisable insights identified from seven applications of the methodology to date, where we find that across the globe policy makers and practitioners in disaster risk management face strikingly similar challenges despite variations in context, indicating encouraging potential for mutual learning. These lessons highlight the importance of integrated risk reduction strategies. We invite others to utilise the freely available PERC approach and contribute to building a repository of learning on disaster risk management and resilience.

Homologous and heterologous recombination between adenovirus vector DNA and chromosomal DNA.

PubMed

Stephen, Sam Laurel; Sivanandam, Vijayshankar Ganesh; Kochanek, Stefan

2008-11-01

Adenovirus vector DNA is perceived to remain as episome following gene transfer. We quantitatively and qualitatively analysed recombination between high capacity adenoviral vector (HC-AdV) and chromosomal DNA following gene transfer in vitro. We studied homologous and heterologous recombination with a single HC-AdV carrying (i) a large genomic HPRT fragment with the HPRT CHICAGO mutation causing translational stop upon homologous recombination with the HPRT locus and (ii) a selection marker to allow for clonal selection in the event of heterologous recombination. We analysed the sequences at the junctions between vector and chromosomal DNA. In primary cells and in cell lines, the frequency of homologous recombination ranged from 2 x 10(-5) to 1.6 x 10(-6). Heterologous recombination occurred at rates between 5.5 x 10(-3) and 1.1 x 10(-4). HC-AdV DNA integrated via the termini mostly as intact molecules. Analysis of the junction sequences indicated vector integration in a relatively random manner without an obvious preference for particular chromosomal regions, but with a preference for integration into genes. Integration into protooncogenes or tumor suppressor genes was not observed. Patchy homologies between vector termini and chromosomal DNA were found at the site of integration. Although the majority of integrations had occurred without causing mutations in the chromosomal DNA, cases of nucleotide substitutions and insertions were observed. In several cases, deletions of even relative large chromosomal regions were likely. These results extend previous information on the integration patterns of adenovirus vector DNA and contribute to a risk-benefit assessment of adenovirus-mediated gene transfer.

A Prorating Method for Estimating MMPI-2-RF Scores From MMPI Responses: Examination of Score Fidelity and Illustration of Empirical Utility in the PERSEREC Police Integrity Study Sample.

PubMed

Tarescavage, Anthony M; Corey, David M; Ben-Porath, Yossef S

2016-04-01

The purpose of the current study was to identify Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) correlates of police officer integrity violations and other problem behaviors in an archival database with original MMPI item responses and collateral information regarding integrity violations obtained for 417 male officers. In Study 1, we estimated MMPI-2-RF scores from the MMPI item pool (which includes approximately 80% of the MMPI-2-RF items) in a normative sample, a psychiatric inpatient sample, and a police officer sample, and conducted analyses that demonstrated the comparability of estimated and full scale scores for 41 of the 51 MMPI-2-RF scales. In Study 2, we correlated estimated MMPI-2-RF scores with information about subsequent integrity violations and problem behaviors from the integrity violation data set. Several meaningful associations were obtained, predominately with scales from the emotional, thought, and behavioral dysfunction domains of the MMPI-2-RF. Application of a correction for range restriction yielded substantially improved validity estimates. Finally, we calculated relative risk ratios for the statistically significant findings using cutoffs lower than 65T, which is traditionally used to identify clinically significant elevations, and found several meaningful relative risk ratios. © The Author(s) 2015.

Space Shuttle critical function audit

NASA Technical Reports Server (NTRS)

Sacks, Ivan J.; Dipol, John; Su, Paul

1990-01-01

A large fault-tolerance model of the main propulsion system of the US space shuttle has been developed. This model is being used to identify single components and pairs of components that will cause loss of shuttle critical functions. In addition, this model is the basis for risk quantification of the shuttle. The process used to develop and analyze the model is digraph matrix analysis (DMA). The DMA modeling and analysis process is accessed via a graphics-based computer user interface. This interface provides coupled display of the integrated system schematics, the digraph models, the component database, and the results of the fault tolerance and risk analyses.

Improvements to the Ionizing Radiation Risk Assessment Program for NASA Astronauts

NASA Technical Reports Server (NTRS)

Semones, E. J.; Bahadori, A. A.; Picco, C. E.; Shavers, M. R.; Flores-McLaughlin, J.

2011-01-01

To perform dosimetry and risk assessment, NASA collects astronaut ionizing radiation exposure data from space flight, medical imaging and therapy, aviation training activities and prior occupational exposure histories. Career risk of exposure induced death (REID) from radiation is limited to 3 percent at a 95 percent confidence level. The Radiation Health Office at Johnson Space Center (JSC) is implementing a program to integrate the gathering, storage, analysis and reporting of astronaut ionizing radiation dose and risk data and records. This work has several motivations, including more efficient analyses and greater flexibility in testing and adopting new methods for evaluating risks. The foundation for these improvements is a set of software tools called the Astronaut Radiation Exposure Analysis System (AREAS). AREAS is a series of MATLAB(Registered TradeMark)-based dose and risk analysis modules that interface with an enterprise level SQL Server database by means of a secure web service. It communicates with other JSC medical and space weather databases to maintain data integrity and consistency across systems. AREAS is part of a larger NASA Space Medicine effort, the Mission Medical Integration Strategy, with the goal of collecting accurate, high-quality and detailed astronaut health data, and then securely, timely and reliably presenting it to medical support personnel. The modular approach to the AREAS design accommodates past, current, and future sources of data from active and passive detectors, space radiation transport algorithms, computational phantoms and cancer risk models. Revisions of the cancer risk model, new radiation detection equipment and improved anthropomorphic computational phantoms can be incorporated. Notable hardware updates include the Radiation Environment Monitor (which uses Medipix technology to report real-time, on-board dosimetry measurements), an updated Tissue-Equivalent Proportional Counter, and the Southwest Research Institute Radiation Assessment Detector. Also, the University of Florida hybrid phantoms, which are flexible in morphometry and positioning, are being explored as alternatives to the current NASA computational phantoms.

Factors associated with menstrual cycle irregularity and menopause.

PubMed

Bae, Jinju; Park, Susan; Kwon, Jin-Won

2018-02-06

A regular menstrual cycle is an important indicator of a healthy reproductive system. Previous studies reported obesity, stress, and smoking as the factors that are associated with irregular menstruation and early menopause. However, the integrative effects of these modifiable risk factors have not been fully understood. This study aimed to investigate the modifiable risk factors of menstrual cycle irregularity and premature menopause, as well as their individual and combined effects among adult women in Korea. This study selected adult women aged 19 years and above who had been included in the 2007-2014 Korean National Health and Nutrition Examination Survey. We used a separate dataset to analyze the risk factors of menstrual cycle irregularity and menopause (pre- and postmenopausal women: n = 4788 and n = 10,697, respectively). Univariate and multiple logistic regression analyses were conducted to evaluate the effects of smoking, drinking, obesity, and perceived level of stress on the menstrual cycle and menopause. Both logit and linear models were used in the analyses of the association between smoking and menopausal age. Equivalized household income, marital status, and educational level were considered as covariates. The modifiable risk factor scores were also calculated to integrate the effect of smoking, drinking, and obesity in the analysis. Results showed that smoking status, pack-year, obesity, and perceived level of stress were significantly associated with irregular menstruation among premenopausal women. Especially, women demonstrating > 3 modifiable risk factor scores had 1.7 times higher risk of having irregular menstruation than those who had a 0 score. Meanwhile, early initiation of smoking (≤19 years) and high pack-year (≥5) were also significantly associated with premature menopause among postmenopausal women. This study demonstrated that modifiable risk factors, such as smoking, obesity, and stress, were significantly associated with menstrual cycle irregularity. Lifetime smoking was also correlated with early menopause. Our results suggested that healthier lifestyle practices, including, cessation of smoking, weight control, and stress management, were important factors in improving the reproductive health of women throughout life.

Integrating public health and medical intelligence gathering into homeland security fusion centres.

PubMed

Lenart, Brienne; Albanese, Joseph; Halstead, William; Schlegelmilch, Jeffrey; Paturas, James

Homeland security fusion centres serve to gather, analyse and share threat-related information among all levels of governments and law enforcement agencies. In order to function effectively, fusion centres must employ people with the necessary competencies to understand the nature of the threat facing a community, discriminate between important information and irrelevant or merely interesting facts and apply domain knowledge to interpret the results to obviate or reduce the existing danger. Public health and medical sector personnel routinely gather, analyse and relay health-related inform-ation, including health security risks, associated with the detection of suspicious biological or chemical agents within a community to law enforcement agencies. This paper provides a rationale for the integration of public health and medical personnel in fusion centres and describes their role in assisting law enforcement agencies, public health organisations and the medical sector to respond to natural or intentional threats against local communities, states or the nation as a whole.

Detecting GNSS spoofing attacks using INS coupling

NASA Astrophysics Data System (ADS)

Tanil, Cagatay

Vulnerability of Global Navigation Satellite Systems (GNSS) users to signal spoofing is a critical threat to positioning integrity, especially in aviation applications, where the consequences are potentially catastrophic. In response, this research describes and evaluates a new approach to directly detect spoofing using integrated Inertial Navigation Systems (INS) and fault detection concepts based on integrity monitoring. The monitors developed here can be implemented into positioning systems using INS/GNSS integration via 1) tightly-coupled, 2) loosely-coupled, and 3) uncoupled schemes. New evaluation methods enable the statistical computation of integrity risk resulting from a worst-case spoofing attack - without needing to simulate an unmanageably large number of individual aircraft approaches. Integrity risk is an absolute measure of safety and a well-established metric in aircraft navigation. A novel closed-form solution to the worst-case time sequence of GNSS signals is derived to maximize the integrity risk for each monitor and used in the covariance analyses. This methodology tests the performance of the monitors against the most sophisticated spoofers, capable of tracking the aircraft position - for example, by means of remote tracking or onboard sensing. Another contribution is a comprehensive closed-loop model that encapsulates the vehicle and compensator (estimator and controller) dynamics. A sensitivity analysis uses this model to quantify the leveraging impact of the vehicle's dynamic responses (e.g., to wind gusts, or to autopilot's acceleration commands) on the monitor's detection capability. The performance of the monitors is evaluated for two safety-critical terminal area navigation applications: 1) autonomous shipboard landing and 2) Boeing 747 (B747) landing assisted with Ground Based Augmentation Systems (GBAS). It is demonstrated that for both systems, the monitors are capable of meeting the most stringent precision approach and landing integrity requirements of the International Civil Aviation Organization (ICAO). The statistical evaluation methods developed here can be used as a baseline procedure in the Federal Aviation Administration's (FAA) certification of spoof-free navigation systems. The final contribution is an investigation of INS sensor quality on detection performance. This determines the minimum sensor requirements to perform standalone GNSS positioning in general en route applications with guaranteed spoofing detection integrity.

Conscious worst case definition for risk assessment, part I: a knowledge mapping approach for defining most critical risk factors in integrative risk management of chemicals and nanomaterials.

PubMed

Sørensen, Peter B; Thomsen, Marianne; Assmuth, Timo; Grieger, Khara D; Baun, Anders

2010-08-15

This paper helps bridge the gap between scientists and other stakeholders in the areas of human and environmental risk management of chemicals and engineered nanomaterials. This connection is needed due to the evolution of stakeholder awareness and scientific progress related to human and environmental health which involves complex methodological demands on risk management. At the same time, the available scientific knowledge is also becoming more scattered across multiple scientific disciplines. Hence, the understanding of potentially risky situations is increasingly multifaceted, which again challenges risk assessors in terms of giving the 'right' relative priority to the multitude of contributing risk factors. A critical issue is therefore to develop procedures that can identify and evaluate worst case risk conditions which may be input to risk level predictions. Therefore, this paper suggests a conceptual modelling procedure that is able to define appropriate worst case conditions in complex risk management. The result of the analysis is an assembly of system models, denoted the Worst Case Definition (WCD) model, to set up and evaluate the conditions of multi-dimensional risk identification and risk quantification. The model can help optimize risk assessment planning by initial screening level analyses and guiding quantitative assessment in relation to knowledge needs for better decision support concerning environmental and human health protection or risk reduction. The WCD model facilitates the evaluation of fundamental uncertainty using knowledge mapping principles and techniques in a way that can improve a complete uncertainty analysis. Ultimately, the WCD is applicable for describing risk contributing factors in relation to many different types of risk management problems since it transparently and effectively handles assumptions and definitions and allows the integration of different forms of knowledge, thereby supporting the inclusion of multifaceted risk components in cumulative risk management. Copyright 2009 Elsevier B.V. All rights reserved.

Integrated Science Assessment (ISA) for Sulfur Oxides ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria final assessment. This report represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standard for oxides of sulfur (SO2) sufficiently protects public health. The Integrated Plan for Review of the Primary NAAQS for SOx U.S. 2: EPA (2007) identifies key policy-relevant questions that provide a framework for this review of the scientific evidence. These questions frame the entire review of the NAAQS, and thus are informed by both science and policy considerations. The ISA organizes and presents the scientific evidence such that, when considered along with findings from risk analyses and policy considerations, will help the EPA address these questions in completing the NAAQS review.

An integrated Diet Monitoring Solution for nutrigenomic research.

PubMed

Conti, Costanza; Rossi, Elena; Marceglia, Sara; Tauro, Vittorio; Rizzi, Federica; Lazzaroni, Monica; Barlassina, Cristina; Soldati, Laura; Cusi, Daniele

2015-01-01

The emergence of evidence pointing at diet as key risk factor for chronic diseases and at gene-diet interactions as key elements in the interplay between an individual genetic background and his/her lifestyle, pave the way for studies in nutrigenomics. Such studies need an integrated solution to collect, monitor and analyse a large set of data. In the frame of ATHENA, a European Commission FP7 project, we developed an integrated platform, called Dietary Monitoring Solution enabling the collection of phenotypic, genetic and lifestyle information, linked to a mHealth application tool. The data collection solution allows maintaining anonymized information and supports a number of features making it particularly suited for multicentre studies. The mHealth application was designed to translate the knowledge generated from research into a personalised prevention programme and to support the patient adherence to the programme.

Addressing Uniqueness and Unison of Reliability and Safety for a Better Integration

NASA Technical Reports Server (NTRS)

Huang, Zhaofeng; Safie, Fayssal

2016-01-01

Over time, it has been observed that Safety and Reliability have not been clearly differentiated, which leads to confusion, inefficiency, and, sometimes, counter-productive practices in executing each of these two disciplines. It is imperative to address this situation to help Reliability and Safety disciplines improve their effectiveness and efficiency. The paper poses an important question to address, "Safety and Reliability - Are they unique or unisonous?" To answer the question, the paper reviewed several most commonly used analyses from each of the disciplines, namely, FMEA, reliability allocation and prediction, reliability design involvement, system safety hazard analysis, Fault Tree Analysis, and Probabilistic Risk Assessment. The paper pointed out uniqueness and unison of Safety and Reliability in their respective roles, requirements, approaches, and tools, and presented some suggestions for enhancing and improving the individual disciplines, as well as promoting the integration of the two. The paper concludes that Safety and Reliability are unique, but compensating each other in many aspects, and need to be integrated. Particularly, the individual roles of Safety and Reliability need to be differentiated, that is, Safety is to ensure and assure the product meets safety requirements, goals, or desires, and Reliability is to ensure and assure maximum achievability of intended design functions. With the integration of Safety and Reliability, personnel can be shared, tools and analyses have to be integrated, and skill sets can be possessed by the same person with the purpose of providing the best value to a product development.

Brain Volume as an Integrated Marker for the Risk of Death in a Community-Based Sample: Age Gene/Environment Susceptibility--Reykjavik Study.

PubMed

Van Elderen, Saskia S G C; Zhang, Qian; Sigurdsson, Sigudur; Haight, Thaddeus J; Lopez, Oscar; Eiriksdottir, Gudny; Jonsson, Palmi; de Jong, Laura; Harris, Tamara B; Garcia, Melissa; Gudnason, Vilmundar; van Buchem, Mark A; Launer, Lenore J

2016-01-01

Total brain volume is an integrated measure of health and may be an independent indicator of mortality risk independent of any one clinical or subclinical disease state. We investigate the association of brain volume to total and cause-specific mortality in a large nondemented stroke-free community-based cohort. The analysis includes 3,543 men and women (born 1907-1935) participating in the Age, Gene, Environment Susceptibility-Reykjavik Study. Participants with a known brain-related high risk for mortality (cognitive impairment or stroke) were excluded from these analyses. Quantitative estimates of total brain volume, white matter, white matter lesions, total gray matter (GM; cortical GM and subcortical GM separately), and focal cerebral vascular disease were generated from brain magnetic resonance imaging. Brain atrophy was expressed as brain tissue volume divided by total intracranial volume, yielding a percentage. Mean follow-up duration was 7.2 (0-10) years, with 647 deaths. Cox regression was used to analyze the association of mortality to brain atrophy, adjusting for demographics, cardiovascular risk factors, and cerebral vascular disease. Reduced risk of mortality was significantly associated with higher total brain volume (hazard ratio, 95% confidence interval = 0.71, 0.65-0.78), white matter (0.85, 0.78-0.93), total GM (0.74, 0.68-0.81), and cortical GM (0.78, 0.70-0.87). Overall, the associations were similar for cardiovascular and noncardiovascular-related deaths. Independent of multiple risk factors and cerebral vascular damage, global brain volume predicts mortality in a large nondemented stroke-free community-dwelling older cohort. Total brain volume may be an integrated measure reflecting a range of health and with further investigation could be a useful clinical tool when assessing risk for mortality. Published by Oxford University Press on behalf of the Gerontological Society of America 2014.

Climatic, ecological, and socioeconomic factors associated with West Nile virus incidence in Atlanta, Georgia, U.S.A.

PubMed

Lockaby, Graeme; Noori, Navideh; Morse, Wayde; Zipperer, Wayne; Kalin, Latif; Governo, Robin; Sawant, Rajesh; Ricker, Matthew

2016-12-01

The integrated effects of the many risk factors associated with West Nile virus (WNV) incidence are complex and not well understood. We studied an array of risk factors in and around Atlanta, GA, that have been shown to be linked with WNV in other locations. This array was comprehensive and included climate and meteorological metrics, vegetation characteristics, land use / land cover analyses, and socioeconomic factors. Data on mosquito abundance and WNV mosquito infection rates were obtained for 58 sites and covered 2009-2011, a period following the combined storm water - sewer overflow remediation in that city. Risk factors were compared to mosquito abundance and the WNV vector index (VI) using regression analyses individually and in combination. Lagged climate variables, including soil moisture and temperature, were significantly correlated (positively) with vector index as were forest patch size and percent pine composition of patches (both negatively). Socioeconomic factors that were most highly correlated (positively) with the VI included the proportion of low income households and homes built before 1960 and housing density. The model selected through stepwise regression that related risk factors to the VI included (in the order of decreasing influence) proportion of houses built before 1960, percent of pine in patches, and proportion of low income households. © 2016 The Society for Vector Ecology.

Dynamic Data Management Based on Archival Process Integration at the Centre for Environmental Data Archival

NASA Astrophysics Data System (ADS)

Conway, Esther; Waterfall, Alison; Pepler, Sam; Newey, Charles

2015-04-01

In this paper we decribe a business process modelling approach to the integration of exisiting archival activities. We provide a high level overview of existing practice and discuss how procedures can be extended and supported through the description of preservation state. The aim of which is to faciliate the dynamic controlled management of scientific data through its lifecycle. The main types of archival processes considered are: • Management processes that govern the operation of an archive. These management processes include archival governance (preservation state management, selection of archival candidates and strategic management) . • Operational processes that constitute the core activities of the archive which maintain the value of research assets. These operational processes are the acquisition, ingestion, deletion, generation of metadata and preservation actvities, • Supporting processes, which include planning, risk analysis and monitoring of the community/preservation environment. We then proceed by describing the feasability testing of extended risk management and planning procedures which integrate current practices. This was done through the CEDA Archival Format Audit which inspected British Atmospherics Data Centre and National Earth Observation Data Centre Archival holdings. These holdings are extensive, comprising of around 2PB of data and 137 million individual files which were analysed and characterised in terms of format based risk. We are then able to present an overview of the risk burden faced by a large scale archive attempting to maintain the usability of heterogeneous environmental data sets. We conclude by presenting a dynamic data management information model that is capable of describing the preservation state of archival holdings throughout the data lifecycle. We provide discussion of the following core model entities and their relationships: • Aspirational entities, which include Data Entity definitions and their associated Preservation Objectives. • Risk entities, which act as drivers for change within the data lifecycle. These include Acquisitional Risks, Technical Risks, Strategic Risks and External Risks • Plan entities, which detail the actions to bring about change within an archive. These include Acquisition Plans, Preservation Plans and Monitoring plans • The Result entities describe the successful outcomes of the executed plans. These include Acquisitions, Mitigations and Accepted Risks.

An integrated assessment of climate change impacts for Athens- relevance to stakeholders and policy makers

NASA Astrophysics Data System (ADS)

Giannakopoulos, C.; Hatzaki, M.; Kostopoulou, E.; Varotsos, K.

2010-09-01

Analysing climate change and its impact needs a production of relevant elements for policy making that can be very different from the parameters considered by climate experts. In the framework of EU project CIRCE, a more realistic approach to match stakeholders and policy-makers demands is attempted. For this reason, within CIRCE selected case studies have been chosen that will provide assessments that can be integrated in practical decision making. In this work, an integrated assessment of climate change impacts on several sectors for the urban site of Athens in Greece is presented. The Athens urban case study has been chosen since it provides excellent opportunities for using an integrated approach across multiple temporal and spatial scales and sectors. In the spatial dimension, work extends from the inner city boundaries to the surrounding mountains and forests. In the temporal dimension, research ranges from the current observed time period (using available meteorological and sector data) to future time periods using data from several climate change projections. In addition, a multi-sector approach to climate change impacts is adopted. Impacts sectors covered range from direct climate impacts on natural ecosystems (such as flash floods, air pollution and forest fire risk) to indirect impacts resulting from combined climate-social-economic linkages (such as energy demand, tourism and health). Discussion of impact sector risks and adaptation measures are also exploited. Case-study work on impact sector risk to climate change is of particular interest to relevant policy makers and stakeholders, communication with who is ensured through a series of briefing notes and information sheets and through regional workshops.

Integrative Genome-Scale Analysis Identifies Epigenetic Mechanisms of Transcriptional Deregulation in Unfavorable Neuroblastomas.

PubMed

Henrich, Kai-Oliver; Bender, Sebastian; Saadati, Maral; Dreidax, Daniel; Gartlgruber, Moritz; Shao, Chunxuan; Herrmann, Carl; Wiesenfarth, Manuel; Parzonka, Martha; Wehrmann, Lea; Fischer, Matthias; Duffy, David J; Bell, Emma; Torkov, Alica; Schmezer, Peter; Plass, Christoph; Höfer, Thomas; Benner, Axel; Pfister, Stefan M; Westermann, Frank

2016-09-15

The broad clinical spectrum of neuroblastoma ranges from spontaneous regression to rapid progression despite intensive multimodal therapy. This diversity is not fully explained by known genetic aberrations, suggesting the possibility of epigenetic involvement in pathogenesis. In pursuit of this hypothesis, we took an integrative approach to analyze the methylomes, transcriptomes, and copy number variations in 105 cases of neuroblastoma, complemented by primary tumor- and cell line-derived global histone modification analyses and epigenetic drug treatment in vitro We found that DNA methylation patterns identify divergent patient subgroups with respect to survival and clinicobiologic variables, including amplified MYCN Transcriptome integration and histone modification-based definition of enhancer elements revealed intragenic enhancer methylation as a mechanism for high-risk-associated transcriptional deregulation. Furthermore, in high-risk neuroblastomas, we obtained evidence for cooperation between PRC2 activity and DNA methylation in blocking tumor-suppressive differentiation programs. Notably, these programs could be re-activated by combination treatments, which targeted both PRC2 and DNA methylation. Overall, our results illuminate how epigenetic deregulation contributes to neuroblastoma pathogenesis, with novel implications for its diagnosis and therapy. Cancer Res; 76(18); 5523-37. ©2016 AACR. ©2016 American Association for Cancer Research.

Integration of parenting skills education and interventions in addiction treatment.

PubMed

Arria, Amelia M; Mericle, Amy A; Rallo, Deanna; Moe, Jerry; White, William L; Winters, Ken C; O'Connor, Garrett

2013-01-01

Children of parents with substance use disorders are at risk for various adverse outcomes, and maladaptive parenting behaviors seem to be an important mediator of this risk. Although numerous research studies have highlighted the promise of parenting interventions in modifying parenting behavior, very little is known about the integration of parenting skills education and interventions into addiction treatment programs. In this study, a convenience sample of 125 addiction treatment programs in the United States was drawn. A key staff member was interviewed to gather basic information about the extent and nature of parenting skills education and interventions offered at their program. In addition, respondents were asked to rate the importance of parenting skills relative to other addiction treatment priorities. Descriptive analyses revealed that 43% reported some form of parenting classes, but few used a structured curriculum. Given the known beneficial influence of effective parenting practices on reducing adverse childhood outcomes, it is surprising that relatively few substance abuse treatment programs have adopted structured parenting skills interventions as part of their standard service offerings. More research is warranted on the extent to which parenting skills interventions are integrated into the continuum of services available to parents with a substance use disorder.

NATO Independent Cost Estimating and the Role of Life Cycle Cost Analysis in Managing the Defence Enterprise (Estimation independante des couts de l’OTAN et role de l’analyse des couts globaux de possesssion au sen de l’OTAN)

DTIC Science & Technology

2012-08-01

Command NBCD Nuclear, Biological, and Chemical Defence NCCA U.S. Naval Center for Cost Analysis NGISSI Northrop Grumman Integrated Systems...analysis (CPA) in the United States which investigated how costs, capabilities, and risks could be examined together in an attempt to engen - der more

Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals.

PubMed

Rasmussen, Thomas Bøjer; Ulrichsen, Sinna Pilgaard; Nørgaard, Mette

2018-01-01

Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM) chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes. The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses. We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations. Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals' estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54). In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease. The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most Danish hospitals. Together with descriptive analyses, it was possible to use an alarm from a risk-adjusted CUSUM chart to identify potential performance problems.

Risk management for optimal land use planning integrating ecosystem services values: A case study in Changsha, Middle China.

PubMed

Liang, Jie; Zhong, Minzhou; Zeng, Guangming; Chen, Gaojie; Hua, Shanshan; Li, Xiaodong; Yuan, Yujie; Wu, Haipeng; Gao, Xiang

2017-02-01

Land-use change has direct impact on ecosystem services and alters ecosystem services values (ESVs). Ecosystem services analysis is beneficial for land management and decisions. However, the application of ESVs for decision-making in land use decisions is scarce. In this paper, a method, integrating ESVs to balance future ecosystem-service benefit and risk, is developed to optimize investment in land for ecological conservation in land use planning. Using ecological conservation in land use planning in Changsha as an example, ESVs is regarded as the expected ecosystem-service benefit. And uncertainty of land use change is regarded as risk. This method can optimize allocation of investment in land to improve ecological benefit. The result shows that investment should be partial to Liuyang City to get higher benefit. The investment should also be shifted from Liuyang City to other regions to reduce risk. In practice, lower limit and upper limit for weight distribution, which affects optimal outcome and selection of investment allocation, should be set in investment. This method can reveal the optimal spatial allocation of investment to maximize the expected ecosystem-service benefit at a given level of risk or minimize risk at a given level of expected ecosystem-service benefit. Our results of optimal analyses highlight tradeoffs between future ecosystem-service benefit and uncertainty of land use change in land use decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

Decision making for animal health and welfare: integrating risk-benefit analysis with prospect theory.

PubMed

Hansson, Helena; Lagerkvist, Carl Johan

2014-06-01

This study integrated risk-benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers' choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder-health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers' assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers' management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds. © 2013 Society for Risk Analysis.

Ethics as an Integral Component of Geoengineering Analysis

NASA Astrophysics Data System (ADS)

Haqq-Misra, J.; Tuana, N.; Keller, K.; Sriver, R. L.; Svoboda, T.; Tonkonojenkov, R.; Irvine, P. J.

2011-12-01

Concerns about the risks of unmitigated greenhouse gas emissions are growing. At the same time, confidence is declining that international policy agreements will succeed in considerably lowering anthropogenic greenhouse gas emissions. Perhaps as a result, various geoengineering solutions are gaining attention and credibility as a way to manage climate change. Serious consideration is currently being given to proposals to cool the planet through solar-radiation management (SRM). Here we analyze how the unique and nontrivial risks of geoengineering strategies pose fundamental questions at the interface between science and ethics. We define key open questions to analyze SRM geoengineering proposals, which include whether SRM can be tested, how quickly learning could occur, normative decisions embedded in how different climate trajectories are valued, and justice issues regarding distribution of the harms and benefits of geoengineering. To ensure that ethical analyses are coupled with scientific analyses of this form of geoengineering, we advocate that funding agencies recognize the essential nature of this coupled research by establishing an Ethical, Legal, and Social Implications (ELSI) program for SRM.

Integrative Analysis of the Physical Transport Network into Australia.

PubMed

Cope, Robert C; Ross, Joshua V; Wittmann, Talia A; Prowse, Thomas A A; Cassey, Phillip

2016-01-01

Effective biosecurity is necessary to protect nations and their citizens from a variety of threats, including emerging infectious diseases, agricultural or environmental pests and pathogens, and illegal wildlife trade. The physical pathways by which these threats are transported internationally, predominantly shipping and air traffic, have undergone significant growth and changes in spatial distributions in recent decades. An understanding of the specific pathways and donor-traffic hotspots created by this integrated physical transport network is vital for the development of effective biosecurity strategies into the future. In this study, we analysed the physical transport network into Australia over the period 1999-2012. Seaborne and air traffic were weighted to calculate a "weighted cumulative impact" score for each source region worldwide, each year. High risk source regions, and those source regions that underwent substantial changes in risk over the study period, were determined. An overall risk ranking was calculated by integrating across all possible weighting combinations. The source regions having greatest overall physical connectedness with Australia were Singapore, which is a global transport hub, and the North Island of New Zealand, a close regional trading partner with Australia. Both those regions with large amounts of traffic across multiple vectors (e.g., Hong Kong), and those with high levels of traffic of only one type (e.g., Bali, Indonesia with respect to passenger flights), were represented among high risk source regions. These data provide a baseline model for the transport of individuals and commodities against which the effectiveness of biosecurity controls may be assessed, and are a valuable tool in the development of future biosecurity policy.

Integrative Analysis of the Physical Transport Network into Australia

PubMed Central

Cope, Robert C.; Ross, Joshua V.; Wittmann, Talia A.; Prowse, Thomas A. A.; Cassey, Phillip

2016-01-01

Effective biosecurity is necessary to protect nations and their citizens from a variety of threats, including emerging infectious diseases, agricultural or environmental pests and pathogens, and illegal wildlife trade. The physical pathways by which these threats are transported internationally, predominantly shipping and air traffic, have undergone significant growth and changes in spatial distributions in recent decades. An understanding of the specific pathways and donor-traffic hotspots created by this integrated physical transport network is vital for the development of effective biosecurity strategies into the future. In this study, we analysed the physical transport network into Australia over the period 1999–2012. Seaborne and air traffic were weighted to calculate a “weighted cumulative impact” score for each source region worldwide, each year. High risk source regions, and those source regions that underwent substantial changes in risk over the study period, were determined. An overall risk ranking was calculated by integrating across all possible weighting combinations. The source regions having greatest overall physical connectedness with Australia were Singapore, which is a global transport hub, and the North Island of New Zealand, a close regional trading partner with Australia. Both those regions with large amounts of traffic across multiple vectors (e.g., Hong Kong), and those with high levels of traffic of only one type (e.g., Bali, Indonesia with respect to passenger flights), were represented among high risk source regions. These data provide a baseline model for the transport of individuals and commodities against which the effectiveness of biosecurity controls may be assessed, and are a valuable tool in the development of future biosecurity policy. PMID:26881782

Preliminary Results Obtained in Integrated Safety Analysis of NASA Aviation Safety Program Technologies

NASA Technical Reports Server (NTRS)

Reveley, Mary S.

2003-01-01

The goal of the NASA Aviation Safety Program (AvSP) is to develop and demonstrate technologies that contribute to a reduction in the aviation fatal accident rate by a factor of 5 by the year 2007 and by a factor of 10 by the year 2022. Integrated safety analysis of day-to-day operations and risks within those operations will provide an understanding of the Aviation Safety Program portfolio. Safety benefits analyses are currently being conducted. Preliminary results for the Synthetic Vision Systems (SVS) and Weather Accident Prevention (WxAP) projects of the AvSP have been completed by the Logistics Management Institute under a contract with the NASA Glenn Research Center. These analyses include both a reliability analysis and a computer simulation model. The integrated safety analysis method comprises two principal components: a reliability model and a simulation model. In the reliability model, the results indicate how different technologies and systems will perform in normal, degraded, and failed modes of operation. In the simulation, an operational scenario is modeled. The primary purpose of the SVS project is to improve safety by providing visual-flightlike situation awareness during instrument conditions. The current analyses are an estimate of the benefits of SVS in avoiding controlled flight into terrain. The scenario modeled has an aircraft flying directly toward a terrain feature. When the flight crew determines that the aircraft is headed toward an obstruction, the aircraft executes a level turn at speed. The simulation is ended when the aircraft completes the turn.

[Economic effects of integrated RIS-PACS solution in the university environment].

PubMed

Kröger, M; Nissen-Meyer, S; Wetekam, V; Reiser, M

1999-04-01

The goal of the current article is to demonstrate how qualitative and monetary effects resulting from an integrated RIS/PACS installation can be evaluated. First of all, the system concept of a RIS/PACS solution for a university hospital is defined and described. Based on this example, a generic method for the evaluation of qualitative and monetary effects as well as associated risks is depicted and demonstrated. To this end, qualitative analyses, investment calculations and risk analysis are employed. The sample analysis of a RIS/PACS solution specially designed for a university hospital demonstrates positive qualitative and monetary effects of the system. Under ideal conditions the payoff time of the investments is reached after 4 years of an assumed 8 years effective life of the system. Furthermore, under conservative assumptions, the risk analysis shows a probability of 0% for realising a negative net present value at the end of the payoff time period. It should be pointed out that the positive result of this sample analysis will not necessarily apply to other clinics or hospitals. However, the same methods may be used for the individual evaluation of the qualitative and monetary effects of a RIS/PACS installation in any clinic.

ILDgenDB: integrated genetic knowledge resource for interstitial lung diseases (ILDs).

PubMed

Mishra, Smriti; Shah, Mohammad I; Sarkar, Malay; Asati, Nimisha; Rout, Chittaranjan

2018-01-01

Interstitial lung diseases (ILDs) are a diverse group of ∼200 acute and chronic pulmonary disorders that are characterized by variable amounts of inflammation, fibrosis and architectural distortion with substantial morbidity and mortality. Inaccurate and delayed diagnoses increase the risk, especially in developing countries. Studies have indicated the significant roles of genetic elements in ILDs pathogenesis. Therefore, the first genetic knowledge resource, ILDgenDB, has been developed with an objective to provide ILDs genetic data and their integrated analyses for the better understanding of disease pathogenesis and identification of diagnostics-based biomarkers. This resource contains literature-curated disease candidate genes (DCGs) enriched with various regulatory elements that have been generated using an integrated bioinformatics workflow of databases searches, literature-mining and DCGs-microRNA (miRNAs)-single nucleotide polymorphisms (SNPs) association analyses. To provide statistical significance to disease-gene association, ILD-specificity index and hypergeomatric test scores were also incorporated. Association analyses of miRNAs, SNPs and pathways responsible for the pathogenesis of different sub-classes of ILDs were also incorporated. Manually verified 299 DCGs and their significant associations with 1932 SNPs, 2966 miRNAs and 9170 miR-polymorphisms were also provided. Furthermore, 216 literature-mined and proposed biomarkers were identified. The ILDgenDB resource provides user-friendly browsing and extensive query-based information retrieval systems. Additionally, this resource also facilitates graphical view of predicted DCGs-SNPs/miRNAs and literature associated DCGs-ILDs interactions for each ILD to facilitate efficient data interpretation. Outcomes of analyses suggested the significant involvement of immune system and defense mechanisms in ILDs pathogenesis. This resource may potentially facilitate genetic-based disease monitoring and diagnosis.Database URL: http://14.139.240.55/ildgendb/index.php.

The Associations Between Forced Sex and Severe Mental Health, Substance Use, and HIV Risk Behaviors Among Asian American Women

PubMed Central

Hahm, Hyeouk Chris; Augsberger, Astraea; Feranil, Mario; Jang, Jisun; Tagerman, Michelle

2017-01-01

We examined the association between forced sex history and mental health, sexual health, and substance use among Asian American women (n = 720); 14.3% of our sample (n = 103) reported forced sex experiences. Multiple logistic regression analyses revealed that participants with forced sex histories were 2-8 times more likely to have higher rates of mental health problems, HIV risk behavior, and substance use. Qualitative analysis was used to supplement the quantitative results and give depth to our findings. Our results suggest that interventions for Asian American women who experienced forced sex should integrate mental health, substance use, and sexual health treatments. PMID:27230614

Prevalence of rape and client-initiated gender-based violence among female sex workers: Kampala, Uganda, 2012.

PubMed

Schwitters, Amee; Swaminathan, Mahesh; Serwadda, David; Muyonga, Michael; Shiraishi, Ray W; Benech, Irene; Mital, Sasha; Bosa, Rose; Lubwama, George; Hladik, Wolfgang

2015-02-01

We utilized data from the 2012 Crane Survey in Kampala, Uganda to estimate prevalence of rape among female sex workers (FSWs) and to identify risk factors for and prevalence of client-initiated gender-based violence (GBV) among FSWs. Participants were recruited using respondent-driven sampling. Analyses were weighted using RDSAT-generated individualized weights for each of the five dependent GBV outcomes. Analyses were conducted utilizing SAS 9.3. Among 1,467 FSWs who were interviewed, 82 % (95 % CI: 79-84) experienced client-initiated GBV and 49 % (95 % CI: 47-53) had been raped at least once in their lifetime. GBV risk increased with increasing frequency of client demands for unprotected sex, length of time engaged in sex work, and FSW alcohol consumption. Risk decreased when sex with clients occurred at the FSW's or client's house or a hotel compared to when sex occurred in open spaces. Our findings demonstrate a high prevalence of GBV among FSWs. This research reinforces the urgent need for GBV prevention and response strategies to be integrated into FSW programming and the continuing need for GBV research among key populations.

Prevalence of Rape and Client-Initiated Gender-Based Violence Among Female Sex Workers: Kampala, Uganda, 2012

PubMed Central

Swaminathan, Mahesh; Serwadda, David; Muyonga, Michael; Shiraishi, Ray W.; Benech, Irene; Mital, Sasha; Bosa, Rose; Lubwama, George; Hladik, Wolfgang

2016-01-01

We utilized data from the 2012 Crane Survey in Kampala, Uganda to estimate prevalence of rape among female sex workers (FSWs) and to identify risk factors for and prevalence of client-initiated gender-based violence (GBV) among FSWs. Participants were recruited using respondent-driven sampling. Analyses were weighted using RDSAT-generated individualized weights for each of the five dependent GBV outcomes. Analyses were conducted utilizing SAS 9.3. Among 1,467 FSWs who were interviewed, 82 % (95 % CI: 79–84) experienced client-initiated GBV and 49 % (95 % CI: 47–53) had been raped at least once in their lifetime. GBV risk increased with increasing frequency of client demands for unprotected sex, length of time engaged in sex work, and FSW alcohol consumption. Risk decreased when sex with clients occurred at the FSW’s or client’s house or a hotel compared to when sex occurred in open spaces. Our findings demonstrate a high prevalence of GBV among FSWs. This research reinforces the urgent need for GBV prevention and response strategies to be integrated into FSW programming and the continuing need for GBV research among key populations. PMID:25432876

The Effect Of Sex Education And Life Skills For Preventive Sexual Risk Behaviours Among University Of Students In Thailand.

PubMed

Seangpraw, Katekaew; Somrongthong, Rattana; Choowanthanapakorn, Monchanok; Kumar, Ramesh

2017-01-01

Currently, the problem of sexual risk behaviour of adolescents has increased worldwide, including Thailand. This study compared the effectiveness of promoting life skills to prevent sexual risk behaviours among university students in the Phayao Province of Thailand. A quasi-experimental design was employed with a pre- and post-test study for a sample of freshmen university students. The students were then split into an intervention group comprised of 300 students, with a second group of 250 students from the same faculty as the control group. The intervention group participated in the integrated life skills model for preventing sexual risk behaviours and participatory learning. The educational activities included; lectures, brainstorming, group discussion, roleplaying, game simulations and naming experiences through six weekly life skills training sessions of 90 minutes each. Data were collected by self-questionnaires and analysed using descriptive statistics and independent sample t-testing. Three different time periods were examined using ANOVA repeated measures analysis of variance. Compared between the intervention and control groups determined that implementation of increased knowledge and improved life skills was statistically significant (p<0.001) in the intervention group. The intervention group also showed significantly improved communication skills and behavioural preventive measures towards sexual risk than the control group (p<0.001). The life skills model also effectively reduced the sexual risk behaviours of students at the university. Therefore, this program was beneficial for the development of strategies to increase self-efficacy and it should be integrated into the universities' curriculum. In the long-term sexual risk behaviour changes must be monitored for programme sustainability.

Reliability and validity of a treatment fidelity assessment for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

PubMed

Seng, Elizabeth K; Lovejoy, Travis I

2013-12-01

This study psychometrically evaluates the Motivational Interviewing Treatment Integrity Code (MITI) to assess fidelity to motivational interviewing to reduce sexual risk behaviors in people living with HIV/AIDS. 74 sessions from a pilot randomized controlled trial of motivational interviewing to reduce sexual risk behaviors in people living with HIV were coded with the MITI. Participants reported sexual behavior at baseline, 3-month, and 6-months. Regarding reliability, excellent inter-rater reliability was achieved for measures of behavior frequency across the 12 sessions coded by both coders; global scales demonstrated poor intraclass correlations, but adequate percent agreement. Regarding validity, principle components analyses indicated that a two-factor model accounted for an adequate amount of variance in the data. These factors were associated with decreases in sexual risk behaviors after treatment. The MITI is a reliable and valid measurement of treatment fidelity for motivational interviewing targeting sexual risk behaviors in people living with HIV/AIDS.

Spatio-temporal assessment of food safety risks in Canadian food distribution systems using GIS.

PubMed

Hashemi Beni, Leila; Villeneuve, Sébastien; LeBlanc, Denyse I; Côté, Kevin; Fazil, Aamir; Otten, Ainsley; McKellar, Robin; Delaquis, Pascal

2012-09-01

While the value of geographic information systems (GIS) is widely applied in public health there have been comparatively few examples of applications that extend to the assessment of risks in food distribution systems. GIS can provide decision makers with strong computing platforms for spatial data management, integration, analysis, querying and visualization. The present report addresses some spatio-analyses in a complex food distribution system and defines influence areas as travel time zones generated through road network analysis on a national scale rather than on a community scale. In addition, a dynamic risk index is defined to translate a contamination event into a public health risk as time progresses. More specifically, in this research, GIS is used to map the Canadian produce distribution system, analyze accessibility to contaminated product by consumers, and estimate the level of risk associated with a contamination event over time, as illustrated in a scenario. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

The impacts of climate change on the risk of natural disasters.

PubMed

van Aalst, Maarten K

2006-03-01

Human emissions of greenhouse gases are already changing our climate. This paper provides an overview of the relation between climate change and weather extremes, and examines three specific cases where recent acute events have stimulated debate on the potential role of climate change: the European heatwave of 2003; the risk of inland flooding, such as recently in Central Europe and Great Britain; and the harsh Atlantic hurricane seasons of 2004 and 2005. Furthermore, it briefly assesses the relation between climate change and El Niño, and the potential of abrupt climate change. Several trends in weather extremes are sufficiently clear to inform risk reduction efforts. In many instances, however, the potential increases in extreme events due to climate change come on top of alarming rises in vulnerability. Hence, the additional risks due to climate change should not be analysed or treated in isolation, but instead integrated into broader efforts to reduce the risk of natural disasters.

Evolution of strategic risks under future scenarios for improved utility master plans.

PubMed

Luís, Ana; Lickorish, Fiona; Pollard, Simon

2016-01-01

Integrated, long-term risk management in the water sector is poorly developed. Whilst scenario planning has been applied to singular issues (e.g. climate change), it often misses a link to risk management because the likelihood of impacts in the long-term are frequently unaccounted for in these analyses. Here we apply the morphological approach to scenario development for a case study utility, Empresa Portuguesa das Águas Livres (EPAL). A baseline portfolio of strategic risks threatening the achievement of EPAL's corporate objectives was evolved through the lens of three future scenarios, 'water scarcity', 'financial resource scarcity' and 'strong economic growth', built on drivers such as climate, demographic, economic, regulatory and technological changes and validated through a set of expert workshops. The results represent how the baseline set of risks might develop over a 30 year period, allowing threats and opportunities to be identified and enabling strategies for master plans to be devised. We believe this to be the first combined use of risk and futures methods applied to a portfolio of strategic risks in the water utility sector. Copyright © 2015 Elsevier Ltd. All rights reserved.

Analysis of labour risks in the Spanish industrial aerospace sector.

PubMed

Laguardia, Juan; Rubio, Emilio; Garcia, Ana; Garcia-Foncillas, Rafael

2016-01-01

Labour risk prevention is an activity integrated within Safety and Hygiene at Work in Spain. In 2003, the Electronic Declaration for Accidents at Work, Delt@ (DELTA) was introduced. The industrial aerospace sector is subject to various risks. Our objective is to analyse the Spanish Industrial Aerospace Sector (SIAS) using the ACSOM methodology to assess its labour risks and to prioritise preventive actions. The SIAS and the Services Subsector (SS) were created and the relevant accident rate data were obtained. The ACSOM method was applied through double contrast (deviation and translocation) of the SIAS or SS risk polygon with the considered pattern, accidents from all sectors (ACSOM G) or the SIAS. A list of risks was obtained, ordered by action phases. In the SIAS vs. ACSOM G analysis, radiation risks were the worst, followed by overstrains. Accidents caused by living beings were also significant in the SS vs. SIAE, which will be able to be used to improve Risk Prevention. Radiation is the most significant risk in the SIAS and the SS. Preventive actions will be primary and secondary. ACSOM has shown itself to be a valid tool for the analysis of labour risks.

Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies.

PubMed

Leong, H M; Carter, Mark; Stephenson, Jennifer

2015-12-01

Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control. Copyright © 2015 Elsevier Ltd. All rights reserved.

Application of Ecosystem Models to Assess Environmental Drivers of Mosquito Abundance and Virus Transmission Risk and Associated Public Health Implications of Climate and Land Use Change

NASA Astrophysics Data System (ADS)

Melton, F.; Barker, C.; Park, B.; Reisen, W.; Michaelis, A.; Wang, W.; Hashimoto, H.; Milesi, C.; Hiatt, S.; Nemani, R.

2008-12-01

The NASA Terrestrial Observation and Prediction System (TOPS) is a modeling framework that integrates satellite observations, meteorological observations, and ancillary data to support monitoring and modeling of ecosystem and land surface conditions in near real-time. TOPS provides spatially continuous gridded estimates of a suite of measurements describing environmental conditions, and these data products are currently being applied to support the development of new models capable of forecasting estimated mosquito abundance and transmission risk for mosquito-borne diseases such as West Nile virus. We present results from the modeling analyses, describe their incorporation into the California Vectorborne Disease Surveillance System, and describe possible implications of projected climate and land use change for patterns in mosquito abundance and transmission risk for West Nile virus in California.

An information diffusion technique to assess integrated hazard risks.

PubMed

Huang, Chongfu; Huang, Yundong

2018-02-01

An integrated risk is a scene in the future associated with some adverse incident caused by multiple hazards. An integrated probability risk is the expected value of disaster. Due to the difficulty of assessing an integrated probability risk with a small sample, weighting methods and copulas are employed to avoid this obstacle. To resolve the problem, in this paper, we develop the information diffusion technique to construct a joint probability distribution and a vulnerability surface. Then, an integrated risk can be directly assessed by using a small sample. A case of an integrated risk caused by flood and earthquake is given to show how the suggested technique is used to assess the integrated risk of annual property loss. Copyright © 2017 Elsevier Inc. All rights reserved.

Toxics Release Inventory Chemical Hazard Information Profiles (TRI-CHIP) Dataset

EPA Pesticide Factsheets

The Toxics Release Inventory (TRI) Chemical Hazard Information Profiles (TRI-CHIP) dataset contains hazard information about the chemicals reported in TRI. Users can use this XML-format dataset to create their own databases and hazard analyses of TRI chemicals. The hazard information is compiled from a series of authoritative sources including the Integrated Risk Information System (IRIS). The dataset is provided as a downloadable .zip file that when extracted provides XML files and schemas for the hazard information tables.

Quantifying and Reducing Uncertainty in Correlated Multi-Area Short-Term Load Forecasting

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

Sun, Yannan; Hou, Zhangshuan; Meng, Da

2016-07-17

In this study, we represent and reduce the uncertainties in short-term electric load forecasting by integrating time series analysis tools including ARIMA modeling, sequential Gaussian simulation, and principal component analysis. The approaches are mainly focusing on maintaining the inter-dependency between multiple geographically related areas. These approaches are applied onto cross-correlated load time series as well as their forecast errors. Multiple short-term prediction realizations are then generated from the reduced uncertainty ranges, which are useful for power system risk analyses.

Integrated Science Assessment (ISA) for Carbon Monoxide ...

EPA Pesticide Factsheets

EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA's decision regarding whether the current standards for CO sufficiently protect public health and the environment. The Integrated Plan for Review of the NAAQS for CO {U.S. EPA, 2008 #8615} identifies key policy-relevant questions that provide a framework for this review of the scientific evidence. These questions frame the entire review of the NAAQS, and thus are informed by both science and policy considerations. The ISA organizes and presents the scientific evidence such that it, when considered along with findings from risk analyses and policy considerations, will help the EPA address these questions during the NAAQS review:

Predicting child maltreatment: A meta-analysis of the predictive validity of risk assessment instruments.

PubMed

van der Put, Claudia E; Assink, Mark; Boekhout van Solinge, Noëlle F

2017-11-01

Risk assessment is crucial in preventing child maltreatment since it can identify high-risk cases in need of child protection intervention. Despite widespread use of risk assessment instruments in child welfare, it is unknown how well these instruments predict maltreatment and what instrument characteristics are associated with higher levels of predictive validity. Therefore, a multilevel meta-analysis was conducted to examine the predictive accuracy of (characteristics of) risk assessment instruments. A literature search yielded 30 independent studies (N=87,329) examining the predictive validity of 27 different risk assessment instruments. From these studies, 67 effect sizes could be extracted. Overall, a medium significant effect was found (AUC=0.681), indicating a moderate predictive accuracy. Moderator analyses revealed that onset of maltreatment can be better predicted than recurrence of maltreatment, which is a promising finding for early detection and prevention of child maltreatment. In addition, actuarial instruments were found to outperform clinical instruments. To bring risk and needs assessment in child welfare to a higher level, actuarial instruments should be further developed and strengthened by distinguishing risk assessment from needs assessment and by integrating risk assessment with case management. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multi-contamination (heavy metals, polychlorinated biphenyls and polycyclic aromatic hydrocarbons) of littoral sediments and the associated ecological risk assessment in a large lake in France (Lake Bourget).

PubMed

Lécrivain, Nathalie; Aurenche, Vincent; Cottin, Nathalie; Frossard, Victor; Clément, Bernard

2018-04-01

The lake littoral sediment is exposed to a large array of contaminants that can exhibit significant spatial variability and challenge our ability to assess contamination at lake scale. In this study, littoral sediment contamination was characterized among ten different sites in a large peri-alpine lake (Lake Bourget) regarding three groups of contaminants: 6 heavy metals, 15 polycyclic aromatic hydrocarbons and 7 polychlorinated biphenyls. The contamination profiles significantly varied among sites and differed from those previously reported for the deepest zone of the lake. An integrative approach including chemical and biological analyses was conducted to relate site contamination to ecological risk. The chemical approach consisted in mean PEC quotient calculation (average of the ratios of the contaminants concentration to their corresponding Probable Effect Concentration values) and revealed a low and heterogeneous toxicity of the contaminant mixture along the littoral. Biological analysis including both laboratory (microcosm assays) and in situ (Acetylcholine Esterase (AChE) and Glutathione S-Transferase (GST) activity measurements) experiments highlighted significant differences among sites both in the field and in laboratory assays suggesting a spatial variation of the biota response to contamination. Linear regressions were performed between mean PEC quotients and biological results to assess whether littoral ecological risk was explained by the contamination profiles. The results highly depended on the study benthic or pelagic compartment. Regarding autochthonous Corbicula fluminea, no significant relationship between mean PEC quotients and biomarker activity was found while a significant increase in AChE was observed on autochthonous chironomids, suggesting different stress among benthic organisms. Both AChE and GST in caged pelagic Daphnia magna showed a significant positive relationship with mean PEC quotients. This study underlines the importance of accounting for spatial variations in lake littoral sediment contamination and the need for performing an integrative approach coupling chemical, field and laboratory analyses to assess the ecological risk. Copyright © 2017 Elsevier B.V. All rights reserved.

Protocol: systematic review and meta-analyses of birth outcomes for women who intend at the onset of labour to give birth at home compared to women of low obstetrical risk who intend to give birth in hospital.

PubMed

Hutton, Eileen K; Reitsma, Angela; Thorpe, Julia; Brunton, Ginny; Kaufman, Karyn

2014-05-29

There has been a renewed interest in the place of birth, including intended home birth, for low risk women. In the absence of adequately-sized randomised controlled trials, a recent Cochrane review recommended that a systematic review and meta-analysis, including observational studies, be undertaken to inform this topic. The objective of this review is to determine if women intending at the onset of labour to give birth at home are more or less likely to experience a foetal or neonatal loss compared to a cohort of women who are comparable to the home birth cohort on the absence of risk factors but who intend to give birth in a hospital setting. We will search using Embase, MEDLINE, CINAHL, AMED and the Cochrane Library to find studies published since 1990 that compare foetal, neonatal and maternal outcomes for women who intended at the onset of labour to give birth at home to a comparison cohort of low risk women who intended at the onset of labour to give birth in hospital. We will obtain pooled estimates of effect using Review Manager. Because of the likelihood of differences in outcomes in settings where home birth is integrated into the health care system, we will stratify our results according to jurisdictions that have a health care system that integrates home birth and those where home birth is provided outside the usual health care system. Since parity is known to be associated with birth outcomes, only studies that take parity into account will be included in the meta-analyses. We will provide results by parity to the extent possible. This protocol was registered with PROSPERO at http://www.crd.york.ac.uk/Prospero/ (Registration number: CRD42013004046).

Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation

PubMed Central

Cole, Steven W.; Capitanio, John P.; Chun, Katie; Arevalo, Jesusa M. G.; Ma, Jeffrey; Cacioppo, John T.

2015-01-01

To define the cellular mechanisms of up-regulated inflammatory gene expression and down-regulated antiviral response in people experiencing perceived social isolation (loneliness), we conducted integrative analyses of leukocyte gene regulation in humans and rhesus macaques. Five longitudinal leukocyte transcriptome surveys in 141 older adults showed up-regulation of the sympathetic nervous system (SNS), monocyte population expansion, and up-regulation of the leukocyte conserved transcriptional response to adversity (CTRA). Mechanistic analyses in a macaque model of perceived social isolation confirmed CTRA activation and identified selective up-regulation of the CD14++/CD16− classical monocyte transcriptome, functional glucocorticoid desensitization, down-regulation of Type I and II interferons, and impaired response to infection by simian immunodeficiency virus (SIV). These analyses identify neuroendocrine-related alterations in myeloid cell population dynamics as a key mediator of CTRA transcriptome skewing, which may both propagate perceived social isolation and contribute to its associated health risks. PMID:26598672

Decreased pain sensitivity due to trimethylbenzene exposure ...

EPA Pesticide Factsheets

Traditionally, human health risk assessments have relied on qualitative approaches for hazard identification, often using the Hill criteria and weight of evidence determinations to integrate data from multiple studies. Recently, the National Research Council has recommended the development of quantitative approaches for evidence integration, including the application of meta-analyses. The following hazard identification case study applies qualitative as well as meta-analytic approaches to trimethylbenzene (TMB) isomers exposure and the potential neurotoxic effects on pain sensitivity. In the meta-analytic approach, a pooled effect size is calculated, after consideration of multiple confounding factors, in order to determine whether the entire database under consideration indicates that TMBs are likely to be a neurotoxic hazard. The pain sensitivity studies included in the present analyses initially seem discordant in their results: effects on pain sensitivity are seen immediately after termination of exposure, appear to resolve 24 hours after exposure, and then reappear 50 days later following foot-shock. Qualitative consideration of toxicological and toxicokinetic characteristics of the TMB isomers suggests that the observed differences between studies are due to testing time and can be explained through a complete consideration of the underlying biology of the effect and the nervous system as a whole. Meta-analyses and –regressions support this conclus

Multilevel integrated flood management aproach

NASA Astrophysics Data System (ADS)

Brilly, Mitja; Rusjan, Simon

2013-04-01

The optimal solution for complex flood management is integrated approach. Word »integration« used very often when we try to put something together, but should distinguish full multiple integrated approach of integration by parts when we put together and analyse only two variables. In doing so, we lost complexity of the phenomenon. Otherwise if we try to put together all variables we should take so much effort and time and we never finish the job properly. Solution is in multiple integration captures the essential factors, which are different on a case-by-case (Brilly, 2000). Physical planning is one of most important activity in which flood management should be integrated. The physical planning is crucial for vulnerability and its future development and on other hand our structural measures must be incorporate in space and will very often dominated in. The best solution is if space development derived on same time with development of structural measures. There are good examples with such approach (Vienna, Belgrade, Zagreb, and Ljubljana). Problems stared when we try incorporating flood management in already urbanised area or we would like to decrease risk to some lower level. Looking to practice we learn that middle Ages practices were much better than to day. There is also »disaster by design« when hazard increased as consequence of upstream development or in stream construction or remediation. In such situation we have risk on areas well protected in the past. Good preparation is essential for integration otherwise we just lost time what is essential for decision making and development. We should develop clear picture about physical characteristics of phenomena and possible solutions. We should develop not only the flood maps; we should know how fast phenomena could develop, in hour, day or more. Do we need to analyse ground water - surface water relations, we would like to protected area that was later flooded by ground water. Do we need to take care about sediment transport, phenomenon close related to floods - could the river bad bottom increase or decrease for some meters or river completely rearrange morphology - how then inundated area will look like. Hazard of floods should be presented properly, with maps, uncertainty and trends related to natural and anthropogenic impacts. We should look time back, how our river look in past centuries and what are water management plans for future. Which activities are on the river? There are good practice in flood protection, hydropower development and physical planning (Vienna, Sava River).

Decision Making for Animal Health and Welfare: Integrating Risk-Benefit Analysis with Prospect Theory

PubMed Central

Hansson, Helena; Lagerkvist, Carl Johan

2013-01-01

This study integrated risk-benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers’ choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder-health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers’ assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers’ management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds. PMID:24372180

Risky music-listening behaviors and associated health-risk behaviors.

PubMed

Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

2012-06-01

To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

Neural substrates of the influence of emotional cues on cognitive control in risk-taking adolescents.

PubMed

Lee, Nikki C; Weeda, Wouter D; Insel, Catherine; Somerville, Leah H; Krabbendam, Lydia; Huizinga, Mariëtte

2018-06-01

Adolescence is a period characterised by increases in risk-taking. This behaviour has been associated with an imbalance in the integration of the networks involved in cognitive control and motivational processes. We examined whether the influence of emotional cues on cognitive control differs between adolescents who show high or low levels of risk-taking behaviour. Participants who scored especially high or low on a risky decision task were subsequently administered an emotional go/no-go fMRI task comprising angry, happy and calm faces. Both groups showed decreased cognitive control when confronted with appetitive and aversive emotional cues. Activation in the inferior frontal gyrus (IFG) increased in line with the cognitive control demands of the task. Though the risk taking groups did not differ in their behavioural performance, functional connectivity analyses revealed the dorsal striatum plays a more central role in the processing of cognitive control in high than low risk-takers. Overall, these findings suggest that variance in fronto-striatal circuitry may underlie individual differences in risk-taking behaviour. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Metabolite Profiling and Cardiovascular Event Risk: A Prospective Study of Three Population-Based Cohorts

PubMed Central

Würtz, Peter; Havulinna, Aki S; Soininen, Pasi; Tynkkynen, Tuulia; Prieto-Merino, David; Tillin, Therese; Ghorbani, Anahita; Artati, Anna; Wang, Qin; Tiainen, Mika; Kangas, Antti J; Kettunen, Johannes; Kaikkonen, Jari; Mikkilä, Vera; Jula, Antti; Kähönen, Mika; Lehtimäki, Terho; Lawlor, Debbie A; Gaunt, Tom R; Hughes, Alun D; Sattar, Naveed; Illig, Thomas; Adamski, Jerzy; Wang, Thomas J; Perola, Markus; Ripatti, Samuli; Vasan, Ramachandran S; Raitakari, Olli T; Gerszten, Robert E; Casas, Juan-Pablo; Chaturvedi, Nish; Ala-Korpela, Mika; Salomaa, Veikko

2015-01-01

Background High-throughput profiling of circulating metabolites may improve cardiovascular risk prediction over established risk factors. Methods and Results We applied quantitative NMR metabolomics to identify biomarkers for incident cardiovascular disease during long-term follow-up. Biomarker discovery was conducted in the FINRISK study (n=7256; 800 events). Replication and incremental risk prediction was assessed in the SABRE study (n=2622; 573 events) and British Women’s Health and Heart Study (n=3563; 368 events). In targeted analyses of 68 lipids and metabolites, 33 measures were associated with incident cardiovascular events at P<0.0007 after adjusting for age, sex, blood pressure, smoking, diabetes and medication. When further adjusting for routine lipids, four metabolites were associated with future cardiovascular events in meta-analyses: higher serum phenylalanine (hazard ratio per standard deviation: 1.18 [95%CI 1.12–1.24]; P=4×10−10) and monounsaturated fatty acid levels (1.17 [1.11–1.24]; P=1×10−8) were associated with increased cardiovascular risk, while higher omega-6 fatty acids (0.89 [0.84–0.94]; P=6×10−5) and docosahexaenoic acid levels (0.90 [0.86–0.95]; P=5×10−5) were associated with lower risk. A risk score incorporating these four biomarkers was derived in FINRISK. Risk prediction estimates were more accurate in the two validation cohorts (relative integrated discrimination improvement 8.8% and 4.3%), albeit discrimination was not enhanced. Risk classification was particularly improved for persons in the 5–10% risk range (net reclassification 27.1% and 15.5%). Biomarker associations were further corroborated with mass spectrometry in FINRISK (n=671) and the Framingham Offspring Study (n=2289). Conclusions Metabolite profiling in large prospective cohorts identified phenylalanine, monounsaturated and polyunsaturated fatty acids as biomarkers for cardiovascular risk. This study substantiates the value of high-throughput metabolomics for biomarker discovery and improved risk assessment. PMID:25573147

Development of a community-based intervention for the control of Chagas disease based on peridomestic animal management: an eco-bio-social perspective

PubMed Central

De Urioste-Stone, Sandra M.; Pennington, Pamela M.; Pellecer, Elizabeth; Aguilar, Teresa M.; Samayoa, Gabriela; Perdomo, Hugo D.; Enríquez, Hugo; Juárez, José G.

2015-01-01

Background Integrated vector management strategies depend on local eco-bio-social conditions, community participation, political will and inter-sectorial partnership. Previously identified risk factors for persistent Triatoma dimidiata infestation include the presence of rodents and chickens, tiled roofs, dirt floors, partial wall plastering and dog density. Methods A community-based intervention was developed and implemented based on cyclical stakeholder and situational analyses. Intervention implementation and evaluation combined participatory action research and cluster randomized pre-test post-test experimental designs. The intervention included modified insecticide application, education regarding Chagas disease and risk factors, and participatory rodent control. Results At final evaluation there was no significant difference in post-test triatomine infestation between intervention and control, keeping pre-test rodent and triatomine infestations constant. Knowledge levels regarding Chagas disease and prevention practices including rodent control, chicken management and health service access increased significantly only in intervention communities. The odds of nymph infection and rat infestation were 8.3 and 1.9-fold higher in control compared to intervention communities, respectively. Conclusion Vector control measures without reservoir control are insufficient to reduce transmission risk in areas with persistent triatomine infestation. This integrated vector management program can complement house improvement initiatives by prioritizing households with risk factors such as tiled roofs. Requirement for active participation and multi-sectorial coordination poses implementation challenges. PMID:25604767

A data-driven algorithm integrating clinical and laboratory features for the diagnosis and prognosis of necrotizing enterocolitis.

PubMed

Ji, Jun; Ling, Xuefeng B; Zhao, Yingzhen; Hu, Zhongkai; Zheng, Xiaolin; Xu, Zhening; Wen, Qiaojun; Kastenberg, Zachary J; Li, Ping; Abdullah, Fizan; Brandt, Mary L; Ehrenkranz, Richard A; Harris, Mary Catherine; Lee, Timothy C; Simpson, B Joyce; Bowers, Corinna; Moss, R Lawrence; Sylvester, Karl G

2014-01-01

Necrotizing enterocolitis (NEC) is a major source of neonatal morbidity and mortality. Since there is no specific diagnostic test or risk of progression model available for NEC, the diagnosis and outcome prediction of NEC is made on clinical grounds. The objective in this study was to develop and validate new NEC scoring systems for automated staging and prognostic forecasting. A six-center consortium of university based pediatric teaching hospitals prospectively collected data on infants under suspicion of having NEC over a 7-year period. A database comprised of 520 infants was utilized to develop the NEC diagnostic and prognostic models by dividing the entire dataset into training and testing cohorts of demographically matched subjects. Developed on the training cohort and validated on the blind testing cohort, our multivariate analyses led to NEC scoring metrics integrating clinical data. Machine learning using clinical and laboratory results at the time of clinical presentation led to two nec models: (1) an automated diagnostic classification scheme; (2) a dynamic prognostic method for risk-stratifying patients into low, intermediate and high NEC scores to determine the risk for disease progression. We submit that dynamic risk stratification of infants with NEC will assist clinicians in determining the need for additional diagnostic testing and guide potential therapies in a dynamic manner. http://translationalmedicine.stanford.edu/cgi-bin/NEC/index.pl and smartphone application upon request.

Social relationships and physiological determinants of longevity across the human life span.

PubMed

Yang, Yang Claire; Boen, Courtney; Gerken, Karen; Li, Ting; Schorpp, Kristen; Harris, Kathleen Mullan

2016-01-19

Two decades of research indicate causal associations between social relationships and mortality, but important questions remain as to how social relationships affect health, when effects emerge, and how long they last. Drawing on data from four nationally representative longitudinal samples of the US population, we implemented an innovative life course design to assess the prospective association of both structural and functional dimensions of social relationships (social integration, social support, and social strain) with objectively measured biomarkers of physical health (C-reactive protein, systolic and diastolic blood pressure, waist circumference, and body mass index) within each life stage, including adolescence and young, middle, and late adulthood, and compare such associations across life stages. We found that a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose-response manner in both early and later life. Conversely, lack of social connections was associated with vastly elevated risk in specific life stages. For example, social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence, and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age. Analyses of multiple dimensions of social relationships within multiple samples across the life course produced consistent and robust associations with health. Physiological impacts of structural and functional dimensions of social relationships emerge uniquely in adolescence and midlife and persist into old age.

A predictive model for spotted wilt epidemics in peanut based on local weather conditions and the tomato spotted wilt virus risk index.

PubMed

Olatinwo, R O; Paz, J O; Brown, S L; Kemerait, R C; Culbreath, A K; Beasley, J P; Hoogenboom, G

2008-10-01

Tomato spotted wilt virus (TSWV), a member of the genus Tospovirus (family Bunyaviridae), is an important plant virus that causes severe damage to peanut (Arachis hypogaea) in the southeastern United States. Disease severity has been extremely variable in individual fields in Georgia, due to several factors including variability in weather patterns. A TSWV risk index has been developed by the University of Georgia to aid peanut growers with the assessment and avoidance of high risk situations. This study was conducted to examine the relationship between weather parameters and spotted wilt severity in peanut, and to develop a predictive model that integrates localized weather information into the risk index. On-farm survey data collected during 1999, 2002, 2004, and 2005 growing seasons, and derived weather variables during the same years were analyzed using nonlinear and multiple regression analyses. Meteorological data were obtained from the Georgia Automated Environmental Monitoring Network. The best model explained 61% of the variation in spotted wilt severity (square root transformed) as a function of the interactions between the TSWV risk index, the average daily temperature in April (TavA), the average daily minimum temperature between March and April (TminMA), the accumulated rainfall in March (RainfallM), the accumulated rainfall in April (RainfallA), the number of rain days in April (RainDayA), evapotranspiration in April (EVTA), and the number of days from 1 January to the planting date (JulianDay). Integrating this weather-based model with the TSWV risk index may help peanut growers more effectively manage tomato spotted wilt disease.

Network gatekeeping: complementary medicine information on the websites of medical institutions.

PubMed

Keshet, Yael

2012-03-01

Integrative medicine - complementary and alternative medicine (CAM) practised in mainstream healthcare organizations - combines medical treatments based on incommensurable paradigms. As the Internet has been portrayed as a crucial pathway to CAM and sites administered by reputable organizations are considered to be relatively reliable sources of medical information, the research sought to explore and compare the ways in which CAM is presented on the Internet websites of diverse medical institutions. The contents of the websites of the Ministry of Health, the Israeli Medical Association and Israeli healthcare organizations were analysed, using an interdisciplinary theory of network gatekeeping. The websites were analysed not only according to the degree to which they are considered to be informative, but also with regard to the perceptions of integration that they convey. Comparison of the websites of community healthcare organizations and hospitals indicates that while the former display CAM treatments as an attractive commodity, the latter convey a message stressing the need to subject CAM to bio-medical scrutiny. Little or no information was provided concerning a number of important issues, such as research findings about efficacy and safety, risks and ethical considerations.

Frameworks and tools for risk assessment of manufactured nanomaterials.

PubMed

Hristozov, Danail; Gottardo, Stefania; Semenzin, Elena; Oomen, Agnes; Bos, Peter; Peijnenburg, Willie; van Tongeren, Martie; Nowack, Bernd; Hunt, Neil; Brunelli, Andrea; Scott-Fordsmand, Janeck J; Tran, Lang; Marcomini, Antonio

2016-10-01

Commercialization of nanotechnologies entails a regulatory requirement for understanding their environmental, health and safety (EHS) risks. Today we face challenges to assess these risks, which emerge from uncertainties around the interactions of manufactured nanomaterials (MNs) with humans and the environment. In order to reduce these uncertainties, it is necessary to generate sound scientific data on hazard and exposure by means of relevant frameworks and tools. The development of such approaches to facilitate the risk assessment (RA) of MNs has become a dynamic area of research. The aim of this paper was to review and critically analyse these approaches against a set of relevant criteria. The analysis concluded that none of the reviewed frameworks were able to fulfill all evaluation criteria. Many of the existing modelling tools are designed to provide screening-level assessments rather than to support regulatory RA and risk management. Nevertheless, there is a tendency towards developing more quantitative, higher-tier models, capable of incorporating uncertainty into their analyses. There is also a trend towards developing validated experimental protocols for material identification and hazard testing, reproducible across laboratories. These tools could enable a shift from a costly case-by-case RA of MNs towards a targeted, flexible and efficient process, based on grouping and read-across strategies and compliant with the 3R (Replacement, Reduction, Refinement) principles. In order to facilitate this process, it is important to transform the current efforts on developing databases and computational models into creating an integrated data and tools infrastructure to support the risk assessment and management of MNs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of the Available Drawdowns for Oil Storage Caverns at the West Hackberry SPR Site

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

Sobolik, Steven R.

The Department of Energy, in response to requests from the U.S. Congress, wishes to maintain an up-to-date table documenting the number of available full drawdowns of each of the caverns owned by the Strategic Petroleum Reserve. This information is important for assessing the SPR’s ability to deliver oil to domestic oil companies expeditiously if national or world events dictate a rapid sale and deployment of the oil reserves. What factors go into assessing available drawdowns? The evaluation of drawdown risks require the consideration of several factors regarding cavern and wellbore integrity and stability, including stress states caused by cavern geometrymore » and operations, salt damage caused by dilatant and tensile stresses, the effect on enhanced creep on wellbore integrity, the sympathetic stress effect of operations on neighboring caverns. Based on the work over the past several months, a consensus has been built regarding the assessment of drawdown capabilities and risks for the SPR caverns. This paper draws upon the recently West Hackberry model upgrade and analyses to reevaluate and update the available drawdowns for each of those caverns. Similar papers for the Bryan Mound, Big Hill, and Bayou Choctaw papers will be developed as the upgrades to those analyses are completed. The rationale and documentation of the methodology is described in the remainder of this report, as are the updated estimates of available drawdowns for the West Hackberry caverns.« less

[Human risk factors and injuries due to road accidents: analysis of current data].

PubMed

Marchetti, Pierpaolo; Morandi, Anna; Lombardo, Carlo; Gigli Berzolari, Francesca; Bruno, Vincenzo; Marinoni, Alessandra

2009-01-01

several studies have shown that most road accidents are due to human factors, and that these are strongly linked to a drive's age and sex. The aim of this study is to test the role that some human factors play in road accidents by analysing current road accident data in the Province of Pavia, in Northern Italy. road accidents that occurred in 2004 were analysed by integrating the paper database of the vehicle licensing office, properly computerised, with the 911 database of the Province of Pavia. This study has been carried out by analysing 1.347 road accidents and the associated 2.908 drivers of motorised vehicles. Northern Italy, the Province of Pavia. the death rate of drivers of 2-wheeled vehicles is almost nine times higher than that of 4-wheeled vehicles. Analysis shows that females are twice as exposed to road accidents than males; it also shows the benefits of extensive road education training and of being aged 30-64 and older. Drivers who have already been punished and have had their driving license scores reduced are likely to respond rapidly when in a dangerous situation and also to be without blame after an accident. Motorcycle riders are 25 times more likely to suffer serious injury than drivers of cars. Additionally, the risk of a woman being seriously injured is higher than for a man. females, young drivers and motorcycle riders who have not previously been penalised for a previous traffic violation have a higher risk of being seriously injured; females and motorcycle riders are also at greater risk of being seriously injured. We hope that this analysis will be used to improve preventative interventions for road accidents.r.

Musculoskeletal Modeling Component of the NASA Digital Astronaut Project

NASA Technical Reports Server (NTRS)

Lewandowski, B. E.; Pennline, J. A.; Stalker, A. R.; Mulugeta, L.; Myers, J. G.

2011-01-01

The NASA Digital Astronaut Project s (DAP) objective is to provide computational tools that support research of the physiological response to low gravity environments and analyses of how changes cause health and safety risks to the astronauts and to the success of the mission. The spaceflight risk associated with muscle atrophy is impaired performance due to reduced muscle mass, strength and endurance. Risks of early onset of osteoporosis and bone fracture are among the spaceflight risks associated with loss of bone mineral density. METHODS: Tools under development include a neuromuscular model, a biomechanical model and a bone remodeling model. The neuromuscular model will include models of neuromuscular drive, muscle atrophy, fiber morphology and metabolic processes as a function of time in space. Human movement will be modeled with the biomechanical model, using muscle and bone model parameters at various states. The bone remodeling model will allow analysis of bone turnover, loss and adaptation. A comprehensive trade study was completed to identify the current state of the art in musculoskeletal modeling. The DAP musculoskeletal models will be developed using a combination of existing commercial software and academic research codes identified in the study, which will be modified for use in human spaceflight research. These individual models are highly dependent upon each other and will be integrated together once they reach sufficient levels of maturity. ANALYSES: The analyses performed with these models will include comparison of different countermeasure exercises for optimizing effectiveness and comparison of task requirements and the state of strength and endurance of a crew member at a particular time in a mission. DISCUSSION: The DAP musculoskeletal model has the potential to complement research conducted on spaceflight induced changes to the musculoskeletal system. It can help with hypothesis formation, identification of causative mechanisms and supplementing small data samples.

Between Oais and Agile a Dynamic Data Management Approach

NASA Astrophysics Data System (ADS)

Bennett, V. L.; Conway, E. A.; Waterfall, A. M.; Pepler, S.

2015-12-01

In this paper we decribe an approach to the integration of existing archival activities which lies between compliance with the more rigid OAIS/TRAC standards and a more flexible "Agile" approach to the curation and preservation of Earth Observation data. We provide a high level overview of existing practice and discuss how these procedures can be extended and supported through the description of preservation state. The aim of which is to facilitate the dynamic controlled management of scientific data through its lifecycle. While processes are considered they are not statically defined but rather driven by human interactions in the form of risk management/review procedure that produce actionable plans, which are responsive to change. We then proceed by describing the feasibility testing of extended risk management and planning procedures which integrate current practices. This was done through the CEDA Archival Format Audit which inspected British Atmospheric Data Centre and NERC Earth Observation Data Centre Archival holdings. These holdings are extensive, comprising of around 2 Petabytes of data and 137 million individual files, which were analysed and characterised in terms of format, based risk. We are then able to present an overview of the format based risk burden faced by a large scale archive attempting to maintain the usability of heterogeneous environmental data sets We continue by presenting a dynamic data management information model and provide discussion of the following core model entities and their relationships: Aspirational entities, which include Data Entity definitions and their associated Preservation Objectives. Risk entities, which act as drivers for change within the data lifecycle. These include Acquisitional Risks, Technical Risks, Strategic Risks and External Risks Plan entities, which detail the actions to bring about change within an archive. These include Acquisition Plans, Preservation Plans and Monitoring plans which support responsive interactions with the community. The Result entities describe the outcomes of the plans. This includes Acquisitions. Mitigations and Accepted Risks. With risk acceptance permitting imperfect but functional solutions that can be realistically supported within an archives resource levels

Health research needs more comprehensive accessibility measures: integrating time and transport modes from open data.

PubMed

Tenkanen, Henrikki; Saarsalmi, Perttu; Järv, Olle; Salonen, Maria; Toivonen, Tuuli

2016-07-28

In this paper, we demonstrate why and how both temporality and multimodality should be integrated in health related studies that include accessibility perspective, in this case healthy food accessibility. We provide evidence regarding the importance of using multimodal spatio-temporal accessibility measures when conducting research in urban contexts and propose a methodological approach for integrating different travel modes and temporality to spatial accessibility analyses. We use the Helsinki metropolitan area (Finland) as our case study region to demonstrate the effects of temporality and modality on the results. Spatial analyses were carried out on 250 m statistical grid squares. We measured travel times between the home location of inhabitants and open grocery stores providing healthy food at 5 p.m., 10 p.m., and 1 a.m. using public transportation and private cars. We applied the so-called door-to-door approach for the travel time measurements to obtain more realistic and comparable results between travel modes. The analyses are based on open access data and publicly available open-source tools, thus similar analyses can be conducted in urban regions worldwide. Our results show that both time and mode of transport have a prominent impact on the outcome of the analyses; thus, understanding the realities of accessibility in a city may be very different according to the setting of the analysis used. In terms of travel time, there is clear variation in the results at different times of the day. In terms of travel mode, our results show that when analyzed in a comparable manner, public transport can be an even faster mode than a private car to access healthy food, especially in central areas of the city where the service network is dense and public transportation system is effective. This study demonstrates that time and transport modes are essential components when modeling health-related accessibility in urban environments. Neglecting them from spatial analyses may lead to overly simplified or even erroneous images of the realities of accessibility. Hence, there is a risk that health related planning and decisions based on simplistic accessibility measures might cause unwanted outcomes in terms of inequality among different groups of people.

Ecological Risk Assessment with MCDM of Some Invasive Alien Plants in China

NASA Astrophysics Data System (ADS)

Xie, Guowen; Chen, Weiguang; Lin, Meizhen; Zheng, Yanling; Guo, Peiguo; Zheng, Yisheng

Alien plant invasion is an urgent global issue that threatens the sustainable development of the ecosystem health. The study of its ecological risk assessment (ERA) could help us to prevent and reduce the invasion risk more effectively. Based on the theory of ERA and methods of the analytic hierarchy process (AHP) of multi-criteria decision-making (MCDM), and through the analyses of the characteristics and processes of alien plant invasion, this paper discusses the methodologies of ERA of alien plant invasion. The assessment procedure consisted of risk source analysis, receptor analysis, exposure and hazard assessment, integral assessment, and countermeasure of risk management. The indicator system of risk source assessment as well as the indices and formulas applied to measure the ecological loss and risk were established, and the method for comprehensively assessing the ecological risk of alien plant invasion was worked out. The result of ecological risk analysis to 9 representative invasive alien plants in China shows that the ecological risk of Erigeron annuus, Ageratum conyzoides, Alternanthera philoxeroides and Mikania midrantha is high (grade1-2), that of Oxalis corymbosa and Wedelia chinensis comes next (grade3), while Mirabilis jalapa, Pilea microphylla and Calendula officinalis of the last (grade 4). Risk strategies are put forward on this basis.

Advances in Integrating Traditional and Omic Biomarkers When Analyzing the Effects of the Mediterranean Diet Intervention in Cardiovascular Prevention

PubMed Central

Fitó, Montserrat; Melander, Olle; Martínez, José Alfredo; Toledo, Estefanía; Carpéné, Christian; Corella, Dolores

2016-01-01

Intervention with Mediterranean diet (MedDiet) has provided a high level of evidence in primary prevention of cardiovascular events. Besides enhancing protection from classical risk factors, an improvement has also been described in a number of non-classical ones. Benefits have been reported on biomarkers of oxidation, inflammation, cellular adhesion, adipokine production, and pro-thrombotic state. Although the benefits of the MedDiet have been attributed to its richness in antioxidants, the mechanisms by which it exercises its beneficial effects are not well known. It is thought that the integration of omics including genomics, transcriptomics, epigenomics, and metabolomics, into studies analyzing nutrition and cardiovascular diseases will provide new clues regarding these mechanisms. However, omics integration is still in its infancy. Currently, some single-omics analyses have provided valuable data, mostly in the field of genomics. Thus, several gene-diet interactions in determining both intermediate (plasma lipids, etc.) and final cardiovascular phenotypes (stroke, myocardial infarction, etc.) have been reported. However, few studies have analyzed changes in gene expression and, moreover very few have focused on epigenomic or metabolomic biomarkers related to the MedDiet. Nevertheless, these preliminary results can help to better understand the inter-individual differences in cardiovascular risk and dietary response for further applications in personalized nutrition. PMID:27598147

Efficacy of an integrated hospital-primary care program for heart failure: a population-based analysis of 56,742 patients.

PubMed

Comín-Colet, Josep; Verdú-Rotellar, José María; Vela, Emili; Clèries, Montse; Bustins, Montserrat; Mendoza, Lola; Badosa, Neus; Cladellas, Mercè; Ferré, Sofía; Bruguera, Jordi

2014-04-01

The efficacy of heart failure programs has been demonstrated in clinical trials but their applicability in the real world practice setting is more controversial. This study evaluates the feasibility and efficacy of an integrated hospital-primary care program for the management of patients with heart failure in an integrated health area covering a population of 309,345. For the analysis, we included all patients consecutively admitted with heart failure as the principal diagnosis who had been discharged alive from all of the hospitals in Catalonia, Spain, from 2005 to 2011, the period when the program was implemented, and compared mortality and readmissions among patients exposed to the program with the rates in the patients of all the remaining integrated health areas of the Servei Català de la Salut (Catalan Health Service). We included 56,742 patients in the study. There were 181,204 hospital admissions and 30,712 deaths during the study period. In the adjusted analyses, when compared to the 54,659 patients from the other health areas, the 2083 patients exposed to the program had a lower risk of death (hazard ratio=0.92 [95% confidence interval, 0.86-0.97]; P=.005), a lower risk of clinically-related readmission (hazard ratio=0.71 [95% confidence interval, 0.66-0.76]; P<.001), and a lower risk of readmission for heart failure (hazard ratio=0.86 [95% confidence interval, 0.80-0.94]; P<.001). The positive impact on the morbidity and mortality rates was more marked once the program had become well established. The implementation of multidisciplinary heart failure management programs that integrate the hospital and the community is feasible and is associated with a significant reduction in patient morbidity and mortality. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

Analysing urban resilience through alternative stormwater management options: application of the conceptual Spatial Decision Support System model at the neighbourhood scale.

PubMed

Balsells, M; Barroca, B; Amdal, J R; Diab, Y; Becue, V; Serre, D

2013-01-01

Recent changes in cities and their environments, caused by rapid urbanisation and climate change, have increased both flood probability and the severity of flooding. Consequently, there is a need for all cities to adapt to climate and socio-economic changes by developing new strategies for flood risk management. Following a risk paradigm shift from traditional to more integrated approaches, and considering the uncertainties of future urban development, one of the main emerging tasks for city managers becomes the development of resilient cities. However, the meaning of the resilience concept and its operability is still not clear. The goal of this research is to study how urban engineering and design disciplines can improve resilience to floods in urban neighbourhoods. This paper presents the conceptual Spatial Decision Support System (DS3) model which we consider a relevant tool to analyse and then implement resilience into neighbourhood design. Using this model, we analyse and discuss alternative stormwater management options at the neighbourhood scale in two specific areas: Rotterdam and New Orleans. The results obtained demonstrate that the DS3 model confirmed in its framework analysis that stormwater management systems can positively contribute to the improved flood resilience of a neighbourhood.

Analyzing best practices in employee health management: how age, sex, and program components relate to employee engagement and health outcomes.

PubMed

Terry, Paul E; Grossmeier, Jessica; Mangen, David J; Gingerich, Stefan B

2013-04-01

Examine the influence of employee health management (EHM) best practices on registration, participation, and health behavior change in telephone-based coaching programs. Individual health assessment data, EHM program data, and health coaching participation data were analyzed for associations with coaching program enrollment, active participation, and risk reduction. Multivariate analyses occurred at the individual (n = 205,672) and company levels (n = 55). Considerable differences were found in how age and sex impacted typical EHM evaluation metrics. Cash incentives for the health assessment were associated with more risk reduction for men than for women. Providing either a noncash or a benefits-integrated incentive for completing the health assessment, or a noncash incentive for lifestyle management, strengthened the relationship between age and risk reduction. In EHM programs, one size does not fit all. These results can help employers tailor engagement strategies for their specific population.

A critical analysis of the South African Disaster Management Act and Policy Framework.

PubMed

van Niekerk, Dewald

2014-10-01

The promulgation of the South African Disaster Management Act No. 57 of 2002 and the National Disaster Management Policy Framework of 2005 placed South Africa at the international forefront by integrating disaster risk reduction into all spheres of government through a decentralised approach. Yet, good policy and legislation do not necessarily translate into good practice. This paper provides a critical analysis of the Act and Policy Framework. Using qualitative research methods, it analyses the attitudes and perceptions of senior public officials on all levels of government, the private sector and academia. The study finds that one of the weakest aspects of the Act and Framework is the absence of clear guidance to local municipalities. The placement of the disaster risk management function on all tiers of government remains problematic, funding is inadequate and overall knowledge and capacities for disaster risk reduction are insufficient. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

75 FR 69065 - Draft Toxicological Review of Urea: In Support of Summary Information on the Integrated Risk...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... Summary Information on the Integrated Risk Information System (IRIS) AGENCY: Environmental Protection..., ``Toxicological Review of Urea: In Support of Summary Information on the Integrated Risk Information System (IRIS...: The draft ``Toxicological Review of Urea: In Support of Summary Information on the Integrated Risk...

Probabilistic cost-benefit analysis of disaster risk management in a development context.

PubMed

Kull, Daniel; Mechler, Reinhard; Hochrainer-Stigler, Stefan

2013-07-01

Limited studies have shown that disaster risk management (DRM) can be cost-efficient in a development context. Cost-benefit analysis (CBA) is an evaluation tool to analyse economic efficiency. This research introduces quantitative, stochastic CBA frameworks and applies them in case studies of flood and drought risk reduction in India and Pakistan, while also incorporating projected climate change impacts. DRM interventions are shown to be economically efficient, with integrated approaches more cost-effective and robust than singular interventions. The paper highlights that CBA can be a useful tool if certain issues are considered properly, including: complexities in estimating risk; data dependency of results; negative effects of interventions; and distributional aspects. The design and process of CBA must take into account specific objectives, available information, resources, and the perceptions and needs of stakeholders as transparently as possible. Intervention design and uncertainties should be qualified through dialogue, indicating that process is as important as numerical results. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Estimating risk factors for HIV infection among women in Mozambique using population-based survey data.

PubMed

Dias, Sara S; Mbofana, Francisco; Cassy, Sheyla R; Dias, Sónia; Augusto, Gonçalo F; Agadjanian, Victor; Martins, Maria R O

2018-03-01

The use of population-based survey data together with sound statistical methods can enhance better estimation of HIV risk factors and explain variations across subgroups of the population. The distribution and determinants of HIV infection in populations must be taken into consideration. We analysed data from the HIV Prevalence and Behaviour Survey in Mozambique aiming to find risk factors associated with HIV infection among Mozambican women. The paper provides a complex survey logistic regression model to explain the variation in HIV seropositivity using demographic, socio-economic and behavioural factors. Results show that women aged 25-29 years, living in female-headed households, living in richer households and those widowed, divorced or not living with a partner have higher odds of being HIV-positive. Findings from our study provide a unique and integrated perspective on risk factors for being HIV-positive among Mozambican women and could support the implementation of programmes aiming to reduce HIV infection in Mozambique.

Bayesian Analysis for Risk Assessment of Selected Medical Events in Support of the Integrated Medical Model Effort

NASA Technical Reports Server (NTRS)

Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.

2012-01-01

The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.

Alpharetroviral Self-inactivating Vectors: Long-term Transgene Expression in Murine Hematopoietic Cells and Low Genotoxicity

PubMed Central

Suerth, Julia D; Maetzig, Tobias; Brugman, Martijn H; Heinz, Niels; Appelt, Jens-Uwe; Kaufmann, Kerstin B; Schmidt, Manfred; Grez, Manuel; Modlich, Ute; Baum, Christopher; Schambach, Axel

2012-01-01

Comparative integrome analyses have highlighted alpharetroviral vectors with a relatively neutral, and thus favorable, integration spectrum. However, previous studies used alpharetroviral vectors harboring viral coding sequences and intact long-terminal repeats (LTRs). We recently developed self-inactivating (SIN) alpharetroviral vectors with an advanced split-packaging design. In a murine bone marrow (BM) transplantation model we now compared alpharetroviral, gammaretroviral, and lentiviral SIN vectors and showed that all vectors transduced hematopoietic stem cells (HSCs), leading to comparable, sustained multilineage transgene expression in primary and secondary transplanted mice. Alpharetroviral integrations were decreased near transcription start sites, CpG islands, and potential cancer genes compared with gammaretroviral, and decreased in genes compared with lentiviral integrations. Analyzing the transcriptome and intragenic integrations in engrafting cells, we observed stronger correlations between in-gene integration targeting and transcriptional activity for gammaretroviral and lentiviral vectors than for alpharetroviral vectors. Importantly, the relatively “extragenic” alpharetroviral integration pattern still supported long-term transgene expression upon serial transplantation. Furthermore, sensitive genotoxicity studies revealed a decreased immortalization incidence compared with gammaretroviral and lentiviral SIN vectors. We conclude that alpharetroviral SIN vectors have a favorable integration pattern which lowers the risk of insertional mutagenesis while supporting long-term transgene expression in the progeny of transplanted HSCs. PMID:22334016

Towards an integrated approach to natural hazards risk assessment using GIS: with reference to bushfires.

PubMed

Chen, Keping; Blong, Russell; Jacobson, Carol

2003-04-01

This paper develops a GIS-based integrated approach to risk assessment in natural hazards, with reference to bushfires. The challenges for undertaking this approach have three components: data integration, risk assessment tasks, and risk decision-making. First, data integration in GIS is a fundamental step for subsequent risk assessment tasks and risk decision-making. A series of spatial data integration issues within GIS such as geographical scales and data models are addressed. Particularly, the integration of both physical environmental data and socioeconomic data is examined with an example linking remotely sensed data and areal census data in GIS. Second, specific risk assessment tasks, such as hazard behavior simulation and vulnerability assessment, should be undertaken in order to understand complex hazard risks and provide support for risk decision-making. For risk assessment tasks involving heterogeneous data sources, the selection of spatial analysis units is important. Third, risk decision-making concerns spatial preferences and/or patterns, and a multicriteria evaluation (MCE)-GIS typology for risk decision-making is presented that incorporates three perspectives: spatial data types, data models, and methods development. Both conventional MCE methods and artificial intelligence-based methods with GIS are identified to facilitate spatial risk decision-making in a rational and interpretable way. Finally, the paper concludes that the integrated approach can be used to assist risk management of natural hazards, in theory and in practice.

76 FR 57033 - Draft Toxicological Review of n-Butanol: In Support of Summary Information on the Integrated Risk...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-15

... Toxicological Review of n-Butanol: In Support of Summary Information on the Integrated Risk Information System..., ``Toxicological Review of n-Butanol: In Support of Summary Information on the Integrated Risk Information System...-Butanol: In Support of Summary Information on the Integrated Risk Information System (IRIS)'' is available...

Moonshot Objectives: Catalyze New Scientific Breakthroughs-Proteogenomics.

PubMed

Rodland, Karin D; Piehowski, Paul; Smith, Richard D

Breaking down the silos between disciplines to accelerate the pace of cancer research is a key paradigm for the Cancer Moonshot. Molecular analyses of cancer biology have tended to segregate between a focus on nucleic acids-DNA, RNA, and their modifications-and a focus on proteins and protein function. Proteogenomics represents a fusion of those two approaches, leveraging the strengths of each to provide a more integrated vision of the flow of information from DNA to RNA to protein and eventually function at the molecular level. Proteogenomic studies have been incorporated into multiple activities associated with the Cancer Moonshot, demonstrating substantial added value. Innovative study designs integrating genomic, transcriptomic, and proteomic data, particularly those using clinically relevant samples and involving clinical trials, are poised to provide new insights regarding cancer risk, progression, and response to therapy.

The spatial optimism model research for the regional land use based on the ecological constraint

NASA Astrophysics Data System (ADS)

XU, K.; Lu, J.; Chi, Y.

2013-12-01

The study focuses on the Yunnan-Guizhou (i.e. Yunnan province and Guizhou province) Plateau in China. Since the Yunnan-Guizhou region consists of closed basins, the land resources suiting for development are in a shortage, and the ecological problems in the area are quite complicated. In such circumstance, in order to get the applicable basins area and distribution, certain spatial optimism model is needed. In this research, Digital Elevation Model (DEM) and land use data are used to get the boundary rules of the basins distribution. Furthermore, natural risks, ecological risks and human-made ecological risks are integrated to be analyzed. Finally, the spatial overlay analysis method is used to model the developable basins area and distribution for industries and urbanization. The study process can be divided into six steps. First, basins and their distribution need to be recognized. In this way, the DEM data is used to extract the geomorphology characteristics. The plaque regions with gradient under eight degrees are selected. Among these regions, the total area of the plaque with the area above 8 km2 is 54,000 km2, 10% of the total area. These regions are selected to the potential application of industries and urbanization. In the later five steps, analyses are aimed at these regions. Secondly, the natural risks are analyzed. The conditions of the earthquake, debris flow and rainstorm and flood are combined to classify the natural risks. Thirdly, the ecological risks are analyzed containing the ecological sensibility and ecosystem service function importance. According to the regional ecologic features, the sensibility containing the soil erosion, acid rain, stony desertification and survive condition factors is derived and classified according to the medium value to get the ecological sensibility partition. The ecosystem service function importance is classified and divided considering the biology variation protection and water conservation factors. The fourth step is the man-made ecological risks analysis. The mineral resources exploitation, forest resources developing, farming, tourism, industrialization and urbanization are integrated to derive the potential ecological risks made by human activities. The risks weight are given using the expert marking method, Then the man-made ecological risks are classified and divided among the regions. In the fifth step, the comprehensive ecological controlling divisions are obtained based on the above factors classification. At last, the applicable regions and distribution are derived using the spatial overlay analysis removing the higher ecological risks area and considering the land use status. In conclusion, based on the above comprehensive analyses, the applicable basins area are 2,575 km2 and 1,011 km2 respectively for the Yunnan province and Guizhou province. The amount is less than 1% of the perspective province total area focusing on the central part of the two provinces.

Electric Propulsion Performance from Geo-transfer to Geosynchronous Orbits

NASA Technical Reports Server (NTRS)

Dankanich, John W.; Carpenter, Christian B.

2007-01-01

For near-Earth application, solar electric propulsion advocates have focused on Low Earth Orbit (LEO) to Geosynchronous (GEO) low-thrust transfers because of the significant improvement in capability over chemical alternatives. While the performance gain attained from starting with a lower orbit is large, there are also increased transfer times and radiation exposure risk that has hindered the commercial advocacy for electric propulsion stages. An incremental step towards electric propulsion stages is the use of integrated solar electric propulsion systems (SEPS) for GTO to GEO transfer. Thorough analyses of electric propulsion systems options and performance are presented. Results are based on existing or near-term capabilities of Arcjets, Hall thrusters, and Gridded Ion engines. Parametric analyses based on "rubber" thruster and launch site metrics are also provided.

Flood risk analysis and adaptive strategy in context of uncertainties: a case study of Nhieu Loc Thi Nghe Basin, Ho Chi Minh City

NASA Astrophysics Data System (ADS)

Ho, Long-Phi; Chau, Nguyen-Xuan-Quang; Nguyen, Hong-Quan

2013-04-01

The Nhieu Loc - Thi Nghe basin is the most important administrative and business area of Ho Chi Minh City. Due to system complexity of the basin such as the increasing trend of rainfall intensity, (tidal) water level and land subsidence, the simulation of hydrological, hydraulic variables for flooding prediction seems rather not adequate in practical projects. The basin is still highly vulnerable despite of multi-million USD investment for urban drainage improvement projects since the last decade. In this paper, an integrated system analysis in both spatial and temporal aspects based on statistical, GIS and modelling approaches has been conducted in order to: (1) Analyse risks before and after projects, (2) Foresee water-related risk under uncertainties of unfavourable driving factors and (3) Develop a sustainable flood risk management strategy for the basin. The results show that given the framework of risk analysis and adaptive strategy, certain urban developing plans in the basin must be carefully revised and/or checked in order to reduce the highly unexpected loss in the future

Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide ...

EPA Pesticide Factsheets

EPA is seeking peer review of the scientific basis supporting the human health hazard and dose-response assessment of ethylene oxide (cancer) that will appear in the Integrated Risk Information System (IRIS) database. EPA seeks external peer review on how the Agency responded to the SAB panel recommendations, the exposure-response modeling of epidemiologic data, including new analyses since the 2007 external peer review, and on the adequacy, transparency, and clarity of the revised draft. The peer review will include an opportunity for the public to address the peer reviewers.

Reducing the Risk of Human Space Missions with INTEGRITY

NASA Technical Reports Server (NTRS)

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

2003-01-01

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

76 FR 71029 - Draft Toxicological Review of n-Butanol: In Support of Summary Information on the Integrated Risk...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... Toxicological Review of n-Butanol: In Support of Summary Information on the Integrated Risk Information System... Information on the Integrated Risk Information System (IRIS)'' (EPA/635/R-11/081A). On September 15, 2011, the... ``Toxicological Review of n-Butanol: In Support of Summary Information on the Integrated Risk Information System...

Integrated concurrent utilization quality review, Part one.

PubMed

Caterinicchio, R P

1987-01-01

This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

Added prognostic value of ischaemic threshold in radionuclide myocardial perfusion imaging: a common-sense integration of exercise tolerance and ischaemia severity.

PubMed

Marini, Cecilia; Acampa, Wanda; Bauckneht, Matteo; Daniele, Stefania; Capitanio, Selene; Cantoni, Valeria; Fiz, Francesco; Zampella, Emilia; Dib, Bassam; Assante, Roberta; Bruzzi, Paolo; Sambuceti, Gianmario; Cuocolo, Alberto

2015-04-01

Reversible ischaemia at radionuclide myocardial perfusion imaging (MPI) accurately predicts risk of cardiac death and nonfatal myocardial infarction (major adverse cardiac events, MACE). This prognostic penetrance might be empowered by accounting for exercise tolerance as an indirect index of ischaemia severity. The present study aimed to verify this hypothesis integrating imaging assessment of ischaemia severity with exercise maximal rate pressure product (RPP) in a large cohort of patients with suspected or known coronary artery disease (CAD). We analysed 1,502 consecutive patients (1,014 men aged 59 ± 10 years) submitted to exercise stress/rest MPI. To account for exercise tolerance, the summed difference score (SDS) was divided by RPP at tracer injection providing a clinical prognostic index (CPI). Reversible ischaemia was documented in 357 patients (24 %) and was classified by SDS as mild (SDS 2-4) in 180, moderate (SDS 5-7) in 118 and severe (SDS >7) in 59. CPI values of ischaemic patients were clustered into tertiles with lowest and highest values indicating low and high risk, respectively. CPI modified SDS risk prediction in 119/357 (33 %) patients. During a 60-month follow-up, MACE occurred in 68 patients. Kaplan-Meier analysis revealed that CPI significantly improved predictive power for MACE incidence with respect to SDS alone. Multivariate Cox analysis confirmed the additive independent value of CPI-derived information. Integration of ischaemic threshold and ischaemia extension and severity can improve accuracy of exercise MPI in predicting long-term outcome in a large cohort of patients with suspected or known CAD.

Hospital outcomes of older people with cognitive impairment: An integrative review.

PubMed

Fogg, Carole; Griffiths, Peter; Meredith, Paul; Bridges, Jackie

2018-06-26

To summarise existing knowledge of outcomes of older hospital patients with cognitive impairment, including the type and frequency of outcomes reported, and the additional risk experienced by this patient group. Integrative literature review. Health care literature databases, reports, and policy documents on key websites were systematically searched. Papers describing the outcomes of older people with cognitive impairment during hospitalisation and at discharge were analysed and summarised using integrative methods. One hundred four articles were included. A range of outcomes were identified, including those occurring during hospitalisation and at discharge. Older people with a dementia diagnosis were at higher risk from death in hospital, nursing home admission, long lengths of stay, as well as intermediate outcomes such as delirium, falls, dehydration, reduction in nutritional status, decline in physical and cognitive function, and new infections in hospital. Fewer studies examined the relationship of all-cause cognitive impairment with outcomes. Patient and carer experiences of hospital admission were often poor. Few studies collected data relating to hospital environment, eg, ward type or staffing levels, and acuity of illness was rarely described. Older people with cognitive impairment have a higher risk of a variety of negative outcomes in hospital. Prevalent intermediate outcomes suggest that changes in care processes are required to ensure maintenance of fundamental care provision and greater attention to patient safety in this vulnerable group. More research is required to understand the most appropriate ways of doing this and how changes in these care processes are best implemented to improve hospital outcomes. © 2018 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.

[Integrative concepts in modern forensic psychiatry].

PubMed

Dittmann, V

1996-03-01

Forensic psychiatric diagnosis and treatment should be guided by juridical goals and never be an end in itself. As a whole it is a public service concerning the interests of the perpetrators and the security of the entire population as well. Recent progress in forensic psychiatry is based on integral and comprehensive concepts. In the evaluation of criminal responsibility the new approaches of psychiatric diagnosis like operationalism, application of quantificating instruments and multiaxial diagnostic systems are of considerable importance. The ICD-10 classification of WHO can now be regarded as our reference system. To be acceptable for juridical purposes the evaluation of criminal responsibility has to be based on a systematical analysis of all important factors like actual situation of crime, environment, influence of psychotropic substances, psychosocial stressors, influences of biography and mental disorders. Assessment of prognosis is obligatory by law in many cases. These are juridical decisions, which have to be prepared by the psychiatric experts in the form of risk evaluations considering factors like development of delinquency, analysis of crime, kind of mental disturbance, insight of the perpetrator in his disorder, social competence, selfexamination of the perpetrator of his crime, possible therapies and social circumstances after discharge. Only an integral multiprofessional approach can be regarded as successful in the therapy of forensic high risk patients with paraphilas and aggressive impulse-control disorders. In Switzerland there is still a considerable lack of appropriate institutions for these patients. The vast amount of data accumulated during forensic psychiatric routine should be analysed in multicenter studies with scientific documentation systems to achieve progress in forensic risk calculation and efficiency of therapies.

Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges.

PubMed

Saidel, Tobi; Adhikary, Rajatashuvra; Mainkar, Mandar; Dale, Jayesh; Loo, Virginia; Rahman, Motiur; Ramesh, Banadakoppa M; Paranjape, Ramesh S

2008-12-01

This paper presents key methodological approaches and challenges in implementing and analysing the first round of the integrated biobehavioural assessment of most-at-risk populations, conducted in conjunction with evaluation of Avahan, the India AIDS initiative. The survey collected data on HIV risk behaviours, sexually transmitted infections and HIV prevalence in 29 districts in six high-prevalence states of India. Groups included female sex workers and clients, men who have sex with men, injecting drug users and truck drivers. Strategies for overcoming some challenges of the large-scale surveys among vulnerable populations, including sampling hidden populations, involvement of the communities targeted by the survey, laboratory and quality control in remote, non-clinic field settings, and data analysis and data use are presented. Satisfying the need for protocols, guidelines and tools that allowed for sufficient standardization, while being tailored enough to fit diverse local situations on such a large scale, with so many implementing partners, emerged as a major management challenge. A major lesson from the first round is the vital importance of investing upfront time in tailoring the sampling methods, data collection instruments, and analysis plan to match measurement objectives. Despite the challenges, the integrated biobehavioural assessment was a huge achievement, and was largely successful in providing previously unavailable information about the HIV situation among populations that are critical to the curtailment of HIV spread in India. Lessons from the first round will be used to evolve the second round into an exercise with increased evaluative capability for Avahan.

Description of OPRA: A Danish database designed for the analyses of risk factors associated with 30-day hospital readmission of people aged 65+ years.

PubMed

Pedersen, Mona K; Nielsen, Gunnar L; Uhrenfeldt, Lisbeth; Rasmussen, Ole S; Lundbye-Christensen, Søren

2017-08-01

To describe the construction of the Older Person at Risk Assessment (OPRA) database, the ability to link this database with existing data sources obtained from Danish nationwide population-based registries and to discuss its research potential for the analyses of risk factors associated with 30-day hospital readmission. We reviewed Danish nationwide registries to obtain information on demographic and social determinants as well as information on health and health care use in a population of hospitalised older people. The sample included all people aged 65+ years discharged from Danish public hospitals in the period from 1 January 2007 to 30 September 2010. We used personal identifiers to link and integrate the data from all events of interest with the outcome measures in the OPRA database. The database contained records of the patients, admissions and variables of interest. The cohort included 1,267,752 admissions for 479,854 unique people. The rate of 30-day all-cause acute readmission was 18.9% ( n=239,077) and the overall 30-day mortality was 5.0% ( n=63,116). The OPRA database provides the possibility of linking data on health and life events in a population of people moving into retirement and ageing. Construction of the database makes it possible to outline individual life and health trajectories over time, transcending organisational boundaries within health care systems. The OPRA database is multi-component and multi-disciplinary in orientation and has been prepared to be used in a wide range of subgroup analyses, including different outcome measures and statistical methods.

Combined Plasma Elevation of CRP, Intestinal-Type Fatty Acid-Binding Protein (I-FABP), and sCD14 Identify Older Patients at High Risk for Health Care-Associated Infections.

PubMed

Paillaud, Elena; Bastuji-Garin, Sylvie; Plonquet, Anne; Foucat, Emile; Fournier, Bénédicte; Boutin, Emmanuelle; Le Thuaut, Aurélie; Levy, Yves; Hue, Sophie

2018-01-16

We hypothesized that low-grade inflammation was driven by microbial translocation and associated with an increased risk of health care-associated infections (HAIs). We included 121 patients aged 75 years or over in this prospective cohort study. High-sensitivity C-reactive protein (hs-CRP), I-FABP, and sCD14-as markers for low-grade inflammation, intestinal epithelial barrier integrity, and monocyte activation, respectively-were measured at admission. HAIs occurred during hospitalization in 62 (51%) patients. Elevated hs-CRP (≥6.02 mg/L, ie, the median) was associated with a significantly higher HAI risk when I-FABP was in the highest quartile (odds ratio [OR], 4; 95% confidence interval [95% CI], 1.39-11.49; p = .010). In patients with hs-CRP elevation and highest-quartile I-FABP, sCD14 elevation (≥0.65 µg/mL, ie, the median) was associated with an 11-fold higher HAI risk (OR, 10.8; 95% CI, 2.28-51.1; p = .003). Multivariate analyses adjusted for invasive procedures and comorbidities did not change the associations linking the three markers to the HAI risk. Increased levels of hs-CRP, I-FABP, and sCD14 may reflect loss of intestinal epithelial barrier integrity with microbial translocation leading to monocyte activation and low-grade inflammation. In our cohort, these markers identified patients at high risk for HAIs. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Accuracy of the Atherosclerotic Cardiovascular Risk Equation in a Large Contemporary, Multiethnic Real-World Population

PubMed Central

Rana, Jamal S.; Tabada, Grace H.; Solomon, Matthew D.; Lo, Joan C.; Jaffe, Marc G.; Sung, Sue Hee; Ballantyne, Christie M.; Go, Alan S.

2016-01-01

Background The accuracy of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) risk equation for atherosclerotic cardiovascular disease (ASCVD) events in contemporary and ethnically diverse populations is not well understood. Objectives We sought to evaluate the accuracy of the 2013 ACC/AHA risk equation within a large, multiethnic population in clinical care. Methods The target population for consideration of cholesterol-lowering therapy in a large, integrated health care delivery system population was identified in 2008 and followed through 2013. The main analyses excluded those with known ASCVD, diabetes mellitus, low-density lipoprotein cholesterol levels <70 or ≥190 mg/dl, prior statin use, or incomplete 5-year follow-up. Patient characteristics were obtained from electronic medical records and ASCVD events were ascertained using validated algorithms for hospitalization databases and death certificates. We compared predicted versus observed 5-year ASCVD risk, overall and by sex and race/ethnicity. We additionally examined predicted versus observed risk in patients with diabetes mellitus. Results Among 307,591 eligible adults without diabetes between 40 and 75 years of age, 22,283 were black, 52,917 Asian/Pacific Islander, and 18,745 Hispanic. We observed 2,061 ASCVD events during 1,515,142 person-years. In each 5-year predicted ASCVD risk category, observed 5-year ASCVD risk was substantially lower: 0.20% for predicted risk <2.50%; 0.65% for predicted risk 2.50 to 3.74%; 0.90% for predicted risk 3.75 to 4.99%; and 1.85% for predicted risk ≥5.00%, with C: 0.74. Similar ASCVD risk overestimation and poor calibration with moderate discrimination (C: 0.68 to 0.74) was observed in sex, racial/ethnic, and socioeconomic status subgroups, and in sensitivity analyses among patients receiving statins for primary prevention. Calibration among 4,242 eligible adults with diabetes was improved, but discrimination was worse (C: 0.64). Conclusions In a large, contemporary “real-world” population, the ACC/AHA Pooled Cohort risk equation substantially overestimated actual 5-year risk in adults without diabetes, overall and across sociodemographic subgroups. PMID:27151343

Application of a multidisciplinary and integrative weight-of-evidence approach to a 1-year monitoring survey of the Seine River.

PubMed

Barjhoux, Iris; Fechner, Lise C; Lebrun, Jérémie D; Anzil, Adriana; Ayrault, Sophie; Budzinski, Hélène; Cachot, Jérôme; Charron, Laetitia; Chaumot, Arnaud; Clérandeau, Christelle; Dedourge-Geffard, Odile; Faburé, Juliette; François, Adeline; Geffard, Olivier; George, Isabelle; Labadie, Pierre; Lévi, Yves; Munoz, Gabriel; Noury, Patrice; Oziol, Lucie; Quéau, Hervé; Servais, Pierre; Uher, Emmanuelle; Urien, Nastassia; Geffard, Alain

2016-06-08

Quality assessment of environments under high anthropogenic pressures such as the Seine Basin, subjected to complex and chronic inputs, can only be based on combined chemical and biological analyses. The present study integrates and summarizes a multidisciplinary dataset acquired throughout a 1-year monitoring survey conducted at three workshop sites along the Seine River (PIREN-Seine program), upstream and downstream of the Paris conurbation, during four seasonal campaigns using a weight-of-evidence approach. Sediment and water column chemical analyses, bioaccumulation levels and biomarker responses in caged gammarids, and laboratory (eco)toxicity bioassays were integrated into four lines of evidence (LOEs). Results from each LOE clearly reflected an anthropogenic gradient, with contamination levels and biological effects increasing from upstream to downstream of Paris, in good agreement with the variations in the structure and composition of bacterial communities from the water column. Based on annual average data, the global hazard was summarized as "moderate" at the upstream station and as "major" at the two downstream ones. Seasonal variability was also highlighted; the winter campaign was least impacted. The model was notably improved using previously established reference and threshold values from national-scale studies. It undoubtedly represents a powerful practical tool to facilitate the decision-making processes of environment managers within the framework of an environmental risk assessment strategy.

Quantifying surgical complexity with machine learning: looking beyond patient factors to improve surgical models.

PubMed

Van Esbroeck, Alexander; Rubinfeld, Ilan; Hall, Bruce; Syed, Zeeshan

2014-11-01

To investigate the use of machine learning to empirically determine the risk of individual surgical procedures and to improve surgical models with this information. American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data from 2005 to 2009 were used to train support vector machine (SVM) classifiers to learn the relationship between textual constructs in current procedural terminology (CPT) descriptions and mortality, morbidity, Clavien 4 complications, and surgical-site infections (SSI) within 30 days of surgery. The procedural risk scores produced by the SVM classifiers were validated on data from 2010 in univariate and multivariate analyses. The procedural risk scores produced by the SVM classifiers achieved moderate-to-high levels of discrimination in univariate analyses (area under receiver operating characteristic curve: 0.871 for mortality, 0.789 for morbidity, 0.791 for SSI, 0.845 for Clavien 4 complications). Addition of these scores also substantially improved multivariate models comprising patient factors and previously proposed correlates of procedural risk (net reclassification improvement and integrated discrimination improvement: 0.54 and 0.001 for mortality, 0.46 and 0.011 for morbidity, 0.68 and 0.022 for SSI, 0.44 and 0.001 for Clavien 4 complications; P < .05 for all comparisons). Similar improvements were noted in discrimination and calibration for other statistical measures, and in subcohorts comprising patients with general or vascular surgery. Machine learning provides clinically useful estimates of surgical risk for individual procedures. This information can be measured in an entirely data-driven manner and substantially improves multifactorial models to predict postoperative complications. Copyright © 2014 Elsevier Inc. All rights reserved.

A Risk-Based Approach to Evaluating Wildlife Demographics for Management in a Changing Climate: A Case Study of the Lewis's Woodpecker

NASA Astrophysics Data System (ADS)

Towler, Erin; Saab, Victoria A.; Sojda, Richard S.; Dickinson, Katherine; Bruyère, Cindy L.; Newlon, Karen R.

2012-12-01

Given the projected threat that climate change poses to biodiversity, the need for proactive response efforts is clear. However, integrating uncertain climate change information into conservation planning is challenging, and more explicit guidance is needed. To this end, this article provides a specific example of how a risk-based approach can be used to incorporate a species' response to climate into conservation decisions. This is shown by taking advantage of species' response (i.e., impact) models that have been developed for a well-studied bird species of conservation concern. Specifically, we examine the current and potential impact of climate on nest survival of the Lewis's Woodpecker ( Melanerpes lewis) in two different habitats. To address climate uncertainty, climate scenarios are developed by manipulating historical weather observations to create ensembles (i.e., multiple sequences of daily weather) that reflect historical variability and potential climate change. These ensembles allow for a probabilistic evaluation of the risk posed to Lewis's Woodpecker nest survival and are used in two demographic analyses. First, the relative value of each habitat is compared in terms of nest survival, and second, the likelihood of exceeding a critical population threshold is examined. By embedding the analyses in a risk framework, we show how management choices can be made to be commensurate with a defined level of acceptable risk. The results can be used to inform habitat prioritization and are discussed in the context of an economic framework for evaluating trade-offs between management alternatives.

A risk-based approach to evaluating wildlife demographics for management in a changing climate: A case study of the Lewis's Woodpecker

USGS Publications Warehouse

Towler, Erin; Saab, Victoria A.; Sojda, Richard S.; Dickinson, Katherine; Bruyere, Cindy L.; Newlon, Karen R.

2012-01-01

Given the projected threat that climate change poses to biodiversity, the need for proactive response efforts is clear. However, integrating uncertain climate change information into conservation planning is challenging, and more explicit guidance is needed. To this end, this article provides a specific example of how a risk-based approach can be used to incorporate a species' response to climate into conservation decisions. This is shown by taking advantage of species' response (i.e., impact) models that have been developed for a well-studied bird species of conservation concern. Specifically, we examine the current and potential impact of climate on nest survival of the Lewis's Woodpecker (Melanerpes lewis) in two different habitats. To address climate uncertainty, climate scenarios are developed by manipulating historical weather observations to create ensembles (i.e., multiple sequences of daily weather) that reflect historical variability and potential climate change. These ensembles allow for a probabilistic evaluation of the risk posed to Lewis's Woodpecker nest survival and are used in two demographic analyses. First, the relative value of each habitat is compared in terms of nest survival, and second, the likelihood of exceeding a critical population threshold is examined. By embedding the analyses in a risk framework, we show how management choices can be made to be commensurate with a defined level of acceptable risk. The results can be used to inform habitat prioritization and are discussed in the context of an economic framework for evaluating trade-offs between management alternatives.

Modeling hard clinical end-point data in economic analyses.

PubMed

Kansal, Anuraag R; Zheng, Ying; Palencia, Roberto; Ruffolo, Antonio; Hass, Bastian; Sorensen, Sonja V

2013-11-01

The availability of hard clinical end-point data, such as that on cardiovascular (CV) events among patients with type 2 diabetes mellitus, is increasing, and as a result there is growing interest in using hard end-point data of this type in economic analyses. This study investigated published approaches for modeling hard end-points from clinical trials and evaluated their applicability in health economic models with different disease features. A review of cost-effectiveness models of interventions in clinically significant therapeutic areas (CV diseases, cancer, and chronic lower respiratory diseases) was conducted in PubMed and Embase using a defined search strategy. Only studies integrating hard end-point data from randomized clinical trials were considered. For each study included, clinical input characteristics and modeling approach were summarized and evaluated. A total of 33 articles (23 CV, eight cancer, two respiratory) were accepted for detailed analysis. Decision trees, Markov models, discrete event simulations, and hybrids were used. Event rates were incorporated either as constant rates, time-dependent risks, or risk equations based on patient characteristics. Risks dependent on time and/or patient characteristics were used where major event rates were >1%/year in models with fewer health states (<7). Models of infrequent events or with numerous health states generally preferred constant event rates. The detailed modeling information and terminology varied, sometimes requiring interpretation. Key considerations for cost-effectiveness models incorporating hard end-point data include the frequency and characteristics of the relevant clinical events and how the trial data is reported. When event risk is low, simplification of both the model structure and event rate modeling is recommended. When event risk is common, such as in high risk populations, more detailed modeling approaches, including individual simulations or explicitly time-dependent event rates, are more appropriate to accurately reflect the trial data.

Balancing benefits and costs in a 4°C world: the need for and challenges of natural-social science dialogue

NASA Astrophysics Data System (ADS)

Kopp, R. E.

2012-12-01

Making wise policy decisions regarding mitigation, adaptation and geoengineering requires fair assessments of the risks of both action and inaction. Such assessments necessitate dialogue between natural and social scientists. Recent attempts by the U.S. government to estimate the social cost of carbon (SCC) for use in balancing the benefits and costs of proposed mitigatory regulations highlight some of the challenges involved. Among them: (1) Scale: The costs and benefits of adaptation decisions generally take place locally, while the benefits of mitigation accrue globally. Most studies to inform adaptation decision have, quite reasonably, taken place at the local scale, but this has left globally aggregate estimates of climate risk in a fairly tenuous state, engaging only a handful of economists. More accurate assessments, needed for making critical policy decisions as we approach a 4°C world, will require both better top-down analyses and a better framework for integrating bottom-up analyses. (2) Historical validation: Integrated assessment models have not been subject to validation studies, such as the historical runs used to test physical climate models. Conducting such studies for impact analyses will require the integration and further development of statistical analyses of the human impact of past and ongoing climate change. If models don't work for a 0.8°C world, there's no reason to think they'll work for a 4°C world. (3) Looking beyond a 4°C world: A world that reaches 4°C in this century may exceed it in the next century; and even if temperature is stabilized, understanding the economic impacts of 4°C warming will require more than the current approach of extrapolating from 2°C impacts. Natural scientists and social scientists need to work together to estimate damage calibration points for considerably warmer conditions. Recent work on the loss of physiologically habitable regions in a >8°C warmer world is a rare step in this direction (Sherwood and Huber, 2010). (4) Characterizing the economic impacts of climate surprises and other hard-to-model climatic events: Complex climate models are tuned to perform well against historical observations, but such tuning leads to undersampling of the tails of probability distribution. Characterizing these tails is critical for risk assessment. Non-model-based approaches (e.g., paleoclimatic studies) can help in assessing the likelihoods of physical climate events that are either hard to model or vary greatly between models (e.g., ice sheet melt, ENSO strengthening, AMOC slowdown, Amazon die-off, etc.) With the exception of sea level change associated with ice sheet melt, the social science literature on the impacts of these events is limited or non-existent. Sherwood, S.C., Huber, M., 2010. Proc. Natl. Acad. Sci. 107, 9552 -9555.

Don't kill canaries! Introducing a new test device to assess the electrostatic risk potential to photomasks

NASA Astrophysics Data System (ADS)

Sebald, Thomas

2008-10-01

Electrostatic protection is an issue for all masks, whether during mask production, shipping, storage, handling or inspection and exposure. Up to now, only manual electrostatic field measurements, or expensive and elaborate analyses with Canary reticles have given hints about the risks of pattern damage by ESD events. A new test device is being introduced, which consists of electrostatic field sensors, integrated INSIDE a closed fused quartz housing which has the outside dimensions of a 6 inch mask. This device can be handled and used like a normal 6 inch reticle. It can be handled and processed while recording the electrostatic charges on the chrome patterns created by friction or field induction just as a reticle would "see" during normal processing.

graph-GPA: A graphical model for prioritizing GWAS results and investigating pleiotropic architecture.

PubMed

Chung, Dongjun; Kim, Hang J; Zhao, Hongyu

2017-02-01

Genome-wide association studies (GWAS) have identified tens of thousands of genetic variants associated with hundreds of phenotypes and diseases, which have provided clinical and medical benefits to patients with novel biomarkers and therapeutic targets. However, identification of risk variants associated with complex diseases remains challenging as they are often affected by many genetic variants with small or moderate effects. There has been accumulating evidence suggesting that different complex traits share common risk basis, namely pleiotropy. Recently, several statistical methods have been developed to improve statistical power to identify risk variants for complex traits through a joint analysis of multiple GWAS datasets by leveraging pleiotropy. While these methods were shown to improve statistical power for association mapping compared to separate analyses, they are still limited in the number of phenotypes that can be integrated. In order to address this challenge, in this paper, we propose a novel statistical framework, graph-GPA, to integrate a large number of GWAS datasets for multiple phenotypes using a hidden Markov random field approach. Application of graph-GPA to a joint analysis of GWAS datasets for 12 phenotypes shows that graph-GPA improves statistical power to identify risk variants compared to statistical methods based on smaller number of GWAS datasets. In addition, graph-GPA also promotes better understanding of genetic mechanisms shared among phenotypes, which can potentially be useful for the development of improved diagnosis and therapeutics. The R implementation of graph-GPA is currently available at https://dongjunchung.github.io/GGPA/.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Astrophysics Data System (ADS)

Drake, Bret G.

2007-07-01

The NASA Deputy Administrator charted an internal NASA planning group to develop the rationale for exploration beyond low-Earth orbit. This team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond Low-Earth Orbit through the human exploration of Mars. Following the results of the Exploration Blueprint study, the NASA Administrator asked for a recommendation on the next steps in human and robotic exploration. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the moon, can help reduce the risk for Mars missions.

Social relationships and physiological determinants of longevity across the human life span

PubMed Central

Yang, Yang Claire; Boen, Courtney; Gerken, Karen; Li, Ting; Schorpp, Kristen; Harris, Kathleen Mullan

2016-01-01

Two decades of research indicate causal associations between social relationships and mortality, but important questions remain as to how social relationships affect health, when effects emerge, and how long they last. Drawing on data from four nationally representative longitudinal samples of the US population, we implemented an innovative life course design to assess the prospective association of both structural and functional dimensions of social relationships (social integration, social support, and social strain) with objectively measured biomarkers of physical health (C-reactive protein, systolic and diastolic blood pressure, waist circumference, and body mass index) within each life stage, including adolescence and young, middle, and late adulthood, and compare such associations across life stages. We found that a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose–response manner in both early and later life. Conversely, lack of social connections was associated with vastly elevated risk in specific life stages. For example, social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence, and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age. Analyses of multiple dimensions of social relationships within multiple samples across the life course produced consistent and robust associations with health. Physiological impacts of structural and functional dimensions of social relationships emerge uniquely in adolescence and midlife and persist into old age. PMID:26729882

Risk as an attribute in discrete choice experiments: a systematic review of the literature.

PubMed

Harrison, Mark; Rigby, Dan; Vass, Caroline; Flynn, Terry; Louviere, Jordan; Payne, Katherine

2014-01-01

Discrete choice experiments (DCEs) are used to elicit preferences of current and future patients and healthcare professionals about how they value different aspects of healthcare. Risk is an integral part of most healthcare decisions. Despite the use of risk attributes in DCEs consistently being highlighted as an area for further research, current methods of incorporating risk attributes in DCEs have not been reviewed explicitly. This study aimed to systematically identify published healthcare DCEs that incorporated a risk attribute, summarise and appraise methods used to present and analyse risk attributes, and recommend best practice regarding including, analysing and transparently reporting the methodology supporting risk attributes in future DCEs. The Web of Science, MEDLINE, EMBASE, PsycINFO and Econlit databases were searched on 18 April 2013 for DCEs that included a risk attribute published since 1995, and on 23 April 2013 to identify studies assessing risk communication in the general (non-DCE) health literature. Healthcare-related DCEs with a risk attribute mentioned or suggested in the title/abstract were obtained and retained in the final review if a risk attribute meeting our definition was included. Extracted data were tabulated and critically appraised to summarise the quality of reporting, and the format, presentation and interpretation of the risk attribute were summarised. This review identified 117 healthcare DCEs that incorporated at least one risk attribute. Whilst there was some evidence of good practice incorporated into the presentation of risk attributes, little evidence was found that developing methods and recommendations from other disciplines about effective methods and validation of risk communication were systematically applied to DCEs. In general, the reviewed DCE studies did not thoroughly report the methodology supporting the explanation of risk in training materials, the impact of framing risk, or exploring the validity of risk communication. The primary limitation of this review was that the methods underlying presentation, format and analysis of risk attributes could only be appraised to the extent that they were reported. Improvements in reporting and transparency of risk presentation from conception to the analysis of DCEs are needed. To define best practice, further research is needed to test how the process of communicating risk affects the way in which people value risk attributes in DCEs.

Biological and Psychosocial Predictors of Postpartum Depression: Systematic Review and Call for Integration

PubMed Central

Tanner Stapleton, Lynlee R.; Guardino, Christine M.; Hahn-Holbrook, Jennifer; Schetter, Christine Dunkel

2017-01-01

Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology. PMID:25822344

Integrated Science Assessment (ISA) for Sulfur Oxides ...

EPA Pesticide Factsheets

EPA announced the availability of the external review draft of the Integrated Science Assessment for Sulfur Oxides– Health Criteria for public comment and independent peer review in a November 24, 2015 Federal Register Notice. This draft document provides EPA’s evaluation and synthesis of the most policy-relevant science related to the health effects of sulfur oxides. When final, it will provide a critical part of the scientific foundation for EPA’s decision regarding the adequacy of the current primary (health-based) National Ambient Air Quality Standard (NAAQS) for sulfur dioxide. The Integrated Plan for Review of the Primary NAAQS for SOx U.S. 2: EPA (2007) identifies key policy-relevant questions that provide a framework for this review of the scientific evidence. These questions frame the entire review of the NAAQS, and thus are informed by both science and policy considerations. The ISA organizes and presents the scientific evidence such that, when considered along with findings from risk analyses and policy considerations, will help the EPA address these questions in completing the NAAQS review.

Prenatal alcohol use: the role of lifetime problems with alcohol, drugs, depression, and violence.

PubMed

Flynn, Heather A; Chermack, Stephen T

2008-07-01

The purpose of this study was to examine a broader array of lifetime factors that theoretically may be associated with prenatal alcohol use than have previously been studied together, including family history of alcohol-use problems, history of physical or sexual abuse, lifetime major depressive disorder, alcohol-use disorder, illicit-drug-use problems, and partner violence. A total of 186 pregnant women, all of whom used alcohol in the year before pregnancy, were initially recruited in prenatal care settings. Women who reported no prenatal alcohol use (n = 96) were compared with women who drank 1-10 standard drinks during pregnancy (n = 75) and with women who drank more than 10 standard drinks during pregnancy (n = 13), considered to be a higher risk group, on the lifetime risk variables. Because of the public health implications, secondary analyses compared women who abstained during pregnancy with those who used any alcohol. Significant intercorrelations were found among most of the lifetime risk factors studied. Multivariate analyses showed that drug-use problems and partner violence were most strongly associated with prenatal alcohol use than any other variable studied. Consistent with a life span risk framework for alcohol-use problems, results of this study show that childhood abuse, familial alcoholism, lifetime major depressive disorder, and alcohol- and drug-use problems are interrelated. However, when considered together, only lifetime partner violence and drug use are significantly related to various levels of prenatal alcohol use. Identification, assessment, and intervention efforts should integrate these important factors.

Unmanned aircraft system sense and avoid integrity and continuity

NASA Astrophysics Data System (ADS)

Jamoom, Michael B.

This thesis describes new methods to guarantee safety of sense and avoid (SAA) functions for Unmanned Aircraft Systems (UAS) by evaluating integrity and continuity risks. Previous SAA efforts focused on relative safety metrics, such as risk ratios, comparing the risk of using an SAA system versus not using it. The methods in this thesis evaluate integrity and continuity risks as absolute measures of safety, as is the established practice in commercial aircraft terminal area navigation applications. The main contribution of this thesis is a derivation of a new method, based on a standard intruder relative constant velocity assumption, that uses hazard state estimates and estimate error covariances to establish (1) the integrity risk of the SAA system not detecting imminent loss of '"well clear," which is the time and distance required to maintain safe separation from intruder aircraft, and (2) the probability of false alert, the continuity risk. Another contribution is applying these integrity and continuity risk evaluation methods to set quantifiable and certifiable safety requirements on sensors. A sensitivity analysis uses this methodology to evaluate the impact of sensor errors on integrity and continuity risks. The penultimate contribution is an integrity and continuity risk evaluation where the estimation model is refined to address realistic intruder relative linear accelerations, which goes beyond the current constant velocity standard. The final contribution is an integrity and continuity risk evaluation addressing multiple intruders. This evaluation is a new innovation-based method to determine the risk of mis-associating intruder measurements. A mis-association occurs when the SAA system incorrectly associates a measurement to the wrong intruder, causing large errors in the estimated intruder trajectories. The new methods described in this thesis can help ensure safe encounters between aircraft and enable SAA sensor certification for UAS integration into the National Airspace System.

Characteristics of genomic signatures derived using univariate methods and mechanistically anchored functional descriptors for predicting drug- and xenobiotic-induced nephrotoxicity.

PubMed

Shi, Weiwei; Bugrim, Andrej; Nikolsky, Yuri; Nikolskya, Tatiana; Brennan, Richard J

2008-01-01

ABSTRACT The ideal toxicity biomarker is composed of the properties of prediction (is detected prior to traditional pathological signs of injury), accuracy (high sensitivity and specificity), and mechanistic relationships to the endpoint measured (biological relevance). Gene expression-based toxicity biomarkers ("signatures") have shown good predictive power and accuracy, but are difficult to interpret biologically. We have compared different statistical methods of feature selection with knowledge-based approaches, using GeneGo's database of canonical pathway maps, to generate gene sets for the classification of renal tubule toxicity. The gene set selection algorithms include four univariate analyses: t-statistics, fold-change, B-statistics, and RankProd, and their combination and overlap for the identification of differentially expressed probes. Enrichment analysis following the results of the four univariate analyses, Hotelling T-square test, and, finally out-of-bag selection, a variant of cross-validation, were used to identify canonical pathway maps-sets of genes coordinately involved in key biological processes-with classification power. Differentially expressed genes identified by the different statistical univariate analyses all generated reasonably performing classifiers of tubule toxicity. Maps identified by enrichment analysis or Hotelling T-square had lower classification power, but highlighted perturbed lipid homeostasis as a common discriminator of nephrotoxic treatments. The out-of-bag method yielded the best functionally integrated classifier. The map "ephrins signaling" performed comparably to a classifier derived using sparse linear programming, a machine learning algorithm, and represents a signaling network specifically involved in renal tubule development and integrity. Such functional descriptors of toxicity promise to better integrate predictive toxicogenomics with mechanistic analysis, facilitating the interpretation and risk assessment of predictive genomic investigations.

Academic and social integration on campus among sexual minority students: the impacts of psychological and experiential campus climate.

PubMed

Woodford, Michael R; Kulick, Alex

2015-03-01

A heterosexist campus climate can increase risk for mental health problems for sexual minority students; however, the relationship between campus climate for sexual minorities and academic outcomes remains understudied. Using a sample of sexual minority respondents extracted from a campus climate survey conducted at a large university in the Midwest, we examine relationships between multiple dimensions of psychological and experiential campus climate for sexual minorities with academic integration (academic disengagement, grade-point average [GPA]) and social integration (institutional satisfaction, acceptance on campus). We also investigate the protective role of engagement with informal academic and peer-group systems. Findings suggest campus climate affects sexual minority students' integration. In multivariate analyses, perceptions of whether lesbian, gay, and bisexual (LGB) people could be open about their sexual identity was positively associated with acceptance on campus; personal heterosexist harassment was positively associated with academic disengagement and negatively with GPA. Students' informal academic integration (instructor relations) and informal social integration (LGB friends) demonstrated influential main effects but did not moderate any of the climate-outcome relationships. Researchers should further explore the relationships between climate and academic outcomes among sexual minority students, both collectively and among specific sub-groups, and address the role of other protective factors.

The Role of Integrative Taxonomy in the Conservation Management of Cryptic Species: The Taxonomic Status of Endangered Earless Dragons (Agamidae: Tympanocryptis) in the Grasslands of Queensland, Australia

PubMed Central

Melville, Jane; Smith, Katie; Hobson, Rod; Hunjan, Sumitha; Shoo, Luke

2014-01-01

Molecular phylogenetics is increasingly highlighting the prevalence of cryptic species, where morphologically similar organisms have long independent evolutionary histories. When such cryptic species are known to be declining in numbers and are at risk of extinction due to a range of threatening processes, the disjunction between molecular systematics research and conservation policy becomes a significant problem. We investigate the taxonomic status of Tympanocryptis populations in Queensland, which have previously been assigned to T. tetraporophora, using three species delimitation approaches. The taxonomic uncertainties in this species-group are of particular importance in the Darling Downs Earless Dragon (T. cf. tetraporophora), which is ranked as an endangered ‘species’ of high priority for conservation by the Queensland Department of Environment and Heritage Protection. We undertook a morphological study, integrated with a comprehensive genetic study and species delimitation analyses, to investigate the species status of populations in the region. Phylogenetic analyses of two gene regions (mtDNA: ND2; nuclear: RAG1) revealed high levels of genetic divergence between populations, indicating isolation over long evolutionary time frames, and strongly supporting two independent evolutionary lineages in southeastern Queensland, from the Darling Downs, and a third in the Gulf Region of northern Queensland. Of the three species delimitation protocols used, we found integrative taxonomy the most applicable to this cryptic species complex. Our study demonstrates the utility of integrative taxonomy as a species delimitation approach in cryptic complexes of species with conservation significance, where limited numbers of specimens are available. PMID:25076129

The role of integrative taxonomy in the conservation management of cryptic species: the taxonomic status of endangered earless dragons (Agamidae: Tympanocryptis) in the grasslands of Queensland, Australia.

PubMed

Melville, Jane; Smith, Katie; Hobson, Rod; Hunjan, Sumitha; Shoo, Luke

2014-01-01

Molecular phylogenetics is increasingly highlighting the prevalence of cryptic species, where morphologically similar organisms have long independent evolutionary histories. When such cryptic species are known to be declining in numbers and are at risk of extinction due to a range of threatening processes, the disjunction between molecular systematics research and conservation policy becomes a significant problem. We investigate the taxonomic status of Tympanocryptis populations in Queensland, which have previously been assigned to T. tetraporophora, using three species delimitation approaches. The taxonomic uncertainties in this species-group are of particular importance in the Darling Downs Earless Dragon (T. cf. tetraporophora), which is ranked as an endangered 'species' of high priority for conservation by the Queensland Department of Environment and Heritage Protection. We undertook a morphological study, integrated with a comprehensive genetic study and species delimitation analyses, to investigate the species status of populations in the region. Phylogenetic analyses of two gene regions (mtDNA: ND2; nuclear: RAG1) revealed high levels of genetic divergence between populations, indicating isolation over long evolutionary time frames, and strongly supporting two independent evolutionary lineages in southeastern Queensland, from the Darling Downs, and a third in the Gulf Region of northern Queensland. Of the three species delimitation protocols used, we found integrative taxonomy the most applicable to this cryptic species complex. Our study demonstrates the utility of integrative taxonomy as a species delimitation approach in cryptic complexes of species with conservation significance, where limited numbers of specimens are available.

Cultural identity, clothing and common mental disorder: a prospective school-based study of white British and Bangladeshi adolescents.

PubMed

Bhui, K; Khatib, Y; Viner, R; Klineberg, E; Clark, C; Head, J; Stansfeld, S

2008-05-01

Cultural integration is the healthiest outcome for young people living in multicultural societies. This paper investigates the influence of different cultural identities on the risk of common mental disorders among Bangladeshi and white British pupils. The cultural identity of 11-14-year-old school pupils was assessed by their preferences for friends and clothes of their own or other cultural groups; using this information pupils were classified into traditional, integrated, assimilated or marginalised groups. We undertook prospective analyses of cultural identity and its impacts on the later mental health of young people. East London. In 2001, white British (573) and Bangladeshi (682) school pupils from a representative sample of schools completed a self-report questionnaire that assessed their cultural, social and health characteristics. In 2003, 383 white British and 517 Bangladeshi pupils were resurveyed and completed measures of mental health. Strengths and difficulties questionnaire. Bangladeshi pupils preferring clothes from their own cultural group (traditional clothing) were less likely to have later mental health problems when compared with Bangladeshi pupils showing an equal preference for clothing from their own and other cultures (integrated clothing; odds ratio (OR) 0.3, 95% CI 0.1 to 0.9). In gender-specific analyses, this finding was sustained only among Bangladeshi girls (OR 0.1, 95% CI 0.1 to 0.7). Integrated clothing choices were least risky only for white British adolescents. Friendship choices showed no prospective associations with later mental health problems. Cultural identity, expressed by clothing preferences, influences mental health; the effects differ by gender and ethnic group.

A systematic review of socio-economic assessments in support of coastal zone management (1992-2011).

PubMed

Le Gentil, Eric; Mongruel, Rémi

2015-02-01

Cooperation between the social and natural sciences has become essential in order to encompass all the dimensions of coastal zone management. Socio-economic approaches are increasingly recommended to complement integrated assessment in support of these initiatives. A systematic review of the academic literature was carried out in order to analyze the main types of socio-economic assessments used to inform the coastal zone management process as well as their effectiveness. A corpus of 1682 articles published between 1992 and 2011 was identified by means of the representative coverage approach, from which 170 were selected by applying inclusion/exclusion criteria and then classified using a content analysis methodology. The percentage of articles that mention the use of socio-economic assessment in support of coastal zone management initiatives is increasing but remains relatively low. The review examines the links between the issues addressed by integrated assessments and the chosen analytical frameworks as well as the various economic assessment methods which are used in the successive steps of the coastal zone management process. The results show that i) analytical frameworks such as 'risk and vulnerability', 'DPSIR', 'valuation', 'ecosystem services' and 'preferences' are likely to lead to effective integration of social sciences in coastal zone management research while 'integration', 'sustainability' and 'participation' remain difficult to operationalize, ii) risk assessments are insufficiently implemented in developing countries, and iii) indicator systems in support of multi-criteria analyses could be used during more stages of the coastal zone management process. Finally, it is suggested that improved collaboration between science and management would require that scientists currently involved in coastal zone management processes further educate themselves in integrated assessment approaches and participatory methodologies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Immediate effects of alcohol marketing communications and media portrayals on consumption and cognition: a systematic review and meta-analysis of experimental studies.

PubMed

Stautz, Kaidy; Brown, Kyle G; King, Sarah E; Shemilt, Ian; Marteau, Theresa M

2016-06-09

Restricting marketing of alcoholic products is purported to be a cost-effective intervention to reduce alcohol consumption. The strength of evidence supporting this claim is contested. This systematic review aimed to assess immediate effects of exposure to alcohol marketing on alcoholic beverage consumption and related cognitions. Electronic searches of nine databases, supplemented with reference list searches and forward citation tracking, were used to identify randomised, experimental studies assessing immediate effects of exposure to alcohol marketing communications on objective alcohol consumption (primary outcome), explicit or implicit alcohol-related cognitions, or selection without purchasing (secondary outcomes). Study limitations were assessed using the Cochrane Risk of Bias tool. Random and fixed effects meta-analyses were conducted to estimate effect sizes. Twenty four studies met the eligibility criteria. A meta-analysis integrating seven studies (758 participants, all students) found that viewing alcohol advertisements increased immediate alcohol consumption relative to viewing non-alcohol advertisements (SMD = 0.20, 95 % CI = 0.05, 0.34). A meta-analysis integrating six studies (631 participants, all students) did not find that viewing alcohol portrayals in television programmes or films increased consumption (SMD = 0.16, 95 % CI = -0.05, 0.37). Meta-analyses of secondary outcome data found that exposure to alcohol portrayals increased explicit alcohol-related cognitions, but did not find that exposure to alcohol advertisements influenced explicit or implicit alcohol-related cognitions. Confidence in results is diminished by underpowered analyses and unclear risk of bias. Viewing alcohol advertisements (but not alcohol portrayals) may increase immediate alcohol consumption by small amounts, equivalent to between 0.39 and 2.67 alcohol units for males and between 0.25 and 1.69 units for females. The generalizability of this finding beyond students and to other marketing channels remains to be established.

75 FR 1617 - Draft Toxicological Review of Methanol: In Support of the Summary Information in the Integrated...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-12

... on the Integrated Risk Information System (IRIS)'' (EPA/635/R-09/013). The draft document was... ``Toxicological Review of Methanol: In Support of Summary Information on the Integrated Risk Information System... Toxicological Review of Methanol: In Support of the Summary Information in the Integrated Risk Information...

76 FR 54228 - Draft Toxicological Review of Acrylonitrile: In Support of Summary Information on the Integrated...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... Toxicological Review of Acrylonitrile: In Support of Summary Information on the Integrated Risk Information... Acrylonitrile: In Support of Summary Information on the Integrated Risk Information System (IRIS)'' (EPA/635/R... Acrylonitrile: In Support of Summary Information on the Integrated Risk Information System (IRIS)'' is available...

Integrating frequency and magnitude information in decision-making in schizophrenia: An account of patient performance on the Iowa Gambling Task.

PubMed

Brown, Elliot C; Hack, Samantha M; Gold, James M; Carpenter, William T; Fischer, Bernard A; Prentice, Kristen P; Waltz, James A

2015-01-01

The Iowa Gambling Task (IGT; Bechara et al., 1994) has frequently been used to assess risky decision making in clinical populations, including patients with schizophrenia (SZ). Poor performance on the IGT is often attributed to reduced sensitivity to punishment, which contrasts with recent findings from reinforcement learning studies in schizophrenia. In order to investigate possible sources of IGT performance deficits in SZ patients, we combined data from the IGT from 59 SZ patients and 43 demographically-matched controls with data from the Balloon Analog Risk Task (BART) in the same participants. Our analyses sought to specifically uncover the role of punishment sensitivity and delineate the capacity to integrate frequency and magnitude information in decision-making under risk. Although SZ patients, on average, made more choices from disadvantageous decks than controls did on the IGT, they avoided decks with frequent punishments at a rate similar to controls. Patients also exhibited excessive loss-avoidance behavior on the BART. We argue that, rather than stemming from reduced sensitivity to negative consequences, performance deficits on the IGT in SZ patients are more likely the result of a reinforcement learning deficit, specifically involving the integration of frequencies and magnitudes of rewards and punishments in the trial-by-trial estimation of expected value. Copyright © 2015 Elsevier Ltd. All rights reserved.

Integrating frequency and magnitude information in decision-making in schizophrenia: An account of patient performance on the Iowa Gambling Task

PubMed Central

Brown, Elliot C.; Hack, Samantha M.; Gold, James M.; Carpenter, William T.; Fischer, Bernard A.; Prentice, Kristen P.; Waltz, James A.

2015-01-01

Background The Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994) has frequently been used to assess risky decision making in clinical populations, including patients with schizophrenia (SZ). Poor performance on the IGT is often attributed to reduced sensitivity to punishment, which contrasts with recent findings from reinforcement learning studies in schizophrenia. Methods In order to investigate possible sources of IGT performance deficits in SZ patients, we combined data from the IGT from 59 SZ patients and 43 demographically-matched controls with data from the Balloon Analog Risk Task (BART) in the same participants. Our analyses sought to specifically uncover the role of punishment sensitivity and delineate the capacity to integrate frequency and magnitude information in decision-making under risk. Results Although SZ patients, on average, made more choices from disadvantageous decks than controls did on the IGT, they avoided decks with frequent punishments at a rate similar to controls. Patients also exhibited excessive loss-avoidance behavior on the BART. Conclusions We argue that, rather than stemming from reduced sensitivity to negative consequences, performance deficits on the IGT in SZ patients are more likely the result of a reinforcement learning deficit, specifically involving the integration of frequencies and magnitudes of rewards and punishments in the trial-by-trial estimation of expected value. PMID:25959618

Integrated pest management of "Golden Delicious" apples.

PubMed

Simončič, A; Stopar, M; Velikonja Bolta, Š; Bavčar, D; Leskovšek, R; Baša Česnik, H

2015-01-01

Monitoring of plant protection product (PPP) residues in "Golden Delicious" apples was performed in 2011-2013, where 216 active substances were analysed with three analytical methods. Integrated pest management (IPM) production and improved IPM production were compared. Results were in favour of improved IPM production. Some active compounds determined in IPM production (boscalid, pyraclostrobin, thiacloprid and thiametoxam) were not found in improved IPM production. Besides that, in 2011 and 2012, captan residues were lower in improved IPM production. Risk assessment was also performed. Chronic exposure of consumers was low in general, but showed no major differences for IPM and improved IPM production for active substances determined in both types of production. Analytical results were compared with the European Union report of 2010 where 1.3% of apple samples exceeded maximum residue levels (MRLs), while MRL exceedances were not observed in this survey.

Integrating human health and ecological data into cumulative risk assessment through the Aggregate Exposure Pathway and Adverse Outcome Pathway frameworks

EPA Science Inventory

Cumulative risk assessment (CRA) methods promote the use of a conceptual site model (CSM) to apportion exposures and integrate risk from relevant stressors across different species. Integration is important to provide a more complete assessment of risk, but evaluating endpoints a...

[Assumption of medical risks and the problem of medical liability in ancient Roman law].

PubMed

Váradi, Agnes

2008-11-02

The claim of an individual to assure his health and life, to assume and compensate the damage from diseases and accidents, had already appeared in the system of the ancient Roman law in the form of many singular legal institutions. In lack of a unified archetype of regulation, we have to analyse the damages caused in the health or corporal integrity of different personal groups: we have to mention the legal interpretation of the diseases or injuries suffered by serves, people under manus or patria potestas and free Roman citizens. The fragments from the Digest od Justinian do not only demonstrate concrete legal problems, but they can serve as a starting point for further theoretical analyses. For example: if death is the consequence of a medical failure, does the doctor have any kind of liability? Was after-care part of the healing process according to the Roman law? Examining these questions, we should not forget to talk about the complex liability system of the Roman law, the compensation of the damages caused in a contractual or delictual context and about the lex Aquilia. Although these conclusions have no direct relation with the present legal regulation of risk assumption, we have to see that analysing the examples of the Roman law can be useful for developing our view of a certain theoretical problem, like that of the modern liability concept in medicine as well.

Workers' Self-management, Recovered Companies and the Sociology of Work.

PubMed

Ozarow, Daniel; Croucher, Richard

2014-10-01

We analyse how far Argentina's worker-recovered companies (WRCs) have sustained themselves and their principles of equity and workers' self-management since becoming widespread following the country's 2001-2 economic crisis. Specialist Spanish-language sources, survey data and documents are analysed through four key sociological themes. We find that the number of WRCs has increased in Argentina, and that they represent a viable production model. Further, they have generally maintained their central principles and even flourished. This occurred despite the global economic crisis, legal and financial pressures to adopt capitalist practices and management structures, the risk of market absorption and state attempts to coopt, demobilise and depoliticise the movement. We argue that today they function as a much-needed international beacon of an alternative vision for labour and that integration of their experience has potential to revitalise the field.

Integrated HPV genomes tend to integrate in gene desert areas in the CaSki, HeLa, and SiHa cervical cancer cell lines.

PubMed

Diao, Ming-Kun; Liu, Chu-Yi; Liu, Hong-Wei; Li, Jin-Tao; Li, Fan; Mehryar, Mohammadreza Mohammadzad; Wang, Yang-Junqi; Zhan, Shao-Bing; Zhou, Yu-Bai; Zhong, Ru-Gang; Zeng, Yi

2015-04-15

The integration preferences of human papillomavirus (HPV) have been intensively studied and contested over recent years. To disclose the integration preferences of high-risk HPV in cervical cancer, HPV transcriptional sites and features in different cervical cancer cell lines were identified. In this study, three cervical cancer cell lines (CaSki, HeLa, and SiHa) were subjected for HPV genome status determination by amplification of papillomavirus oncogene transcripts (APOT) assay. The numbers of viral copies in human genomes and numbers of viral-human fusion mRNAs in three HPV-integrated cervical cancer cell lines were measured and analysed. The results revealed that the gene desert region 8q24 of the HPV type 18 integrated HeLa cell line and the 13q21-22 region of the HPV type 16 integrated CaSki and SiHa cell lines were hotspots for HPV integration, and the numbers of viral copies in the human genomes of the three cell lines that we detected were not in accordance with those reported in previous studies. Integration of the HPV genome into the host cell chromosome suggests that persistent HPV infection is vital for malignant cell transformation and carcinogenesis. This study provides information to benefit health care professionals seeking more comprehensive and accurate diagnostics for HPV-related disease"? Please check, and amend as necessary. Copyright © 2015 Elsevier Inc. All rights reserved.

Systems engineering and integration: Cost estimation and benefits analysis

NASA Technical Reports Server (NTRS)

Dean, ED; Fridge, Ernie; Hamaker, Joe

1990-01-01

Space Transportation Avionics hardware and software cost has traditionally been estimated in Phase A and B using cost techniques which predict cost as a function of various cost predictive variables such as weight, lines of code, functions to be performed, quantities of test hardware, quantities of flight hardware, design and development heritage, complexity, etc. The output of such analyses has been life cycle costs, economic benefits and related data. The major objectives of Cost Estimation and Benefits analysis are twofold: (1) to play a role in the evaluation of potential new space transportation avionics technologies, and (2) to benefit from emerging technological innovations. Both aspects of cost estimation and technology are discussed here. The role of cost analysis in the evaluation of potential technologies should be one of offering additional quantitative and qualitative information to aid decision-making. The cost analyses process needs to be fully integrated into the design process in such a way that cost trades, optimizations and sensitivities are understood. Current hardware cost models tend to primarily use weights, functional specifications, quantities, design heritage and complexity as metrics to predict cost. Software models mostly use functionality, volume of code, heritage and complexity as cost descriptive variables. Basic research needs to be initiated to develop metrics more responsive to the trades which are required for future launch vehicle avionics systems. These would include cost estimating capabilities that are sensitive to technological innovations such as improved materials and fabrication processes, computer aided design and manufacturing, self checkout and many others. In addition to basic cost estimating improvements, the process must be sensitive to the fact that no cost estimate can be quoted without also quoting a confidence associated with the estimate. In order to achieve this, better cost risk evaluation techniques are needed as well as improved usage of risk data by decision-makers. More and better ways to display and communicate cost and cost risk to management are required.

Exploration Systems Development (ESD) Approach to Enterprise Risk Management

NASA Technical Reports Server (NTRS)

Bauder, Stephen P.

2014-01-01

The National Aeronautics and Space Administration (NASA) Exploration Systems Development (ESD) Division has implemented an innovative approach to Enterprise Risk Management under a unique governance structure and streamlined integration model. ESD's mission is to design and build the capability to extend human existence to deep space. The Enterprise consists of three Programs: Space Launch System (SLS), Orion, and Ground Systems Development and Operations (GSDO). The SLS is a rocket and launch system that will be capable of powering humans, habitats, and support systems to deep space. Orion will be the first spacecraft in history capable of taking humans to multiple destinations within deep space. GSDO is modernizing Kennedy's spaceport to launch spacecraft built and designed by both NASA and private industry. ESD's approach to Enterprise Risk Management is commensurate with affordability and a streamlined management philosophy. ESD Enterprise Risk Management leverages off of the primary mechanisms for integration within the Enterprise. The Enterprise integration approach emphasizes delegation of authority to manage and execute the majority of cross-program activities and products to the individual Programs, while maintaining the overall responsibility for all cross-program activities at the Division. The intent of the ESD Enterprise Risk Management approach is to improve risk communication, to avoid replication and/or contradictory strategies, and to minimize overhead process burden. This is accomplished by the facilitation and integration of risk information within ESD. The ESD Division risks, Orion risks, SLS risks, and GSDO risks are owned and managed by the applicable Program. When the Programs have shared risks with multiple consequences, they are jointly owned and managed. When a risk is associated with the integrated system that involves more than one Program in condition, consequence, or mitigation plan, it is considered an Exploration Systems Integration (ESI) Risk. An ESI risk may require visibility and risk handling by multiple organizations. The Integrated Risk Working Group (IRWG) is a small team of Risk experts that are responsible for collaborating and communicating best practices. In addition, the forum facilitates proper integration of risks across the Enterprise. The IRWG uses a Continuous Risk Management approach for facilitating the identification, analysis, planning, tracking, and controlling of ESI Risks. The ESD Division, Programs, and Integrated Task Teams identify ESI Risks. The IRWG maintains a set of metrics for understanding Enterprise Risk process and the overall Risk Posture. The team is also actively involved in the modeling of risk for Enterprise Performance Management. With the Enterprise being constrained in Schedule and Budget, and with significant technical complexity, the appropriate use of Risk Management techniques is crucial to the success of the Enterprise. The IRWG achieves this through the modified approach, providing a forum for collaboration on risks that cross boundaries between the separate entities.

Cross-Cutting Risk Framework: Mining Data for Common Risks Across the Portfolio

NASA Technical Reports Server (NTRS)

Klein, Gerald A., Jr.; Ruark, Valerie

2017-01-01

The National Aeronautics and Space Administration (NASA) defines risk management as an integrated framework, combining risk-informed decision making and continuous risk management to foster forward-thinking and decision making from an integrated risk perspective. Therefore, decision makers must have access to risks outside of their own project to gain the knowledge that provides the integrated risk perspective. Through the Goddard Space Flight Center (GSFC) Flight Projects Directorate (FPD) Business Change Initiative (BCI), risks were integrated into one repository to facilitate access to risk data between projects. With the centralized repository, communications between the FPD, project managers, and risk managers improved and GSFC created the cross-cutting risk framework (CCRF) team. The creation of the consolidated risk repository, in parallel with the initiation of monthly FPD risk managers and risk governance board meetings, are now providing a complete risk management picture spanning the entire directorate. This paper will describe the challenges, methodologies, tools, and techniques used to develop the CCRF, and the lessons learned as the team collectively worked to identify risks that FPD programs projects had in common, both past and present.

Shared genetic variance between obesity and white matter integrity in Mexican Americans.

PubMed

Spieker, Elena A; Kochunov, Peter; Rowland, Laura M; Sprooten, Emma; Winkler, Anderson M; Olvera, Rene L; Almasy, Laura; Duggirala, Ravi; Fox, Peter T; Blangero, John; Glahn, David C; Curran, Joanne E

2015-01-01

Obesity is a chronic metabolic disorder that may also lead to reduced white matter integrity, potentially due to shared genetic risk factors. Genetic correlation analyses were conducted in a large cohort of Mexican American families in San Antonio (N = 761, 58% females, ages 18-81 years; 41.3 ± 14.5) from the Genetics of Brain Structure and Function Study. Shared genetic variance was calculated between measures of adiposity [(body mass index (BMI; kg/m(2)) and waist circumference (WC; in)] and whole-brain and regional measurements of cerebral white matter integrity (fractional anisotropy). Whole-brain average and regional fractional anisotropy values for 10 major white matter tracts were calculated from high angular resolution diffusion tensor imaging data (DTI; 1.7 × 1.7 × 3 mm; 55 directions). Additive genetic factors explained intersubject variance in BMI (heritability, h (2) = 0.58), WC (h (2) = 0.57), and FA (h (2) = 0.49). FA shared significant portions of genetic variance with BMI in the genu (ρG = -0.25), body (ρG = -0.30), and splenium (ρG = -0.26) of the corpus callosum, internal capsule (ρG = -0.29), and thalamic radiation (ρG = -0.31) (all p's = 0.043). The strongest evidence of shared variance was between BMI/WC and FA in the superior fronto-occipital fasciculus (ρG = -0.39, p = 0.020; ρG = -0.39, p = 0.030), which highlights region-specific variation in neural correlates of obesity. This may suggest that increase in obesity and reduced white matter integrity share common genetic risk factors.

Systematic overview and critical appraisal of meta-analyses of interventions in intensive care medicine.

PubMed

Koster, T M; Wetterslev, J; Gluud, C; Keus, F; van der Horst, I C C

2018-05-24

Meta-analysed intervention effect estimates are perceived to represent the highest level of evidence. However, such effects and the randomized clinical trials which are included in them need critical appraisal before the effects can be trusted. Critical appraisal of a predefined set of all meta-analyses on interventions in intensive care medicine to assess their quality and assessed the risks of bias in those meta-analyses having the best quality. We conducted a systematic search to select all meta-analyses of randomized clinical trials on interventions used in intensive care medicine. Selected meta-analyses were critically appraised for basic scientific criteria, (1) presence of an available protocol, (2) report of a full search strategy, and (3) use of any bias risk assessment of included trials. All meta-analyses which qualified these criteria were scrutinized by full "Risk of Bias in Systematic Reviews" ROBIS evaluation of 4 domains of risks of bias, and a "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" PRISMA evaluation. We identified 467 meta-analyses. A total of 56 meta-analyses complied with these basic scientific criteria. We scrutinized the risks of bias in the 56 meta-analyses by full ROBIS evaluation and a PRISMA evaluation. Only 4 meta-analyses scored low risk of bias in all the 4 ROBIS domains and 41 meta-analyses reported all 27 items of the PRISMA checklist. In contrast with what might be perceived as the highest level of evidence only 0.9% of all meta-analyses were judged to have overall low risk of bias. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

High school youth and suicide risk: exploring protection afforded through physical activity and sport participation.

PubMed

Taliaferro, Lindsay A; Rienzo, Barbara A; Miller, M David; Pigg, R Morgan; Dodd, Virginia J

2008-10-01

Suicide ranks as the third leading cause of death for adolescents. Recent data from the Centers for Disease Control and Prevention (CDC) indicate that the adolescent suicide rate increased 18% between 2003 and 2004. Sport may represent a promising protective factor against adolescent suicide. This study examined the relative risk of hopelessness and suicidality associated with physical activity and sport participation. Data from the CDC's 2005 Youth Risk Behavior Survey were analyzed. Logistic regression modeling was used to compare the odds of hopelessness and suicidality in students who engaged in various levels of physical activity to inactive students. Similar analyses were performed comparing risks of athletes to nonathletes, and the risks of highly involved athletes to nonathletes. Findings showed that frequent, vigorous activity reduced the risk of hopelessness and suicidality among male adolescents. However, low levels of activity actually increased the risk of feeling hopeless among young females. Yet, for both males and females, sport participation protected against hopelessness and suicidality. These findings indicate that involvement in sport confers unique psychosocial benefits that protect adolescents against suicidality. Findings suggest that mechanisms other than physical activity contribute to the protective association between sport and reduced suicidality. Social support and integration may account for some of the differences found in suicidality between athletes and nonathletes.

Long-term safety and efficacy of raloxifene in the prevention and treatment of postmenopausal osteoporosis: an update

PubMed Central

Messalli, Enrico M; Scaffa, Cono

2010-01-01

The integrity of bone tissue and its remodeling that occurs throughout life requires a coordinated activity of osteoblasts and osteoclasts. The decreased estrogen circulating level during postmenopausal transition, with a prevalence of osteoclastic activity over osteoblastic activity, represents the main cause of bone loss and osteoporosis. Osteoporosis is a chronic disease requiring long-term therapy and it is important to evaluate the efficacy and safety of treatments over several years, as the fear of health risks is a common reason for discontinuing therapy. Raloxifene is a selective estrogen receptor modulator (SERM) leading to estrogen-agonist effects in some tissues and estrogen-antagonist effects in others. Raloxifene is effective to prevent and treat postmenopausal vertebral osteoporosis, with reduction of spine fractures and, in post-hoc analyses, non-spine fractures in high-risk subjects. Moreover, raloxifene reduces the risk of invasive breast cancer and improves the levels of serum lipoprotein but with an increased risk of venous thromboembolism and fatal stroke, without significant change in the incidence of coronary events. For these reasons the overall risk-benefit profile is favorable. Therefore, when considering the use of raloxifene in a postmenopausal woman, we should take into account the osteoporosis-related individual risk and weigh the potential benefits, skeletal and extra-skeletal, against the health risks. PMID:21072271

Factors associated with perception of risk of contracting HIV among secondary school female learners in Mbonge subdivision of rural Cameroon.

PubMed

Tarkang, Elvis Enowbeyang

2014-01-01

Since learners in secondary schools fall within the age group hardest hit by HIV/AIDS, it is obvious that these learners might be at high risk of contracting HIV/AIDS. However, little has been explored on the perception of risk of contracting HIV among secondary school learners in Cameroon. This study aimed at examining the perception of risk of contracting HIV among secondary school learners in Mbonge subdivision of rural Cameroon using the Health Belief Model (HBM) as framework. A quantitative, correlational design was adopted, using a self-administered questionnaire to collect data from 210 female learners selected through disproportional, stratified, simple random sampling technique, from three participating senior secondary schools. Statistics were calculated using SPSS version 20 software program. Only 39.4% of the respondents perceived themselves to be at high risk of contracting HIV, though the majority, 54.0% were sexually active. Multinomial logistic regression analyses show that sexual risk behaviours (p=0.000) and the Integrated Value Mapping (IVM) of the perception components of the HBM are the most significant factors associated with perception of risk of contracting HIV at the level p<0.05. The findings of this study can play an instrumental role in the development of effective preventive and interventional messages for adolescents in Cameroon.

Integration of Active and Passive Safety Technologies--A Method to Study and Estimate Field Capability.

PubMed

Hu, Jingwen; Flannagan, Carol A; Bao, Shan; McCoy, Robert W; Siasoco, Kevin M; Barbat, Saeed

2015-11-01

The objective of this study is to develop a method that uses a combination of field data analysis, naturalistic driving data analysis, and computational simulations to explore the potential injury reduction capabilities of integrating passive and active safety systems in frontal impact conditions. For the purposes of this study, the active safety system is actually a driver assist (DA) feature that has the potential to reduce delta-V prior to a crash, in frontal or other crash scenarios. A field data analysis was first conducted to estimate the delta-V distribution change based on an assumption of 20% crash avoidance resulting from a pre-crash braking DA feature. Analysis of changes in driver head location during 470 hard braking events in a naturalistic driving study found that drivers' head positions were mostly in the center position before the braking onset, while the percentage of time drivers leaning forward or backward increased significantly after the braking onset. Parametric studies with a total of 4800 MADYMO simulations showed that both delta-V and occupant pre-crash posture had pronounced effects on occupant injury risks and on the optimal restraint designs. By combining the results for the delta-V and head position distribution changes, a weighted average of injury risk reduction of 17% and 48% was predicted by the 50th percentile Anthropomorphic Test Device (ATD) model and human body model, respectively, with the assumption that the restraint system can adapt to the specific delta-V and pre-crash posture. This study demonstrated the potential for further reducing occupant injury risk in frontal crashes by the integration of a passive safety system with a DA feature. Future analyses considering more vehicle models, various crash conditions, and variations of occupant characteristics, such as age, gender, weight, and height, are necessary to further investigate the potential capability of integrating passive and DA or active safety systems.

Ethical media competence as a protective factor against cyberbullying and cybervictimization among german school students.

PubMed

Müller, Christin R; Pfetsch, Jan; Ittel, Angela

2014-10-01

The use of digital information and communication technologies is an integral part of adolescents' everyday life. Besides various opportunities for information, entertainment, and communication, media use is associated with risks such as cyberbullying. Cyberbullying refers to aggressive behavior in the context of computer-mediated communication, characterized by repetition, an intention to harm, and power imbalance. Previous studies have shown that increased media use is a major risk factor for cyberbullying and cybervictimization. Given that restricting media use is not a practical way to reduce the negative effects inherent in media use, the present study examines the relevance of ethical media competence. We expected ethical media competence to buffer the effect of increased media use on cyberbullying and cybervictimization. A survey was conducted with 934 students (53% female) aged 10-17 years (M=13.26, SD=1.63). As expected, hierarchical regression analyses showed a positive main effect of media use, a negative main effect of ethical media competence, and a negative interaction effect of media use and media competence on cyberbullying and cybervictimization. Simple slope analyses revealed that at high levels of ethical media competence, media use has almost no effect on cybervictimization and a significant negative effect on cyberbullying. Consequently, promoting ethical media competence constitutes a potential measure to prevent the risks of increased media use for cyberbullying and cybervictimization.

Culturally-grounded mother-daughter communication-focused intervention for Thai female adolescents.

PubMed

Powwattana, Arpaporn; Thammaraksa, Pimrat; Manora, Sroy

2018-02-05

Teenage pregnancy-prevention interventions have fallen short in significantly decreasing risk of pregnancy for Thai populations. The "breaking the voice" ("rak luk khun tong pood") culture-appropriate teenage pregnancy-prevention program was developed using community-based research. Qualitative analyses of focus group data identified salient factors related to sexual communication and behavior. The integration of focus group results with theoretical constructs guided the development of an intervention to reduce risky sexual behavior by increasing communication between mothers and their adolescent daughters. A total of 157 mother-daughter dyads from congested areas in Bangkok participated in pilot testing of the intervention by the use of a survey. The findings indicated a significant increase in the frequency of and number of sexual risk communication (P < .05). There was a significant increase in perceived power in relationship control, ability to prevent sexual risk, assertiveness, and ability to decrease sexual risk among daughters (P < .05). "Breaking the voice" represents a female-focused and culturally-relevant intervention to combat teenage pregnancy. © 2018 John Wiley & Sons Australia, Ltd.

Prevalence and Risk Factors for Overweight and Obesity among HIV-Infected Adults in Dar es Salaam, Tanzania.

PubMed

Semu, Helen; Zack, Rachel M; Liu, Enju; Hertzmark, Ellen; Spiegelman, Donna; Sztam, Kevin; Hawkins, Claudia; Chalamila, Guerino; Muya, Aisa; Siril, Hellen; Mwiru, Ramadhani; Mtasiwa, Deo; Fawzi, Wafaie

2016-11-01

Overweight and obesity are increasingly prevalent among HIV-infected populations. We describe their prevalence and associated risk factors among HIV-infected adults in Dar es Salaam, Tanzania. A cross-sectional study was conducted to determine the proportion of patients who were overweight or obese at enrollment to care and treatment centres from 2004 to 2011. Multivariate relative risk regression models were fit to identify risk factors.  A total of 53 825 patients were included in the analysis. In all, 16% of women and 8% of men were overweight, while 7% and 2% were obese, respectively. In multivariate analyses, older age, higher CD4 count, higher hemoglobin levels, female sex, and being married were associated with obesity and overweight. World Health Organization HIV disease stage, tuberculosis history, and previous antiretroviral therapy were inversely associated with obesity and overweight. Overweight and obesity were highly prevalent among HIV-infected patients. Screening for overweight and obesity and focused interventions should be integrated into HIV care. © The Author(s) 2014.

Evaluation of the Inhalation Carcinogenicity of Ethylene Oxide ...

EPA Pesticide Factsheets

EPA is initiating a public comment period prior to peer review of the scientific basis supporting the human health hazard and dose-response assessment of ethylene oxide (cancer) that will appear in the Integrated Risk Information System (IRIS) database. EPA seeks external peer review on how the Agency responded to the SAB panel recommendations, the exposure-response modeling of epidemiologic data, including new analyses since the 2007 external peer review, and on the adequacy, transparency, and clarity of the revised draft. The peer review will include an opportunity for the public to address the peer reviewers.

A Practical Approach to Starting Fission Surface Power Development

NASA Technical Reports Server (NTRS)

Mason, Lee S.

2006-01-01

The Prometheus Power and Propulsion Program has been reformulated to address NASA needs relative to lunar and Mars exploration. Emphasis has switched from the Jupiter Icy Moons Orbiter (JIMO) flight system development to more generalized technology development addressing Fission Surface Power (FSP) and Nuclear Thermal Propulsion (NTP). Current NASA budget priorities and the deferred mission need date for nuclear systems prohibit a fully funded reactor Flight Development Program. However, a modestly funded Advanced Technology Program can and should be conducted to reduce the risk and cost of future flight systems. A potential roadmap for FSP technology development leading to possible flight applications could include three elements: 1) Conceptual Design Studies, 2) Advanced Component Technology, and 3) Non-Nuclear System Testing. The Conceptual Design Studies would expand on recent NASA and DOE analyses while increasing the depth of study in areas of greatest uncertainty such as reactor integration and human-rated shielding. The Advanced Component Technology element would address the major technology risks through development and testing of reactor fuels, structural materials, primary loop components, shielding, power conversion, heat rejection, and power management and distribution (PMAD). The Non-Nuclear System Testing would provide a modular, technology testbed to investigate and resolve system integration issues.

Foundation stones for a real socio-environmental integration in projects' impact assessments

NASA Astrophysics Data System (ADS)

Andres Dominguez-Gomez, J.

2015-04-01

In the last twenty years, both the increase in academic production and the expansion of professional involvement in Environmental Impact Assessment (EIA) and Social Impact Assessment (SIA), have evidenced growing scientific and business interest in risk and impact analysis. However, this growth has not brought with it a parallel progress in addressing their main shortcomings: insufficient integration of environmental and social features into development project analyses and, in cases where the social aspects are considered, technical-methodological failings in their diagnosis and assessment. It is clear that these weaknesses carry with them substantial threats to the sustainability (social, environmental and economic) of schemes which impact on the environment, and in consequence, to the local contexts where they are carried out and to the delicate balance of the global ecosystem. This paper argue that, in a sociological context of growing complexity, four foundation-stones are required to underpin research methodologies (for both diagnosis and assessment) in the socio-environmental risks of development projects: a theoretical foundation in actor-network theory; an ethical grounding in values which are internationally recognized though not always carried through into practice; a (new) epistemological-scientific base; and a methodological foundation in social participation.

Impact of Micro-to Meso-scale Fractures on Sealing Behavior of Argillaceous Cap Rocks For CO 2 Sequestration

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

Evans, James

This multi-disciplinary project evaluated seal lithologies for the safety and security of long-term geosequestration of CO 2. We used integrated studies to provide qualitative risk for potential seal failure; we integrated data sets from outcrop, core, geochemical analysis, rock failure properties from mechanical testing, geophysical wireline log analysis, and geomechanical modeling to understand the effects of lithologic heterogeneity and changing mechanical properties have on the mechanical properties of the seal. The objectives of this study were to characterize cap rock seals using natural field analogs, available drillhole logging data and whole-rock core, geochemical and isotopic analyses. Rock deformation experiments weremore » carried out on collected samples to develop better models of risk estimation for potential cap rock seal failure. We also sampled variably faulted and fractured cap rocks to examine the impacts of mineralization and/or alteration on the mechanical properties. We compared CO 2 reacted systems to non-CO 2 reacted seal rock types to determine response of each to increased pore fluid pressures and potential for the creation of unintentional hydrofractures at depth.« less

Depressive symptoms in HIV-infected and seronegative control subjects in Cameroon: Effect of age, education and gender

PubMed Central

Kanmogne, Georgette D.; Qiu, Fang; Ntone, Félicien E.; Fonsah, Julius Y.; Njamnshi, Dora M.; Kuate, Callixte T.; Doh, Roland F.; Kengne, Anne M.; Tagny, Claude T.; Nchindap, Emilienne; Kenmogne, Léopoldine; Mbanya, Dora; Cherner, Mariana; Heaton, Robert K.; Njamnshi, Alfred K.

2017-01-01

Depression is a leading cause of HIV/AIDS disease burden; it worsens health outcomes and quality of life. Addressing this problem requires accurate quantification of the extra burden of depression to HIV/AIDS in a given population, and knowledge of the baseline depression prevalence in the general population. There has been no previous study of depression in the general Cameroonian population. The current study attempts to address that important need. We used the Beck Depression Inventory-II to assess the prevalence and severity of depressive symptoms in 270 HIV-infected and seronegative Cameroonians. Univariate analyses showed a trend toward higher depressive symptoms among cases, compared to controls (p = 0.055), and among older subjects (>40 years), compared to younger subjects (≤40 years) (p = 0.059). Analysis of depression severity showed that 33.73% of cases had moderate-to-severe depressive symptoms, compared to 19.8% of controls (p<0.01). However, multivariable negative binomial regression analyses showed no effect of age, HIV status, CD4 levels, viral loads, ART, or opportunistic infections on the risk of depressive symptoms. Both univariate and multivariable regression analyses showed significantly higher risk of depressive symptoms among females compared to males; this was significant for both female controls and female cases. Female cases had significantly higher CD4 cell counts and lower viral loads, compared to males. Both univariate and multivariable regression analyses showed that lower education (≤10 years) was associated with increased risk of depressive symptoms. This study shows a high prevalence of depressive symptoms among seronegative controls and HIV-infected Cameroonians. Integrating care for mental disorders such as depression into primary health care and existing HIV/AIDS treatment programs in Cameroon may improve the wellbeing of the general population and could lower the HIV/AIDS burden. PMID:28231258

Depressive symptoms in HIV-infected and seronegative control subjects in Cameroon: Effect of age, education and gender.

PubMed

Kanmogne, Georgette D; Qiu, Fang; Ntone, Félicien E; Fonsah, Julius Y; Njamnshi, Dora M; Kuate, Callixte T; Doh, Roland F; Kengne, Anne M; Tagny, Claude T; Nchindap, Emilienne; Kenmogne, Léopoldine; Mbanya, Dora; Cherner, Mariana; Heaton, Robert K; Njamnshi, Alfred K

2017-01-01

Depression is a leading cause of HIV/AIDS disease burden; it worsens health outcomes and quality of life. Addressing this problem requires accurate quantification of the extra burden of depression to HIV/AIDS in a given population, and knowledge of the baseline depression prevalence in the general population. There has been no previous study of depression in the general Cameroonian population. The current study attempts to address that important need. We used the Beck Depression Inventory-II to assess the prevalence and severity of depressive symptoms in 270 HIV-infected and seronegative Cameroonians. Univariate analyses showed a trend toward higher depressive symptoms among cases, compared to controls (p = 0.055), and among older subjects (>40 years), compared to younger subjects (≤40 years) (p = 0.059). Analysis of depression severity showed that 33.73% of cases had moderate-to-severe depressive symptoms, compared to 19.8% of controls (p<0.01). However, multivariable negative binomial regression analyses showed no effect of age, HIV status, CD4 levels, viral loads, ART, or opportunistic infections on the risk of depressive symptoms. Both univariate and multivariable regression analyses showed significantly higher risk of depressive symptoms among females compared to males; this was significant for both female controls and female cases. Female cases had significantly higher CD4 cell counts and lower viral loads, compared to males. Both univariate and multivariable regression analyses showed that lower education (≤10 years) was associated with increased risk of depressive symptoms. This study shows a high prevalence of depressive symptoms among seronegative controls and HIV-infected Cameroonians. Integrating care for mental disorders such as depression into primary health care and existing HIV/AIDS treatment programs in Cameroon may improve the wellbeing of the general population and could lower the HIV/AIDS burden.

Integrated fault seal analysis and risk assessemt: Okan and Meren Fields, Nigeria

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

Eisenberg, R.A.; Brenneman, R.J.; Adepoju, A.A.

1996-01-01

Integration of production, geochemical, seismic, well log, and structural data provides important constraints on the sealing capacity and dynamic behavior of fault juxtaposed reservoirs in Okan and Meren fields, offshore Nigeria. Correlations were found between pressure decline histories, juxtaposed fluid types, oil composition, fluid contact relationships, fault sealing/leaking condition, and estimates of the composition of the fault gouge. Fault plane sections defined reservoir juxtapositions and potential cross-fault spill points. Smear gouge ratios calculated from E-logs were used to estimate the composition of fault-gouge materials between juxtaposed reservoirs. These tools augmented interpretation of seal/nonseal character in proved reservoirs and were usedmore » to quantify fault seal risk of untested, fault-dependent closures. In the Okan Field juxtapositions of the G-, H, L-, M, and O-sands were analyzed. Smear gouge ratios correlated to fluid contact relationships and pressure decline histories within these juxtaposed reservoirs empirically calibrate sealing potential. The results of these analyses were then used to interpret production-induced fault seal breakdown within the G-sands and to risk seal integrity of fault-dependent closures within the untested 0-sands in an adjacent, upthrown fault block. Within this fault block the presence of potential fault intersection leak points and large areas of sand/sand juxtaposition with high smear gouge ratios (low sealing potential) limits column heights and potential reserves within the O-sand package. In the Meren Field the E- and G-sands are juxtaposed, on different pressure decline, geochemically distinct, and are characterized by low smear gouge ratios. In contrast, the G- and H-sands, juxtaposed across the same fault, contain similar OOWCs and are characterized by high smear gouge ratios.« less

Soil contamination assessment for Pb, Zn and Cd in a slag disposal area using the integration of geochemical and microbiological data.

PubMed

Kasemodel, Mariana Consiglio; Lima, Jacqueline Zanin; Sakamoto, Isabel Kimiko; Varesche, Maria Bernadete Amancio; Trofino, Julio Cesar; Rodrigues, Valéria Guimarães Silvestre

2016-12-01

Improper disposal of mining waste is still considered a global problem, and further details on the contamination by potentially toxic metals are required for a proper assessment. In this context, it is important to have a combined view of the chemical and biological changes in the mining dump area. Thus, the objective of this study was to evaluate the Pb, Zn and Cd contamination in a slag disposal area using the integration of geochemical and microbiological data. Analyses of soil organic matter (SOM), pH, Eh, pseudo-total concentration of metals, sequential extraction and microbial community by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) were conducted. Metal availability was evaluated based on the geoaccumulation index (I geo ), ecological risk ([Formula: see text]), Risk Assessment Code (RAC) and experimental data, and different reference values were tested to assist in the interpretation of the indices. The soil pH was slightly acidic to neutral, the Eh values indicated oxidized conditions and the average SOM content varied from 12.10 to 53.60 g kg -1 . The average pseudo-total concentrations of metals were in the order of Zn > Pb > Cd. Pb and Zn were mainly bound to the residual fraction and Fe-Mn oxides, and a significant proportion of Cd was bound to the exchangeable and carbonate fractions. The topsoil (0-20 cm) is highly contaminated (I geo ) with Cd and has a very high potential ecological risk ([Formula: see text]). Higher bacterial diversity was mainly associated with higher metal concentrations. It is concluded that the integration of geochemical and microbiological data can provide an appropriate evaluation of mining waste-contaminated areas.

Integrated fault seal analysis and risk assessemt: Okan and Meren Fields, Nigeria

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

Eisenberg, R.A.; Brenneman, R.J.; Adepoju, A.A.

Integration of production, geochemical, seismic, well log, and structural data provides important constraints on the sealing capacity and dynamic behavior of fault juxtaposed reservoirs in Okan and Meren fields, offshore Nigeria. Correlations were found between pressure decline histories, juxtaposed fluid types, oil composition, fluid contact relationships, fault sealing/leaking condition, and estimates of the composition of the fault gouge. Fault plane sections defined reservoir juxtapositions and potential cross-fault spill points. Smear gouge ratios calculated from E-logs were used to estimate the composition of fault-gouge materials between juxtaposed reservoirs. These tools augmented interpretation of seal/nonseal character in proved reservoirs and were usedmore » to quantify fault seal risk of untested, fault-dependent closures. In the Okan Field juxtapositions of the G-, H, L-, M, and O-sands were analyzed. Smear gouge ratios correlated to fluid contact relationships and pressure decline histories within these juxtaposed reservoirs empirically calibrate sealing potential. The results of these analyses were then used to interpret production-induced fault seal breakdown within the G-sands and to risk seal integrity of fault-dependent closures within the untested 0-sands in an adjacent, upthrown fault block. Within this fault block the presence of potential fault intersection leak points and large areas of sand/sand juxtaposition with high smear gouge ratios (low sealing potential) limits column heights and potential reserves within the O-sand package. In the Meren Field the E- and G-sands are juxtaposed, on different pressure decline, geochemically distinct, and are characterized by low smear gouge ratios. In contrast, the G- and H-sands, juxtaposed across the same fault, contain similar OOWCs and are characterized by high smear gouge ratios.« less

Trade-offs of Solar Geoengineering and Mitigation under Climate Targets

NASA Astrophysics Data System (ADS)

Mohammadi Khabbazan, M.; Stankoweit, M.; Roshan, E.; Schmidt, H.; Held, H.

2016-12-01

Scientific analyses have hitherto focused on the pros and cons of solar-radiation management (SRM) as a climate-policy option mainly in mere isolation. Here we put SRM into the context of mitigation by a strictly temperature-target-based approach. To the best of our knowledge, for the first time, we introduce a concept for a regional integrated analysis of SRM and mitigation in-line with the `2°C target'. We explicitly account for a risk-risk comparison of SRM and global warming, extending the applicability regime of temperature targets from mitigation-only to joint-SRM-mitigation analysis while minimizing economic costs required for complying with the 2°C target. Upgrading it to include SRM, we employ the integrated energy-economy-climate model MIND. We utilize the two-box climate model of DICE and calibrate the short and long time scales respectively into GeoMIP G3 experiment and quadrupled atmospheric CO2 concentrations experiment from CEMIP5 suite. Our results show that without risk-risk accounting SRM will displace mitigation. However, our analysis highlights that the value system enshrined in the 2°C target can almost preclude SRM; this is exemplified by one single regional climate variable, here precipitation, which is confined to regional bounds compatible with 2°C of global warming. Although about a half of policy costs can be saved, the results indicate that the additional amount of CO2 that could be released to the atmosphere corresponds to only 0.2°C of further global warming. Hence, the society might debate whether the risks of SRM should be taken for that rather small amount of additional carbon emissions. Nonetheless, our results point out a significantly larger role for SRM implementation if the guardrails of some regions are relaxed.

Impact of a cis-associated gene expression SNP in 20q11.22 on bipolar disorder susceptibility, hippocampal structure and cognitive performance

PubMed Central

Li, Ming; Luo, Xiong-jian; Landén, Mikael; Bergen, Sarah E.; Hultman, Christina M.; Li, Xiao; Zhang, Wen; Yao, Yong-Gang; Zhang, Chen; Liu, Jiewei; Mattheisen, Manuel; Cichon, Sven; Mühleisen, Thomas W.; Degenhardt, Franziska A.; Nöthen, Markus M.; Schulze, Thomas G.; Grigoroiu-Serbanescu, Maria; Li, Hao; Fuller, Chris K.; Chen, Chunhui; Dong, Qi; Chen, Chuansheng; Jamain, Stéphane; Leboyer, Marion; Bellivier, Frank; Etain, Bruno; Kahn, Jean-Pierre; Henry, Chantal; Preisig, Martin; Kutalik, Zoltán; Castelao, Enrique; Wright, Adam; Mitchell, Philip B.; Fullerton, Janice M.; Schofield, Peter R.; Montgomery, Grant W.; Medland, Sarah E.; Gordon, Scott D.; Martin, Nicholas G.; Rietschel, Marcella; Liu, Chunyu; Kleinman, Joel E.; Hyde, Thomas M.; Weinberger, Daniel R.; Su, Bing

2016-01-01

Summary Bipolar disorder (BPD) is a highly heritable polygenic disorder. Recent enrichment analyses suggest that there may be true risk variants for BPD among the expression quantitative trait loci (eQTL) in the brain. Aims We sought to assess the impact of eQTL variants on BPD risk by combining data from both BPD genome-wide association study (GWAS) and brain eQTL. Method To detect single-nucleotide polymorphisms (SNPs) that influence expression levels of genes associated with BPD, we jointly analyzed data from a BPD GWAS (7,481 cases and 9,250 controls) and a genome-wide brain (cortical) eQTL (193 healthy controls) using a Bayesian statistical method, with independent follow-up replications. The identified risk SNP was then further tested for association with hippocampal volume (N=5,775) and cognitive performance (N=342) among healthy subjects. Results Integrative analysis revealed a significant association between a brain eQTL rs6088662 in 20q11.22 and BPD (Log Bayes Factor=5.48; BPD p-val=5.85×10−5). Follow-up studies across multiple independent samples confirmed the association of the risk SNP (rs6088662) with gene expression and BPD susceptibility (p-val=3.54×10−8). Further exploratory analysis revealed that rs6088662 is also associated with hippocampal volume and cognitive performance in healthy subjects. Conclusions Our findings suggest that 20q11.22 is likely a risk region for BPD, highlighting the informativeness of integrating functional annotation of genetic variants for gene expression in advancing our understanding of the biological basis underlying complex diseases such as BPD. PMID:26338991

Characterizing Uncertainty and Variability in PBPK Models ...

EPA Pesticide Factsheets

Mode-of-action based risk and safety assessments can rely upon tissue dosimetry estimates in animals and humans obtained from physiologically-based pharmacokinetic (PBPK) modeling. However, risk assessment also increasingly requires characterization of uncertainty and variability; such characterization for PBPK model predictions represents a continuing challenge to both modelers and users. Current practices show significant progress in specifying deterministic biological models and the non-deterministic (often statistical) models, estimating their parameters using diverse data sets from multiple sources, and using them to make predictions and characterize uncertainty and variability. The International Workshop on Uncertainty and Variability in PBPK Models, held Oct 31-Nov 2, 2006, sought to identify the state-of-the-science in this area and recommend priorities for research and changes in practice and implementation. For the short term, these include: (1) multidisciplinary teams to integrate deterministic and non-deterministic/statistical models; (2) broader use of sensitivity analyses, including for structural and global (rather than local) parameter changes; and (3) enhanced transparency and reproducibility through more complete documentation of the model structure(s) and parameter values, the results of sensitivity and other analyses, and supporting, discrepant, or excluded data. Longer-term needs include: (1) theoretic and practical methodological impro

Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011

PubMed Central

Pradhan, Rina; Wynter, Karen; Fisher, Jane

2018-01-01

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy. PMID:29385771

On the development of weighting factors for ballast ranking prioritization & development of the relationship and rate of defective segments based on volume of missing ballast

NASA Astrophysics Data System (ADS)

Cronin, John

This thesis explores the effects of missing ballast on track behavior and degradation. As ballast is an integral part of the track structure, the hypothesized effect of missing ballast is that defects will be more common which in turn leads to more derailments. In order to quantify the volume of missing ballast, remote sensing technologies were used to provide an accurate profile of the ballast. When the existing profile is compared to an idealized profile, the area of missing ballast can be computed. The area is then subdivided into zones which represent the area in which the ballast performs a key function in the track structure. These areas are then extrapolated into the volume of missing ballast for each zone based on the distance between collected profiles. In order to emphasize the key functions that the zones previously created perform, weighting factors were developed based on common risk-increasing hazards, such as curves and heavy axle loads, which are commonly found on railways. These weighting factors are applied to the specified zones' missing ballast volume when such a hazard exists in that segment of track. Another set of weighting factors were developed to represent the increased risk, or preference for lower risk, for operational factors such as the transport of hazardous materials or for being a key route. Through these weighting factors, ballast replenishment can be prioritized to focus on the areas that pose a higher risk of derailments and their associated costs. For the special cases where the risk or aversion to risk comes from what is being transported, such as the case with hazardous materials or passengers, an economic risk assessment was completed in order to quantify the risk associated with their transport. This economic risk assessment looks at the increased costs associated with incidents that occur and how they compare to incidents which do not directly involve the special cargos. In order to provide support for the use of the previously developed weightings as well as to quantify the actual impact that missing ballast has on the rate of geometry defects, analyses which quantified the risk of missing ballast were performed. In addition to quantifying the rate of defects, analyses were performed which looked at the impact associated with curved track, how the location of missing ballast impacts the rate of geometry defects and how the combination of the two compared with the previous analyses. Through this research, the relationship between the volume of missing ballast and ballast-related defects has been identified and quantified. This relationship is positive for the aggregate of all ballast-related defects but does not always exist for individual defects which occasionally have unique behavior. For the non-ballast defects, a relationship between missing ballast and their rate of occurrence did not always appear to exist. The impact of curves was apparent, showing that the rate of defects was either similar to or exceeded the rate of defects for tangent track. For the analyses which looked at the location of ballast in crib or shoulder, the results were quite similar to the previous analyses. The development, application and improvements of a risk-based ballast maintenance prioritization system provides a relatively low-cost and effective method to improve the operational safety for all railroads.

Trades Between Opposition and Conjunction Class Trajectories for Early Human Missions to Mars

NASA Technical Reports Server (NTRS)

Mattfeld, Bryan; Stromgren, Chel; Shyface, Hilary; Komar, David R.; Cirillo, William; Goodliff, Kandyce

2014-01-01

Candidate human missions to Mars, including NASA's Design Reference Architecture 5.0, have focused on conjunction-class missions with long crewed durations and minimum energy trajectories to reduce total propellant requirements and total launch mass. However, in order to progressively reduce risk and gain experience in interplanetary mission operations, it may be desirable that initial human missions to Mars, whether to the surface or to Mars orbit, have shorter total crewed durations and minimal stay times at the destination. Opposition-class missions require larger total energy requirements relative to conjunction-class missions but offer the potential for much shorter mission durations, potentially reducing risk and overall systems performance requirements. This paper will present a detailed comparison of conjunction-class and opposition-class human missions to Mars vicinity with a focus on how such missions could be integrated into the initial phases of a Mars exploration campaign. The paper will present the results of a trade study that integrates trajectory/propellant analysis, element design, logistics and sparing analysis, and risk assessment to produce a comprehensive comparison of opposition and conjunction exploration mission constructs. Included in the trade study is an assessment of the risk to the crew and the trade offs between the mission duration and element, logistics, and spares mass. The analysis of the mission trade space was conducted using four simulation and analysis tools developed by NASA. Trajectory analyses for Mars destination missions were conducted using VISITOR (Versatile ImpulSive Interplanetary Trajectory OptimizeR), an in-house tool developed by NASA Langley Research Center. Architecture elements were evaluated using EXploration Architecture Model for IN-space and Earth-to-orbit (EXAMINE), a parametric modeling tool that generates exploration architectures through an integrated systems model. Logistics analysis was conducted using NASA's Human Exploration Logistics Model (HELM), and sparing allocation predictions were generated via the Exploration Maintainability Analysis Tool (EMAT), which is a probabilistic simulation engine that evaluates trades in spacecraft reliability and sparing requirements based on spacecraft system maintainability and reparability.

Risk-based maintenance of ethylene oxide production facilities.

PubMed

Khan, Faisal I; Haddara, Mahmoud R

2004-05-20

This paper discusses a methodology for the design of an optimum inspection and maintenance program. The methodology, called risk-based maintenance (RBM) is based on integrating a reliability approach and a risk assessment strategy to obtain an optimum maintenance schedule. First, the likely equipment failure scenarios are formulated. Out of many likely failure scenarios, the ones, which are most probable, are subjected to a detailed study. Detailed consequence analysis is done for the selected scenarios. Subsequently, these failure scenarios are subjected to a fault tree analysis to determine their probabilities. Finally, risk is computed by combining the results of the consequence and the probability analyses. The calculated risk is compared against known acceptable criteria. The frequencies of the maintenance tasks are obtained by minimizing the estimated risk. A case study involving an ethylene oxide production facility is presented. Out of the five most hazardous units considered, the pipeline used for the transportation of the ethylene is found to have the highest risk. Using available failure data and a lognormal reliability distribution function human health risk factors are calculated. Both societal risk factors and individual risk factors exceeded the acceptable risk criteria. To determine an optimal maintenance interval, a reverse fault tree analysis was used. The maintenance interval was determined such that the original high risk is brought down to an acceptable level. A sensitivity analysis is also undertaken to study the impact of changing the distribution of the reliability model as well as the error in the distribution parameters on the maintenance interval.

Integration of bioinformatics and imaging informatics for identifying rare PSEN1 variants in Alzheimer's disease.

PubMed

Nho, Kwangsik; Horgusluoglu, Emrin; Kim, Sungeun; Risacher, Shannon L; Kim, Dokyoon; Foroud, Tatiana; Aisen, Paul S; Petersen, Ronald C; Jack, Clifford R; Shaw, Leslie M; Trojanowski, John Q; Weiner, Michael W; Green, Robert C; Toga, Arthur W; Saykin, Andrew J

2016-08-12

Pathogenic mutations in PSEN1 are known to cause familial early-onset Alzheimer's disease (EOAD) but common variants in PSEN1 have not been found to strongly influence late-onset AD (LOAD). The association of rare variants in PSEN1 with LOAD-related endophenotypes has received little attention. In this study, we performed a rare variant association analysis of PSEN1 with quantitative biomarkers of LOAD using whole genome sequencing (WGS) by integrating bioinformatics and imaging informatics. A WGS data set (N = 815) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort was used in this analysis. 757 non-Hispanic Caucasian participants underwent WGS from a blood sample and high resolution T1-weighted structural MRI at baseline. An automated MRI analysis technique (FreeSurfer) was used to measure cortical thickness and volume of neuroanatomical structures. We assessed imaging and cerebrospinal fluid (CSF) biomarkers as LOAD-related quantitative endophenotypes. Single variant analyses were performed using PLINK and gene-based analyses of rare variants were performed using the optimal Sequence Kernel Association Test (SKAT-O). A total of 839 rare variants (MAF < 1/√(2 N) = 0.0257) were found within a region of ±10 kb from PSEN1. Among them, six exonic (three non-synonymous) variants were observed. A single variant association analysis showed that the PSEN1 p. E318G variant increases the risk of LOAD only in participants carrying APOE ε4 allele where individuals carrying the minor allele of this PSEN1 risk variant have lower CSF Aβ1-42 and higher CSF tau. A gene-based analysis resulted in a significant association of rare but not common (MAF ≥ 0.0257) PSEN1 variants with bilateral entorhinal cortical thickness. This is the first study to show that PSEN1 rare variants collectively show a significant association with the brain atrophy in regions preferentially affected by LOAD, providing further support for a role of PSEN1 in LOAD. The PSEN1 p. E318G variant increases the risk of LOAD only in APOE ε4 carriers. Integrating bioinformatics with imaging informatics for identification of rare variants could help explain the missing heritability in LOAD.

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

NASA Astrophysics Data System (ADS)

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

2012-04-01

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

Coffee consumption during pregnancy and the risk of hyperkinetic disorder and ADHD: a prospective cohort study.

PubMed

Linnet, Karen Markussen; Wisborg, Kirsten; Secher, Niels Jørgen; Thomsen, Per Hove; Obel, Carsten; Dalsgaard, Søren; Henriksen, Tine Brink

2009-01-01

Based on hypotheses from experimental studies, we studied the association between intrauterine exposure to coffee and the risk of clinically verified hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD). A cohort study with prospectively collected data from the Aarhus Birth Cohort, Denmark. We included 24 068 singletons delivered between 1990 and 1998. Linkage was performed with three Danish longitudinal registers: The Danish Psychiatric Central Register, The Integrated Database for Labour Market Research and The Danish Civil Registration System. We identified 88 children with hyperkinetic disorder and ADHD. Information about coffee consumption during pregnancy was obtained at 16 weeks of gestation from self-administrated questionnaires. Potential confounding factors were evaluated using Cox regression analyses. We found that intrauterine exposure to 10 or more cups of coffee per day was associated with a threefold increased risk of hyperkinetic disorder and ADHD. After adjustments for a number of confounding factors, the risk decreased and became statistically insignificant (RR 2.3, 95% CI 0.9-5.9). Prenatal exposure to high levels of coffee did not significantly increase the risk of clinically verified hyperkinetic disorder and ADHD in childhood.

Sensitivity to Uncertainty in Asteroid Impact Risk Assessment

NASA Astrophysics Data System (ADS)

Mathias, D.; Wheeler, L.; Prabhu, D. K.; Aftosmis, M.; Dotson, J.; Robertson, D. K.

2015-12-01

The Engineering Risk Assessment (ERA) team at NASA Ames Research Center is developing a physics-based impact risk model for probabilistically assessing threats from potential asteroid impacts on Earth. The model integrates probabilistic sampling of asteroid parameter ranges with physics-based analyses of entry, breakup, and impact to estimate damage areas and casualties from various impact scenarios. Assessing these threats is a highly coupled, dynamic problem involving significant uncertainties in the range of expected asteroid characteristics, how those characteristics may affect the level of damage, and the fidelity of various modeling approaches and assumptions. The presented model is used to explore the sensitivity of impact risk estimates to these uncertainties in order to gain insight into what additional data or modeling refinements are most important for producing effective, meaningful risk assessments. In the extreme cases of very small or very large impacts, the results are generally insensitive to many of the characterization and modeling assumptions. However, the nature of the sensitivity can change across moderate-sized impacts. Results will focus on the value of additional information in this critical, mid-size range, and how this additional data can support more robust mitigation decisions.

College students' drinking patterns: trajectories of AUDIT scores during the first four years at university.

PubMed

Johnsson, Kent O; Leifman, Anders; Berglund, Mats

2008-01-01

Changes in AUDIT score trajectories were examined in a student population during their first 4 years at a university, including high-risk consumers and a subsample of low-risk consumers. 359 students were selected for the present study, comprising all high-risk consumers (the 27% with highest scores, i.e. 11 for males and 7 for females) and a randomized sample of low-risk consumers (n = 177 and 182, respectively). The Alcohol Use Disorder Identification Test (AUDIT) was used as screening instrument. Trajectory analyses were made using a semiparametric group-based model. In the low-AUDIT group, five distinct trajectories were identified: three stable non-risky consumption groups (83%) and two increasing groups (17%; from non-risky to risky). In the high-AUDIT group, three groups were identified: two stable high groups (58%) and one decreasing group (from risky to non-risky consumption; 41%). In the integrated model, stable risky consumption comprised 16% of the total sample, decreasing consumption 11%, increasing consumption comprised 13% and stable non-risky consumption 60% of the sample. Gender influenced the trajectories. The pattern of changes in risk consumption is similar to that found in corresponding US studies. (c) 2008 S. Karger AG, Basel

Intimate Partner Violence, Maternal Stress, Nativity, and Risk for Maternal Maltreatment of Young Children

PubMed Central

Guterman, Neil B.; Lee, Shawna J.; Rathouz, Paul J.

2009-01-01

Objectives. We examined the associations of intimate partner violence (IPV) and maternal risk factors with maternal child maltreatment risk within a diverse sample of mothers. Methods. We derived the study sample (N = 2508) from the Fragile Families and Child Well-Being Study. We conducted regression analyses to examine associations between IPV, parenting stress, major depression, key covariates, and 4 proxy variables for maternal child maltreatment. Results. Mothers reported an average of 25 acts of psychological aggression and 17 acts of physical aggression against their 3-year-old children in the year before the study, 11% reported some act of neglect toward their children during the same period, and 55% had spanked their children during the previous month. About 40% of mothers had experienced IPV by their current partner. IPV and maternal parenting stress were both consistent risk factors for all 4 maltreatment proxy variables. Although foreign-born mothers reported fewer incidents of child maltreatment, the IPV relative risk for child maltreatment was greater for foreign-born than for US-born mothers. Conclusions. Further integration of IPV and child maltreatment prevention and intervention efforts is warranted; such efforts must carefully balance the needs of adult and child victims. PMID:19008518

Postauthorization safety study of the DPP-4 inhibitor saxagliptin: a large-scale multinational family of cohort studies of five outcomes.

PubMed

Lo Re, Vincent; Carbonari, Dena M; Saine, M Elle; Newcomb, Craig W; Roy, Jason A; Liu, Qing; Wu, Qufei; Cardillo, Serena; Haynes, Kevin; Kimmel, Stephen E; Reese, Peter P; Margolis, David J; Apter, Andrea J; Reddy, K Rajender; Hennessy, Sean; Bhullar, Harshvinder; Gallagher, Arlene M; Esposito, Daina B; Strom, Brian L

2017-01-01

To evaluate the risk of serious adverse events among patients with type 2 diabetes mellitus initiating saxagliptin compared with oral antidiabetic drugs (OADs) in classes other than dipeptidyl peptidase-4 (DPP-4) inhibitors. Cohort studies using 2009-2014 data from two UK medical record data sources (Clinical Practice Research Datalink, The Health Improvement Network) and two USA claims-based data sources (HealthCore Integrated Research Database, Medicare). All eligible adult patients newly prescribed saxagliptin (n=110 740) and random samples of up to 10 matched initiators of non-DPP-4 inhibitor OADs within each data source were selected (n=913 384). Outcomes were hospitalized major adverse cardiovascular events (MACE), acute kidney injury (AKI), acute liver failure (ALF), infections, and severe hypersensitivity events, evaluated using diagnostic coding algorithms and medical records. Cox regression was used to determine HRs with 95% CIs for each outcome. Meta-analyses across data sources were performed for each outcome as feasible. There were no increased incidence rates or risk of MACE, AKI, ALF, infection, or severe hypersensitivity reactions among saxagliptin initiators compared with other OAD initiators within any data source. Meta-analyses demonstrated a reduced risk of hospitalization/death from MACE (HR 0.91, 95% CI 0.85 to 0.97) and no increased risk of hospitalization for infection (HR 0.97, 95% CI 0.93 to 1.02) or AKI (HR 0.99, 95% CI 0.88 to 1.11) associated with saxagliptin initiation. ALF and hypersensitivity events were too rare to permit meta-analysis. Saxagliptin initiation was not associated with increased risk of MACE, infection, AKI, ALF, or severe hypersensitivity reactions in clinical practice settings. NCT01086280, NCT01086293, NCT01086319, NCT01086306, and NCT01377935; Results.

The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilisation in Philadelphia.

PubMed

Culhane, D P; Gollub, E; Kuhn, R; Shpaner, M

2001-07-01

Administrative databases from the City of Philadelphia that track public shelter utilisation (n=44 337) and AIDS case reporting (n=7749) were merged to identify rates and risk factors for co-occurring homelessness and AIDS. Multiple decrement life tables analyses were conducted, and logistic regression analyses used to identify risk factors associated with AIDS among the homeless, and homelessness among people with AIDS. City of Philadelphia, Pennsylvania, USA. People admitted to public shelters had a three year rate of subsequent AIDS diagnosis of 1.8 per 100 person years; nine times the rate for the general population of Philadelphia. Logistic regression results show that substance abuse history (OR = 3.14), male gender (OR = 2.05), and a history of serious mental disorder (OR = 1.62) were significantly related to the risk for AIDS diagnosis among shelter users. Among people with AIDS, results show a three year rate of subsequent shelter admission of 6.9 per 100 person years, and a three year rate of prior shelter admission of 9%, three times the three year rate of shelter admission for the general population. Logistic regression results show that intravenous drug user history (OR = 3.14); no private insurance (OR = 2.93); black race (OR = 2.82); pulmonary or extra-pulmonary TB (OR = 1.43); and pneumocystis pneumonia (OR = 0.56) were all related to the risk for shelter admission. Homelessness prevention programmes should target people with HIV risk factors, and HIV prevention programmes should be targeted to homeless persons, as these populations have significant intersection. Reasons and implications for this intersection are discussed.

Genetics and Beyond – The Transcriptome of Human Monocytes and Disease Susceptibility

PubMed Central

Zeller, Tanja; Wild, Philipp; Szymczak, Silke; Rotival, Maxime; Schillert, Arne; Castagne, Raphaele; Maouche, Seraya; Germain, Marine; Lackner, Karl; Rossmann, Heidi; Eleftheriadis, Medea; Sinning, Christoph R.; Schnabel, Renate B.; Lubos, Edith; Mennerich, Detlev; Rust, Werner; Perret, Claire; Proust, Carole; Nicaud, Viviane; Loscalzo, Joseph; Hübner, Norbert; Tregouet, David; Münzel, Thomas; Ziegler, Andreas; Tiret, Laurence

2010-01-01

Background Variability of gene expression in human may link gene sequence variability and phenotypes; however, non-genetic variations, alone or in combination with genetics, may also influence expression traits and have a critical role in physiological and disease processes. Methodology/Principal Findings To get better insight into the overall variability of gene expression, we assessed the transcriptome of circulating monocytes, a key cell involved in immunity-related diseases and atherosclerosis, in 1,490 unrelated individuals and investigated its association with >675,000 SNPs and 10 common cardiovascular risk factors. Out of 12,808 expressed genes, 2,745 expression quantitative trait loci were detected (P<5.78×10−12), most of them (90%) being cis-modulated. Extensive analyses showed that associations identified by genome-wide association studies of lipids, body mass index or blood pressure were rarely compatible with a mediation by monocyte expression level at the locus. At a study-wide level (P<3.9×10−7), 1,662 expression traits (13.0%) were significantly associated with at least one risk factor. Genome-wide interaction analyses suggested that genetic variability and risk factors mostly acted additively on gene expression. Because of the structure of correlation among expression traits, the variability of risk factors could be characterized by a limited set of independent gene expressions which may have biological and clinical relevance. For example expression traits associated with cigarette smoking were more strongly associated with carotid atherosclerosis than smoking itself. Conclusions/Significance This study demonstrates that the monocyte transcriptome is a potent integrator of genetic and non-genetic influences of relevance for disease pathophysiology and risk assessment. PMID:20502693

Integrated Quantitative Cancer Risk Assessment of Inorganic Arsenic

EPA Science Inventory

This paper attempts to make an integrated risk assessment of arsenic, using data on humans exposed to arsenic via inhalation and ingestion. he data useful for making an integrated analysis and data gaps are discussed. rsenic provides a rare opportunity to compare the cancer risk ...

AN ASSESSMENT OF INTEGRATED RISK ASSESSMENT (Journal Article)

EPA Science Inventory

In order to promote international understanding and acceptance of the integrated risk assessment process, the WHO/IPCS, in collaboration with the U.S. EPA and the OECD, initiated a number of activities related to integrated risk assessment. In this project, WHO/IPCS defines inte...

Simplified spacecraft vulnerability assessments at component level in early design phase at the European Space Agency's Concurrent Design Facility

NASA Astrophysics Data System (ADS)

Kempf, Scott; Schäfer, Frank K.; Cardone, Tiziana; Ferreira, Ivo; Gerené, Sam; Destefanis, Roberto; Grassi, Lilith

2016-12-01

During recent years, the state-of-the-art risk assessment of the threat posed to spacecraft by micrometeoroids and space debris has been expanded to the analysis of failure modes of internal spacecraft components. This method can now be used to perform risk analyses for satellites to assess various failure levels - from failure of specific sub-systems to catastrophic break-up. This new assessment methodology is based on triple-wall ballistic limit equations (BLEs), specifically the Schäfer-Ryan-Lambert (SRL) BLE, which is applicable for describing failure threshold levels for satellite components following a hypervelocity impact. The methodology is implemented in the form of the software tool Particle Impact Risk and vulnerability Analysis Tool (PIRAT). During a recent European Space Agency (ESA) funded study, the PIRAT functionality was expanded in order to provide an interface to ESA's Concurrent Design Facility (CDF). The additions include a geometry importer and an OCDT (Open Concurrent Design Tool) interface. The new interface provides both the expanded geometrical flexibility, which is provided by external computer aided design (CAD) modelling, and an ease of import of existing data without the need for extensive preparation of the model. The reduced effort required to perform vulnerability analyses makes it feasible for application during early design phase, at which point modifications to satellite design can be undertaken with relatively little extra effort. The integration of PIRAT in the CDF represents the first time that vulnerability analyses can be performed in-session in ESA's CDF and the first time that comprehensive vulnerability studies can be applied cost-effectively in early design phase in general.

Adjuvant Sunitinib for High-risk Renal Cell Carcinoma After Nephrectomy: Subgroup Analyses and Updated Overall Survival Results.

PubMed

Motzer, Robert J; Ravaud, Alain; Patard, Jean-Jacques; Pandha, Hardev S; George, Daniel J; Patel, Anup; Chang, Yen-Hwa; Escudier, Bernard; Donskov, Frede; Magheli, Ahmed; Carteni, Giacomo; Laguerre, Brigitte; Tomczak, Piotr; Breza, Jan; Gerletti, Paola; Lechuga, Mariajose; Lin, Xun; Casey, Michelle; Serfass, Lucile; Pantuck, Allan J; Staehler, Michael

2018-01-01

Adjuvant sunitinib significantly improved disease-free survival (DFS) versus placebo in patients with locoregional renal cell carcinoma (RCC) at high risk of recurrence after nephrectomy (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.59-0.98; p=0.03). To report the relationship between baseline factors and DFS, pattern of recurrence, and updated overall survival (OS). Data for 615 patients randomized to sunitinib (n=309) or placebo (n=306) in the S-TRAC trial. Subgroup DFS analyses by baseline risk factors were conducted using a Cox proportional hazards model. Baseline risk factors included: modified University of California Los Angeles integrated staging system criteria, age, gender, Eastern Cooperative Oncology Group performance status (ECOG PS), weight, neutrophil-to-lymphocyte ratio (NLR), and Fuhrman grade. Of 615 patients, 97 and 122 in the sunitinib and placebo arms developed metastatic disease, with the most common sites of distant recurrence being lung (40 and 49), lymph node (21 and 26), and liver (11 and 14), respectively. A benefit of adjuvant sunitinib over placebo was observed across subgroups, including: higher risk (T3, no or undetermined nodal involvement, Fuhrman grade ≥2, ECOG PS ≥1, T4 and/or nodal involvement; hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.55-0.99; p=0.04), NLR ≤3 (HR 0.72, 95% CI 0.54-0.95; p=0.02), and Fuhrman grade 3/4 (HR 0.73, 95% CI 0.55-0.98; p=0.04). All subgroup analyses were exploratory, and no adjustments for multiplicity were made. Median OS was not reached in either arm (HR 0.92, 95% CI 0.66-1.28; p=0.6); 67 and 74 patients died in the sunitinib and placebo arms, respectively. A benefit of adjuvant sunitinib over placebo was observed across subgroups. The results are consistent with the primary analysis, which showed a benefit for adjuvant sunitinib in patients at high risk of recurrent RCC after nephrectomy. Most subgroups of patients at high risk of recurrent renal cell carcinoma after nephrectomy experienced a clinical benefit with adjuvant sunitinib. ClinicalTrials.gov NCT00375674. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

2014 SRP Integration Transcript

NASA Technical Reports Server (NTRS)

Steinberg, Susan

2014-01-01

HRP's mission is to reduce the risks to human health and performance during long-duration spaceflight. The HRP Integrated Research Plan (IRP) contains the research plans for the 32 risks that require research to characterize and mitigate. From its inception the "integrate" aspect of the IRP has denoted the integrated nature of risks to human health and performance. Even though each risk in the IRP has its own research plan and is tracked separately, the interrelated nature of health and performance requires that they be addressed in an integrative or holistic fashion so that the connectedness of physiological systems within the human body and the integrated response to spaceflight can be addressed. Common characteristics of the spaceflight environment include altered gravity, atmospheres, and light/dark cycles; space radiation; isolation; noise; and periods of high or low workload. Long-term exposure to this unique environment produces a suite of physiological effects such as stress; vision, neurocognitive, and anthropometric changes; circadian misalignment; fluid shifts; cardiovascular deconditioning; immune dysregulation; and altered nutritional requirements. Expanding cross-disciplinary integrative approaches that synthesize concepts or data from two or more disciplines would improve the identification and characterization risk factors, and enable the development of countermeasures relevant to multiple risks. Cross-disciplinary approaches might also help to illuminate problem areas that may arise when a countermeasure adversely impacts risks other than those which it was developed to mitigate, or to identify groupings of physiological changes that are likely to occur that may impact the overall risk posture. In 2014 HRP embarked on a pilot study that combined four SRPs (and 12 HRP risks) - Behavioral Health, Sensorimotor, Cardiovascular, and Bone/Muscle - specifically to discuss cross-disciplinary integration. The points outlined below were suggested to seed the discussion, within the bounding constraint that research plans must be feasible and relevant to the HRP mission. While these were suggested starting points, the overall guiding principle was to allow free discussion from panel members on any aspect of integrated research that they felt was important, Existing cross-disciplinary integration as documented in the IRP (HRR), Existing or needed integration already identified by HRP, but not yet well defined within the IRP, Areas of integration that are missing.

Integrative medicine for managing the symptoms of lupus nephritis

PubMed Central

Choi, Tae-Young; Jun, Ji Hee; Lee, Myeong Soo

2018-01-01

Abstract Background: Integrative medicine is claimed to improve symptoms of lupus nephritis. No systematic reviews have been performed for the application of integrative medicine for lupus nephritis on patients with systemic lupus erythematosus (SLE). Thus, this review will aim to evaluate the current evidence on the efficacy of integrative medicine for the management of lupus nephritis in patients with SLE. Methods and analyses: The following electronic databases will be searched for studies published from their dates of inception February 2018: Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as 6 Korean medical databases (Korea Med, the Oriental Medicine Advanced Search Integrated System [OASIS], DBpia, the Korean Medical Database [KM base], the Research Information Service System [RISS], and the Korean Studies Information Services System [KISS]), and 1 Chinese medical database (the China National Knowledge Infrastructure [CNKI]). Study selection, data extraction, and assessment will be performed independently by 2 researchers. The risk of bias (ROB) will be assessed using the Cochrane ROB tool. Dissemination: This systematic review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. Trial registration number: PROSPERO 2018 CRD42018085205 PMID:29595669

Genomic paradigms for food-borne enteric pathogen analysis at the USFDA: case studies highlighting method utility, integration and resolution.

PubMed

Elkins, C A; Kotewicz, M L; Jackson, S A; Lacher, D W; Abu-Ali, G S; Patel, I R

2013-01-01

Modern risk control and food safety practices involving food-borne bacterial pathogens are benefiting from new genomic technologies for rapid, yet highly specific, strain characterisations. Within the United States Food and Drug Administration (USFDA) Center for Food Safety and Applied Nutrition (CFSAN), optical genome mapping and DNA microarray genotyping have been used for several years to quickly assess genomic architecture and gene content, respectively, for outbreak strain subtyping and to enhance retrospective trace-back analyses. The application and relative utility of each method varies with outbreak scenario and the suspect pathogen, with comparative analytical power enhanced by database scale and depth. Integration of these two technologies allows high-resolution scrutiny of the genomic landscapes of enteric food-borne pathogens with notable examples including Shiga toxin-producing Escherichia coli (STEC) and Salmonella enterica serovars from a variety of food commodities. Moreover, the recent application of whole genome sequencing technologies to food-borne pathogen outbreaks and surveillance has enhanced resolution to the single nucleotide scale. This new wealth of sequence data will support more refined next-generation custom microarray designs, targeted re-sequencing and "genomic signature recognition" approaches involving a combination of genes and single nucleotide polymorphism detection to distil strain-specific fingerprinting to a minimised scale. This paper examines the utility of microarrays and optical mapping in analysing outbreaks, reviews best practices and the limits of these technologies for pathogen differentiation, and it considers future integration with whole genome sequencing efforts.

Integrated Science Assessment (ISA) for Carbon Monoxide ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Integrated Science Assessment (ISA) for Carbon Monoxide (CO). This report is EPA’s latest evaluation of the scientific literature on the potential human health and welfare effects associated with ambient exposures to CO. The development of this document is part of the Agency's periodic review of the national ambient air quality standards (NAAQS) for CO. The recently completed CO ISA and supplementary annexes, in conjunction with additional technical and policy assessments developed by EPA’s Office of Air and Radiation, will provide the scientific basis to inform EPA decisions related to the review of the current CO NAAQS. The integrated Plan for Review of the National Ambient Air Quality Standards for Carbon Monoxide (U.S. EPA, 2008, 193995) identifies key policy-relevant questions that provide a framework for this assessment of the scientific evidence. These questions frame the entire review of the NAAQS for CO and thus are informed by both science and policy considerations. The ISA organizes, presents, and integrates the scientific evidence which is considered along with findings from risk analyses and policy considerations to help the U.S. Environmental Protection Agency (EPA) address these questions during the NAAQS review.

Integrated urban drainage, status and perspectives.

PubMed

Harremoës, P

2002-01-01

This paper summarises the status of urban storm drainage as an integrated professional discipline, including the management-policy interface, by which the goals of society are implemented. The paper assesses the development of the discipline since the INTERURBA conference in 1992 and includes aspects of the papers presented at the INTERURBA-II conference in 2001 and the discussions during the conference. Tools for integrated analysis have been developed, but there is less implementation than could be expected. That is due to lack of adequate knowledge about important mechanisms, coupled with a significant conservatism in the business. However, significant integrated analyses have been reported. Most of them deal with the sewer system and the treatment plant, while few incorporate the receiving water as anything but the object of the loads to be minimised by engineering measures up-stream. Important measures are local infiltration, source control, storage basins, local treatment and real time control. New paradigms have been introduced: risk of pollution due to system failure, technology for water reuse, sustainability, new architecture and greener up-stream solutions as opposed to down-stream concrete solutions. The challenge is to combine the inherited approaches with the new approaches by flexibility and adaptability.

Childhood trauma- and cannabis-associated microstructural white matter changes in patients with psychotic disorder: a longitudinal family-based diffusion imaging study.

PubMed

Domen, Patrick; Michielse, Stijn; Peeters, Sanne; Viechtbauer, Wolfgang; van Os, Jim; Marcelis, Machteld

2018-05-29

Decreased white matter (WM) integrity in patients with psychotic disorder has been a consistent finding in diffusion tensor imaging (DTI) studies. However, the contribution of environmental risk factors to these WM alterations is rarely investigated. The current study examines whether individuals with (increased risk for) psychotic disorder will show increased WM integrity change over time with increasing levels of childhood trauma and cannabis exposure. DTI scans were obtained from 85 patients with a psychotic disorder, 93 non-psychotic siblings and 80 healthy controls, of which 60% were rescanned 3 years later. In a whole-brain voxel-based analysis, associations between change in fractional anisotropy (ΔFA) and environmental exposures as well as interactions between group and environmental exposure in the model of FA and ΔFA were investigated. Analyses were adjusted for a priori hypothesized confounding variables: age, sex, and level of education. At baseline, no significant associations were found between FA and both environmental risk factors. At follow-up as well as over a 3-year interval, significant interactions between group and, respectively, cannabis exposure and childhood trauma exposure in the model of FA and ΔFA were found. Patients showed more FA decrease over time compared with both controls and siblings when exposed to higher levels of cannabis or childhood trauma. Higher levels of cannabis or childhood trauma may compromise connectivity over the course of the illness in patients, but not in individuals at low or higher than average genetic risk for psychotic disorder, suggesting interactions between the environment and illness-related factors.

Emotional intelligence is a protective factor for suicidal behavior.

PubMed

Cha, Christine; Nock, Matthew

2009-04-01

Little is known about what factors protect against the occurrence of suicidal ideation and attempts. We tested whether emotional intelligence (EI)-the ability to perceive, integrate into thoughts, understand, and manage one's emotions-decreases the likelihood of suicidal ideation and attempts among those at risk. Adolescents (N = 54) aged 12 to 19 years were recruited from local psychiatric clinics and the community to participate in this cross-sectional laboratory-based study. Analyses examined whether the relations between childhood sexual abuse and suicidal ideation and attempts were moderated by adolescents' EI. These constructs were assessed using self-report, structured interviews, and performance-based tests, respectively. Analyses revealed that EI is a protective factor for both suicidal ideation and attempts. Specifically, childhood sexual abuse was strongly predictive of these outcomes among those with low EI, weakly predictive among those with medium EI, and completely unrelated among those with high EI. Follow-up analyses revealed that the protective effect of EI was driven primarily by differences in strategic EI (i.e., ability to understand and manage emotions) but not experiential EI (i.e., ability to perceive emotions and integrate emotions into thoughts). This study provides preliminary evidence that EI is a protective factor for suicidal ideation and attempts. Important next steps include testing the moderating influence of EI on a wider range of stressful life events and self-injurious behaviors, as well as conducting experimental studies to determine whether enhancing EI decreases the subsequent occurrence of these behavior problems.

Bridging the Divide between Safety and Risk Management for your Project or Program

NASA Technical Reports Server (NTRS)

Lutomski, Mike

2005-01-01

This presentation will bridge the divide between these separate but overlapping disciplines and help explain how to use Risk Management as an effective management decision support tool that includes safety. Risk Management is an over arching communication tool used by management to prioritize and effectively mitigate potential problems before they concur. Risk Management encompasses every kind of potential problem that can occur on a program or project. Some of these are safety issues such as hazards that have a specific likelihood and consequence that need to be controlled and included to show an integrated picture of accepted) mitigated, and residual risk. Integrating safety and other assurance disciplines is paramount to accurately representing a program s or projects risk posture. Risk is made up of several components such as technical) cost, schedule, or supportability. Safety should also be a consideration for every risk. The safety component can also have an impact on the technical, cost, and schedule aspect of a given risk. The current formats used for communication of safety and risk issues are not consistent or integrated. The presentation will explore the history of these disciplines, current work to integrate them, and suggestions for integration for the future.

Designing new institutions for implementing integrated disaster risk management: key elements and future directions.

PubMed

Gopalakrishnan, Chennat; Okada, Norio

2007-12-01

The goal of integrated disaster risk management is to promote an overall improvement in the quality of safety and security in a region, city or community at disaster risk. This paper presents the case for a thorough overhaul of the institutional component of integrated disaster risk management. A review of disaster management institutions in the United States indicates significant weaknesses in their ability to contribute effectively to the implementation of integrated disaster risk management. Our analysis and findings identify eight key elements for the design of dynamic new disaster management institutions. Six specific approaches are suggested for incorporating the identified key elements in building new institutions that would have significant potential for enhancing the effective implementation of integrated disaster risk management. We have developed a possible blueprint for effective design and construction of efficient, sustainable and functional disaster management institutions.

Meta-assessment of bias in science

PubMed Central

Fanelli, Daniele; Costas, Rodrigo; Ioannidis, John P. A.

2017-01-01

Numerous biases are believed to affect the scientific literature, but their actual prevalence across disciplines is unknown. To gain a comprehensive picture of the potential imprint of bias in science, we probed for the most commonly postulated bias-related patterns and risk factors, in a large random sample of meta-analyses taken from all disciplines. The magnitude of these biases varied widely across fields and was overall relatively small. However, we consistently observed a significant risk of small, early, and highly cited studies to overestimate effects and of studies not published in peer-reviewed journals to underestimate them. We also found at least partial confirmation of previous evidence suggesting that US studies and early studies might report more extreme effects, although these effects were smaller and more heterogeneously distributed across meta-analyses and disciplines. Authors publishing at high rates and receiving many citations were, overall, not at greater risk of bias. However, effect sizes were likely to be overestimated by early-career researchers, those working in small or long-distance collaborations, and those responsible for scientific misconduct, supporting hypotheses that connect bias to situational factors, lack of mutual control, and individual integrity. Some of these patterns and risk factors might have modestly increased in intensity over time, particularly in the social sciences. Our findings suggest that, besides one being routinely cautious that published small, highly-cited, and earlier studies may yield inflated results, the feasibility and costs of interventions to attenuate biases in the literature might need to be discussed on a discipline-specific and topic-specific basis. PMID:28320937

75 FR 69064 - Draft Toxicological Review of Hexavalent Chromium: In Support of Summary Information on the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... Toxicological Review of Hexavalent Chromium: In Support of Summary Information on the Integrated Risk... of Hexavalent Chromium: In Support of Summary Information on the Integrated Risk Information System... ``Toxicological Review of Hexavalent Chromium: In Support of Summary Information on the Integrated Risk...

Analysing Surface Exposure to Climate Dynamics in the Himalayas to Adopt a Planning Framework for Landslide Risk Reduction

NASA Astrophysics Data System (ADS)

Tiwari, A.

2017-12-01

Himalayas rank first in the inventory of most densely populated and congested high altitude mountain regions of the planet. The region is mostly characterized by inadequate infrastructure, lack of mitigation tools along with constraints of terrain undermining the carrying capacity and resilience of urban ecosystems. Moreover, climate change has increased vulnerability of poor and marginalized population living in rapidly urbanizing mountain towns to increased frequency and severity of risks from extreme weather events. Such events pose multifold threat by easily translating to hazards, without the ability to respond and mitigate. Additionally, the recent extreme climate dynamics such as rainfall patterns have influenced the natural rate of surface/slope processes in the Himalaya. The aim of the study was to analyze the extent of interaction between climate dynamics and upland surface to develop participatory planning framework for landslide risk reduction using Integral Geographic Information System (integral GIS). At this stage, the study is limited to only rainfall triggered landslides (RTL). The study region lies in the middle Himalayan range (Himachal). Research utilized terrain analysis tools in integral GIS and identified risk susceptible surface without: 1.adding to its (often) complex fragmentation, and 2. Interference in surface/slope processes. Analysis covered most of the relevant surface factors including geology, slope instability, infrastructure development, natural and urban drainage system, land-cover and land-use as well. The outcome included an exposure-reduced model of existing terrain and the surface-process accommodated by it, with the use of local technical tools available among the poor and fragile mountain community. The final participatory planning framework successfully harmonized people's perception and adaptation knowledge, and incorporated priorities of local authorities. This research is significant as it rises above the fundamental challenges arising during management of the (often) conflicting perspectives, interests, and approaches of multiplicity of stakeholders thereby having vast potential to replicate/upscale in mountains beyond the study region as it ensures barrier free risk-communication through the most affordable and innovative tools.

The relationship between acculturation strategies and depressive and anxiety disorders in Turkish migrants in the Netherlands.

PubMed

Ünlü Ince, Burçin; Fassaert, Thijs; de Wit, Matty A S; Cuijpers, Pim; Smit, Jan; Ruwaard, Jeroen; Riper, Heleen

2014-09-05

Turkish migrants in the Netherlands have a high prevalence of depressive and/or anxiety disorders. Acculturation has been shown to be related to higher levels of psychological distress, although it is not clear whether this also holds for depressive and anxiety disorders in Turkish migrants. This study aims to clarify the relationship between acculturation strategies (integration, assimilation, separation and marginalization) and the prevalence of depressive and anxiety disorders as well as utilisation of GP care among Turkish migrants. Existing data from an epidemiological study conducted among Dutch, Turkish and Moroccan inhabitants of Amsterdam were re-examined. Four scales of acculturation strategies were created in combination with the bi-dimensional approach of acculturation by factor analysis. The Lowlands Acculturation Scale and the Composite International Diagnostic Interview were used to assess acculturation and mood and anxiety disorders. Socio-demographic variables, depressive, anxiety and co-morbidity of both disorders and the use of health care services were associated with the four acculturation strategies by means of Chi-Squared and Likelihood tests. Three two-step logistic regression analyses were performed to control for possible, confounding variables. The sample consisted of 210 Turkish migrants. Significant associations were found between the acculturation strategies and age (p < .01), education (p < .01), daily occupation (p < .01) and having a long-term relationship (p = .03). A significant association was found between acculturation strategies and depressive disorders (p = .049): integration was associated with a lower risk of depression, separation with a higher risk. Using the axis separately, participation in Dutch society showed a significant relationship with a decreased risk of depressive, anxiety and co-morbidity of both disorders (OR = .15; 95% CI: .024 - .98). Non-participation showed no significant association. No association was found between the acculturation strategies and uptake of GP care. Turkish migrants who integrate may have a lower risk of developing a depressive disorder. Participation in Dutch culture is associated with a decreased risk of depressive, anxiety and co-morbidity of both disorders. Further research should focus on the assessment of acculturation in the detection of depression.

Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective.

PubMed

Kuziemsky, Craig E; Gogia, Shashi B; Househ, Mowafa; Petersen, Carolyn; Basu, Arindam

2018-04-22

 Connected healthcare is an essential part of patient-centred care delivery. Technology such as telehealth is a critical part of connected healthcare. However, exchanging health information brings the risk of privacy issues. To better manage privacy risks we first need to understand the different patterns of patient-centred care in order to tailor solutions to address privacy risks.  Drawing upon published literature, we develop a business model to enable patient-centred care via telehealth. The model identifies three patient-centred connected health patterns. We then use the patterns to analyse potential privacy risks and possible solutions from different types of telehealth delivery.  Connected healthcare raises the risk of unwarranted access to health data and related invasion of privacy. However, the risk and extent of privacy issues differ according to the pattern of patient-centred care delivery and the type of particular challenge as they enable the highest degree of connectivity and thus the greatest potential for privacy breaches.  Privacy issues are a major concern in telehealth systems and patients, providers, and administrators need to be aware of these privacy issues and have guidance on how to manage them. This paper integrates patient-centred connected health care, telehealth, and privacy risks to provide an understanding of how risks vary across different patterns of patient-centred connected health and different types of telehealth delivery. Georg Thieme Verlag KG Stuttgart.

[What Surgeons Should Know about Risk Management].

PubMed

Strametz, R; Tannheimer, M; Rall, M

2017-02-01

Background: The fact that medical treatment is associated with errors has long been recognized. Based on the principle of "first do no harm", numerous efforts have since been made to prevent such errors or limit their impact. However, recent statistics show that these measures do not sufficiently prevent grave mistakes with serious consequences. Preventable mistakes such as wrong patient or wrong site surgery still frequently occur in error statistics. Methods: Based on insight from research on human error, in due consideration of recent legislative regulations in Germany, the authors give an overview of the clinical risk management tools needed to identify risks in surgery, analyse their causes, and determine adequate measures to manage those risks depending on their relevance. The use and limitations of critical incident reporting systems (CIRS), safety checklists and crisis resource management (CRM) are highlighted. Also the rationale for IT systems to support the risk management process is addressed. Results/Conclusion: No single tool of risk management can be effective as a standalone instrument, but unfolds its effect only when embedded in a superordinate risk management system, which integrates tailor-made elements to increase patient safety into the workflows of each organisation. Competence in choosing adequate tools, effective IT systems to support the risk management process as well as leadership and commitment to constructive handling of human error are crucial components to establish a safety culture in surgery. Georg Thieme Verlag KG Stuttgart · New York.

Stable integration of recombinant adeno-associated virus vector genomes after transduction of murine hematopoietic stem cells.

PubMed

Han, Zongchao; Zhong, Li; Maina, Njeri; Hu, Zhongbo; Li, Xiaomiao; Chouthai, Nitin S; Bischof, Daniela; Weigel-Van Aken, Kirsten A; Slayton, William B; Yoder, Mervin C; Srivastava, Arun

2008-03-01

We previously reported that among single-stranded adeno-associated virus (ssAAV) vectors, serotypes 1 through 5, ssAAV1 is the most efficient in transducing murine hematopoietic stem cells (HSCs), but viral second-strand DNA synthesis remains a rate-limiting step. Subsequently, using double-stranded, self-complementary AAV (scAAV) vectors, serotypes 7 through 10, we observed that scAAV7 vectors also transduce murine HSCs efficiently. In the present study, we used scAAV1 and scAAV7 shuttle vectors to transduce HSCs in a murine bone marrow serial transplant model in vivo, which allowed examination of the AAV proviral integration pattern in the mouse genome, as well as recovery and nucleotide sequence analyses of AAV-HSC DNA junction fragments. The proviral genomes were stably integrated, and integration sites were localized to different mouse chromosomes. None of the integration sites was found to be in a transcribed gene, or near a cellular oncogene. None of the animals, monitored for up to 1 year, exhibited pathological abnormalities. Thus, AAV proviral integration-induced risk of oncogenesis was not found in our study, which provides functional confirmation of stable transduction of self-renewing multipotential HSCs by scAAV vectors as well as promise for the use of these vectors in the potential treatment of disorders of the hematopoietic system.

75 FR 52302 - Notice of Availability of Pest Risk Analyses for the Importation of Fresh Celery, Arugula, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

... Inspection Service [Docket No. APHIS-2010-0074] Notice of Availability of Pest Risk Analyses for the... spinach from Colombia. We are making these pest risk analyses available to the public for review and..., based on the findings of a pest- risk analysis, can be safely imported subject to one or more of the...

Systems Analysis Programs for Hands-on Integrated Reliability Evaluations (SAPHIRE) Tutorial

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

C. L. Smith; S. T. Beck; S. T. Wood

2008-08-01

The Systems Analysis Programs for Hands-on Integrated Reliability Evaluations (SAPHIRE) refers to a set of computer programs that were developed to create and analyze probabilistic risk assessment (PRAs). This volume is the tutorial manual for the SAPHIRE system. In this document, a series of lessons are provided that guide the user through basic steps common to most analyses preformed with SAPHIRE. The tutorial is divided into two major sections covering both basic and advanced features. The section covering basic topics contains lessons that lead the reader through development of a probabilistic hypothetical problem involving a vehicle accident, highlighting the program’smore » most fundamental features. The advanced features section contains additional lessons that expand on fundamental analysis features of SAPHIRE and provide insights into more complex analysis techniques. Together, these two elements provide an overview into the operation and capabilities of the SAPHIRE software.« less

Method for Assessing the Integrated Risk of Soil Pollution in Industrial and Mining Gathering Areas

PubMed Central

Guan, Yang; Shao, Chaofeng; Gu, Qingbao; Ju, Meiting; Zhang, Qian

2015-01-01

Industrial and mining activities are recognized as major sources of soil pollution. This study proposes an index system for evaluating the inherent risk level of polluting factories and introduces an integrated risk assessment method based on human health risk. As a case study, the health risk, polluting factories and integrated risks were analyzed in a typical industrial and mining gathering area in China, namely, Binhai New Area. The spatial distribution of the risk level was determined using a Geographic Information System. The results confirmed the following: (1) Human health risk in the study area is moderate to extreme, with heavy metals posing the greatest threat; (2) Polluting factories pose a moderate to extreme inherent risk in the study area. Such factories are concentrated in industrial and urban areas, but are irregularly distributed and also occupy agricultural land, showing a lack of proper planning and management; (3) The integrated risks of soil are moderate to high in the study area. PMID:26580644

Spatial Clustering and Local Risk Factors of Chronic Obstructive Pulmonary Disease (COPD).

PubMed

Chan, Ta-Chien; Wang, Hsuan-Wen; Tseng, Tzu-Jung; Chiang, Po-Huang

2015-12-10

Chronic obstructive pulmonary disease (COPD) mortality has been steadily increasing in Taiwan since 2009. In order to understand where the hotspot areas are and what the local risk factors are, we integrated an ecological and a case-control study. We used a two-stage approach to identify hotspots and explore the possible risk factors for developing COPD. The first stage used the annual township COPD mortality from 2000 to 2012 and applied the retrospective space-time scan statistic to calculate the local relative risks in each township. In the second stage, we conducted a case-control study, recruiting 200 patients from one local hospital within the one identified hotspot area located in southern Taiwan. Logistic regression was applied for analyzing the personal risk factors of COPD. The univariate analyses showed that higher percentages of aborigines, patients with tuberculosis (TB) history, and those with smoking history had COPD (p < 0.05). After controlling for demographic variables, aboriginal status (adjusted odds ratios (AORs): 3.01, 95% CI: 1.52-5.93) and smoking history (AORs: 2.64, 95% CI: 1.46-4.76) were still the two significant risk factors. This two-stage approach might be beneficial to examine and cross-validate the findings from an aggregate to an individual scale, and can be easily extended to other chronic diseases.

Direct oral anticoagulants for extended thromboprophylaxis in medically ill patients: meta-analysis and risk/benefit assessment.

PubMed

Al Yami, Majed S; Kurdi, Sawsan; Abraham, Ivo

2018-01-01

Standard-duration (7-10 days) thromboprophylaxis with low molecular weight heparin, low dose unfractionated heparin, or fondaparinux in hospitalized medically ill patients is associated with ~50% reduction in venous thromboembolism (VTE) risk. However, these patients remain at high risk for VTE post-discharge. The direct oral anticoagulants (DOACs) apixaban, rivaroxaban and betrixaban have been evaluated for extended-duration (30-42 days) thromboprophylaxis in this population. We review the efficacy and safety results from the 3 pivotal trials of extended-duration DOAC thromboprophylaxis in medically ill patients. We performed a meta-analysis of these pivotal trials focusing on 6 VTE (efficacy) and three bleeding outcomes (safety). These results were integrated into a quantitative risk/benefit assessment. The trials evaluating extended-duration DOAC thromboprophylaxis in medically ill patients failed to establish clear efficacy and/or safety signals for each agent. Our meta-analysis shows that, as a class, DOACs have selective and partial extended-duration prophylactic activity in preventing VTE events. However, this is associated with a marked increase in the risk of various bleeding events. The risk/benefit analyses fail to show a consistent net clinical benefit of extended-duration DOAC prophylaxis in medically ill patients. At this time, the evidence of safe and effective extended-duration thromboprophylaxis with DOACs in this population is inconclusive.

Accuracy of the Atherosclerotic Cardiovascular Risk Equation in a Large Contemporary, Multiethnic Population.

PubMed

Rana, Jamal S; Tabada, Grace H; Solomon, Matthew D; Lo, Joan C; Jaffe, Marc G; Sung, Sue Hee; Ballantyne, Christie M; Go, Alan S

2016-05-10

The accuracy of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Risk Equation for atherosclerotic cardiovascular disease (ASCVD) events in contemporary and ethnically diverse populations is not well understood. The goal of this study was to evaluate the accuracy of the 2013 ACC/AHA Pooled Cohort Risk Equation within a large, multiethnic population in clinical care. The target population for consideration of cholesterol-lowering therapy in a large, integrated health care delivery system population was identified in 2008 and followed up through 2013. The main analyses excluded those with known ASCVD, diabetes mellitus, low-density lipoprotein cholesterol levels <70 or ≥190 mg/dl, prior lipid-lowering therapy use, or incomplete 5-year follow-up. Patient characteristics were obtained from electronic medical records, and ASCVD events were ascertained by using validated algorithms for hospitalization databases and death certificates. We compared predicted versus observed 5-year ASCVD risk, overall and according to sex and race/ethnicity. We additionally examined predicted versus observed risk in patients with diabetes mellitus. Among 307,591 eligible adults without diabetes between 40 and 75 years of age, 22,283 were black, 52,917 were Asian/Pacific Islander, and 18,745 were Hispanic. We observed 2,061 ASCVD events during 1,515,142 person-years. In each 5-year predicted ASCVD risk category, observed 5-year ASCVD risk was substantially lower: 0.20% for predicted risk <2.50%; 0.65% for predicted risk 2.50% to <3.75%; 0.90% for predicted risk 3.75% to <5.00%; and 1.85% for predicted risk ≥5.00% (C statistic: 0.74). Similar ASCVD risk overestimation and poor calibration with moderate discrimination (C statistic: 0.68 to 0.74) were observed in sex, racial/ethnic, and socioeconomic status subgroups, and in sensitivity analyses among patients receiving statins for primary prevention. Calibration among 4,242 eligible adults with diabetes was improved, but discrimination was worse (C statistic: 0.64). In a large, contemporary "real-world" population, the ACC/AHA Pooled Cohort Risk Equation substantially overestimated actual 5-year risk in adults without diabetes, overall and across sociodemographic subgroups. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Workers’ Self-management, Recovered Companies and the Sociology of Work

PubMed Central

Croucher, Richard

2014-01-01

We analyse how far Argentina’s worker-recovered companies (WRCs) have sustained themselves and their principles of equity and workers’ self-management since becoming widespread following the country’s 2001–2 economic crisis. Specialist Spanish-language sources, survey data and documents are analysed through four key sociological themes. We find that the number of WRCs has increased in Argentina, and that they represent a viable production model. Further, they have generally maintained their central principles and even flourished. This occurred despite the global economic crisis, legal and financial pressures to adopt capitalist practices and management structures, the risk of market absorption and state attempts to coopt, demobilise and depoliticise the movement. We argue that today they function as a much-needed international beacon of an alternative vision for labour and that integration of their experience has potential to revitalise the field. PMID:25419009

Integrated Risk Management Within NASA Programs/Projects

NASA Technical Reports Server (NTRS)

Connley, Warren; Rad, Adrian; Botzum, Stephen

2004-01-01

As NASA Project Risk Management activities continue to evolve, the need to successfully integrate risk management processes across the life cycle, between functional disciplines, stakeholders, various management policies, and within cost, schedule and performance requirements/constraints become more evident and important. Today's programs and projects are complex undertakings that include a myriad of processes, tools, techniques, management arrangements and other variables all of which must function together in order to achieve mission success. The perception and impact of risk may vary significantly among stakeholders and may influence decisions that may have unintended consequences on the project during a future phase of the life cycle. In these cases, risks may be unintentionally and/or arbitrarily transferred to others without the benefit of a comprehensive systemic risk assessment. Integrating risk across people, processes, and project requirements/constraints serves to enhance decisions, strengthen communication pathways, and reinforce the ability of the project team to identify and manage risks across the broad spectrum of project management responsibilities. The ability to identify risks in all areas of project management increases the likelihood a project will identify significant issues before they become problems and allows projects to make effective and efficient use of shrinking resources. By getting a total team integrated risk effort, applying a disciplined and rigorous process, along with understanding project requirements/constraints provides the opportunity for more effective risk management. Applying an integrated approach to risk management makes it possible to do a better job at balancing safety, cost, schedule, operational performance and other elements of risk. This paper will examine how people, processes, and project requirements/constraints can be integrated across the project lifecycle for better risk management and ultimately improve the chances for mission success.

From Physical Process to Economic Cost - Integrated Approaches of Landslide Risk Assessment

NASA Astrophysics Data System (ADS)

Klose, M.; Damm, B.

2014-12-01

The nature of landslides is complex in many respects, with landslide hazard and impact being dependent on a variety of factors. This obviously requires an integrated assessment for fundamental understanding of landslide risk. Integrated risk assessment, according to the approach presented in this contribution, implies combining prediction of future landslide occurrence with analysis of landslide impact in the past. A critical step for assessing landslide risk in integrated perspective is to analyze what types of landslide damage affected people and property in which way and how people contributed and responded to these damage types. In integrated risk assessment, the focus is on systematic identification and monetization of landslide damage, and analytical tools that allow deriving economic costs from physical landslide processes are at the heart of this approach. The broad spectrum of landslide types and process mechanisms as well as nonlinearity between landslide magnitude, damage intensity, and direct costs are some main factors explaining recent challenges in risk assessment. The two prevailing approaches for assessing the impact of landslides in economic terms are cost survey (ex-post) and risk analysis (ex-ante). Both approaches are able to complement each other, but yet a combination of them has not been realized so far. It is common practice today to derive landslide risk without considering landslide process-based cause-effect relationships, since integrated concepts or new modeling tools expanding conventional methods are still widely missing. The approach introduced in this contribution is based on a systematic framework that combines cost survey and GIS-based tools for hazard or cost modeling with methods to assess interactions between land use practices and landslides in historical perspective. Fundamental understanding of landslide risk also requires knowledge about the economic and fiscal relevance of landslide losses, wherefore analysis of their impact on public budgets is a further component of this approach. In integrated risk assessment, combination of methods plays an important role, with the objective of collecting and integrating complex data sets on landslide risk.

76 FR 69736 - Draft Toxicological Review of Vanadium Pentoxide: In Support of Summary Information on the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

... Toxicological Review of Vanadium Pentoxide: In Support of Summary Information on the Integrated Risk Information..., ``Toxicological Review of Vanadium Pentoxide: In Support of Summary Information on the Integrated Risk Information... Vanadium Pentoxide: In Support of Summary Information on the Integrated Risk Information System (IRIS)'' is...

75 FR 50761 - Draft Toxicological Review of Dichloromethane: In Support of Summary Information on the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-17

... Toxicological Review of Dichloromethane: In Support of Summary Information on the Integrated Risk Information... Summary Information on the Integrated Risk Information System (IRIS)'' (EPA/635/R-10/003A). The draft... Support of Summary Information on the Integrated Risk Information System (IRIS)'' is available primarily...

Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education.

PubMed

Henriksen, Eva; Burkow, Tatjana M; Johnsen, Elin; Vognild, Lars K

2013-08-09

Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient's TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO's standard for information security risk management. A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Most of the identified threats are applicable for healthcare services intended for patients or citizens in their own homes. Confidentiality risks in home are different from in a more controlled environment such as a hospital; and electronic equipment located in private homes and communicating via Internet, is more exposed to unauthorised access. By implementing the proposed measures, it has been possible to design a home-based service which ensures the necessary level of information security and privacy.

Integrating antiretroviral therapy into antenatal care and maternal and child health settings: a systematic review and meta-analysis

PubMed Central

Hoos, David; Beqiri, Alba; Lorenz-Dehne, Karl; McClure, Craig; Duncombe, Chris

2013-01-01

Abstract Objective To determine whether integrating antiretroviral therapy (ART) into antenatal care (ANC) and maternal and child health (MCH) clinics could improve programmatic and patient outcomes. Methods The authors systematically searched PubMed, Embase, African Index Medicus and LiLACS for randomized controlled trials, prospective cohort studies, or retrospective cohort studies comparing outcomes in ANC or MCH clinics that had and had not integrated ART. The outcomes of interest were ART coverage, ART enrolment, ART retention, mortality and transmission of human immunodeficiency virus (HIV). Findings Four studies met the inclusion criteria. All were conducted in ANC clinics. Increased enrolment of pregnant women in ART was observed in ANC clinics that had integrated ART (relative risk, RR: 2.09; 95% confidence interval, CI; 1.78–2.46; I2: 15%). Increased ART coverage was also noted in such clinics (RR: 1.37; 95% CI: 1.05–1.79; I2: 83%). Sensitivity analyses revealed a trend for the national prevalence of HIV infection to explain the heterogeneity in the size of the effect of ART integration on ART coverage (P = 0.13). Retention in ART was similar in ANC clinics with and without ART integration. Conclusion Although few data were available, ART integration in ANC clinics appears to lead to higher rates of ART enrolment and ART coverage. Rates of retention in ART remain similar to those observed in referral-based models. PMID:23397350

Integration of second cancer risk calculations in a radiotherapy treatment planning system

NASA Astrophysics Data System (ADS)

Hartmann, M.; Schneider, U.

2014-03-01

Second cancer risk in patients, in particular in children, who were treated with radiotherapy is an important side effect. It should be minimized by selecting an appropriate treatment plan for the patient. The objectives of this study were to integrate a risk model for radiation induced cancer into a treatment planning system which allows to judge different treatment plans with regard to second cancer induction and to quantify the potential reduction in predicted risk. A model for radiation induced cancer including fractionation effects which is valid for doses in the radiotherapy range was integrated into a treatment planning system. From the three-dimensional (3D) dose distribution the 3D-risk equivalent dose (RED) was calculated on an organ specific basis. In addition to RED further risk coefficients like OED (organ equivalent dose), EAR (excess absolute risk) and LAR (lifetime attributable risk) are computed. A risk model for radiation induced cancer was successfully integrated in a treatment planning system. Several risk coefficients can be viewed and used to obtain critical situations were a plan can be optimised. Risk-volume-histograms and organ specific risks were calculated for different treatment plans and were used in combination with NTCP estimates for plan evaluation. It is concluded that the integration of second cancer risk estimates in a commercial treatment planning system is feasible. It can be used in addition to NTCP modelling for optimising treatment plans which result in the lowest possible second cancer risk for a patient.

Integrating an infectious disease programme into the primary health care service: a retrospective analysis of Chagas disease community-based surveillance in Honduras.

PubMed

Hashimoto, Ken; Zúniga, Concepción; Nakamura, Jiro; Hanada, Kyo

2015-03-24

Integration of disease-specific programmes into the primary health care (PHC) service has been attempted mostly in clinically oriented disease control such as HIV/AIDS and tuberculosis but rarely in vector control. Chagas disease is controlled principally by interventions against the triatomine vector. In Honduras, after successful reduction of household infestation by vertical approach, the Ministry of Health implemented community-based vector surveillance at the PHC services (health centres) to prevent the resurgence of infection. This paper retrospectively analyses the effects and process of integrating a Chagas disease vector surveillance system into health centres. We evaluated the effects of integration at six pilot sites in western Honduras during 2008-2011 on; surveillance performance; knowledge, attitude and practice in schoolchildren; reports of triatomine bug infestation and institutional response; and seroprevalence among children under 15 years of age. The process of integration of the surveillance system was analysed using the PRECEDE-PROCEED model for health programme planning. The model was employed to systematically determine influential and interactive factors which facilitated the integration process at different levels of the Ministry of Health and the community. Overall surveillance performance improved from 46 to 84 on a 100 point-scale. Schoolchildren's attitude (risk awareness) score significantly increased from 77 to 83 points. Seroprevalence declined from 3.4% to 0.4%. Health centres responded to the community bug reports by insecticide spraying. As key factors, the health centres had potential management capacity and influence over the inhabitants' behaviours and living environment directly and through community health volunteers. The National Chagas Programme played an essential role in facilitating changes with adequate distribution of responsibilities, participatory modelling, training and, evaluation and advocacy. We found that Chagas disease vector surveillance can be integrated into the PHC service. Health centres demonstrated capacity to manage vector surveillance and improve performance, children's awareness, vector report-response and seroprevalence, once tasks were simplified to be performed by trained non-specialists and distributed among the stakeholders. Health systems integration requires health workers to perform beyond their usual responsibilities and acquire management skills. Integration of vector control is feasible and can contribute to strengthening the preventive capacity of the PHC service.

Application of multivariate statistical analysis in the pollution and health risk of traffic-related heavy metals.

PubMed

Ebqa'ai, Mohammad; Ibrahim, Bashar

2017-12-01

This study aims to analyse the heavy metal pollutants in Jeddah, the second largest city in the Gulf Cooperation Council with a population exceeding 3.5 million, and many vehicles. Ninety-eight street dust samples were collected seasonally from the six major roads as well as the Jeddah Beach, and subsequently digested using modified Leeds Public Analyst method. The heavy metals (Fe, Zn, Mn, Cu, Cd, and Pb) were extracted from the ash using methyl isobutyl ketone as solvent extraction and eventually analysed by atomic absorption spectroscopy. Multivariate statistical techniques, principal component analysis (PCA), and hierarchical cluster analysis were applied to these data. Heavy metal concentrations were ranked according to the following descending order: Fe > Zn > Mn > Cu > Pb > Cd. In order to study the pollution and health risk from these heavy metals as well as estimating their effect on the environment, pollution indices, integrated pollution index, enrichment factor, daily dose average, hazard quotient, and hazard index were all analysed. The PCA showed high levels of Zn, Fe, and Cd in Al Kurnish road, while these elements were consistently detected on King Abdulaziz and Al Madina roads. The study indicates that high levels of Zn and Pb pollution were recorded for major roads in Jeddah. Six out of seven roads had high pollution indices. This study is the first step towards further investigations into current health problems in Jeddah, such as anaemia and asthma.

Healthy co-twins of patients with affective disorders show reduced risk-related activation of the insula during a monetary gambling task.

PubMed

Macoveanu, Julian; Miskowiak, Kamilla; Kessing, Lars V; Vinberg, Maj; Siebner, Hartwig R

2016-01-01

Healthy first-degree relatives of patients with affective disorders are at increased risk for affective disorders and express discrete structural and functional abnormalities in the brain reward system. However, value-based decision making is not well understood in these at-risk individuals. We investigated healthy monozygotic and dizygotic twins with or without a co-twin history of affective disorders (high-risk and low-risk groups, respectively) using functional MRI during a gambling task. We assessed group differences in activity related to gambling risk over the entire brain. We included 30 monozygotic and 37 dizygotic twins in our analysis. Neural activity in the anterior insula and ventral striatum increased linearly with the amount of gambling risk in the entire cohort. Individual neuroticism scores were positively correlated with the neural response in the ventral striatum to increasing gambling risk and negatively correlated with individual risk-taking behaviour. Compared with low-risk twins, the high-risk twins showed a bilateral reduction of risk-related activity in the middle insula extending into the temporal cortex with increasing gambling risk. Post hoc analyses revealed that this effect was strongest in dizygotic twins. The relatively old average age of the mono- and dizygotic twin cohort (49.2 yr) may indicate an increased resilience to affective disorders. The size of the monozygotic high-risk group was relatively small (n = 13). The reduced processing of risk magnitude in the middle insula may indicate a deficient integration of exteroceptive information related to risk-related cues with interoceptive states in individuals at familial risk for affective disorders. Impaired risk processing might contribute to increased vulnerability to affective disorders.

What is new about covered interest parity condition in the European Union? Evidence from fractal cross-correlation regressions

NASA Astrophysics Data System (ADS)

Ferreira, Paulo; Kristoufek, Ladislav

2017-11-01

We analyse the covered interest parity (CIP) using two novel regression frameworks based on cross-correlation analysis (detrended cross-correlation analysis and detrending moving-average cross-correlation analysis), which allow for studying the relationships at different scales and work well under non-stationarity and heavy tails. CIP is a measure of capital mobility commonly used to analyse financial integration, which remains an interesting feature of study in the context of the European Union. The importance of this features is related to the fact that the adoption of a common currency is associated with some benefits for countries, but also involves some risks such as the loss of economic instruments to face possible asymmetric shocks. While studying the Eurozone members could explain some problems in the common currency, studying the non-Euro countries is important to analyse if they are fit to take the possible benefits. Our results point to the CIP verification mainly in the Central European countries while in the remaining countries, the verification of the parity is only residual.

Shared genetic variance between obesity and white matter integrity in Mexican Americans

PubMed Central

Spieker, Elena A.; Kochunov, Peter; Rowland, Laura M.; Sprooten, Emma; Winkler, Anderson M.; Olvera, Rene L.; Almasy, Laura; Duggirala, Ravi; Fox, Peter T.; Blangero, John; Glahn, David C.; Curran, Joanne E.

2015-01-01

Obesity is a chronic metabolic disorder that may also lead to reduced white matter integrity, potentially due to shared genetic risk factors. Genetic correlation analyses were conducted in a large cohort of Mexican American families in San Antonio (N = 761, 58% females, ages 18–81 years; 41.3 ± 14.5) from the Genetics of Brain Structure and Function Study. Shared genetic variance was calculated between measures of adiposity [(body mass index (BMI; kg/m2) and waist circumference (WC; in)] and whole-brain and regional measurements of cerebral white matter integrity (fractional anisotropy). Whole-brain average and regional fractional anisotropy values for 10 major white matter tracts were calculated from high angular resolution diffusion tensor imaging data (DTI; 1.7 × 1.7 × 3 mm; 55 directions). Additive genetic factors explained intersubject variance in BMI (heritability, h2 = 0.58), WC (h2 = 0.57), and FA (h2 = 0.49). FA shared significant portions of genetic variance with BMI in the genu (ρG = −0.25), body (ρG = −0.30), and splenium (ρG = −0.26) of the corpus callosum, internal capsule (ρG = −0.29), and thalamic radiation (ρG = −0.31) (all p's = 0.043). The strongest evidence of shared variance was between BMI/WC and FA in the superior fronto-occipital fasciculus (ρG = −0.39, p = 0.020; ρG = −0.39, p = 0.030), which highlights region-specific variation in neural correlates of obesity. This may suggest that increase in obesity and reduced white matter integrity share common genetic risk factors. PMID:25763009

Deficits in vision and visual attention associated with motor performance of very preterm/very low birth weight children.

PubMed

Geldof, Christiaan J A; van Hus, Janeline W P; Jeukens-Visser, Martine; Nollet, Frans; Kok, Joke H; Oosterlaan, Jaap; van Wassenaer-Leemhuis, Aleid G

2016-01-01

To extend understanding of impaired motor functioning of very preterm (VP)/very low birth weight (VLBW) children by investigating its relationship with visual attention, visual and visual-motor functioning. Motor functioning (Movement Assessment Battery for Children, MABC-2; Manual Dexterity, Aiming & Catching, and Balance component), as well as visual attention (attention network and visual search tests), vision (oculomotor, visual sensory and perceptive functioning), visual-motor integration (Beery Visual Motor Integration), and neurological status (Touwen examination) were comprehensively assessed in a sample of 106 5.5-year-old VP/VLBW children. Stepwise linear regression analyses were conducted to investigate multivariate associations between deficits in visual attention, oculomotor, visual sensory, perceptive and visual-motor integration functioning, abnormal neurological status, neonatal risk factors, and MABC-2 scores. Abnormal MABC-2 Total or component scores occurred in 23-36% of VP/VLBW children. Visual and visual-motor functioning accounted for 9-11% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Visual perceptive deficits only were associated with Aiming & Catching. Abnormal neurological status accounted for an additional 19-30% of variance in MABC-2 Total, Manual Dexterity and Balance scores, and 5% of variance in Aiming & Catching, and neonatal risk factors for 3-6% of variance in MABC-2 Total, Manual Dexterity and Balance scores. Motor functioning is weakly associated with visual and visual-motor integration deficits and moderately associated with abnormal neurological status, indicating that motor performance reflects long term vulnerability following very preterm birth, and that visual deficits are of minor importance in understanding motor functioning of VP/VLBW children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integration of copy number and transcriptomics provides risk stratification in prostate cancer: A discovery and validation cohort study

PubMed Central

Ross-Adams, H.; Lamb, A.D.; Dunning, M.J.; Halim, S.; Lindberg, J.; Massie, C.M.; Egevad, L.A.; Russell, R.; Ramos-Montoya, A.; Vowler, S.L.; Sharma, N.L.; Kay, J.; Whitaker, H.; Clark, J.; Hurst, R.; Gnanapragasam, V.J.; Shah, N.C.; Warren, A.Y.; Cooper, C.S.; Lynch, A.G.; Stark, R.; Mills, I.G.; Grönberg, H.; Neal, D.E.

2015-01-01

Background Understanding the heterogeneous genotypes and phenotypes of prostate cancer is fundamental to improving the way we treat this disease. As yet, there are no validated descriptions of prostate cancer subgroups derived from integrated genomics linked with clinical outcome. Methods In a study of 482 tumour, benign and germline samples from 259 men with primary prostate cancer, we used integrative analysis of copy number alterations (CNA) and array transcriptomics to identify genomic loci that affect expression levels of mRNA in an expression quantitative trait loci (eQTL) approach, to stratify patients into subgroups that we then associated with future clinical behaviour, and compared with either CNA or transcriptomics alone. Findings We identified five separate patient subgroups with distinct genomic alterations and expression profiles based on 100 discriminating genes in our separate discovery and validation sets of 125 and 103 men. These subgroups were able to consistently predict biochemical relapse (p = 0.0017 and p = 0.016 respectively) and were further validated in a third cohort with long-term follow-up (p = 0.027). We show the relative contributions of gene expression and copy number data on phenotype, and demonstrate the improved power gained from integrative analyses. We confirm alterations in six genes previously associated with prostate cancer (MAP3K7, MELK, RCBTB2, ELAC2, TPD52, ZBTB4), and also identify 94 genes not previously linked to prostate cancer progression that would not have been detected using either transcript or copy number data alone. We confirm a number of previously published molecular changes associated with high risk disease, including MYC amplification, and NKX3-1, RB1 and PTEN deletions, as well as over-expression of PCA3 and AMACR, and loss of MSMB in tumour tissue. A subset of the 100 genes outperforms established clinical predictors of poor prognosis (PSA, Gleason score), as well as previously published gene signatures (p = 0.0001). We further show how our molecular profiles can be used for the early detection of aggressive cases in a clinical setting, and inform treatment decisions. Interpretation For the first time in prostate cancer this study demonstrates the importance of integrated genomic analyses incorporating both benign and tumour tissue data in identifying molecular alterations leading to the generation of robust gene sets that are predictive of clinical outcome in independent patient cohorts. PMID:26501111

GRADE: Assessing the quality of evidence in environmental and occupational health.

PubMed

Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary S; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Characterization of ecological risks at the Milltown Reservoir-Clark Fork River Sediments Superfund Site, Montana

USGS Publications Warehouse

Pascoe, Gary A.; Blanchet, Richard J.; Linder, Greg L.; Palawski, Don; Brumbaugh, William G.; Canfield, Tim J.; Kemble, Nile E.; Ingersoll, Chris G.; Farag, Aïda M.; DalSoglio, Julie A.

1994-01-01

A comprehensive field and laboratory approach to the ecological risk assessment for the Milltown Reservoir-Clark Fork River Sediments Site, a Superfund site in the Rocky Mountains of Montana, has been described in the preceding reports of this series. The risk assessment addresses concerns over the ecological impacts of upstream releases of mining wastes to fisheries of the upper Clark Fork River (CFR) and the benthic and terrestrial habitats further downstream in Milltown Reservoir. The risk characterization component of the process integrated results from a triad of information sources: (a) chemistry studies of environmental media to identify and quantify exposures of terrestrial and aquatic organisms to site-related contaminants; (b) ecological or population studies of terrestrial vegetation, birds, benthic communities, and fish; and (c) in situ and laboratory toxicity studies with terrestrial and aquatic invertebrates and plants, small mammals, amphibians, and fish exposed to contaminated surface water, sediments, wetland soils, and food sources. Trophic transfer studies were performed on waterfowl, mammals, and predatory birds using field measurement data on metals concentrations in environmental media and lower trophic food sources. Studies with sediment exposures were incorporated into the Sediment Quality Triad approach to evaluate risks to benthic ecology. Overall results of the wetland and terrestrial studies suggested that acute adverse biological effects were largely absent from the wetland; however, adverse effects to reproductive, growth, and physiological end points of various terrestrial and aquatic species were related to metals exposures in more highly contaminated depositional areas. Feeding studies with contaminated diet collected from the upper CFR indicated that trout are at high risk from elevated metals concentrations in surface water, sediment, and aquatic invertebrates. Integration of chemical analyses with toxicological and ecological evaluations of metal effects on the wetland and fishery has provided an important foundation for environmental decisions at this site.

GRADE: Assessing the quality of evidence in environmental and occupational health

PubMed Central

Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A.; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C.; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modelling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE’s applicability to environmental health, and identify priority areas for method assessment and development. PMID:26827182

The Maricopa Integrated Risk Assessment Project: A New Way of Looking at Risk

ERIC Educational Resources Information Center

Unks, Ruth A.; Thor, Linda

2008-01-01

This article reviews the Maricopa Integrated Risk Assessment (MIRA) project and discusses its challenges and successes. Strategies and resources are offered for assisting community college administrators, faculty, and staff to successfully implement enterprise risk management at their institutions.

HIV Risk and Protection among Gay Male Couples: The Role of Gay Community Integration

ERIC Educational Resources Information Center

Fergus, Stevenson; Lewis, Megan A.; Darbes, Lynae A.; Butterfield, Rita M.

2005-01-01

This study examined the association between different types of integration in the gay community and HIV risk among gay male couples. Previous research linking gay community integration and involvement among couples to HIV risk has been equivocal. Each partner in 59 gay couples completed a separate anonymous questionnaire that assessed two types of…

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

ERIC Educational Resources Information Center

Howard, Sarah K.; Gigliotti, Amanda

2016-01-01

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

78 FR 26029 - Toxicological Review of Methanol (Non-Cancer): In Support of Summary Information on the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... of Methanol (Non-Cancer): In Support of Summary Information on the Integrated Risk Information System... Integrated Risk Information System (IRIS)'' (EPA/635/R-11/001Ba), which will be posted on NCEA's Web site... Review of Methanol (Non-Cancer): In Support of Summary Information on the Integrated Risk Information...

INFLUENCE OF THE CIVIC COMMUNITY RELIGIOUS ENVIRONMENT ON FAMILY POVERTY: A MULTILEVEL ANALYSIS

PubMed Central

Myers, Candice A.

2016-01-01

This study integrates research in the civic community tradition and structuralist and individualist perspectives on poverty to assess the relationship between religious-based civic community structures and family poverty in the United States. Using multilevel analyses of 2006–2008 American Community Survey, 2000 Census of Population and Housing, and 2000 Religious Congregations and Membership Survey data, results demonstrate that the presence of Mainline Protestant and Catholics adherents within communities – measured as the percentage of a community’s population comprised of Mainline Protestant and Catholic adherents – is significantly and negatively associated with family poverty risks, net of other family and community factors. That is, in communities with a greater presence of Mainline Protestants and Catholics, there were also lower risks of families being in poverty. These findings suggest the importance of the ecology of religion within communities in understanding poverty outcomes for families. PMID:28580372

Risk of defeats in the central nervous system during deep space missions.

PubMed

Kokhan, Viktor S; Matveeva, Marina I; Mukhametov, Azat; Shtemberg, Andrey S

2016-12-01

Space flight factors (SFF) significantly affect the operating activity of astronauts during deep space missions. Gravitational overloads, hypo-magnetic field and ionizing radiation are the main SFF that perturb the normal activity of the central nervous system (CNS). Acute and chronic CNS risks include alterations in cognitive abilities, reduction of motor functions and behavioural changes. Multiple experimental works have been devoted to the SFF effects on integrative functional activity of the brain; however, the model parameters utilized have not always been ideal and consistent. Even less is known regarding the combined effects of these SFF in a real interplanetary mission, for example to Mars. Our review aims to systemize and analyse the last advancements in astrobiology, with a focus on the combined effects of SFF; as well as to discuss on unification of the parameters for ground-based models of deep space missions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Economic and Sociological Correlates of Suicides: Multilevel Analysis of the Time Series Data in the United Kingdom.

PubMed

Sun, Bruce Qiang; Zhang, Jie

2016-03-01

For the effects of social integration on suicides, there have been different and even contradictive conclusions. In this study, the selected economic and social risks of suicide for different age groups and genders in the United Kingdom were identified and the effects were estimated by the multilevel time series analyses. To our knowledge, there exist no previous studies that estimated a dynamic model of suicides on the time series data together with multilevel analysis and autoregressive distributed lags. The investigation indicated that unemployment rate, inflation rate, and divorce rate are all significantly and positively related to the national suicide rates in the United Kingdom from 1981 to 2011. Furthermore, the suicide rates of almost all groups above 40 years are significantly associated with the risk factors of unemployment and inflation rate, in comparison with the younger groups. © 2016 American Academy of Forensic Sciences.

A tool for efficient, model-independent management optimization under uncertainty

USGS Publications Warehouse

White, Jeremy; Fienen, Michael N.; Barlow, Paul M.; Welter, Dave E.

2018-01-01

To fill a need for risk-based environmental management optimization, we have developed PESTPP-OPT, a model-independent tool for resource management optimization under uncertainty. PESTPP-OPT solves a sequential linear programming (SLP) problem and also implements (optional) efficient, “on-the-fly” (without user intervention) first-order, second-moment (FOSM) uncertainty techniques to estimate model-derived constraint uncertainty. Combined with a user-specified risk value, the constraint uncertainty estimates are used to form chance-constraints for the SLP solution process, so that any optimal solution includes contributions from model input and observation uncertainty. In this way, a “single answer” that includes uncertainty is yielded from the modeling analysis. PESTPP-OPT uses the familiar PEST/PEST++ model interface protocols, which makes it widely applicable to many modeling analyses. The use of PESTPP-OPT is demonstrated with a synthetic, integrated surface-water/groundwater model. The function and implications of chance constraints for this synthetic model are discussed.

Factors associated with perception of risk of contracting HIV among secondary school female learners in Mbonge subdivision of rural Cameroon

PubMed Central

Tarkang, Elvis Enowbeyang

2014-01-01

Introduction Since learners in secondary schools fall within the age group hardest hit by HIV/AIDS, it is obvious that these learners might be at high risk of contracting HIV/AIDS. However, little has been explored on the perception of risk of contracting HIV among secondary school learners in Cameroon. This study aimed at examining the perception of risk of contracting HIV among secondary school learners in Mbonge subdivision of rural Cameroon using the Health Belief Model (HBM) as framework. Methods A quantitative, correlational design was adopted, using a self-administered questionnaire to collect data from 210 female learners selected through disproportional, stratified, simple random sampling technique, from three participating senior secondary schools. Statistics were calculated using SPSS version 20 software program. Results Only 39.4% of the respondents perceived themselves to be at high risk of contracting HIV, though the majority, 54.0% were sexually active. Multinomial logistic regression analyses show that sexual risk behaviours (p=0.000) and the Integrated Value Mapping (IVM) of the perception components of the HBM are the most significant factors associated with perception of risk of contracting HIV at the level p<0.05. Conclusion The findings of this study can play an instrumental role in the development of effective preventive and interventional messages for adolescents in Cameroon. PMID:25309659

Development of Improved Caprock Integrity and Risk Assessment Techniques

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

Bruno, Michael

GeoMechanics Technologies has completed a geomechanical caprock integrity analysis and risk assessment study funded through the US Department of Energy. The project included: a detailed review of historical caprock integrity problems experienced in the natural gas storage industry; a theoretical description and documentation of caprock integrity issues; advanced coupled transport flow modelling and geomechanical simulation of three large-scale potential geologic sequestration sites to estimate geomechanical effects from CO₂ injection; development of a quantitative risk and decision analysis tool to assess caprock integrity risks; and, ultimately the development of recommendations and guidelines for caprock characterization and CO₂ injection operating practices. Historicalmore » data from gas storage operations and CO₂ sequestration projects suggest that leakage and containment incident risks are on the order of 10-1 to 10-2, which is higher risk than some previous studies have suggested for CO₂. Geomechanical analysis, as described herein, can be applied to quantify risks and to provide operating guidelines to reduce risks. The risk assessment tool developed for this project has been applied to five areas: The Wilmington Graben offshore Southern California, Kevin Dome in Montana, the Louden Field in Illinois, the Sleipner CO₂ sequestration operation in the North Sea, and the In Salah CO₂ sequestration operation in North Africa. Of these five, the Wilmington Graben area represents the highest relative risk while the Kevin Dome area represents the lowest relative risk.« less

Train integrity detection risk analysis based on PRISM

NASA Astrophysics Data System (ADS)

Wen, Yuan

2018-04-01

GNSS based Train Integrity Monitoring System (TIMS) is an effective and low-cost detection scheme for train integrity detection. However, as an external auxiliary system of CTCS, GNSS may be influenced by external environments, such as uncertainty of wireless communication channels, which may lead to the failure of communication and positioning. In order to guarantee the reliability and safety of train operation, a risk analysis method of train integrity detection based on PRISM is proposed in this article. First, we analyze the risk factors (in GNSS communication process and the on-board communication process) and model them. Then, we evaluate the performance of the model in PRISM based on the field data. Finally, we discuss how these risk factors influence the train integrity detection process.

Evolution of Mobil`s methods to evaluate exploration and producing opportunities

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

Gaynor, C.B.; Cook, D.M. Jr.

1996-08-01

Over the past decade, Mobil has changed significantly in size, structure and focus to improve profitability. Concurrently, work processes and methodologies have been modified to improve resource utilization and opportunity selection. The key imperative has been recognition of the full range of hydrocarbon volume uncertainty, its risk and value. Exploration has focussed on increasing success through improved geotechnical estimates and demonstrating value addition. For Producing, the important tasks: (1) A centralized Exploration and Producing team was formed to help ensure an integrated, consistent worldwide approach to prospect and field assessments. Monte Carlo simulation was instituted to recognize probability-weighted ranges ofmore » possible outcomes for prospects and fields, and hydrocarbon volume category definitions were standardized. (2) Exploration instituted a global Prospect Inventory, tracking wildcat predictions vs. results. Performance analyses led to initiatives to improve the quality and consistency of assessments. Process improvement efforts included the use of multidisciplinary teams and peer reviews. Continued overestimates of hydrocarbon volumes prompted methodology changes such as the use of {open_quotes}reality checks{close_quotes} and log-normal distributions. The communication of value predictions and additions became paramount. (3) Producing now recognizes the need for Exploration`s commercial discoveries and new Producing ventures, notwithstanding the associated risk. Multi-disciplinary teams of engineers and geoscientists work on post-discovery assessments to optimize field development and maximize the value of opportunities. Mobil now integrates volume and risk assessment with correlative future capital investment programs to make proactive strategic choices to maximize shareholder value.« less

The non-target impact of spinosyns on beneficial arthropods.

PubMed

Biondi, Antonio; Mommaerts, Veerle; Smagghe, Guy; Viñuela, Elisa; Zappalà, Lucia; Desneux, Nicolas

2012-12-01

Spinosyn-based products, mostly spinosad, have been widely recommended by extension specialists and agribusiness companies; consequently, they have been used to control various pests in many different cropping systems. Following the worldwide adoption of spinosad-based products for integrated and organic farming, an increasing number of ecotoxicological studies have been published in the past 10 years. These studies are primarily related to the risk assessment of spinosad towards beneficial arthropods. This review takes into account recent data with the aim of (i) highlighting potentially adverse effects of spinosyns on beneficial arthropods (and hence on ecosystem services that they provide in agroecosystems), (ii) clarifying the range of methods used to address spinosyn side effects on biocontrol agents and pollinators in order to provide new insights for the development of more accurate bioassays, (iii) identifying pitfalls when analysing laboratory results to assess field risks and (iv) gaining increasing knowledge on side effects when using spinosad for integrated pest management (IPM) programmes and organic farming. For the first time, a thorough review of possible risks of spinosad and novel spinosyns (such as spinetoram) to beneficial arthropods (notably natural enemies and pollinators) is provided. The acute lethal effect and multiple sublethal effects have been identified in almost all arthropod groups studied. This review will help to optimise the future use of spinosad and new spinosyns in IPM programmes and for organic farming, notably by preventing the possible side effects of spinosyns on beneficial arthropods. Copyright © 2012 Society of Chemical Industry.

Four conceptual issues to consider in integrating social and environmental factors in risk and impact assessments

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

Domínguez-Gómez, J. Andrés, E-mail: andres@uhu.es

In the last twenty years, both the increase in academic production and the expansion of professional involvement in Environmental Impact Assessment (EIA) and Social Impact Assessment (SIA) have evidenced growing scientific and business interest in risk and impact analysis. However, this growth has not brought with it parallel progress in addressing the main shortcomings of EIA/SIA, i.e. insufficient integration of environmental and social factors into development project analyses and, in cases where the social aspects are considered, technical-methodological failings in their analysis and assessment. It is clear that these weaknesses carry with them substantial threats to the sustainability (social, environmentalmore » and economic) of projects which impact on the environment, and consequently to the local contexts where they are carried out and to the delicate balance of the global ecosystem. This paper argues that, in a sociological context of complexity and dynamism, four conceptual elements should underpin approaches to socio-environmental risk and impact assessment in development projects: a theoretical base in actor–network theory; an ethical grounding in values which are internationally recognized (though not always fulfilled in practice); a (new) epistemological-scientific base; and a methodological foundation in social participation. - Highlights: • A theoretical foundation in actor–network theory • An ethical grounding in values which are internationally recognized, but rarely carried through into practice • A (new) epistemological-scientific base • A methodological foundation in social participation.« less

Incorporating High-Dimensional Exposure Modelling into Studies of Air Pollution and Health.

PubMed

Liu, Yi; Shaddick, Gavin; Zidek, James V

2017-01-01

Performing studies on the risks of environmental hazards on human health requires accurate estimates of exposures that might be experienced by the populations at risk. Often there will be missing data and in many epidemiological studies, the locations and times of exposure measurements and health data do not match. To a large extent this will be due to the health and exposure data having arisen from completely different data sources and not as the result of a carefully designed study, leading to problems of both 'change of support' and 'misaligned data'. In such cases, a direct comparison of the exposure and health outcome is often not possible without an underlying model to align the two in the spatial and temporal domains. The Bayesian approach provides the natural framework for such models; however, the large amounts of data that can arise from environmental networks means that inference using Markov Chain Monte Carlo might not be computationally feasible in this setting. Here we adapt the integrated nested Laplace approximation to implement spatio-temporal exposure models. We also propose methods for the integration of large-scale exposure models and health analyses. It is important that any model structure allows the correct propagation of uncertainty from the predictions of the exposure model through to the estimates of risk and associated confidence intervals. The methods are demonstrated using a case study of the levels of black smoke in the UK, measured over several decades, and respiratory mortality.

Risk of a Second Malignant Neoplasm After Cancer in Childhood Treated With Radiotherapy: Correlation With the Integral Dose Restricted to the Irradiated Fields

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

Nguyen, France; Institut Gustave Roussy, Villejuif; Universite Paris XI, Villejuif

2008-03-01

Purpose: After successful treatment of cancers in childhood, the occurrence of second malignant neoplasm (SMN) came to the fore. Few studies have considered the relationship between the radiation dose received and the risk of developing an SMN. To take into account the heterogeneity of the dose distribution so as to evaluate the overall risk of an SMN after a childhood cancer, we therefore focused on the integral dose restricted to the irradiated fields. Methods and Materials: The study was performed in a cohort of 4,401 patients who were 3-year survivors of all types of childhood cancer treated between 1947 andmore » 1986 in France and Great Britain. For each patient, the integral dose was estimated for the volume inside the beam edges. Results: We found a significant dose-response relationship between the overall risk of an SMN and the estimated integral dose. The excess relative risk for each incremental unit of the integral dose was only 0.008 in a linear model and 0.017 when a negative exponential term was considered, when adjusted for chemotherapy. The risk of SMN occurrence was 2.6 times higher in the case of irradiation. However among patients who had received radiotherapy, only those who had received the highest integral dose actually had a higher risk. Conclusions: The integral dose in our study cannot be considered as a good predictor of later risks. However other studies with the same study design are obviously needed to evaluate the use of the integral dose as a tool for decision making concerning different radiotherapy techniques.« less

Improving the Linkages between Air Pollution Epidemiology and Quantitative Risk Assessment

PubMed Central

Bell, Michelle L.; Walker, Katy; Hubbell, Bryan

2011-01-01

Background: Air pollution epidemiology plays an integral role in both identifying the hazards of air pollution as well as supplying the risk coefficients that are used in quantitative risk assessments. Evidence from both epidemiology and risk assessments has historically supported critical environmental policy decisions. The extent to which risk assessors can properly specify a quantitative risk assessment and characterize key sources of uncertainty depends in part on the availability, and clarity, of data and assumptions in the epidemiological studies. Objectives: We discuss the interests shared by air pollution epidemiology and risk assessment communities in ensuring that the findings of epidemiological studies are appropriately characterized and applied correctly in risk assessments. We highlight the key input parameters for risk assessments and consider how modest changes in the characterization of these data might enable more accurate risk assessments that better represent the findings of epidemiological studies. Discussion: We argue that more complete information regarding the methodological choices and input data used in epidemiological studies would support more accurate risk assessments—to the benefit of both disciplines. In particular, we suggest including additional details regarding air quality, demographic, and health data, as well as certain types of data-rich graphics. Conclusions: Relatively modest changes to the data reported in epidemiological studies will improve the quality of risk assessments and help prevent the misinterpretation and mischaracterization of the results of epidemiological studies. Such changes may also benefit epidemiologists undertaking meta-analyses. We suggest workshops as a way to improve the dialogue between the two communities. PMID:21816702

An integrated multi-scale risk analysis procedure for pluvial flooding

NASA Astrophysics Data System (ADS)

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

2016-04-01

Mitigation of or adaptation to the negative impacts of natural processes on society requires a better understanding of the spatio-temporal distribution not only of the processes themselves, but also of the elements at risk. Information on their values, exposures and vulnerabilities towards the expected impact magnitudes/intensities of the relevant processes is needed. GIS-supported methods are particularly useful for integrated spatio-temporal analyses of natural processes and their potential consequences. Hereby, pluvial floods are of particular concern for many parts of Austria. The overall aim of the present study is to calculate the hazards emanating from pluvial floods, to determine the exposure of given elements at risk, to determine their vulnerabilities towards given pluvial flood hazards and to analyze potential consequences in terms of monetary losses. The whole approach builds on data available on a national scale. We introduce an integrated, multi-scale risk analysis procedure with regard to pluvial flooding. Focusing on the risk to buildings, we firstly exemplify this procedure with a well-documented event in the city of Graz (Austria), in order to highlight the associated potentials and limitations. Secondly, we attempt to predict the possible consequences of pluvial flooding triggered by rainfall events with recurrence intervals of 30, 100 and 300 years. (i) We compute spatially distributed inundation depths using the software FloodArea. Infiltration capacity and surface roughness are estimated from the land cover units given by the official cadastre. Various assumptions are tested with regard to the inflow to the urban sewer system. (ii) Based on the inundation depths and the official building register, we employ a set of rules and functions to deduce the exposure, vulnerability and risk for each building. A risk indicator for each building, expressed as the expected damage associated to a given event, is derived by combining the building value and its vulnerability. (iii) The object-based hazards, exposures, vulnerabilities and risks can be scaled to any spatial unit desired. For this purpose we have developed an automated work flow building on the Python programming language in combination with ArcGIS and the R statistical software. This enables us to easily adapt the resulting risk indication maps to different zooming levels; to build statistics for various types of units; to flexibly react to the needs of the end users; and to account for the availability of reference data for validation. In the present study, we scale the results to the level of postal code zones. The evaluation of the results is based on loss reports of an insurance company and on photographs and videos obtained from various sources. We show a potential of the suggested work flow to reproduce the documented damages at the level of postal code zones. However, the results are very sensitive to the input parameters and model assumptions, and a robust back-calculation even of well-documented events remains a major challenge. Ultimately, we aim at integrating the procedure presented in a work flow for generating risk indication maps for pluvial flooding throughout the entire territory of Austria.

The neurobiological basis of human aggression: A review on genetic and epigenetic mechanisms.

PubMed

Waltes, Regina; Chiocchetti, Andreas G; Freitag, Christine M

2016-07-01

Aggression is an evolutionary conserved behavior present in most species including humans. Inadequate aggression can lead to long-term detrimental personal and societal effects. Here, we differentiate between proactive and reactive forms of aggression and review the genetic determinants of it. Heritability estimates of aggression in general vary between studies due to differing assessment instruments for aggressive behavior (AB) as well as age and gender of study participants. In addition, especially non-shared environmental factors shape AB. Current hypotheses suggest that environmental effects such as early life stress or chronic psychosocial risk factors (e.g., maltreatment) and variation in genes related to neuroendocrine, dopaminergic as well as serotonergic systems increase the risk to develop AB. In this review, we summarize the current knowledge of the genetics of human aggression based on twin studies, genetic association studies, animal models, and epigenetic analyses with the aim to differentiate between mechanisms associated with proactive or reactive aggression. We hypothesize that from a genetic perspective, the aminergic systems are likely to regulate both reactive and proactive aggression, whereas the endocrine pathways seem to be more involved in regulation of reactive aggression through modulation of impulsivity. Epigenetic studies on aggression have associated non-genetic risk factors with modifications of the stress response and the immune system. Finally, we point to the urgent need for further genome-wide analyses and the integration of genetic and epigenetic information to understand individual differences in reactive and proactive AB. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Validation of Preoperative Risk Grouping of the Selection of Patients Most Likely to Benefit From Neoadjuvant Chemotherapy Before Radical Cystectomy.

PubMed

Moschini, Marco; Soria, Francesco; Klatte, Tobias; Wirth, Gregory J; Özsoy, Mehmet; Gust, Killian; Briganti, Alberto; Roupret, Morgan; Susani, Martin; Haitel, Andrea; Shariat, Shahrokh F

2017-04-01

The aim of this study was to validate the value of preoperative patient characteristics in prognosticating survival after radical cystectomy (RC) to guide treatment decisions regarding neoadjuvant systemic treatment. We evaluated a single cohort of 449 consecutive patients treated with RC for bladder cancer. Patients treated with neoadjuvant therapy were excluded from the study cohort (n = 24). Patients were stratified based on preoperative characteristics into 2 risk groups. The high-risk group included patients harboring clinically non-organ-confined disease (≥ cT3), hydroureteronephrosis, lymphovascular invasion, or variant histology (micropapillary, neuroendocrine, sarcomatoid, or plasmacytoid variants on transurethral resection). The low-risk group included patients with cT2 disease without any of the aforementioned features. Survival expectancies after surgery were evaluated using competing risk and Kaplan-Meier analyses. We identified 153 (44.6%) low-risk and 190 (55.4%) high-risk patients. The majority of high-risk patients had only 1 high-risk feature (n = 111; 58.4%); the most common high-risk feature was preoperative hydroureteronephrosis (n = 107; 56.3%). The majority of low-risk patients were upstaged at time of RC (n = 118; 70.6%), whereas a pathologic downstage occurred only in 27 high-risk patients (14.2%). Cancer-specific mortality-free rates at 5 years after RC were 77.4% versus 64.4% for low-risk versus high-risk patients, respectively. We confirm that preoperative risk features can stratify patients with muscle-invasive bladder cancer into differential risk groups regarding survival. Decision-making regarding neoadjuvant systemic therapy administration is likely to be improved by integrating clinical stage, lymphovascular invasion, variant histology, and hydroureteronephrosis. Copyright © 2016 Elsevier Inc. All rights reserved.

An Integrated Learning System: Impact on At-Risk Students' Ninth Grade TAKS Mathematics Achievement

ERIC Educational Resources Information Center

Harris, Tina D.

2011-01-01

The purpose of this study was to determine the impact of an integrated learning system on students who were considered at-risk of academic failure on the Texas Assessment of Knowledge and Skills (TAKS) mathematics assessment. Voyager Math (VMath), an integrated learning system had been implemented to address the needs of students at-risk of…

Food and Feed Safety Assessment: The Importance of Proper Sampling.

PubMed

Kuiper, Harry A; Paoletti, Claudia

2015-03-24

The general principles for safety and nutritional evaluation of foods and feed and the potential health risks associated with hazardous compounds are described as developed by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) and further elaborated in the European Union-funded project Safe Foods. We underline the crucial role of sampling in foods/feed safety assessment. High quality sampling should always be applied to ensure the use of adequate and representative samples as test materials for hazard identification, toxicological and nutritional characterization of identified hazards, as well as for estimating quantitative and reliable exposure levels of foods/feed or related compounds of concern for humans and animals. The importance of representative sampling is emphasized through examples of risk analyses in different areas of foods/feed production. The Theory of Sampling (TOS) is recognized as the only framework within which to ensure accuracy and precision of all sampling steps involved in the field-to-fork continuum, which is crucial to monitor foods and feed safety. Therefore, TOS must be integrated in the well-established FAO/WHO risk assessment approach in order to guarantee a transparent and correct frame for the risk assessment and decision making process.

A brief intervention for at-risk drinking in an employee assistance program.

PubMed

Osilla, Karen Chan; Zellmer, Steven P; Larimer, Mary E; Neighbors, Clayton; Marlatt, G Alan

2008-01-01

The current pilot study examined the preliminary efficacy of a brief intervention (BI) for at-risk drinking in an employee assistance program. Clients (N = 107) entering the employee assistance program (EAP) for mental health services were screened and met criteria for at-risk drinking. EAP therapists were randomly assigned to deliver either the BI plus EAP services as usual (SAU) or SAU only. Participants in the final analyses consisted of 44 BI + SAU (30 women, 14 men) and 30 SAU (21 women, 9 men) EAP clients who completed a 3-month follow-up. Results suggested that participants in the BI + SAU group had significant reductions in peak blood alcohol concentration, peak quantity, and alcohol-related consequences compared with the SAU group. Men in the BI + SAU group had greater reductions in alcohol-related problems compared with men in the SAU group. Groups did not differ by number of total EAP sessions attended or rates of presenting problem resolution. Results provide preliminary evidence to support the integration of alcohol screening and BI as a low-cost method of intervening with clients with at-risk drinking in the context of co-occurring presenting problems.

On the Empirical Importance of the Conditional Skewness Assumption in Modelling the Relationship between Risk and Return

NASA Astrophysics Data System (ADS)

Pipień, M.

2008-09-01

We present the results of an application of Bayesian inference in testing the relation between risk and return on the financial instruments. On the basis of the Intertemporal Capital Asset Pricing Model, proposed by Merton we built a general sampling distribution suitable in analysing this relationship. The most important feature of our assumptions is that the skewness of the conditional distribution of returns is used as an alternative source of relation between risk and return. This general specification relates to Skewed Generalized Autoregressive Conditionally Heteroscedastic-in-Mean model. In order to make conditional distribution of financial returns skewed we considered the unified approach based on the inverse probability integral transformation. In particular, we applied hidden truncation mechanism, inverse scale factors, order statistics concept, Beta and Bernstein distribution transformations and also a constructive method. Based on the daily excess returns on the Warsaw Stock Exchange Index we checked the empirical importance of the conditional skewness assumption on the relation between risk and return on the Warsaw Stock Market. We present posterior probabilities of all competing specifications as well as the posterior analysis of the positive sign of the tested relationship.

Food and feed safety assessment: the importance of proper sampling.

PubMed

Kuiper, Harry A; Paoletti, Claudia

2015-01-01

The general principles for safety and nutritional evaluation of foods and feed and the potential health risks associated with hazardous compounds are described as developed by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) and further elaborated in the European Union-funded project Safe Foods. We underline the crucial role of sampling in foods/feed safety assessment. High quality sampling should always be applied to ensure the use of adequate and representative samples as test materials for hazard identification, toxicological and nutritional characterization of identified hazards, as well as for estimating quantitative and reliable exposure levels of foods/feed or related compounds of concern for humans and animals. The importance of representative sampling is emphasized through examples of risk analyses in different areas of foods/feed production. The Theory of Sampling (TOS) is recognized as the only framework within which to ensure accuracy and precision of all sampling steps involved in the field-to-fork continuum, which is crucial to monitor foods and feed safety. Therefore, TOS must be integrated in the well-established FAO/WHO risk assessment approach in order to guarantee a transparent and correct frame for the risk assessment and decision making process.

[How the information system can contribute to the implementation of a risk management program in a hospital?].

PubMed

Staccini, P; Quaranta, J F; Staccini-Myx, A; Veyres, P; Jambou, P

2003-09-01

Nowadays, information system is recognised as one of the key points of the management strategy. An information system is regarded conceptualised as a mean to link 3 aspects of a firm (structure, organisation rules and staff). Its design and implementation have to meet the objectives of medical and economical evaluation, especially risk management objectives. In order to identify, analyse, reduce and prevent the occurrence of adverse events, and also to measure the efficacy and efficiency of the production of care services, the design of information systems should be based on a process analysis in order to describe and classify all the working practices within the hospital. According to various methodologies (usually top-down analysis), each process can be divided into activities. Each activity (especially each care activity) can be described according to its potential risks and expected results. For care professionals performing a task, the access to official or internal guidelines and the adverse events reporting forms has also to be defined. Putting together all the elements of such a process analysis will contribute to integrate, into daily practice, the management of risks, supported by the information system.

Considerations in deriving quantitative cancer criteria for inorganic arsenic exposure via inhalation.

PubMed

Lewis, Ari S; Beyer, Leslie A; Zu, Ke

2015-01-01

The inhalation unit risk (IUR) that currently exists in the United States Environmental Protection Agency's (US EPA's) Integrated Risk Information System was developed in 1984 based on studies examining the relationship between respiratory cancer and arsenic exposure in copper smelters from two US locations: the copper smelter in Anaconda, Montana, and the American Smelting And Refining COmpany (ASARCO) smelter in Tacoma, Washington. Since US EPA last conducted its assessment, additional data have become available from epidemiology and mechanistic studies. In addition, the California Air Resources Board, Texas Commission of Environmental Quality, and Dutch Expert Committee on Occupational Safety have all conducted new risk assessments. All three analyses, which calculated IURs based on respiratory/lung cancer mortality, generated IURs that are lower (i.e., less restrictive) than the current US EPA value of 4.3×10(-3) (μg/m(3))(-1). The IURs developed by these agencies, which vary more than 20-fold, are based on somewhat different studies and use different methodologies to address uncertainties in the underlying datasets. Despite these differences, all were developed based on a cumulative exposure metric assuming a low-dose linear dose-response relationship. In this paper, we contrast and compare the analyses conducted by these agencies and critically evaluate strengths and limitations inherent in the data and methodologies used to develop quantitative risk estimates. In addition, we consider how these data could be best used to assess risk at much lower levels of arsenic in air, such as those experienced by the general public. Given that the mode of action for arsenic supports a threshold effect, and epidemiological evidence suggests that the arsenic concentration in air is a reliable predictor of lung/respiratory cancer risk, we developed a quantitative cancer risk analysis using a nonlinear threshold model. Applying a nonlinear model to occupational data, we established points of departure based on both cumulative exposure (μg/m(3)-years) to arsenic and arsenic concentration (μg/m(3)) via inhalation. Using these values, one can assess the lifetime risk of respiratory cancer mortality associated with ambient air concentrations of arsenic for the general US population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Risk factors for stress fractures.

PubMed

Bennell, K; Matheson, G; Meeuwisse, W; Brukner, P

1999-08-01

Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.

Use of surrogate indicators for the evaluation of potential health risks due to poor urban water quality: A Bayesian Network approach.

PubMed

Wijesiri, Buddhi; Deilami, Kaveh; McGree, James; Goonetilleke, Ashantha

2018-02-01

Urban water pollution poses risks of waterborne infectious diseases. Therefore, in order to improve urban liveability, effective pollution mitigation strategies are required underpinned by predictions generated using water quality models. However, the lack of reliability in current modelling practices detrimentally impacts planning and management decision making. This research study adopted a novel approach in the form of Bayesian Networks to model urban water quality to better investigate the factors that influence risks to human health. The application of Bayesian Networks was found to enhance the integration of quantitative and qualitative spatially distributed data for analysing the influence of environmental and anthropogenic factors using three surrogate indicators of human health risk, namely, turbidity, total nitrogen and fats/oils. Expert knowledge was found to be of critical importance in assessing the interdependent relationships between health risk indicators and influential factors. The spatial variability maps of health risk indicators developed enabled the initial identification of high risk areas in which flooding was found to be the most significant influential factor in relation to human health risk. Surprisingly, population density was found to be less significant in influencing health risk indicators. These high risk areas in turn can be subjected to more in-depth investigations instead of the entire region, saving time and resources. It was evident that decision making in relation to the design of pollution mitigation strategies needs to account for the impact of landscape characteristics on water quality, which can be related to risk to human health. Copyright © 2017 Elsevier Ltd. All rights reserved.

The need for transparency and reproducibility in documenting values for regulatory decision making and evaluating causality: The example of formaldehyde.

PubMed

Van Landingham, Cynthia; Mundt, Kenneth A; Allen, Bruce C; Gentry, P Robinan

2016-11-01

Reproducibility and transparency in scientific reporting is paramount to advancing science and providing the foundation required for sound regulation. Recent examples demonstrate that pivotal scientific findings cannot be replicated, due to poor documentation or methodological bias, sparking debate across scientific and regulatory communities. However, there is general agreement that improvements in communicating and documenting research and risk assessment methods are needed. In the case of formaldehyde, the peer-review conducted by a National Academy of Sciences (NAS) Committee questioned the approaches used by the Integrated Risk Information System (IRIS) in developing draft unit risk values. Using the original data from the key study (Beane Freeman et al., 2009) and documentation provided in the draft IRIS profile, we attempted to duplicate the reported inhalation unit risk values and address the NAS Committee's questions regarding application of the appropriate dose-response model. Overall, documentation of the methods lacked sufficient detail to allow for replication of the unit risk estimates, specifically for Hodgkin lymphoma and leukemias, the key systemic endpoints selected by IRIS. The lack of apparent exposure-response relationships for selected endpoints raises the question whether quantitative analyses are appropriate for these endpoints, and if so, how results are to be interpreted. Copyright © 2016. Published by Elsevier Inc.

Parental Discussion of Child Sexual Abuse: Is It Associated with the Parenting Practices of Involvement, Monitoring, and General Communication?

PubMed

Rudolph, Julia; Zimmer-Gembeck, Melanie J; Shanley, Dianne C; Walsh, Kerrryann; Hawkins, Russell

2018-01-01

We investigated whether parents who reported more positive parenting practices (i.e., monitoring, involvement, and communication) reported more discussion of child sexual abuse (CSA) with their children. Parents from Australia and the UK (N = 248), with children aged 6 to 11 years, completed an online survey. About half of parents reported directly discussing CSA, whereas 35% reported telling their children that CSA perpetrators may be family members. Rates of discussion were higher for other CSA-related topics such as body integrity and abduction. Correlational analyses showed that parents who reported speaking to their children about CSA also reported more positive parenting practices, more discussion of other sensitive topics, and assessed CSA risk for children (in general) to be higher. Discussion of CSA risk was not associated with parents' CSA knowledge, confidence or appraisal of own-child risk. Parents higher in positive parenting believed their children to be at less CSA risk. Parents who appraised higher own-child risk reported less positive parenting practices and were less confident about their parenting and their ability to protect their children from CSA. The findings are the first to report on the associations of parenting practices with parents' CSA discussion with their children.

The Reduction of Distress Using Therapeutic Geothermal Water Procedures in a Randomized Controlled Clinical Trial

PubMed Central

Rapolienė, Lolita; Razbadauskas, Artūras; Jurgelėnas, Antanas

2015-01-01

Stress is an element of each human's life and an indicator of its quality. Thermal mineral waters have been used empirically for the treatment of different diseases for centuries. Aim of the Study. To investigate the effects of highly mineralised geothermal water balneotherapy on distress and health risk. Methodology. A randomized controlled clinical trial was performed with 130 seafarers: 65 underwent 2 weeks of balneotherapy with 108 g/L full-mineralisation bath treatment; the others were in control group. The effect of distress was measured using the General Symptoms Distress Scale. Factorial and logistic regression analyses were used for statistical analysis. Results. A significant positive effect on distress (P < 0.001) was established after 2 weeks of treatment: the number of stress symptoms declined by 60%, while the intensity of stress symptoms reduced by 41%, and the control improved by 32%. Health risks caused by distress were reduced, and resources increased, whereas the probability of general health risk decreased by 18% (P = 0.01). Conclusion. Balneotherapy with highly mineralised geothermal water reduces distress, by reducing the health risk posed by distress by 26%, increasing the health resources by 11%, and reducing probability of general health risk by 18%. Balneotherapy is an effective preventive tool and can take a significant place in integrative medicine. PMID:25866680

An APOE-independent cis-eSNP on chromosome 19q13.32 influences tau levels and late-onset Alzheimer's disease risk.

PubMed

Rao, Shuquan; Ghani, Mahdi; Guo, Zhiyun; Deming, Yuetiva; Wang, Kesheng; Sims, Rebecca; Mao, Canquan; Yao, Yao; Cruchaga, Carlos; Stephan, Dietrich A; Rogaeva, Ekaterina

2018-06-01

Although multiple susceptibility loci for late-onset Alzheimer's disease (LOAD) have been identified, a large portion of the genetic risk for this disease remains unexplained. LOAD risk may be associated with single-nucleotide polymorphisms responsible for changes in gene expression (eSNPs). To detect eSNPs associated with LOAD, we integrated data from LOAD genome-wide association studies and expression quantitative trait loci using Sherlock (a Bayesian statistical method). We identified a cis-regulatory eSNP (rs2927438) located on chromosome 19q13.32, for which subsequent analyses confirmed the association with both LOAD risk and the expression level of several nearby genes. Importantly, rs2927438 may represent an APOE-independent LOAD eSNP according to the weak linkage disequilibrium of rs2927438 with the 2 polymorphisms (rs7412 and rs429358) defining the APOE-ε2, -ε3, and -ε4 alleles. Furthermore, rs2927438 does not influence chromatin interaction events at the APOE locus or cis-regulation of APOE expression. Further exploratory analysis revealed that rs2927438 is significantly associated with tau levels in the cerebrospinal fluid. Our findings suggest that rs2927438 may confer APOE-independent risk for LOAD. Copyright © 2017 Elsevier Inc. All rights reserved.

Quantitative risk analysis of oil storage facilities in seismic areas.

PubMed

Fabbrocino, Giovanni; Iervolino, Iunio; Orlando, Francesca; Salzano, Ernesto

2005-08-31

Quantitative risk analysis (QRA) of industrial facilities has to take into account multiple hazards threatening critical equipment. Nevertheless, engineering procedures able to evaluate quantitatively the effect of seismic action are not well established. Indeed, relevant industrial accidents may be triggered by loss of containment following ground shaking or other relevant natural hazards, either directly or through cascade effects ('domino effects'). The issue of integrating structural seismic risk into quantitative probabilistic seismic risk analysis (QpsRA) is addressed in this paper by a representative study case regarding an oil storage plant with a number of atmospheric steel tanks containing flammable substances. Empirical seismic fragility curves and probit functions, properly defined both for building-like and non building-like industrial components, have been crossed with outcomes of probabilistic seismic hazard analysis (PSHA) for a test site located in south Italy. Once the seismic failure probabilities have been quantified, consequence analysis has been performed for those events which may be triggered by the loss of containment following seismic action. Results are combined by means of a specific developed code in terms of local risk contour plots, i.e. the contour line for the probability of fatal injures at any point (x, y) in the analysed area. Finally, a comparison with QRA obtained by considering only process-related top events is reported for reference.

Potassium channel gene associations with joint processing speed and white matter impairments in schizophrenia.

PubMed

Bruce, H A; Kochunov, P; Paciga, S A; Hyde, C L; Chen, X; Xie, Z; Zhang, B; Xi, H S; O'Donnell, P; Whelan, C; Schubert, C R; Bellon, A; Ament, S A; Shukla, D K; Du, X; Rowland, L M; O'Neill, H; Hong, L E

2017-06-01

Patients with schizophrenia show decreased processing speed on neuropsychological testing and decreased white matter integrity as measured by diffusion tensor imaging, two traits shown to be both heritable and genetically associated indicating that there may be genes that influence both traits as well as schizophrenia disease risk. The potassium channel gene family is a reasonable candidate to harbor such a gene given the prominent role potassium channels play in the central nervous system in signal transduction, particularly in myelinated axons. We genotyped members of the large potassium channel gene family focusing on putatively functional single nucleotide polymorphisms (SNPs) in a population of 363 controls, 194 patients with schizophrenia spectrum disorder (SSD) and 28 patients with affective disorders with psychotic features who completed imaging and neuropsychological testing. We then performed three association analyses using three phenotypes - processing speed, whole-brain white matter fractional anisotropy (FA) and schizophrenia spectrum diagnosis. We extracted SNPs showing an association at a nominal P value of <0.05 with all three phenotypes in the expected direction: decreased processing speed, decreased FA and increased risk of SSD. A single SNP, rs8234, in the 3' untranslated region of voltage-gated potassium channel subfamily Q member 1 (KCNQ1) was identified. Rs8234 has been shown to affect KCNQ1 expression levels, and KCNQ1 levels have been shown to affect neuronal action potentials. This exploratory analysis provides preliminary data suggesting that KCNQ1 may contribute to the shared risk for diminished processing speed, diminished white mater integrity and increased risk of schizophrenia. © 2017 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

Relating plastic in the ocean to ecological harm, a review of recent progress in risk analysis

NASA Astrophysics Data System (ADS)

Schuyler, Q. A.; Hardesty, B. D.; Wilcox, C.; van Sebille, E.; Mallos, N. J.; Leonard, G. H.

2016-02-01

Plastic pollution in the ocean is emerging as a global environmental concern. Estimates suggest that we dump on the order of 8.4 million tons of plastic in the ocean each year. This plastic reaches substantial concentrations, with at sea sampling measuring densities over 580,000 items per square kilometer. However, it is difficult to relate this exposure to resulting ecological impacts. Animals dying due to plastic ingestion or entanglement may not was ahsore, and sampling at sea is expensive and infrequent. Thus demonstrating a direct relationship between plastic in the envioronment and harm to marine wildlife is challenging. Here we review current progress on risk assessment for impacts to marine wildlife from plastic pollution. The analyses we review range from expert elicitation to integrated statistical and physical models. They range widely in scope, from estimates at the individual level to who taxa analysis. Some of the analyses reach only to exposure to the pressure, whie others carry through to estimate demographic impacts and even mortality due to ingestion of or entanglement in plastic debris in the ocean. We summarize the results of these studies, and provide a roadmap for future contributions toward estimating the actual ecological impact of plastic pollution.

Lonely young adults in modern Britain: findings from an epidemiological cohort study.

PubMed

Matthews, Timothy; Danese, Andrea; Caspi, Avshalom; Fisher, Helen L; Goldman-Mellor, Sidra; Kepa, Agnieszka; Moffitt, Terrie E; Odgers, Candice L; Arseneault, Louise

2018-04-24

The aim of this study was to build a detailed, integrative profile of the correlates of young adults' feelings of loneliness, in terms of their current health and functioning and their childhood experiences and circumstances. Data were drawn from the Environmental Risk Longitudinal Twin Study, a birth cohort of 2232 individuals born in England and Wales in 1994 and 1995. Loneliness was measured when participants were aged 18. Regression analyses were used to test concurrent associations between loneliness and health and functioning in young adulthood. Longitudinal analyses were conducted to examine childhood factors associated with young adult loneliness. Lonelier young adults were more likely to experience mental health problems, to engage in physical health risk behaviours, and to use more negative strategies to cope with stress. They were less confident in their employment prospects and were more likely to be out of work. Lonelier young adults were, as children, more likely to have had mental health difficulties and to have experienced bullying and social isolation. Loneliness was evenly distributed across genders and socioeconomic backgrounds. Young adults' experience of loneliness co-occurs with a diverse range of problems, with potential implications for health in later life. The findings underscore the importance of early intervention to prevent lonely young adults from being trapped in loneliness as they age.

LIFESTAT - Living with statins: An interdisciplinary project on the use of statins as a cholesterol-lowering treatment and for cardiovascular risk reduction.

PubMed

Christensen, Christa Lykke; Wulff Helge, Jørn; Krasnik, Allan; Kriegbaum, Margit; Rasmussen, Lene Juel; Hickson, Ian D; Liisberg, Kasper Bering; Oxlund, Bjarke; Bruun, Birgitte; Lau, Sofie Rosenlund; Olsen, Maria Nathalie Angleys; Andersen, John Sahl; Heltberg, Andreas Søndergaard; Kuhlman, Anja Birk; Morville, Thomas Hoffmann; Dohlmann, Tine Lovsø; Larsen, Steen; Dela, Flemming

2016-07-01

LIFESTAT is an interdisciplinary project that leverages approaches and knowledge from medicine, the humanities and the social sciences to analyze the impact of statin use on health, lifestyle and well-being in cohorts of Danish citizens. The impetus for the study is the fact that 10% of the population in the Scandinavian countries are treated with statins in order to maintain good health and to avoid cardiovascular disease by counteracting high blood levels of cholesterol. The potential benefit of treatment with statins should be considered in light of evidence that statin use has prevalent and unintended side effects (e.g. myalgia, and glucose and exercise intolerance). The LIFESTAT project combines invasive human experiments, biomedical analyses, nationwide surveys, epidemiological studies, qualitative interviews, media content analyses, and ethnographic participant observations. The study investigates the biological consequences of statin treatment; determines the mechanism(s) by which statin use causes muscle and mitochondrial dysfunction; and analyzes achievement of treatment goals, people's perception of disease risk, media influence on people's risk and health perception, and the way people manage to live with the risk (personally, socially and technologically). CONCLUSIONS THE ORIGINALITY AND SUCCESS OF LIFESTAT DEPEND ON AND DERIVE FROM ITS INTERDISCIPLINARY APPROACH, IN WHICH THE DISCIPLINES CONVERGE INTO THOROUGH AND HOLISTIC STUDY AND DESCRIBE THE IMPACT OF STATIN USE ON THE EVERYDAY LIFE OF STATIN USERS THIS HAS THE POTENTIAL FOR MUCH GREATER BENEFIT THAN ANY ONE OF THE DISCIPLINES ALONE INTEGRATING TRADITIONAL DISCIPLINES PROVIDES NOVEL PERSPECTIVES ON POTENTIAL CURRENT AND FUTURE SOCIAL, MEDICAL AND PERSONAL BENEFITS OF STATIN USE. © 2016 the Nordic Societies of Public Health.

Urban Nexus Science for Future Cities: Focus on the Energy-Water-Food-X Nexus

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

Sperling, Joshua B.; Berke, Philip R.

Rapid urban expansion of the world's cities is placing unprecedented demands on the energy, water, food, and other (X) systems (e.g., mobility) that each offer multiple life-supporting services. Coordination that considers inter-sectoral connections among these urban systems and services remains nascent in practice, yet are critical to the future well-being, resource/operational efficiency, and resilience of urban areas. This paper therefore proposes an applied 'urban nexus science' framework to identify integrated and synergistic pathways toward achieving urban sustainability. The design, planning, and operation of urban W-E-F systems can benefit from integrated analyses to accelerate infrastructure, land use, and hazard mitigation planningmore » and decision-making. New knowledge quantifying the key effects of W-E-F systems designed in isolation versus an increasingly integrated systems, especially when exposed to hazards, health risks, or extreme events, are a critical need. Interactive system modeling and participatory technologies are needed to support stakeholder engagement and two-way (and multi-directional) information flow, for exploring outcomes of alternative solutions for integrating W-E-F sectors. To support such important efforts, research is needed to fill critical gaps in data, identify tradeoffs, and develop synergistic solutions that measure sustainability co-benefits based on different levels of urban integration among W-E-F systems and services.« less

Urban Nexus Science for Future Cities: Focus on the Energy-Water-Food-X Nexus

DOE PAGES

Sperling, Joshua B.; Berke, Philip R.

2017-08-25

Rapid urban expansion of the world's cities is placing unprecedented demands on the energy, water, food, and other (X) systems (e.g., mobility) that each offer multiple life-supporting services. Coordination that considers inter-sectoral connections among these urban systems and services remains nascent in practice, yet are critical to the future well-being, resource/operational efficiency, and resilience of urban areas. This paper therefore proposes an applied 'urban nexus science' framework to identify integrated and synergistic pathways toward achieving urban sustainability. The design, planning, and operation of urban W-E-F systems can benefit from integrated analyses to accelerate infrastructure, land use, and hazard mitigation planningmore » and decision-making. New knowledge quantifying the key effects of W-E-F systems designed in isolation versus an increasingly integrated systems, especially when exposed to hazards, health risks, or extreme events, are a critical need. Interactive system modeling and participatory technologies are needed to support stakeholder engagement and two-way (and multi-directional) information flow, for exploring outcomes of alternative solutions for integrating W-E-F sectors. To support such important efforts, research is needed to fill critical gaps in data, identify tradeoffs, and develop synergistic solutions that measure sustainability co-benefits based on different levels of urban integration among W-E-F systems and services.« less

How Confident can we be in Flood Risk Assessments?

NASA Astrophysics Data System (ADS)

Merz, B.

2017-12-01

Flood risk management should be based on risk analyses quantifying the risk and its reduction for different risk reduction strategies. However, validating risk estimates by comparing model simulations with past observations is hardly possible, since the assessment typically encompasses extreme events and their impacts that have not been observed before. Hence, risk analyses are strongly based on assumptions and expert judgement. This situation opens the door for cognitive biases, such as `illusion of certainty', `overconfidence' or `recency bias'. Such biases operate specifically in complex situations with many factors involved, when uncertainty is high and events are probabilistic, or when close learning feedback loops are missing - aspects that all apply to risk analyses. This contribution discusses how confident we can be in flood risk assessments, and reflects about more rigorous approaches towards their validation.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

ScienceCinema

None

2018-01-16

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Climate Change Impacts and Adaptation on Southwestern DoD Facilities

DTIC Science & Technology

2017-03-03

integrating climate change risks into decision priorities. 15. SUBJECT TERMS adaptation, baseline sensitivity, climate change, climate exposure...four bases we found that integrating climate change risks into the current decision matrix, by linking projected risks to current or past impacts...data and decision tools and methods. Bases have some capacity to integrate climate-related information, but they have limited resources to undertake

Integrating Climate and Risk-Informed Science to Support Critical Decisions

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

None

2016-07-27

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Self-injurious behaviour in people with intellectual disability and autism spectrum disorder.

PubMed

Oliver, Chris; Licence, Lucy; Richards, Caroline

2017-03-01

This review summarises the recent trends in research in the field of self-injurious behaviour in people with intellectual disability and autism spectrum disorder. New data on incidence, persistence and severity add to studies of prevalence to indicate the large scale of the clinical need. A number of person characteristics have been repeatedly identified in prevalence and cohort studies that: can be considered as risk markers (e.g. stereotyped behaviour, autism spectrum disorder) and indicate possible causal mechanisms (e.g. sleep disorder, anxiety). Studies have started to integrate traditional operant learning paradigms with known person characteristics and reviews and meta-analyses of applied behaviour analytic procedures can now inform practice. Despite these positive developments interventions and appropriate support falls far short of the required need. Expansions in applied research are warranted to develop and evaluate innovative service delivery models that can translate knowledge of risk markers and operant learning paradigms into widespread, low cost routine clinical practice. Alongside this, further pure research is needed to elucidate the direction of causality of implicated risk factors, in order to understand and intervene more effectively in self-injury.

Towards a comprehensive assessment and framework for low and high flow water risks

NASA Astrophysics Data System (ADS)

Motschmann, Alina; Huggel, Christian; Drenkhan, Fabian; León, Christian

2017-04-01

Driven by international organizations such as the Intergovernmental Panel on Climate Change (IPCC) the past years have seen a move from a vulnerability concept of climate change impacts towards a risk framework. Risk is now conceived at the intersection of climate-driven hazard and socioeconomic-driven vulnerability and exposure. The concept of risk so far has been mainly adopted for sudden-onset events. However, for slow-onset and cumulative climate change impacts such as changing water resources there is missing clarity and experience how to apply a risk framework. Research has hardly dealt with the challenge of how to integrate both low and high flow risks in a common framework. Comprehensive analyses of risks related to water resources considering climate change within multi-dimensional drivers across different scales are complex and often missing in climate-sensitive mountain regions where data scarcity and inconsistencies represent important limitations. Here we review existing vulnerability and risk assessments of low and high flow water conditions and identify critical conceptual and practical gaps. Based on this, we develop an integrated framework for low and high flow water risks which is applicable to both past and future conditions. The framework explicitly considers a water balance model simulating both water supply and demand on a daily basis. We test and apply this new framework in the highly glacierized Santa River catchment (SRC, Cordillera Blanca, Peru), representative for many developing mountain regions with both low and high flow water risks and poor data availability. In fact, in the SRC, both low and high flow hazards, such as droughts and floods, play a central role especially for agricultural, hydropower, domestic and mining use. During the dry season (austral winter) people are increasingly affected by water scarcity due to shrinking glaciers supplying melt water. On the other hand during the wet season (austral summer) high flow water risks are associated with hazards such as floods and debris flows and high socioeconomic vulnerability and exposure of e. g. infrastructure. Nonetheless, comprehensive water resource risk studies have barely been developed in the SRC and other developing high-mountain regions. To consider all components of risks as well as the economic and social conditions for different processes, a comprehensive risk assessment is needed. The urgency of this matter is emphasized by recent social conflicts in the SRC and the tropical Andes in general, related to prevailing drought conditions in combination with weak state institutions and unequal decision-making as well as differentiated perspectives on low flow versus high flow risks.

Using integrated environmental modeling to automate a process-based Quantitative Microbial Risk Assessment

EPA Science Inventory

Integrated Environmental Modeling (IEM) organizes multidisciplinary knowledge that explains and predicts environmental-system response to stressors. A Quantitative Microbial Risk Assessment (QMRA) is an approach integrating a range of disparate data (fate/transport, exposure, an...

Using Integrated Environmental Modeling to Automate a Process-Based Quantitative Microbial Risk Assessment (presentation)

EPA Science Inventory

Integrated Environmental Modeling (IEM) organizes multidisciplinary knowledge that explains and predicts environmental-system response to stressors. A Quantitative Microbial Risk Assessment (QMRA) is an approach integrating a range of disparate data (fate/transport, exposure, and...

Systemic Approach for Health Risk Assessment of Ambient Air Concentrations of Benzene in Petrochemical Environments: Integration of Fuzzy Logic, Artificial Neural Network, and IRIS Toxicity Method

PubMed Central

NOVIN, Vahid; GIVEHCHI, Saeed; HOVEIDI, Hassan

2016-01-01

Background: Reliable methods are crucial to cope with uncertainties in the risk analysis process. The aim of this study is to develop an integrated approach to assessing risks of benzene in the petrochemical plant that produces benzene. We offer an integrated system to contribute imprecise variables into the health risk calculation. Methods: The project was conducted in Asaluyeh, southern Iran during the years from 2013 to 2014. Integrated method includes fuzzy logic and artificial neural networks. Each technique had specific computational properties. Fuzzy logic was used for estimation of absorption rate. Artificial neural networks can decrease the noise of the data so applied for prediction of benzene concentration. First, the actual exposure was calculated then it combined with Integrated Risk Information System (IRIS) toxicity factors to assess real health risks. Results: High correlation between the measured and predicted benzene concentration was achieved (R2= 0.941). As for variable distribution, the best estimation of risk in a population implied 33% of workers exposed less than 1×10−5 and 67% inserted between 1.0×10−5 to 9.8×10−5 risk levels. The average estimated risk of exposure to benzene for entire work zones is equal to 2.4×10−5, ranging from 1.5×10−6 to 6.9×10−5. Conclusion: The integrated model is highly flexible as well as the rules possibly will be changed according to the necessities of the user in a different circumstance. The measured exposures can be duplicated well through proposed model and realistic risk assessment data will be produced. PMID:27957464

CLIMATE CHANGE RISK ASSESSMENT FRAMEWORK (CCRAF)

EPA Science Inventory

Development of a numerical framework that integrates socio-economic and physical drivers of greenhouse gas emissions, related climate changes and risks and benefits of alternative responses to perceived change or risks. The project integrates and extends existing peer-reviewed m...

Total Risk Integrated Methodology (TRIM) - TRIM.Risk

EPA Pesticide Factsheets

TRIM.Riskis used to integrate the information on exposure received from TRIM.FaTE or TRIM.Expo with that on dose-response or hazard assessment and to provide quantitative descriptions of risk or hazard and some of the attendant uncertainties.

Prediction of breast cancer risk by genetic risk factors, overall and by hormone receptor status.

PubMed

Hüsing, Anika; Canzian, Federico; Beckmann, Lars; Garcia-Closas, Montserrat; Diver, W Ryan; Thun, Michael J; Berg, Christine D; Hoover, Robert N; Ziegler, Regina G; Figueroa, Jonine D; Isaacs, Claudine; Olsen, Anja; Viallon, Vivian; Boeing, Heiner; Masala, Giovanna; Trichopoulos, Dimitrios; Peeters, Petra H M; Lund, Eiliv; Ardanaz, Eva; Khaw, Kay-Tee; Lenner, Per; Kolonel, Laurence N; Stram, Daniel O; Le Marchand, Loïc; McCarty, Catherine A; Buring, Julie E; Lee, I-Min; Zhang, Shumin; Lindström, Sara; Hankinson, Susan E; Riboli, Elio; Hunter, David J; Henderson, Brian E; Chanock, Stephen J; Haiman, Christopher A; Kraft, Peter; Kaaks, Rudolf

2012-09-01

There is increasing interest in adding common genetic variants identified through genome wide association studies (GWAS) to breast cancer risk prediction models. First results from such models showed modest benefits in terms of risk discrimination. Heterogeneity of breast cancer as defined by hormone-receptor status has not been considered in this context. In this study we investigated the predictive capacity of 32 GWAS-detected common variants for breast cancer risk, alone and in combination with classical risk factors, and for tumours with different hormone receptor status. Within the Breast and Prostate Cancer Cohort Consortium, we analysed 6009 invasive breast cancer cases and 7827 matched controls of European ancestry, with data on classical breast cancer risk factors and 32 common gene variants identified through GWAS. Discriminatory ability with respect to breast cancer of specific hormone receptor-status was assessed with the age adjusted and cohort-adjusted concordance statistic (AUROC(a)). Absolute risk scores were calculated with external reference data. Integrated discrimination improvement was used to measure improvements in risk prediction. We found a small but steady increase in discriminatory ability with increasing numbers of genetic variants included in the model (difference in AUROC(a) going from 2.7% to 4%). Discriminatory ability for all models varied strongly by hormone receptor status. Adding information on common polymorphisms provides small but statistically significant improvements in the quality of breast cancer risk prediction models. We consistently observed better performance for receptor-positive cases, but the gain in discriminatory quality is not sufficient for clinical application.

Exploring methods to minimize the risk of mosquitoes in rainwater harvesting systems

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Gan, Kein; Delbridge, Nathan

2016-12-01

Rainwater harvesting in residential homes is emerging as an important complement to centralized water supplies in urban centres around the world. Domestic rainwater harvesting systems provide a variety of benefits for water management and contribute to sustainable and integrated urban water management. There are however risks associated with rainwater harvesting that requires appropriate mitigation. One such risk is that systems can become breeding grounds for mosquitoes. This can constitute a significant health risk through the spread of mosquito-borne diseases (i.e. arbovirus and malaria). This paper explores the extent to which mosquitoes breed in rainwater harvesting systems as well as the effectiveness of different risk mitigation actions. Data were sourced from a large-scale domestic rainwater tank inspection survey undertaken in Melbourne and were analysed using simple Bayesian Network models. The observed rate of mosquito breeding was too high and was identified as a serious concern for health officials and water managers. The most common access routes into the tank system were found to be through the tank inlet or overflow. By exploring different system set-ups it was found that in order to mitigate the risk of mosquito breeding in tanks, all potential access routes must be adequately sealed. The complete eradication of mosquitos in rainwater tanks, however, may need further investigation, as 4% of systems with adequate protection at the inlet and overflow were still found to have mosquitoes in them.

Genetic Biopsy for Prediction of Surveillance Intervals after Endoscopic Resection of Colonic Polyps: Results of the GENESIS Study

PubMed Central

Berger, Andreas W; Raedler, Katja; Langner, Cord; Ludwig, Leopold; Dikopoulos, Nektarios; Becker, Karl F; Slotta-Huspenina, Julia; Quante, Michael; Schwerdel, Daniel; Perkhofer, Lukas; Kleger, Alexander; Zizer, Eugen; Oswald, Franz; Seufferlein, Thomas; Meining, Alexander

2017-01-01

Background and objective Current surveillance strategies for colorectal cancer following polypectomy are determined by endoscopic and histopathological factors. Such a distinction has been challenged. The present study was designed to identify molecular parameters in colonic polyps potentially defining new sub-groups at risk. Methods One hundred patients were enrolled in this multicentre study. Polyps biopsies underwent formalin-free processing (PAXgene, PreAnalytiX) and targeted next generation sequencing (38 genes (QIAGEN), NextSeq 500 platform (Illumina)). Genetic and histopathological analyses were done blinded to other data. Results In 100 patients, 224 polyps were removed. Significant associations of genetic alterations with endoscopic or histological polyp characteristics were observed for BRAF, KRAS, TCF7L2, FBXW7 and CTNNB1 mutations. Multivariate analysis revealed that polyps ≥ 10 mm have a significant higher relative risk for harbouring oncogene mutations (relative risk 3.467 (1.742–6.933)). Adenomas and right-sided polyps are independent risk factors for CTNNB1 mutations (relative risk 18.559 (2.371–145.245) and 12.987 (1.637–100.00)). Conclusions Assessment of the mutational landscape of polyps can be integrated in the workflow of current colonoscopy practice. There are distinct genetic patterns related to polyp size and location. These results suffice to optimise individual risk calculation and may help to better define surveillance intervals. PMID:29511559

GPS navigation algorithms for Autonomous Airborne Refueling of Unmanned Air Vehicles

NASA Astrophysics Data System (ADS)

Khanafseh, Samer Mahmoud

Unmanned Air Vehicles (UAVs) have recently generated great interest because of their potential to perform hazardous missions without risking loss of life. If autonomous airborne refueling is possible for UAVs, mission range and endurance will be greatly enhanced. However, concerns about UAV-tanker proximity, dynamic mobility and safety demand that the relative navigation system meets stringent requirements on accuracy, integrity, and continuity. In response, this research focuses on developing high-performance GPS-based navigation architectures for Autonomous Airborne Refueling (AAR) of UAVs. The AAR mission is unique because of the potentially severe sky blockage introduced by the tanker. To address this issue, a high-fidelity dynamic sky blockage model was developed and experimentally validated. In addition, robust carrier phase differential GPS navigation algorithms were derived, including a new method for high-integrity reacquisition of carrier cycle ambiguities for recently-blocked satellites. In order to evaluate navigation performance, world-wide global availability and sensitivity covariance analyses were conducted. The new navigation algorithms were shown to be sufficient for turn-free scenarios, but improvement in performance was necessary to meet the difficult requirements for a general refueling mission with banked turns. Therefore, several innovative methods were pursued to enhance navigation performance. First, a new theoretical approach was developed to quantify the position-domain integrity risk in cycle ambiguity resolution problems. A mechanism to implement this method with partially-fixed cycle ambiguity vectors was derived, and it was used to define tight upper bounds on AAR navigation integrity risk. A second method, where a new algorithm for optimal fusion of measurements from multiple antennas was developed, was used to improve satellite coverage in poor visibility environments such as in AAR. Finally, methods for using data-link extracted measurements as an additional inter-vehicle ranging measurement were also introduced. The algorithms and methods developed in this work are generally applicable to realize high-performance GPS-based navigation in partially obstructed environments. Navigation performance for AAR was quantified through covariance analysis, and it was shown that the stringent navigation requirements for this application are achievable. Finally, a real-time implementation of the algorithms was developed and successfully validated in autopiloted flight tests.

Relationships Between Performance on Assessments of Executive Function and Fall Risk Screening Measures in Community-Dwelling Older Adults.

PubMed

Blackwood, Jennifer; Shubert, Tiffany; Forgarty, Kieran; Chase, Carla

2016-01-01

Fall-related injuries are a leading cause of institutionalization and morbidity in older adults. Limitations in cognition, including deficits in higher cognitive processes, like executive function (EF), contribute to a higher risk of falling in older adults. Specifically, declines in EF have been associated with changes in gait, limited mobility, and an increased frequency of falling. It is unknown whether associations between performance on commonly used clinical assessments of EF and performance on commonly used physical performance measures of fall risk are present. The purpose of this study was to examine the relationship between a clinical measure of EF, the Trail Making Test Part B (TMT-B), and 3 physical performance measures of fall risk: the Timed Up and Go (TUG) test, gait speed, and the Five Times Sit to Stand (FTSTS) test, in a group of community-dwelling older adults. Forty-seven community-dwelling older adults met the inclusion/exclusion criteria. Demographic information was obtained and measures of fall risk and cognition were performed. Correlations and linear regression analyses to assess relationships between measures were completed. To account for the high prevalence of mild cognitive impairment (MCI) in this population, the sample was screened and stratified for MCI in post hoc analyses. The EF performance was not significantly correlated with performance on the FTSTS test (ρ = 0.26, P > .05) but was significantly correlated with the TUG test (ρ = 0.31, P < .05) and gait speed (r = -0.36, P < .05). These relationships remained after adjusting for age and education in multivariate models. Results from post hoc analyses demonstrated that only those with MCI had significant relationships between EF and physical performance measures. TMT-B scores in the MCI group were significantly correlated with gait speed (ρ = -0.51, P < .05) and TUG test (ρ = 0.58, P < .05). A significant relationship exists between performance on clinical assessments of EF and fall risk assessments that integrate a mobility task for those individuals who screen positive for MCI. For those who screened negative, no significant relationship exists. Given the large prevalence of undiagnosed MCI in community-dwelling older adults, this finding could be used as an indication to screen older adults for MCI. Screening tools that require cognitive resources such as gait speed appear to have significant relationships with performance of EF for those who screen positive for MCI. This information could be used clinically to identify older adults with cognitive limitations, which could put them at higher risk for falling.

Substance Use, Depression and Sociodemographic Determinants of HIV Sexual Risk Behavior in Outpatient Substance Abuse Treatment Patients.

PubMed

Tross, Susan; Feaster, Daniel J; Thorens, Gabriel; Duan, Rui; Gomez, Zoilyn; Pavlicova, Martina; Hu, Mei Chen; Kyle, Tiffany; Erickson, Sarah; Spector, Anya; Haynes, Louise; Metsch, Lisa R

2015-01-01

The NIDA Clinical Trials Network trial of rapid HIV testing/counseling in 1281 patients was a unique opportunity to examine relationships among substance use, depressive symptoms, and sex risk behavior. Past 6-month substance use; substance use severity (Drug Abuse Screening Test - 10); depressive symptoms (Quick Inventory of Depressive Symptomatology); and three types of sex risk behavior (unprotected sex occasions [USOs] with primary partners; USOs with nonprimary partners; and USOs while high/drunk) were assessed. Zero-inflated negative binomial analyses provided: probability and rate of sex risk behavior (in risk behavior subsample). Levels of sexual risk behavior were high, while variable across the three types of sex risk behaviors. Among the patients, 50.4% had engaged in USOs with primary partners, 42% in sex while drunk or high, and 23.8% in USOs with nonprimary partners. Similar factors were significantly associated with all three types of sex risk behaviors. For all types, problem drinking, cocaine use, and substance use severity had an exacerbating effect. Older age was associated with lower risk behavior; other relationship categories (eg, married, separated/divorced, cohabitating) were associated with greater risk behavior than was single status. Depressive symptoms were associated with decreased likelihood of USOs with a primary partner. Sexual risk behavior is common among individuals in outpatient substance abuse treatment. Results highlight problem drinking (eg, up to three-fold) and cocaine (eg, up to twice) in increasing sex risk behavior. They demonstrate the utility of distinguishing between partner types and presence/absence of alcohol/drugs during sex. Findings argue for the need to integrate sex risk reduction into drug treatment.

University Lawyers: A Study of Legal Risk, Risk Management and Role in Work Integrated Learning Programmes

ERIC Educational Resources Information Center

Cameron, Craig; Klopper, Christopher

2015-01-01

Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…

Comparison of risk estimates using life-table methods.

PubMed

Sullivan, R E; Weng, P S

1987-08-01

Risk estimates promulgated by various radiation protection authorities in recent years have become increasingly more complex. Early "integral" estimates in the form of health effects per 0.01 person-Gy (per person-rad) or per 10(4) person-Gy (per 10(6) person-rad) have tended to be replaced by "differential" estimates which are age- and sex-dependent and specify both minimum induction (latency) and duration of risk expression (plateau) periods. These latter types of risk estimate must be used in conjunction with a life table in order to reduce them to integral form. In this paper, the life table has been used to effect a comparison of the organ and tissue risk estimates derived in several recent reports. In addition, a brief review of life-table methodology is presented and some features of the models used in deriving differential coefficients are discussed. While the great number of permutations possible with dose-response models, detailed risk estimates and proposed projection models precludes any unique result, the reduced integral coefficients are required to conform to the linear, absolute-risk model recommended for use with the integral risk estimates reviewed.

Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

PubMed

Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

2015-01-13

An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a longitudinal manner, for ED visits across all payers, all diseases, and all age groups. Therefore, providers can implement targeted care management strategies to the patient subgroups with similar patterns of clinical histories, driving the delivery of more efficient and effective health care interventions. To the best of our knowledge, this prospectively validated EMR-based, Web-based tool is the first one to allow real-time total population risk assessment for statewide ED visits.

Can Vertical Integration Reduce Hospital Readmissions? A Difference-in-Differences Approach.

PubMed

Lopes, Sílvia; Fernandes, Óscar B; Marques, Ana Patrícia; Moita, Bruno; Sarmento, João; Santana, Rui

2017-05-01

Vertical integration is expected to improve communication and coordination between inpatient care and care after discharge. Despite being used across health systems worldwide, evidence about its impact on readmissions is sparse and contradictory. To assess the impact of vertical integration on hospital readmissions. Using difference-in-differences we compared readmissions before and after vertical integration in 6 Portuguese hospitals for years 2004-2013. A control group with 6 similar hospitals not integrated was utilized. Considered outcome was 30-day unplanned readmission. We used logistic regression at the admission level and accounted for patients' risk factors using claims data. Analyses for each hospital and selected conditions were also run. Our results suggest that readmissions decreased overall after vertical integration [odds ratio (OR)=0.900; 95% confidence interval (CI), 0.812-0.997]. Hospital analysis indicated that there was no impact for 2 hospitals (OR=0.960; 95% CI, 0.848-1.087 and OR=0.944; 95% CI, 0.857-1.038), and a positive effect in 4 hospitals (greatest effect: OR=0.811; 95% CI, 0.736-0.894). A positive evolution was observed for a limited number of conditions, with better results for diabetes with complications (OR=0.689; 95% CI, 0.525-0.904), but no impact regarding congestive heart failure (OR=1.067; 95% CI, 0.827-1.377). Merging acute and primary care providers was associated with reduced readmissions, even though improvements were not found for all institutions or condition-specific groups. There are still challenges to be addressed regarding the success of vertical integration in reducing 30-day hospital readmissions.

Spatial clustering of childhood leukaemia with the integration of the Paediatric Environmental History.

PubMed

Cárceles-Álvarez, Alberto; Ortega-García, Juan A; López-Hernández, Fernando A; Orozco-Llamas, Mayra; Espinosa-López, Blanca; Tobarra-Sánchez, Esther; Alvarez, Lizbeth

2017-07-01

Leukaemia remains the most common type of paediatric cancer and its aetiology remains unknown, but considered to be multifactorial. It is suggested that the initiation in utero by relevant exposures and/or inherited genetic variants and, other promotional postnatal exposures are probably required to develop leukaemia. This study aimed to map the incidence and analyse possible clusters in the geographical distribution of childhood acute leukaemia during the critical periods and to evaluate the factors that may be involved in the aetiology by conducting community and individual risk assessments. We analysed all incident cases of acute childhood leukaemia (<15 years) diagnosed in a Spanish region during the period 1998-2013. At diagnosis, the addresses during pregnancy, early childhood and diagnosis were collected and codified to analyse the spatial distribution of acute leukaemia. Scan statistical test methodology was used for the identification of high-incidence spatial clusters. Once identified, individual and community risk assessments were conducted using the Paediatric Environmental History. A total of 158 cases of acute leukaemia were analysed. The crude rate for the period was 42.7 cases per million children. Among subtypes, acute lymphoblastic leukaemia had the highest incidence (31.9 per million children). A spatial cluster of acute lymphoblastic leukaemia was detected using the pregnancy address (p<0.05). The most common environmental risk factors related with the aetiology of acute lymphoblastic leukaemia, identified by the Paediatric Environmental History were: prenatal exposure to tobacco (75%) and alcohol (50%); residential and community exposure to pesticides (62.5%); prenatal or neonatal ionizing radiation (42.8%); and parental workplace exposure (37.5%) CONCLUSIONS: Our study suggests that environmental exposures in utero may be important in the development of childhood leukaemia. Due to the presence of high-incidence clusters using pregnancy address, it is necessary to introduce this address into the childhood cancer registers. The Paediatric Environmental History which includes pregnancy address and a careful and comprehensive evaluation of the environmental exposures will allow us to build the knowledge of the causes of childhood leukaemia. Copyright © 2017 Elsevier Inc. All rights reserved.

The Application of Integrated Knowledge-based Systems for the Biomedical Risk Assessment Intelligent Network (BRAIN)

NASA Technical Reports Server (NTRS)

Loftin, Karin C.; Ly, Bebe; Webster, Laurie; Verlander, James; Taylor, Gerald R.; Riley, Gary; Culbert, Chris; Holden, Tina; Rudisill, Marianne

1993-01-01

One of NASA's goals for long duration space flight is to maintain acceptable levels of crew health, safety, and performance. One way of meeting this goal is through the Biomedical Risk Assessment Intelligent Network (BRAIN), an integrated network of both human and computer elements. The BRAIN will function as an advisor to flight surgeons by assessing the risk of in-flight biomedical problems and recommending appropriate countermeasures. This paper describes the joint effort among various NASA elements to develop BRAIN and an Infectious Disease Risk Assessment (IDRA) prototype. The implementation of this effort addresses the technological aspects of the following: (1) knowledge acquisition; (2) integration of IDRA components; (3) use of expert systems to automate the biomedical prediction process; (4) development of a user-friendly interface; and (5) integration of the IDRA prototype and Exercise Countermeasures Intelligent System (ExerCISys). Because the C Language, CLIPS (the C Language Integrated Production System), and the X-Window System were portable and easily integrated, they were chosen as the tools for the initial IDRA prototype. The feasibility was tested by developing an IDRA prototype that predicts the individual risk of influenza. The application of knowledge-based systems to risk assessment is of great market value to the medical technology industry.

Using integrated environmental modeling to automate a process-based Quantitative Microbial Risk Assessment

USDA-ARS?s Scientific Manuscript database

Integrated Environmental Modeling (IEM) organizes multidisciplinary knowledge that explains and predicts environmental-system response to stressors. A Quantitative Microbial Risk Assessment (QMRA) is an approach integrating a range of disparate data (fate/transport, exposure, and human health effect...

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...

Social Integration and Reduced Risk of Coronary Heart Disease in Women: The Role of Lifestyle Behaviors

PubMed Central

Chang, Shun-Chiao; Glymour, Maria; Cornelis, Marilyn; Walter, Stefan; Rimm, Eric B.; Tchetgen, Eric Tchetgen; Kawachi, Ichiro; Kubzansky, Laura D.

2017-01-01

Rationale Higher social integration is associated with lower cardiovascular mortality; however, whether it is associated with incident coronary heart disease (CHD), especially in women, and if associations differ by case fatality is unclear. Objectives This study sought to examine the associations between social integration and risk of incident CHD in a large female prospective cohort. Methods and Results 76,362 women in the Nurses’ Health Study (NHS), free of CHD and stroke at baseline (1992), were followed until 2014. Social integration was assessed by a simplified Berkman-Syme Social Network Index every 4 years. Endpoints included nonfatal myocardial infarction (MI) and fatal CHD. 2,372 incident CHD events occurred throughout follow-up. Adjusting for demographic, health/medical risk factors and depressive symptoms, being socially integrated was significantly associated with lower CHD risk, particularly fatal CHD. The most socially integrated women had a hazard ratio of 0.55 (95% confidence interval, 0.41–0.73) of developing fatal CHD compared to those least socially integrated (p-for-trend < 0.0001). When additionally adjusting for lifestyle behaviors, findings for fatal CHD were maintained but attenuated (p-for-trend = 0.02) whereas the significant associations no longer remained for nonfatal MI. The inverse associations between social integration and nonfatal MI risk were largely explained by health-promoting behaviors, particularly through differences in cigarette smoking; however, the association with fatal CHD risk remained after accounting for these behaviors and thus may involve more direct biological mechanisms. Conclusions Social integration is inversely associated with CHD incidence in women, but is largely explained by lifestyle/behavioral pathways. PMID:28373350

Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

PubMed Central

Roland, Martin; Lewis, Richard; Steventon, Adam; Abel, Gary; Adams, John; Bardsley, Martin; Brereton, Laura; Chitnis, Xavier; Conklin, Annalijn; Staetsky, Laura; Tunkel, Sarah; Ling, Tom

2012-01-01

Introduction In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner’s Chronic Care Model. Methods Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3646 patients and 17,311 matched controls, and changes in overall secondary care utilisation. Results Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes. Conclusion Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve patient experience, case management approaches need to be introduced in a way which respects patients’ wishes, for example the ability to see a familiar doctor or nurse. PMID:23593045

Reappraisal of previously reported meta-analyses on antibiotic prophylaxis for low-risk laparoscopic cholecystectomy: an overview of systematic reviews

PubMed Central

Matsui, Yoichi; Satoi, Sohei; Hirooka, Satoshi; Kosaka, Hisashi; Kawaura, Takayuki; Kitawaki, Tomoki

2018-01-01

Introduction Many researchers have addressed overdosage and inappropriate use of antibiotics. Many meta-analyses have investigated antibiotic prophylaxis for low-risk laparoscopic cholecystectomy with the aim of reducing unnecessary antibiotic use. Most of these meta-analyses have concluded that prophylactic antibiotics are not required for low-risk laparoscopic cholecystectomies. This study aimed to assess the validity of this conclusion by systematically reviewing these meta-analyses. Methods A systematic review was undertaken. Searches were limited to meta-analyses and systematic reviews. PubMed and Cochrane Library electronic databases were searched from inception until March 2016 using the following keyword combinations: ‘antibiotic prophylaxis’, ‘laparoscopic cholecystectomy’ and ‘systematic review or meta-analysis’. Two independent reviewers selected meta-analyses or systematic reviews evaluating prophylactic antibiotics for laparoscopic cholecystectomy. All of the randomised controlled trials (RCTs) analysed in these meta-analyses were also reviewed. Results Seven meta-analyses regarding prophylactic antibiotics for low-risk laparoscopic cholecystectomy that had examined a total of 28 RCTs were included. Review of these meta-analyses revealed 48 miscounts of the number of outcomes. Six RCTs were inappropriate for the meta-analyses; one targeted patients with acute cholecystitis, another measured inappropriate outcomes, the original source of a third was not found and the study protocols of the remaining three were not appropriate for the meta-analyses. After correcting the above miscounts and excluding the six inappropriate RCTs, pooled risk ratios (RRs) were recalculated. These showed that, contrary to what had previously been concluded, antibiotics significantly reduced the risk of postoperative infections. The rates of surgical site, distant and overall infections were all significantly reduced by antibiotic administration (RR (95% CI); 0.71 (0.51 to 0.99), 0.37 (0.19 to 0.73), 0.50 (0.34 to 0.75), respectively). Conclusions Prophylactic antibiotics reduce the incidence of postoperative infections after elective laparoscopic cholecystectomy. PMID:29549197

The Necessity of Functional Analysis for Space Exploration Programs

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Breidenthal, Julian C.

2011-01-01

As NASA moves toward expanded commercial spaceflight within its human exploration capability, there is increased emphasis on how to allocate responsibilities between government and commercial organizations to achieve coordinated program objectives. The practice of program-level functional analysis offers an opportunity for improved understanding of collaborative functions among heterogeneous partners. Functional analysis is contrasted with the physical analysis more commonly done at the program level, and is shown to provide theoretical performance, risk, and safety advantages beneficial to a government-commercial partnership. Performance advantages include faster convergence to acceptable system solutions; discovery of superior solutions with higher commonality, greater simplicity and greater parallelism by substituting functional for physical redundancy to achieve robustness and safety goals; and greater organizational cohesion around program objectives. Risk advantages include avoidance of rework by revelation of some kinds of architectural and contractual mismatches before systems are specified, designed, constructed, or integrated; avoidance of cost and schedule growth by more complete and precise specifications of cost and schedule estimates; and higher likelihood of successful integration on the first try. Safety advantages include effective delineation of must-work and must-not-work functions for integrated hazard analysis, the ability to formally demonstrate completeness of safety analyses, and provably correct logic for certification of flight readiness. The key mechanism for realizing these benefits is the development of an inter-functional architecture at the program level, which reveals relationships between top-level system requirements that would otherwise be invisible using only a physical architecture. This paper describes the advantages and pitfalls of functional analysis as a means of coordinating the actions of large heterogeneous organizations for space exploration programs.

A Methodology for Conducting Integrative Mixed Methods Research and Data Analyses

PubMed Central

Castro, Felipe González; Kellison, Joshua G.; Boyd, Stephen J.; Kopak, Albert

2011-01-01

Mixed methods research has gained visibility within the last few years, although limitations persist regarding the scientific caliber of certain mixed methods research designs and methods. The need exists for rigorous mixed methods designs that integrate various data analytic procedures for a seamless transfer of evidence across qualitative and quantitative modalities. Such designs can offer the strength of confirmatory results drawn from quantitative multivariate analyses, along with “deep structure” explanatory descriptions as drawn from qualitative analyses. This article presents evidence generated from over a decade of pilot research in developing an integrative mixed methods methodology. It presents a conceptual framework and methodological and data analytic procedures for conducting mixed methods research studies, and it also presents illustrative examples from the authors' ongoing integrative mixed methods research studies. PMID:22167325

An evaluation of the effectiveness of a risk-based monitoring approach implemented with clinical trials involving implantable cardiac medical devices.

PubMed

Diani, Christopher A; Rock, Angie; Moll, Phil

2017-12-01

Background Risk-based monitoring is a concept endorsed by the Food and Drug Administration to improve clinical trial data quality by focusing monitoring efforts on critical data elements and higher risk investigator sites. BIOTRONIK approached this by implementing a comprehensive strategy that assesses risk and data quality through a combination of operational controls and data surveillance. This publication demonstrates the effectiveness of a data-driven risk assessment methodology when used in conjunction with a tailored monitoring plan. Methods We developed a data-driven risk assessment system to rank 133 investigator sites comprising 3442 subjects and identify those sites that pose a potential risk to the integrity of data collected in implantable cardiac device clinical trials. This included identification of specific risk factors and a weighted scoring mechanism. We conducted trend analyses for risk assessment data collected over 1 year to assess the overall impact of our data surveillance process combined with other operational monitoring efforts. Results Trending analyses of key risk factors revealed an improvement in the quality of data collected during the observation period. The three risk factors follow-up compliance rate, unavailability of critical data, and noncompliance rate correspond closely with Food and Drug Administration's risk-based monitoring guidance document. Among these three risk factors, 100% (12/12) of quantiles analyzed showed an increase in data quality. Of these, 67% (8/12) of the improving trends in worst performing quantiles had p-values less than 0.05, and 17% (2/12) had p-values between 0.05 and 0.06. Among the poorest performing site quantiles, there was a statistically significant decrease in subject follow-up noncompliance rates, protocol noncompliance rates, and incidence of missing critical data. Conclusion One year after implementation of a comprehensive strategy for risk-based monitoring, including a data-driven risk assessment methodology to target on-site monitoring visits, statistically significant improvement was seen in a majority of measurable risk factors at the worst performing site quantiles. For the three risk factors which are most critical to the overall compliance of cardiac rhythm management medical device studies: follow-up compliance rate, unavailability of critical data, and noncompliance rate, we measured significant improvement in data quality. Although the worst performing site quantiles improved but not significantly in some risk factors such as subject attrition, the data-driven risk assessment highlighted key areas on which to continue focusing both on-site and centralized monitoring efforts. Data-driven surveillance of clinical trial performance provides actionable observations that can improve site performance. Clinical trials utilizing risk-based monitoring by leveraging a data-driven quality assessment combined with specific operational procedures may lead to an improvement in data quality and resource efficiencies.

An Integrated Approach to Risk Assessment for Concurrent Design

NASA Technical Reports Server (NTRS)

Meshkat, Leila; Voss, Luke; Feather, Martin; Cornford, Steve

2005-01-01

This paper describes an approach to risk assessment and analysis suited to the early phase, concurrent design of a space mission. The approach integrates an agile, multi-user risk collection tool, a more in-depth risk analysis tool, and repositories of risk information. A JPL developed tool, named RAP, is used for collecting expert opinions about risk from designers involved in the concurrent design of a space mission. Another in-house developed risk assessment tool, named DDP, is used for the analysis.

[Urban ecological risk assessment: a review].

PubMed

Wang, Mei-E; Chen, Wei-Ping; Peng, Chi

2014-03-01

With the development of urbanization and the degradation of urban living environment, urban ecological risks caused by urbanization have attracted more and more attentions. Based on urban ecology principles and ecological risk assessment frameworks, contents of urban ecological risk assessment were reviewed in terms of driven forces, risk resources, risk receptors, endpoints and integrated approaches for risk assessment. It was suggested that types and degrees of urban economical and social activities were the driven forces for urban ecological risks. Ecological functional components at different levels in urban ecosystems as well as the urban system as a whole were the risk receptors. Assessment endpoints involved in changes of urban ecological structures, processes, functional components and the integrity of characteristic and function. Social-ecological models should be the major approaches for urban ecological risk assessment. Trends for urban ecological risk assessment study should focus on setting a definite protection target and criteria corresponding to assessment endpoints, establishing a multiple-parameter assessment system and integrative assessment approaches.

Exploring the roots of unintended safety threats associated with the introduction of hospital ePrescribing systems and candidate avoidance and/or mitigation strategies: a qualitative study.

PubMed

Mozaffar, Hajar; Cresswell, Kathrin M; Williams, Robin; Bates, David W; Sheikh, Aziz

2017-09-01

Hospital electronic prescribing (ePrescribing) systems offer a wide range of patient safety benefits. Like other hospital health information technology interventions, however, they may also introduce new areas of risk. Despite recent advances in identifying these risks, the development and use of ePrescribing systems is still leading to numerous unintended consequences, which may undermine improvement and threaten patient safety. These negative consequences need to be analysed in the design, implementation and use of these systems. We therefore aimed to understand the roots of these reported threats and identify candidate avoidance/mitigation strategies. We analysed a longitudinal, qualitative study of the implementation and adoption of ePrescribing systems in six English hospitals, each being conceptualised as a case study. Data included semistructured interviews, observations of implementation meetings and system use, and a collection of relevant documents. We analysed data first within and then across the case studies. Our dataset included 214 interviews, 24 observations and 18 documents. We developed a taxonomy of factors underlying unintended safety threats in: (1) suboptimal system design, including lack of support for complex medication administration regimens, lack of effective integration between different systems, and lack of effective automated decision support tools; (2) inappropriate use of systems-in particular, too much reliance on the system and introduction of workarounds; and (3) suboptimal implementation strategies resulting from partial roll-outs/dual systems and lack of appropriate training. We have identified a number of system and organisational strategies that could potentially avoid or reduce these risks. Imperfections in the design, implementation and use of ePrescribing systems can give rise to unintended consequences, including safety threats. Hospitals and suppliers need to implement short- and long-term strategies in terms of the technology and organisation to minimise the unintended safety risks. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Bayesian Framework for Water Quality Model Uncertainty Estimation and Risk Management

EPA Science Inventory

A formal Bayesian methodology is presented for integrated model calibration and risk-based water quality management using Bayesian Monte Carlo simulation and maximum likelihood estimation (BMCML). The primary focus is on lucid integration of model calibration with risk-based wat...

[Future status of ischaemic heart disease in the state of San Luis Potosí: A predictive dynamic model].

PubMed

Gaytán-Hernández, Darío; Díaz-Oviedo, Aracely; Gallegos-García, Verónica; Terán-Figueroa, Yolanda

To develop a predictive dynamic model to generate and analyse the future status of the incidence rate of ischaemic heart disease in a population of 25 years and over in Mexico, according to the variation in time of some risk factors. Retrospective ecological study performed during the period 2013-2015, in San Luis Potosí City, Mexico. Secondary databases that corresponded to the years 2000, 2005, and 2010, were used along with official indicators of the 58 municipalities of the state of San Luis Potosí. Eight indicators were analysed at municipality level, using principal components analysis, structural equation modelling, dynamic modelling, and simulation software methods. Three components were extracted, which together explained 80.43% of the total variance of the official indicators used. The second component had a weight of 16.36 units that favoured an increase of the disease analysed. This component was integrated only by the indicator AGE 60-64 and the expected stage of it increasing. The structural model confirmed that the indicators explain 42% of the variation of this disease. The possible stages for the years 2015, 2020, and 2025 are 195.7, 240.7, and 298.0, respectively for every 100,000 inhabitants aged 25 and over. An exponential increase in the incidence rate of ischaemic heart disease is expected, with the age of 60-64 years being identified as the highest risk factor. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

Application of crowdsourced hail data and damage information for hail risk assessment in the province of Styria, Austria

NASA Astrophysics Data System (ADS)

Tani, Satyanarayana; Rechberger, Andreas; Süsser Rechberger, Barbara; Teschl, Reinhard; Paulitsch, Helmut

2017-04-01

Hail storm damage is a major concern to the farmers in the province of Styria, Austria. Each year severe hail storms are causing damages to crops, resulting in losses of millions of euros. High spatial and timely ground truth information of the hail event and crop damage measurements are essential for better hail risk assessment. Usually, hail pad networks and visual damage surveys are used to collect the hail data and corresponding damage information. However, these hail pad networks are expensive and need laborious maintenance. The traditional crop damage assessment approaches are very labour-intensive and time-consuming. The advancements in information and communication technology (ICT) and the power of citizen based crowdsourcing data, will help to overcome these problems and ultimately provide a platform for data collection. A user-friendly and bilingual web interface was developed to collect hail data and crop damage information in the province of Styria, Austria. The dynamic web interface was developed using HTML5, JavaScript, and PHP7 combined with a MySQL database back-end. OpenStreetMap was integrated into the web interface and tile server optimised for an easy identification of geolocation information. The user needs an internet connection to transfer the data through smartphone or computer. Crowdsourced data will be quality tested and evaluated with 3D single polarisation C-band weather radar data to remove potential false reports. Further, the relationship between the reported hail events and radar-based hail detection algorithms (Waldvogel and Auer) and derived hail signature information intended for crop hail risk assessment will be investigated. The details about the web interface tool, application and verification methods to collect, analyse, and integrate different data sets are given. Further, the high spatial risk assessment information is communicated to support risk management policy.

Risk-based damage potential and loss estimation of extreme flooding scenarios in the Austrian Federal Province of Tyrol

NASA Astrophysics Data System (ADS)

Huttenlau, M.; Stötter, J.; Stiefelmeyer, H.

2010-12-01

Within the last decades serious flooding events occurred in many parts of Europe and especially in 2005 the Austrian Federal Province of Tyrol was serious affected. These events in general and particularly the 2005 event have sensitised decision makers and the public. Beside discussions pertaining to protection goals and lessons learnt, the issue concerning potential consequences of extreme and severe flooding events has been raised. Additionally to the general interest of the public, decision makers of the insurance industry, public authorities, and responsible politicians are especially confronted with the question of possible consequences of extreme events. Answers thereof are necessary for the implementation of preventive appropriate risk management strategies. Thereby, property and liability losses reflect a large proportion of the direct tangible losses. These are of great interest for the insurance sector and can be understood as main indicators to interpret the severity of potential events. The natural scientific-technical risk analysis concept provides a predefined and structured framework to analyse the quantities of affected elements at risk, their corresponding damage potentials, and the potential losses. Generally, this risk concept framework follows the process steps hazard analysis, exposition analysis, and consequence analysis. Additionally to the conventional hazard analysis, the potential amount of endangered elements and their corresponding damage potentials were analysed and, thereupon, concrete losses were estimated. These took the specific vulnerability of the various individual elements at risk into consideration. The present flood risk analysis estimates firstly the general exposures of the risk indicators in the study area and secondly analyses the specific exposures and consequences of five extreme event scenarios. In order to precisely identify, localize, and characterize the relevant risk indicators of buildings, dwellings and inventory, vehicles, and individuals, a detailed geodatabase of the existing stock of elements and values was established on a single object level. Therefore, the localized and functional differentiated stock of elements was assessed monetarily on the basis of derived representative mean insurance values. Thus, well known difference factors between the analysis of the stock of elements and values on local and on regional scale could be reduced considerably. The spatial join of the results of the hazard analysis with the stock of elements and values enables the identification and quantification of the elements at risk and their corresponding damage potential. Thereupon, Extreme Scenario Losses (ESL) were analysed under consideration of different vulnerability approaches which describe the individual element's specific susceptibility. This results in scenario-specific ranges of ESL rather than in single values. The exposure analysis of the general endangerment in Tyrol identifies (i) 105 330 individuals, (ii) 20 272 buildings and 50 157 dwellings with a corresponding damage potential of approx. EUR 20 bn. and (iii) 62 494 vehicles with a corresponding damage potential of EUR 1 bn. Depending on the individual extreme event scenarios, the ESL solely to buildings and inventory vary between EUR 0.9-1.3 bn. for the scenario with the least ESL and EUR 2.2-2.5 bn. for the most serious scenarios. The correlation of the private property losses to buildings and inventory with further direct tangible loss categories on the basis of investigation after the event in 2005, results in potential direct tangible ESL of up to EUR 7.6 bn. Apart from the specific study results a general finding shows that beside the further development of modelling capabilities and scenario concepts, the key to considerably decrease uncertainties of integral flood risk analyses is the development and implementation of more precise methods. These are to determine the stock of elements and values and to evaluate the vulnerability or susceptibility of affected structures to certain flood characteristics more differentiated.

Models Extracted from Text for System-Software Safety Analyses

NASA Technical Reports Server (NTRS)

Malin, Jane T.

2010-01-01

This presentation describes extraction and integration of requirements information and safety information in visualizations to support early review of completeness, correctness, and consistency of lengthy and diverse system safety analyses. Software tools have been developed and extended to perform the following tasks: 1) extract model parts and safety information from text in interface requirements documents, failure modes and effects analyses and hazard reports; 2) map and integrate the information to develop system architecture models and visualizations for safety analysts; and 3) provide model output to support virtual system integration testing. This presentation illustrates the methods and products with a rocket motor initiation case.

Climate change adaptation and Integrated Water Resource Management in the water sector

NASA Astrophysics Data System (ADS)

Ludwig, Fulco; van Slobbe, Erik; Cofino, Wim

2014-10-01

Integrated Water Resources Management (IWRM) was introduced in 1980s to better optimise water uses between different water demanding sectors. However, since it was introduced water systems have become more complicated due to changes in the global water cycle as a result of climate change. The realization that climate change will have a significant impact on water availability and flood risks has driven research and policy making on adaptation. This paper discusses the main similarities and differences between climate change adaptation and IWRM. The main difference between the two is the focus on current and historic issues of IWRM compared to the (long-term) future focus of adaptation. One of the main problems of implementing climate change adaptation is the large uncertainties in future projections. Two completely different approaches to adaptation have been developed in response to these large uncertainties. A top-down approach based on large scale biophysical impacts analyses focussing on quantifying and minimizing uncertainty by using a large range of scenarios and different climate and impact models. The main problem with this approach is the propagation of uncertainties within the modelling chain. The opposite is the bottom up approach which basically ignores uncertainty. It focusses on reducing vulnerabilities, often at local scale, by developing resilient water systems. Both these approaches however are unsuitable for integrating into water management. The bottom up approach focuses too much on socio-economic vulnerability and too little on developing (technical) solutions. The top-down approach often results in an “explosion” of uncertainty and therefore complicates decision making. A more promising direction of adaptation would be a risk based approach. Future research should further develop and test an approach which starts with developing adaptation strategies based on current and future risks. These strategies should then be evaluated using a range of future scenarios in order to develop robust adaptation measures and strategies.

Spatial characterization, risk assessment, and statistical source identification of the dissolved trace elements in the Ganjiang River-feeding tributary of the Poyang Lake, China.

PubMed

Zhang, Hua; Jiang, Yinghui; Wang, Min; Wang, Peng; Shi, Guangxun; Ding, Mingjun

2017-01-01

Surface water samples were collected from 20 sampling sites throughout the Ganjiang River during pre-monsoon, monsoon, and post-monsoon seasons, and the concentrations of dissolved trace elements were determined by inductively coupled plasma-mass spectrometry (ICP-MS) for the spatial and seasonal variations, risk assessment, source identification, and categorization for risk area. The result demonstrated that concentrations of the elements exhibited significant seasonality. The high total element concentrations were detected at sites close to the intensive mining and urban activities. The concentrations of the elements were under the permissible limits as prescribed by related standards with a few exceptions. The most of heavy metal pollution index (HPI) values were lower than the critical index limit, indicating the basically clean water used as habitat for aquatic life. As was identified as the priority pollutant of non-carcinogenic and carcinogenic concerns, and the inhabitants ingesting the surface water at particular site might be subjected to the integrated health risks for exposure to the mixed trace elements. Multivariate statistical analyses confirmed that Zn, As, Cd, and Tl were derived from mining and urban activities; V, Cd, and Pb exhibited mixed origin; and Co, Ni, and Cu mainly resulted from natural processes. Three categorized risk areas corresponded to high, moderate, and low risks, respectively. As a whole, the upstream of the Ganjiang River was identified as the high-risk area relatively.

Postauthorization safety study of the DPP-4 inhibitor saxagliptin: a large-scale multinational family of cohort studies of five outcomes

PubMed Central

Carbonari, Dena M; Saine, M Elle; Newcomb, Craig W; Roy, Jason A; Liu, Qing; Wu, Qufei; Cardillo, Serena; Haynes, Kevin; Kimmel, Stephen E; Reese, Peter P; Margolis, David J; Apter, Andrea J; Reddy, K Rajender; Hennessy, Sean; Bhullar, Harshvinder; Gallagher, Arlene M; Esposito, Daina B; Strom, Brian L

2017-01-01

Objective To evaluate the risk of serious adverse events among patients with type 2 diabetes mellitus initiating saxagliptin compared with oral antidiabetic drugs (OADs) in classes other than dipeptidyl peptidase-4 (DPP-4) inhibitors. Research design and methods Cohort studies using 2009–2014 data from two UK medical record data sources (Clinical Practice Research Datalink, The Health Improvement Network) and two USA claims-based data sources (HealthCore Integrated Research Database, Medicare). All eligible adult patients newly prescribed saxagliptin (n=110 740) and random samples of up to 10 matched initiators of non-DPP-4 inhibitor OADs within each data source were selected (n=913 384). Outcomes were hospitalized major adverse cardiovascular events (MACE), acute kidney injury (AKI), acute liver failure (ALF), infections, and severe hypersensitivity events, evaluated using diagnostic coding algorithms and medical records. Cox regression was used to determine HRs with 95% CIs for each outcome. Meta-analyses across data sources were performed for each outcome as feasible. Results There were no increased incidence rates or risk of MACE, AKI, ALF, infection, or severe hypersensitivity reactions among saxagliptin initiators compared with other OAD initiators within any data source. Meta-analyses demonstrated a reduced risk of hospitalization/death from MACE (HR 0.91, 95% CI 0.85 to 0.97) and no increased risk of hospitalization for infection (HR 0.97, 95% CI 0.93 to 1.02) or AKI (HR 0.99, 95% CI 0.88 to 1.11) associated with saxagliptin initiation. ALF and hypersensitivity events were too rare to permit meta-analysis. Conclusions Saxagliptin initiation was not associated with increased risk of MACE, infection, AKI, ALF, or severe hypersensitivity reactions in clinical practice settings. Trial registration number NCT01086280, NCT01086293, NCT01086319, NCT01086306, and NCT01377935; Results. PMID:28878934

Mortality and long-term exposure to ambient air pollution: ongoing analyses based on the American Cancer Society cohort.

PubMed

Krewski, Daniel; Burnett, Richard; Jerrett, Michael; Pope, C Arden; Rainham, Daniel; Calle, Eugenia; Thurston, George; Thun, Michael

This article provides an overview of previous analysis and reanalysis of the American Cancer Society (ACS) cohort, along with an indication of current ongoing analyses of the cohort with additional follow-up information through to 2000. Results of the first analysis conducted by Pope et al. (1995) showed that higher average sulfate levels were associated with increased mortality, particularly from cardiopulmonary disease. A reanalysis of the ACS cohort, undertaken by Krewski et al. (2000), found the original risk estimates for fine-particle and sulfate air pollution to be highly robust against alternative statistical techniques and spatial modeling approaches. A detailed investigation of covariate effects found a significant modifying effect of education with risk of mortality associated with fine particles declining with increasing educational attainment. Pope et al. (2002) subsequently reported results of a subsequent study using an additional 10 yr of follow-up of the ACS cohort. This updated analysis included gaseous copollutant and new fine-particle measurements, more comprehensive information on occupational exposures, dietary variables, and the most recent developments in statistical modeling integrating random effects and nonparametric spatial smoothing into the Cox proportional hazards model. Robust associations between ambient fine particulate air pollution and elevated risks of cardiopulmonary and lung cancer mortality were clearly evident, providing the strongest evidence to date that long-term exposure to fine particles is an important health risk. Current ongoing analysis using the extended follow-up information will explore the role of ecologic, economic, and, demographic covariates in the particulate air pollution and mortality association. This analysis will also provide insight into the role of spatial autocorrelation at multiple geographic scales, and whether critical instances in time of exposure to fine particles influence the risk of mortality from cardiopulmonary and lung cancer. Information on the influence of covariates at multiple scales and of critical exposure time windows can assist policymakers in establishing timelines for regulatory interventions that maximize population health benefits.

Characterization and Fate of Gun and Rocket Propellant Residues on Testing and Training Ranges

DTIC Science & Technology

2008-01-01

ext/reg_e.html. 36. United States Environmental Protection Agency (2007) Integrated Risk Information System: Hydrogen cyanide, http://www.epa.gov/ iris ...Environmental Protection Agency (2007) Integrated Risk Information System: Benzene, http://www.epa.gov/ iris /subst/0276.htm 42. United States Environmental...Protection Agency (2007) Integrated Risk Information System: Toluene, http://www.epa.gov/ iris /subst/0118.htm. 43. National Library of Medicine’s TOXNET

Tell Me What I Need to Know: What Mayors and Governors Want From Their Fusion Center

DTIC Science & Technology

2009-09-01

jurisdictions where daily risks and threats emerge from the complexities of an integrated world. Paradoxically, as will be outlined through this...environment for their jurisdictions where daily risks and threats emerge from the complexities of an integrated world. Paradoxically, as will be outlined...their jurisdictions where daily risks and threats emerge from the complexities of an integrated world. This setting, where the confluence of

Life cycle of petroleum biodegradation metabolite plumes, and implications for risk management at fuel release sites.

PubMed

Zemo, Dawn A; O'Reilly, Kirk T; Mohler, Rachel E; Magaw, Renae I; Espino Devine, Catalina; Ahn, Sungwoo; Tiwary, Asheesh K

2017-07-01

This paper summarizes the results of a 5-y research study of the nature and toxicity of petroleum biodegradation metabolites in groundwater at fuel release sites that are quantified as diesel-range "Total Petroleum Hydrocarbons" (TPH; also known as TPHd, diesel-range organics (DRO), etc.), unless a silica gel cleanup (SGC) step is used on the sample extract prior to the TPH analysis. This issue is important for site risk management in regulatory jurisdictions that use TPH as a metric; the presence of these metabolites may preclude site closure even if all other factors can be considered "low-risk." Previous work has shown that up to 100% of the extractable organics in groundwater at petroleum release sites can be biodegradation metabolites. The metabolites can be separated from the hydrocarbons by incorporating an SGC step; however, regulatory agency acceptance of SGC has been inconsistent because of questions about the nature and toxicity of the metabolites. The present study was conducted to answer these specific questions. Groundwater samples collected from source and downgradient wells at fuel release sites were extracted and subjected to targeted gas chromatography-mass spectrometry (GC-MS) and nontargeted two-dimensional gas chromatography with time-of-flight mass spectrometry (GC×GC-MS) analyses, and the metabolites identified in each sample were classified according to molecular structural classes and assigned an oral reference dose (RfD)-based toxicity ranking. Our work demonstrates that the metabolites identified in groundwater at biodegrading fuel release sites are in classes ranked as low toxicity to humans and are not expected to pose significant risk to human health. The identified metabolites naturally attenuate in a predictable manner, with an overall trend to an increasingly higher proportion of organic acids and esters, and a lower human toxicity profile, and a life cycle that is consistent with the low-risk natural attenuation paradigm adopted by many regulatory agencies for petroleum release sites. Integr Environ Assess Manag 2017;13:714-727. © 2016 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2016 The Authors. Integrated Environmental Assessment and Management Published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Adolescent mental health education InSciEd Out: a case study of an alternative middle school population.

PubMed

Yang, Joanna; Lopez Cervera, Roberto; Tye, Susannah J; Ekker, Stephen C; Pierret, Chris

2018-04-03

Mental illness contributes substantially to global disease burden, particularly when illness onset occurs during youth and help-seeking is delayed and/or limited. Yet, few mental health promotion interventions target youth, particularly those with or at high risk of developing mental illness ("at-risk" youth). Community-based translational research has the capacity to identify and intervene upon barriers to positive health outcomes. This is especially important for integrated care in at-risk youth populations. Here the Integrated Science Education Outreach (InSciEd Out) program delivered a novel school-based anti-stigma intervention in mental health to a cohort of seventh and eighth grade at-risk students. These students were assessed for changes in mental health knowledge, stigmatization, and help-seeking intentions via a classroom activity, surveys, and teacher interviews. Descriptive statistics and Cohen's d effect sizes were employed to assess pre-post changes. Inferential statistical analyses were also conducted on pilot results to provide a benchmark to inform future studies. Elimination of mental health misconceptions (substance weakness p = 0.00; recovery p = 0.05; prevention p = 0.05; violent p = 0.05) was accompanied by slight gains in mental health literacy (d = 0.18) and small to medium improvements in help-seeking intentions (anxiety d = 0.24; depression d = 0.48; substance d = 0.43; psychosis d = 0.53). Within this particular cohort of students, stigma was exceptionally low at baseline and remained largely unchanged. Teacher narratives revealed positive teacher views of programming, increased student openness to talk about mental illness, and higher peer and self-acceptance of mental health diagnoses and help-seeking. Curricular-based efforts focused on mental illness in an alternative school setting are feasible and integrated well into general curricula under the InSciEd Out framework. Preliminary data suggest the existence of unique help-seeking barriers in at-risk youth. Increased focus upon community-based programming has potential to bridge gaps in translation, bringing this critical population to clinical care in pursuit of improved mental health for all. Trial registration ClinicalTrials.gov, ID:NCT02680899. Registered 12 February 2016, https://clinicaltrials.gov/ct2/show/NCT02680899.

Integrating payer and provider risk through capitation.

PubMed

Barth, S M

1997-01-01

Capitation payment mechanisms promote conservative use of medical resources by transferring risk to the decision maker, the physician. However, there is another view of capitation: defining common risk between provider-driven organizations (i.e., physician/hospital organizations (PHOs) or integrated delivery systems (IDS), and risk-managing entities such as HMOs or insurance companies. This article discusses a strategy to align provider and risk manager incentives to share the risks and rewards for a total book of business or population.

Risk assessment of integrated electronic health records.

PubMed

Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri

2010-01-01

The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems.

An integrated science-based methodology to assess potential risks and implications of engineered nanomaterials

EPA Science Inventory

There is an urgent need for broad and integrated studies that address the risks of engineered nanomaterials (ENMs) along the different endpoints of the society, environment, and economy (SEE) complex adaptive system. This article presents an integrated science-based methodology ...

Solar power satellite system definition study. Volume 3: Operations and systems synthesis, phase 2

NASA Technical Reports Server (NTRS)

1979-01-01

The results of the operations analyses are reported. Some of these analyses examined operations aspects of space vehicle in-space maintenance. Many of the analyses explored in great depth operations concerned the LEO Base cargo handling operations. Personnel transportation operations and cargo packaging were also analyzed. These operations analyses were performed to define the operational requirements for all of the SPS system elements so that equipment and facilities could be synthesized, and to make estimates of the manpower requirements. An overall, integrated, end-to-end description of the SPS operations is presented. The detailed operations analyses, upon which this integrated description was based, are included.

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults.

PubMed

Munro-Kramer, Michelle L; Fava, Nicole M; Saftner, Melissa A; Darling-Fisher, Cynthia S; Tate, Nutrena H; Stoddard, Sarah A; Martyn, Kristy K

2016-09-01

Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. ©2016 American Association of Nurse Practitioners.

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults

PubMed Central

Munro-Kramer, Michelle L.; Fava, Nicole M.; Saftner, Melissa A.; Darling-Fisher, Cynthia S.; Tate, Nutrena H.; Stoddard, Sarah A.; Martyn, Kristy K.

2016-01-01

Background and Purpose Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (15-23 years old) within their life context, as well as the association between these behaviors. Methods A secondary analysis of data on a subset of Arab-American participants obtained from a randomized control trial were utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n=24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n=57). Conclusions Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life events, and (b) minimal risk behaviors and positive life events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. Implications for Practice The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. PMID:26990394

The early identification of risk factors on the pathway to school dropout in the SIODO study: a sequential mixed-methods study.

PubMed

Theunissen, Marie-José; Griensven van, Ilse; Verdonk, Petra; Feron, Frans; Bosma, Hans

2012-11-27

School dropout is a persisting problem with major socioeconomic consequences. Although poor health probably contributes to pathways leading to school dropout and health is likely negatively affected by dropout, these issues are relatively absent on the public health agenda. This emphasises the importance of integrative research aimed at identifying children at risk for school dropout at an early stage, discovering how socioeconomic status and gender affect health-related pathways that lead to dropout and developing a prevention tool that can be used in public health services for youth. The SIODO study is a sequential mixed-methods study. A case-control study will be conducted among 18 to 24 year olds in the south of the Netherlands (n = 580). Data are currently being collected from compulsory education departments at municipalities (dropout data), regional public health services (developmental data from birth onwards) and an additional questionnaire has been sent to participants (e.g. personality data). Advanced analyses, including cluster and factor analyses, will be used to identify children at risk at an early stage. Using the quantitative data, we have planned individual interviews with participants and focus groups with important stakeholders such as parents, teachers and public health professionals. A thematic content analysis will be used to analyse the qualitative data. The SIODO study will use a life-course perspective, the ICF-CY model to group the determinants and a mixed-methods design. In this respect, the SIODO study is innovative because it both broadens and deepens the study of health-related determinants of school dropout. It examines how these determinants contribute to socioeconomic and gender differences in health and contributes to the development of a tool that can be used in public health practice to tackle the problem of school dropout at its roots.

A Combined Pathway and Regional Heritability Analysis Indicates NETRIN1 Pathway Is Associated With Major Depressive Disorder.

PubMed

Zeng, Yanni; Navarro, Pau; Fernandez-Pujals, Ana M; Hall, Lynsey S; Clarke, Toni-Kim; Thomson, Pippa A; Smith, Blair H; Hocking, Lynne J; Padmanabhan, Sandosh; Hayward, Caroline; MacIntyre, Donald J; Wray, Naomi R; Deary, Ian J; Porteous, David J; Haley, Chris S; McIntosh, Andrew M

2017-02-15

Genome-wide association studies (GWASs) of major depressive disorder (MDD) have identified few significant associations. Testing the aggregation of genetic variants, in particular biological pathways, may be more powerful. Regional heritability analysis can be used to detect genomic regions that contribute to disease risk. We integrated pathway analysis and multilevel regional heritability analyses in a pipeline designed to identify MDD-associated pathways. The pipeline was applied to two independent GWAS samples [Generation Scotland: The Scottish Family Health Study (GS:SFHS, N = 6455) and Psychiatric Genomics Consortium (PGC:MDD) (N = 18,759)]. A polygenic risk score (PRS) composed of single nucleotide polymorphisms from the pathway most consistently associated with MDD was created, and its accuracy to predict MDD, using area under the curve, logistic regression, and linear mixed model analyses, was tested. In GS:SFHS, four pathways were significantly associated with MDD, and two of these explained a significant amount of pathway-level regional heritability. In PGC:MDD, one pathway was significantly associated with MDD. Pathway-level regional heritability was significant in this pathway in one subset of PGC:MDD. For both samples the regional heritabilities were further localized to the gene and subregion levels. The NETRIN1 signaling pathway showed the most consistent association with MDD across the two samples. PRSs from this pathway showed competitive predictive accuracy compared with the whole-genome PRSs when using area under the curve statistics, logistic regression, and linear mixed model. These post-GWAS analyses highlight the value of combining multiple methods on multiple GWAS data for the identification of risk pathways for MDD. The NETRIN1 signaling pathway is identified as a candidate pathway for MDD and should be explored in further large population studies. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Integrative genomic analysis implicates limited peripheral adipose storage capacity in the pathogenesis of human insulin resistance.

PubMed

Lotta, Luca A; Gulati, Pawan; Day, Felix R; Payne, Felicity; Ongen, Halit; van de Bunt, Martijn; Gaulton, Kyle J; Eicher, John D; Sharp, Stephen J; Luan, Jian'an; De Lucia Rolfe, Emanuella; Stewart, Isobel D; Wheeler, Eleanor; Willems, Sara M; Adams, Claire; Yaghootkar, Hanieh; Forouhi, Nita G; Khaw, Kay-Tee; Johnson, Andrew D; Semple, Robert K; Frayling, Timothy; Perry, John R B; Dermitzakis, Emmanouil; McCarthy, Mark I; Barroso, Inês; Wareham, Nicholas J; Savage, David B; Langenberg, Claudia; O'Rahilly, Stephen; Scott, Robert A

2017-01-01

Insulin resistance is a key mediator of obesity-related cardiometabolic disease, yet the mechanisms underlying this link remain obscure. Using an integrative genomic approach, we identify 53 genomic regions associated with insulin resistance phenotypes (higher fasting insulin levels adjusted for BMI, lower HDL cholesterol levels and higher triglyceride levels) and provide evidence that their link with higher cardiometabolic risk is underpinned by an association with lower adipose mass in peripheral compartments. Using these 53 loci, we show a polygenic contribution to familial partial lipodystrophy type 1, a severe form of insulin resistance, and highlight shared molecular mechanisms in common/mild and rare/severe insulin resistance. Population-level genetic analyses combined with experiments in cellular models implicate CCDC92, DNAH10 and L3MBTL3 as previously unrecognized molecules influencing adipocyte differentiation. Our findings support the notion that limited storage capacity of peripheral adipose tissue is an important etiological component in insulin-resistant cardiometabolic disease and highlight genes and mechanisms underpinning this link.

Integrated Molecular Characterization of Testicular Germ Cell Tumors.

PubMed

Shen, Hui; Shih, Juliann; Hollern, Daniel P; Wang, Linghua; Bowlby, Reanne; Tickoo, Satish K; Thorsson, Vésteinn; Mungall, Andrew J; Newton, Yulia; Hegde, Apurva M; Armenia, Joshua; Sánchez-Vega, Francisco; Pluta, John; Pyle, Louise C; Mehra, Rohit; Reuter, Victor E; Godoy, Guilherme; Jones, Jeffrey; Shelley, Carl S; Feldman, Darren R; Vidal, Daniel O; Lessel, Davor; Kulis, Tomislav; Cárcano, Flavio M; Leraas, Kristen M; Lichtenberg, Tara M; Brooks, Denise; Cherniack, Andrew D; Cho, Juok; Heiman, David I; Kasaian, Katayoon; Liu, Minwei; Noble, Michael S; Xi, Liu; Zhang, Hailei; Zhou, Wanding; ZenKlusen, Jean C; Hutter, Carolyn M; Felau, Ina; Zhang, Jiashan; Schultz, Nikolaus; Getz, Gad; Meyerson, Matthew; Stuart, Joshua M; Akbani, Rehan; Wheeler, David A; Laird, Peter W; Nathanson, Katherine L; Cortessis, Victoria K; Hoadley, Katherine A

2018-06-12

We studied 137 primary testicular germ cell tumors (TGCTs) using high-dimensional assays of genomic, epigenomic, transcriptomic, and proteomic features. These tumors exhibited high aneuploidy and a paucity of somatic mutations. Somatic mutation of only three genes achieved significance-KIT, KRAS, and NRAS-exclusively in samples with seminoma components. Integrated analyses identified distinct molecular patterns that characterized the major recognized histologic subtypes of TGCT: seminoma, embryonal carcinoma, yolk sac tumor, and teratoma. Striking differences in global DNA methylation and microRNA expression between histology subtypes highlight a likely role of epigenomic processes in determining histologic fates in TGCTs. We also identified a subset of pure seminomas defined by KIT mutations, increased immune infiltration, globally demethylated DNA, and decreased KRAS copy number. We report potential biomarkers for risk stratification, such as miRNA specifically expressed in teratoma, and others with molecular diagnostic potential, such as CpH (CpA/CpC/CpT) methylation identifying embryonal carcinomas. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Integrated Laboratory and Field Investigations: Assessing Contaminant Risk to American Badgers

EPA Science Inventory

This manuscript provides an example of integrated laboratory and field approach to complete a toxicological ecological risk assessment at the landscape level. The core findings from the study demonstrate how radio telemetry data can allow for ranking the relative risks of contam...

Financial risk management of pharmacy benefits.

PubMed

Saikami, D

1997-10-01

Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

Integration of RAMS in LCC analysis for linear transport infrastructures. A case study for railways.

NASA Astrophysics Data System (ADS)

Calle-Cordón, Álvaro; Jiménez-Redondo, Noemi; Morales-Gámiz, F. J.; García-Villena, F. A.; Garmabaki, Amir H. S.; Odelius, Johan

2017-09-01

Life-cycle cost (LCC) analysis is an economic technique used to assess the total costs associated with the lifetime of a system in order to support decision making in long term strategic planning. For complex systems, such as railway and road infrastructures, the cost of maintenance plays an important role in the LCC analysis. Costs associated with maintenance interventions can be more reliably estimated by integrating the probabilistic nature of the failures associated to these interventions in the LCC models. Reliability, Maintainability, Availability and Safety (RAMS) parameters describe the maintenance needs of an asset in a quantitative way by using probabilistic information extracted from registered maintenance activities. Therefore, the integration of RAMS in the LCC analysis allows obtaining reliable predictions of system maintenance costs and the dependencies of these costs with specific cost drivers through sensitivity analyses. This paper presents an innovative approach for a combined RAMS & LCC methodology for railway and road transport infrastructures being developed under the on-going H2020 project INFRALERT. Such RAMS & LCC analysis provides relevant probabilistic information to be used for condition and risk-based planning of maintenance activities as well as for decision support in long term strategic investment planning.

An integrated analysis of genes and functional pathways for aggression in human and rodent models.

PubMed

Zhang-James, Yanli; Fernàndez-Castillo, Noèlia; Hess, Jonathan L; Malki, Karim; Glatt, Stephen J; Cormand, Bru; Faraone, Stephen V

2018-06-01

Human genome-wide association studies (GWAS), transcriptome analyses of animal models, and candidate gene studies have advanced our understanding of the genetic architecture of aggressive behaviors. However, each of these methods presents unique limitations. To generate a more confident and comprehensive view of the complex genetics underlying aggression, we undertook an integrated, cross-species approach. We focused on human and rodent models to derive eight gene lists from three main categories of genetic evidence: two sets of genes identified in GWAS studies, four sets implicated by transcriptome-wide studies of rodent models, and two sets of genes with causal evidence from online Mendelian inheritance in man (OMIM) and knockout (KO) mice reports. These gene sets were evaluated for overlap and pathway enrichment to extract their similarities and differences. We identified enriched common pathways such as the G-protein coupled receptor (GPCR) signaling pathway, axon guidance, reelin signaling in neurons, and ERK/MAPK signaling. Also, individual genes were ranked based on their cumulative weights to quantify their importance as risk factors for aggressive behavior, which resulted in 40 top-ranked and highly interconnected genes. The results of our cross-species and integrated approach provide insights into the genetic etiology of aggression.

Tracking Biocultural Pathways to Health Disparities: The Value of Biomarkers

PubMed Central

Worthman, Carol M.; Costello, E. Jane

2009-01-01

Background Cultural factors and biomarkers are emerging emphases in social epidemiology that readily ally with human biology and anthropology. Persistent health challenges and disparities have established biocultural roots, and environment plays an integral role in physical development and function that form the bases of population health. Biomarkers have proven to be valuable tools for investigating biocultural bases of health disparities. Aims We apply recent insights from biology to consider how culture gets under the skin and evaluate the construct of embodiment. We analyze contrasting biomarker models and applications, and propose an integrated model for biomarkers. Three examples from the Great Smoky Mountains Study (GSMS) illustrate these points. Subjects and methods The longitudinal developmental epidemiological GSMS comprises a population-based sample of 1420 children with repeated measures including mental and physical health, life events, household conditions, and biomarkers for pubertal development and allostatic load. Results Analyses using biomarkers resolved competing explanations for links between puberty and depression, identified gender differences in stress at puberty, and revealed interactive effects of birthweight and postnatal adversity on risk for depression at puberty in girls. Conclusion An integrated biomarker model can both enrich epidemiology and illuminate biocultural pathways in population health. PMID:19381986

Analysing the Costs of Integrated Care: A Case on Model Selection for Chronic Care Purposes

PubMed Central

Sánchez-Pérez, Inma; Ibern, Pere; Coderch, Jordi; Inoriza, José María

2016-01-01

Background: The objective of this study is to investigate whether the algorithm proposed by Manning and Mullahy, a consolidated health economics procedure, can also be used to estimate individual costs for different groups of healthcare services in the context of integrated care. Methods: A cross-sectional study focused on the population of the Baix Empordà (Catalonia-Spain) for the year 2012 (N = 92,498 individuals). A set of individual cost models as a function of sex, age and morbidity burden were adjusted and individual healthcare costs were calculated using a retrospective full-costing system. The individual morbidity burden was inferred using the Clinical Risk Groups (CRG) patient classification system. Results: Depending on the characteristics of the data, and according to the algorithm criteria, the choice of model was a linear model on the log of costs or a generalized linear model with a log link. We checked for goodness of fit, accuracy, linear structure and heteroscedasticity for the models obtained. Conclusion: The proposed algorithm identified a set of suitable cost models for the distinct groups of services integrated care entails. The individual morbidity burden was found to be indispensable when allocating appropriate resources to targeted individuals. PMID:28316542

Do improvements in dietary behaviour contribute to cardiovascular risk factor reduction over and above cardio-protective medication in newly diagnosed diabetes patients?

PubMed

Cooper, A J M; Schliemann, D; Long, G H; Griffin, S J; Simmons, R K

2014-10-01

A healthy diet is an integral component of successful diabetes management. However, the comparative importance of adopting a healthy diet for cardiovascular risk factor reduction over and above medication use among newly diagnosed diabetes patients remains unclear. We computed a dietary score consistent with American Diabetes Association and Diabetes UK recommendations in 574 newly diagnosed diabetes patients by summing standardised values for the intake of total energy, saturated fat, sodium, fibre and plasma vitamin C. In linear regression analyses, stratified by cardio-protective medication use (yes/no), we quantified the comparative longitudinal associations of baseline diet and change in diet over 1 year with change in blood pressure, HbA1c and lipids. Baseline diet was generally not predictive of change in cardiovascular risk factor levels at 1 year. In contrast, dietary change over 1 year among patients prescribed and not prescribed cardio-protective medication after baseline was associated with comparative (p-interaction all ⩾0.95) reductions in diastolic blood pressure (-2.38 vs -2.93 mm Hg, respectively) and triglycerides (-0.31 vs -0.21 mmol/l, respectively), independent of potential confounding factors and change from baseline to follow-up in physical activity and smoking status. Modest dietary change over the first year following diagnosis of diabetes was associated with reductions in blood pressure and triglycerides, over and above the effects of cardio-protective medication. Our findings support the notion that dietary change should be viewed as an integral component of successful diabetes self-management, irrespective of medication use.

A knowledge integration approach to flood vulnerability

NASA Astrophysics Data System (ADS)

Mazzorana, Bruno; Fuchs, Sven

2014-05-01

Understanding, qualifying and quantifying vulnerability is an essential need for implementing effective and efficient flood risk mitigation strategies; in particular if possible synergies between different mitigation alternatives, such as active and passive measures, should be achieved. In order to combine different risk management options it is necessary to take an interdisciplinary approach to vulnerability reduction, and as a result the affected society may be willing to accept a certain degree of self-responsibility. However, due to differing mono-disciplinary approaches and regional foci undertaken until now, different aspects of vulnerability to natural hazards in general and to floods in particular remain uncovered and as a result the developed management options remain sub-optimal. Taking an even more fundamental viewpoint, the empirical vulnerability functions used in risk assessment specifically fail to capture physical principles of the damage-generating mechanisms to the build environment. The aim of this paper is to partially close this gap by discussing a balanced knowledge integration approach which can be used to resolve the multidisciplinary disorder in flood vulnerability research. Modelling techniques such as mathematical-physical modelling of the flood hazard impact to and response from the building envelope affected, and formative scenario analyses of possible consequences in terms of damage and loss are used in synergy to provide an enhanced understanding of vulnerability and to render the derived knowledge into interdisciplinary mitigation strategies. The outlined formal procedure allows for a convincing knowledge alignment of quantified, but partial, information about vulnerability as a result of the application of physical and engineering notions and valuable, but often underspecified, qualitative argumentation strings emerging from the adopted socio-economic viewpoint.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Astrophysics Data System (ADS)

Drake, Bret G.

2007-07-01

During the summer of 2002 the NASA Deputy Administrator charted an internal NASA planning group to develop the rationale for exploration beyond low-Earth orbit. This team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond Low-Earth Orbit through the human exploration of Mars. The previous NASA Exploration Team (NEXT) activities laid the foundation and framework for development of NASA s Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the Stepping Stone approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low- Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars. Following the results of the Exploration Blueprint study, the NASA Administrator has asked for a recommendation by June, 2003 on the next steps in human and robotic exploration in order to put into context an updated Integrated Space Transportation Plan (post- Columbia) and guide Agency planning. NASA was on the verge of committing significant funding in programs that would be better served if longer term goals were better known including the Orbital Space Plane, research on the ISS, National Aerospace Initiative, Shuttle Life Extension Program, Project Prometheus, as well as a wide range of technology development throughout the Agency. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary viewgraph presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the Moon, can help reduce the risk for Mars missions.

Reducing the Risk of Human Missions to Mars Through Testing

NASA Technical Reports Server (NTRS)

Drake, Bret G.

2007-01-01

During the summer of 2002 the NASA Deputy Administrator charted an internal NASA planning group to develop the rationale for exploration beyond low-Earth orbit. This team, termed the Exploration Blueprint, performed architecture analyses to develop roadmaps for how to accomplish the first steps beyond Low-Earth Orbit through the human exploration of Mars. The previous NASA Exploration Team (NEXT) activities laid the foundation and framework for development of NASA s Integrated Space Plan. The reference missions resulting from the analysis performed by the Exploration Blueprint team formed the basis for requirement definition, systems development, technology roadmapping, and risk assessments for future human exploration beyond low-Earth orbit. Emphasis was placed on developing recommendations on what could be done now to effect future exploration activities. The Exploration Blueprint team embraced the Stepping Stone approach to exploration where human and robotic activities are conducted through progressive expansion outward beyond low- Earth orbit. Results from this study produced a long-term strategy for exploration with near-term implementation plans, program recommendations, and technology investments. Specific results included the development of a common exploration crew vehicle concept, a unified space nuclear strategy, focused bioastronautics research objectives, and an integrated human and robotic exploration strategy. Recommendations from the Exploration Blueprint included the endorsement of the Nuclear Systems Initiative, augmentation of the bioastronautics research, a focused space transportation program including heavy-lift launch and a common exploration vehicle design for ISS and exploration missions, as well as an integrated human and robotic exploration strategy for Mars. Following the results of the Exploration Blueprint study, the NASA Administrator has asked for a recommendation by June, 2003 on the next steps in human and robotic exploration in order to put into context an updated Integrated Space Transportation Plan (post- Columbia) and guide Agency planning. NASA was on the verge of committing significant funding in programs that would be better served if longer term goals were better known including the Orbital Space Plane, research on the ISS, National Aerospace Initiative, Shuttle Life Extension Program, Project Prometheus, as well as a wide range of technology development throughout the Agency. Much of the focus during this period was on integrating the results from the previous studies into more concrete implementation strategies in order to understand the relationship between NASA programs, timing, and resulting budgetary implications. This resulted in an integrated approach including lunar surface operations to retire risk of human Mars missions, maximum use of common and modular systems including what was termed the exploration transfer vehicle, Earth orbit and lunar surface demonstrations of long-life systems, collaboration of human and robotic missions to vastly increase mission return, and high-efficiency transportation systems (nuclear) for deep-space transportation and power. The data provided in this summary viewgraph presentation was developed to begin to address one of the key elements of the emerging implementation strategy, namely how lunar missions help retire risk of human missions to Mars. During this process the scope of the activity broadened into the issue of how testing in general, in various venues including the Moon, can help reduce the risk for Mars missions.

A methodology for post-mainshock probabilistic assessment of building collapse risk

USGS Publications Warehouse

Luco, N.; Gerstenberger, M.C.; Uma, S.R.; Ryu, H.; Liel, A.B.; Raghunandan, M.

2011-01-01

This paper presents a methodology for post-earthquake probabilistic risk (of damage) assessment that we propose in order to develop a computational tool for automatic or semi-automatic assessment. The methodology utilizes the same so-called risk integral which can be used for pre-earthquake probabilistic assessment. The risk integral couples (i) ground motion hazard information for the location of a structure of interest with (ii) knowledge of the fragility of the structure with respect to potential ground motion intensities. In the proposed post-mainshock methodology, the ground motion hazard component of the risk integral is adapted to account for aftershocks which are deliberately excluded from typical pre-earthquake hazard assessments and which decrease in frequency with the time elapsed since the mainshock. Correspondingly, the structural fragility component is adapted to account for any damage caused by the mainshock, as well as any uncertainty in the extent of this damage. The result of the adapted risk integral is a fully-probabilistic quantification of post-mainshock seismic risk that can inform emergency response mobilization, inspection prioritization, and re-occupancy decisions.

Finite element analysis of container ship's cargo hold using ANSYS and POSEIDON software

NASA Astrophysics Data System (ADS)

Tanny, Tania Tamiz; Akter, Naznin; Amin, Osman Md.

2017-12-01

Nowadays ship structural analysis has become an integral part of the preliminary ship design providing further support for the development and detail design of ship structures. Structural analyses of container ship's cargo holds are carried out for the balancing of their safety and capacity, as those ships are exposed to the high risk of structural damage during voyage. Two different design methodologies have been considered for the structural analysis of a container ship's cargo hold. One is rule-based methodology and the other is a more conventional software based analyses. The rule based analysis is done by DNV-GL's software POSEIDON and the conventional package based analysis is done by ANSYS structural module. Both methods have been applied to analyze some of the mechanical properties of the model such as total deformation, stress-strain distribution, Von Mises stress, Fatigue etc., following different design bases and approaches, to indicate some guidance's for further improvements in ship structural design.

Vulnerability of port and harbor communities to earthquake and tsunami hazards: The use of GIS in community hazard planning

USGS Publications Warehouse

Wood, Nathan J.; Good, James W.

2004-01-01

AbstractEarthquakes and tsunamis pose significant threats to Pacific Northwest coastal port and harbor communities. Developing holistic mitigation and preparedness strategies to reduce the potential for loss of life and property damage requires community-wide vulnerability assessments that transcend traditional site-specific analyses. The ability of a geographic information system (GIS) to integrate natural, socioeconomic, and hazards information makes it an ideal assessment tool to support community hazard planning efforts. This article summarizes how GIS was used to assess the vulnerability of an Oregon port and harbor community to earthquake and tsunami hazards, as part of a larger risk-reduction planning initiative. The primary purposes of the GIS were to highlight community vulnerability issues and to identify areas that both are susceptible to hazards and contain valued port and harbor community resources. Results of the GIS analyses can help decision makers with limited mitigation resources set priorities for increasing community resiliency to natural hazards.

Systems integration and demonstration of advanced reusable structure for ALS

NASA Technical Reports Server (NTRS)

Gibbins, Martin N.

1991-01-01

The objective was to investigate the potential of advanced material to achieve life cycle cost (LCC) benefits for reusable structure on the advanced launch system. Three structural elements were investigated - all components of an Advanced Launch System reusable propulsion/avionics module. Leading aeroshell configurations included sandwich structure using titanium, graphite/polyimide (Gr/PI), or high-temperature aluminum (HTA) face sheets. Thrust structure truss concepts used titanium, graphite/epoxy, or silicon carbide/aluminum struts. Leading aft bulkhead concepts employed graphite epoxy and aluminum. The technical effort focused on the aeroshell because the greatest benefits were expected there. Thermal analyses show the structural temperature profiles during operation. Finite element analyses show stresses during splash-down. Weight statements and manufacturing cost estimates were prepared for calculation of LCC for each design. The Gr/PI aeroshell showed the lowest potential LCC, but the HTA aeroshell was judged to be lower risk. A technology development plan was prepared to validate the applicable structural technology.

Analysis Commons, A Team Approach to Discovery in a Big-Data Environment for Genetic Epidemiology

PubMed Central

Brody, Jennifer A.; Morrison, Alanna C.; Bis, Joshua C.; O'Connell, Jeffrey R.; Brown, Michael R.; Huffman, Jennifer E.; Ames, Darren C.; Carroll, Andrew; Conomos, Matthew P.; Gabriel, Stacey; Gibbs, Richard A.; Gogarten, Stephanie M.; Gupta, Namrata; Jaquish, Cashell E.; Johnson, Andrew D.; Lewis, Joshua P.; Liu, Xiaoming; Manning, Alisa K.; Papanicolaou, George J.; Pitsillides, Achilleas N.; Rice, Kenneth M.; Salerno, William; Sitlani, Colleen M.; Smith, Nicholas L.; Heckbert, Susan R.; Laurie, Cathy C.; Mitchell, Braxton D.; Vasan, Ramachandran S.; Rich, Stephen S.; Rotter, Jerome I.; Wilson, James G.; Boerwinkle, Eric; Psaty, Bruce M.; Cupples, L. Adrienne

2017-01-01

Summary paragraph The exploding volume of whole-genome sequence (WGS) and multi-omics data requires new approaches for analysis. As one solution, we have created a cloud-based Analysis Commons, which brings together genotype and phenotype data from multiple studies in a setting that is accessible by multiple investigators. This framework addresses many of the challenges of multi-center WGS analyses, including data sharing mechanisms, phenotype harmonization, integrated multi-omics analyses, annotation, and computational flexibility. In this setting, the computational pipeline facilitates a sequence-to-discovery analysis workflow illustrated here by an analysis of plasma fibrinogen levels in 3996 individuals from the National Heart, Lung, and Blood Institute (NHLBI) Trans-Omics for Precision Medicine (TOPMed) WGS program. The Analysis Commons represents a novel model for transforming WGS resources from a massive quantity of phenotypic and genomic data into knowledge of the determinants of health and disease risk in diverse human populations. PMID:29074945

The Lifetime Surveillance of Astronaut Health Newsletter

NASA Technical Reports Server (NTRS)

Lee, Lesley

2011-01-01

The June 2010 LSAH newsletter introduced the change from the Longitudinal Study of Astronaut Health research study to the new Lifetime Surveillance of Astronaut Health program (An Overview of the New Occupational Surveillance Program for the Astronaut Corps). Instead of performing research-focused retrospective analyses of astronaut medical data compared to a JSC civil servant control population, the new program is focused on prevention of disease and prospective identification and mitigation of health risks in each astronaut due to individual exposure history and the unique occupational exposures experienced by the astronaut corps. The new LSAH program has 5 primary goals: (1) Provide a comprehensive medical exam for each LSAH participant; (2) Conduct occupational surveillance; (3) Improve communication, data accessibility, integrity and storage; (4) Support operational and healthcare analyses; and (5) Support NASA research objectives. This article will focus primarily on the first goal, the comprehensive medical exam. Future newsletters will outline in detail the plans and processes for addressing the remaining program goals.

Landscape of Conditional eQTL in Dorsolateral Prefrontal Cortex and Co-localization with Schizophrenia GWAS.

PubMed

Dobbyn, Amanda; Huckins, Laura M; Boocock, James; Sloofman, Laura G; Glicksberg, Benjamin S; Giambartolomei, Claudia; Hoffman, Gabriel E; Perumal, Thanneer M; Girdhar, Kiran; Jiang, Yan; Raj, Towfique; Ruderfer, Douglas M; Kramer, Robin S; Pinto, Dalila; Akbarian, Schahram; Roussos, Panos; Domenici, Enrico; Devlin, Bernie; Sklar, Pamela; Stahl, Eli A; Sieberts, Solveig K

2018-06-07

Causal genes and variants within genome-wide association study (GWAS) loci can be identified by integrating GWAS statistics with expression quantitative trait loci (eQTL) and determining which variants underlie both GWAS and eQTL signals. Most analyses, however, consider only the marginal eQTL signal, rather than dissect this signal into multiple conditionally independent signals for each gene. Here we show that analyzing conditional eQTL signatures, which could be important under specific cellular or temporal contexts, leads to improved fine mapping of GWAS associations. Using genotypes and gene expression levels from post-mortem human brain samples (n = 467) reported by the CommonMind Consortium (CMC), we find that conditional eQTL are widespread; 63% of genes with primary eQTL also have conditional eQTL. In addition, genomic features associated with conditional eQTL are consistent with context-specific (e.g., tissue-, cell type-, or developmental time point-specific) regulation of gene expression. Integrating the 2014 Psychiatric Genomics Consortium schizophrenia (SCZ) GWAS and CMC primary and conditional eQTL data reveals 40 loci with strong evidence for co-localization (posterior probability > 0.8), including six loci with co-localization of conditional eQTL. Our co-localization analyses support previously reported genes, identify novel genes associated with schizophrenia risk, and provide specific hypotheses for their functional follow-up. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

A critical source area phosphorus index with topographic transport factors using high resolution LiDAR digital elevation models

NASA Astrophysics Data System (ADS)

Thomas, Ian; Murphy, Paul; Fenton, Owen; Shine, Oliver; Mellander, Per-Erik; Dunlop, Paul; Jordan, Phil

2015-04-01

A new phosphorus index (PI) tool is presented which aims to improve the identification of critical source areas (CSAs) of phosphorus (P) losses from agricultural land to surface waters. In a novel approach, the PI incorporates topographic indices rather than watercourse proximity as proxies for runoff risk, to account for the dominant control of topography on runoff-generating areas and P transport pathways. Runoff propensity and hydrological connectivity are modelled using the Topographic Wetness Index (TWI) and Network Index (NI) respectively, utilising high resolution digital elevation models (DEMs) derived from Light Detection and Ranging (LiDAR) to capture the influence of micro-topographic features on runoff pathways. Additionally, the PI attempts to improve risk estimates of particulate P losses by incorporating an erosion factor that accounts for fine-scale topographic variability within fields. Erosion risk is modelled using the Unit Stream Power Erosion Deposition (USPED) model, which integrates DEM-derived upslope contributing area and Universal Soil Loss Equation (USLE) factors. The PI was developed using field, sub-field and sub-catchment scale datasets of P source, mobilisation and transport factors, for four intensive agricultural catchments in Ireland representing different agri-environmental conditions. Datasets included soil test P concentrations, degree of P saturation, soil attributes, land use, artificial subsurface drainage locations, and 2 m resolution LiDAR DEMs resampled from 0.25 m resolution data. All factor datasets were integrated within a Geographical Information System (GIS) and rasterised to 2 m resolution. For each factor, values were categorised and assigned relative risk scores which ranked P loss potential. Total risk scores were calculated for each grid cell using a component formulation, which summed the products of weighted factor risk scores for runoff and erosion pathways. Results showed that the new PI was able to predict in-field risk variability and hence was able to identify CSAs at the sub-field scale. PI risk estimates and component scores were analysed at catchment and subcatchment scales, and validated using measured dissolved, particulate and total P losses at subcatchment snapshot sites and gauging stations at catchment outlets. The new PI provides CSA delineations at higher precision compared to conventional PIs, and more robust P transport risk estimates. The tool can be used to target cost-effective mitigation measures for P management within single farm units and wider catchments.

War-related trauma exposure and multiple risk behaviors among school-going adolescents in Northern Uganda: the mediating role of depression symptoms.

PubMed

Okello, James; Nakimuli-Mpungu, Etheldreda; Musisi, Seggane; Broekaert, Eric; Derluyn, Ilse

2013-11-01

The relationship between war-related trauma exposure, depressive symptoms and multiple risk behaviors among adolescents is less clear in sub-Saharan Africa. We analyzed data collected from a sample of school-going adolescents four years postwar. Participants completed interviews assessing various risk behaviors defined by the Youth Self Report (YSR) and a sexual risk behavior survey, and were screened for post-traumatic stress, anxiety and depression symptoms based on the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Multivariate logistic regression was used to assess factors independently associated with multiple risk behaviors. The logistic regression model of Baron and Kenny (1986) was used to evaluate the mediating role of depression in the relationship between stressful war events and multiple risk behaviors. Of 551 participants, 139 (25%) reported multiple (three or more) risk behaviors in the past year. In the multivariate analyses, depression symptoms remained uniquely associated with multiple risk behavior after adjusting for potential confounders including socio-demographic characteristics, war-related trauma exposure variables, anxiety and post-traumatic stress symptoms. In mediation analysis, depression symptoms mediated the associations between stressful war events and multiple risk behaviors. The psychometric properties of the questionnaires used in this study are not well established in war affected African samples thus ethno cultural variation may decrease the validity of our measures. Adolescents with depression may be at a greater risk of increased engagement in multiple risk behaviors. Culturally sensitive and integrated interventions to treat and prevent depression among adolescents in post-conflict settings are urgently needed. © 2013 Elsevier B.V. All rights reserved.

Role of frailty and nutritional status in predicting complications following total gastrectomy with D2 lymphadenectomy in patients with gastric cancer: a prospective study.

PubMed

Chen, Fan-Feng; Zhang, Fei-Yu; Zhou, Xuan-You; Shen, Xian; Yu, Zhen; Zhuang, Cheng-Le

2016-09-01

This study was performed to determine the association of frailty and nutritional status with postoperative complications after total gastrectomy (TG) with D2 lymphadenectomy in patients with gastric cancer. Patients undergoing TG with D2 lymphadenectomy for gastric cancer between August 2014 and February 2016 were enrolled. Frailty was evaluated by sarcopenia which was diagnosed by a combination of third lumbar vertebra muscle index (L3 MI), handgrip strength, and 6-m usual gait speed. Nutritional status was evaluated by the nutritional risk screening 2002 (NRS 2002) score. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. A total of 158 patients were analyzed, and 27.2 % developed complications within 30 days of surgery. One patient died within 30 days of the operation. In the univariate analyses, NRS 2002 score ≥3 (OR = 2.468, P = 0.012), sarcopenia (OR = 2.764, P = 0.008), and tumor located at the cardia (OR = 2.072, P = 0.046) were associated with the postoperative complications. Multivariable analysis revealed that sarcopenia (OR = 3.084, P = 0.005) and tumor located at the cardia (OR = 2.347, P = 0.026) were independent predictors of postoperative complications. This study showed a significant relationship between postoperative complications and geriatric frailty using sarcopenia in patients with gastric cancer after TG with D2 lymphadenectomy. Frailty should be integrated into preoperative risk assessment and may have implications in preoperative decisionmaking.

Integrating drivers influencing the detection of plant pests carried in the international cut flower trade.

PubMed

Areal, F J; Touza, J; MacLeod, A; Dehnen-Schmutz, K; Perrings, C; Palmieri, M G; Spence, N J

2008-12-01

This paper analyses the cut flower market as an example of an invasion pathway along which species of non-indigenous plant pests can travel to reach new areas. The paper examines the probability of pest detection by assessing information on pest detection and detection effort associated with the import of cut flowers. We test the link between the probability of plant pest arrivals, as a precursor to potential invasion, and volume of traded flowers using count data regression models. The analysis is applied to the UK import of specific genera of cut flowers from Kenya between 1996 and 2004. There is a link between pest detection and the Genus of cut flower imported. Hence, pest detection efforts should focus on identifying and targeting those imported plants with a high risk of carrying pest species. For most of the plants studied, efforts allocated to inspection have a significant influence on the probability of pest detection. However, by better targeting inspection efforts, it is shown that plant inspection effort could be reduced without increasing the risk of pest entry. Similarly, for most of the plants analysed, an increase in volume traded will not necessarily lead to an increase in the number of pests entering the UK. For some species, such as Carthamus and Veronica, the volume of flowers traded has a significant and positive impact on the likelihood of pest detection. We conclude that analysis at the rank of plant Genus is important both to understand the effectiveness of plant pest detection efforts and consequently to manage the risk of introduction of non-indigenous species.

Integrated Risk Research. Case of Study: Motozintla, Chiapas, Mexico

NASA Astrophysics Data System (ADS)

Novelo-Casanova, D. A.; Jaimes, M.

2015-12-01

This integrated risk research include the analysis of all components of individual constituents of risk such hazard identification, hazard exposure, and vulnerability. We determined risk to natural hazards in the community of Motozintla located in southern Mexico in the state of Chiapas (15.37ºN, 92.25ºW. Due to its geographical and geological location, this community is continuously exposed mainly to earthquakes, landslides and floods. We developed integrated studies and analysis of seismic zonation, landslides and flood susceptibility using standard methodologies. Vulnerability was quantified from data collected from local families interviews considering five social variables: characteristics of housing construction, availability of basic public services, family economic conditions, existing community plans for disaster preparedness, and risk perception. Local families surveyed were randomly selected considering a sample statistically significant. Our results were spatially represented using a Geographical Information System (GIS). Structural vulnerability curves were generated for typical housing constructions. Our integrated risk analysis demonstrates that the community of Motozintla has a high level of structural and socio-economical risk to floods and earthquakes. More than half of the population does not know any existing Civil Protection Plan and perceive that they are in high risk to landslides and floods. Although the community is located in a high seismic risk zone, most of the local people believe that cannot be impacted by a large earthquake. These natural and social conditions indicate that the community of Motozintla has a very high level of risk to natural hazards. This research will support local decision makers in developing an integrated comprehensive natural hazards mitigation and prevention program.

Ochratoxin A in cereal-based baby foods: occurrence and safety evaluation.

PubMed

Beretta, B; De Domenico, R; Gaiaschi, A; Ballabio, C; Galli, C L; Gigliotti, C; Restani, P

2002-01-01

Ochratoxin A is a typical cereal contaminant with strong nephrotoxic activity. To estimate the quantity of ochratoxin A that can be taken in by a child in the weaning period, several samples of cereal-based baby foods were analysed. Although most samples analysed contained ochratoxin A in undetectable amounts or below the Italian legal limit of 0.5 microg kg(-1), some irregular products were found. In particular, the analyses of the 119 batches (338 samples) of baby foods considered indicated that: 20 batches (16.8%) contained detectable quantities of ochratoxin A and four of these (3.4% of the total) contained ochratoxin A above the Italian permitted value. All samples coming from agricultural practices based on integrated pest management contained undetectable amounts of ochratoxin A, while approximately 5% of batches coming from conventional and organic agricultural practices were above the legal limit. On the basis of the established provisional tolerable weekly intake (PTWI), there is no significant toxicological risk for a child who occasionally consumes a formula with ochratoxin concentration slightly above the permitted level. However, stricter controls have to be applied to reject the batches containing irregular concentrations of ochratoxin A.

Security Risks: Management and Mitigation in the Software Life Cycle

NASA Technical Reports Server (NTRS)

Gilliam, David P.

2004-01-01

A formal approach to managing and mitigating security risks in the software life cycle is requisite to developing software that has a higher degree of assurance that it is free of security defects which pose risk to the computing environment and the organization. Due to its criticality, security should be integrated as a formal approach in the software life cycle. Both a software security checklist and assessment tools should be incorporated into this life cycle process and integrated with a security risk assessment and mitigation tool. The current research at JPL addresses these areas through the development of a Sotfware Security Assessment Instrument (SSAI) and integrating it with a Defect Detection and Prevention (DDP) risk management tool.

Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education

PubMed Central

2013-01-01

Background Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient’s TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Methods Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO’s standard for information security risk management. Results A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Conclusions Most of the identified threats are applicable for healthcare services intended for patients or citizens in their own homes. Confidentiality risks in home are different from in a more controlled environment such as a hospital; and electronic equipment located in private homes and communicating via Internet, is more exposed to unauthorised access. By implementing the proposed measures, it has been possible to design a home-based service which ensures the necessary level of information security and privacy. PMID:23937965

A case study to illustrate the utility of the Aggregate Exposure Pathway and Adverse Outcome Pathway frameworks for integrating human health and ecological data into cumulative risk assessment

EPA Science Inventory

Cumulative risk assessment (CRA) methods, which evaluate the risk of multiple adverse outcomes (AOs) from multiple chemicals, promote the use of a conceptual site model (CSM) to integrate risk from relevant stressors. The Adverse Outcome Pathway (AOP) framework can inform these r...

Assessing natural hazards in forestry for risk management: a review

Treesearch

Marc Hanewinkel; Susan Hummel; Axel Albrecht

2011-01-01

We address the problem of how to integrate risk assessment into forest management and therefore provide a comprehensive review of recent and past literature on risk analysis and modeling and, moreover, an evaluation and summary on these papers. We provide a general scheme on how to integrate concepts of risk into forest management decisions. After an overview of the...

Barriers and facilitators to integrating care: experiences from the English Integrated Care Pilots

PubMed Central

Ling, Tom; Brereton, Laura; Conklin, Annalijn; Newbould, Jennifer; Roland, Martin

2012-01-01

Background: In 2008, the English Department of Health appointed 16 ‘Integrated Care Pilots’ which used a range of approaches to provide better integrated care. We report qualitative analyses from a three-year multi-method evaluation to identify barriers and facilitators to successful integration of care. Theory and methods: Data were analysed from transcripts of 213 in-depth staff interviews, and from semi-structured questionnaires (the ‘Living Document’) completed by staff in pilot sites at six points over a two-year period. Emerging findings were therefore built from ‘bottom up’ and grounded in the data. However, we were then interested in how these findings compared and contrasted with more generic analyses. Therefore after our analyses were complete we then systematically compared and contrasted the findings with the analysis of barriers and facilitators to quality improvement identified in a systematic review by Kaplan et al. (2010) and the analysis of more micro-level shapers of behaviour found in Normalisation Process Theory (May et al. 2007). Neither of these approaches claims to be full blown theories but both claim to provide mid-range theoretical arguments which may be used to structure existing data and which can be undercut or reinforced by new data. Results and discussion: Many barriers and facilitators to integrating care are those of any large-scale organisational change. These include issues relating to leadership, organisational culture, information technology, physician involvement, and availability of resources. However, activities which appear particularly important for delivering integrated care include personal relationships between leaders in different organisations, the scale of planned activities, governance and finance arrangements, support for staff in new roles, and organisational and staff stability. We illustrate our analyses with a ‘routemap’ which identifies questions that providers may wish to consider when planning interventions to improve the integration of care. PMID:23593044

Supporting BPMN choreography with system integration artefacts for enterprise process collaboration

NASA Astrophysics Data System (ADS)

Nie, Hongchao; Lu, Xudong; Duan, Huilong

2014-07-01

Business Process Model and Notation (BPMN) choreography modelling depicts externally visible message exchanges between collaborating processes of enterprise information systems. Implementation of choreography relies on designing system integration solutions to realise message exchanges between independently developed systems. Enterprise integration patterns (EIPs) are widely accepted artefacts to design integration solutions. If the choreography model represents coordination requirements between processes with behaviour mismatches, the integration designer needs to analyse the routing requirements and address these requirements by manually designing EIP message routers. As collaboration scales and complexity increases, manual design becomes inefficient. Thus, the research problem of this paper is to explore a method to automatically identify routing requirements from BPMN choreography model and to accordingly design routing in the integration solution. To achieve this goal, recurring behaviour mismatch scenarios are analysed as patterns, and corresponding solutions are proposed as EIP routers. Using this method, a choreography model can be analysed by computer to identify occurrences of mismatch patterns, leading to corresponding router selection. A case study demonstrates that the proposed method enables computer-assisted integration design to implement choreography. A further experiment reveals that the method is effective to improve the design quality and reduce time cost.

Development of a High Fidelity Dynamic Module of the Advanced Resistive Exercise Device (ARED) Using Adams

NASA Technical Reports Server (NTRS)

Humphreys, B. T.; Thompson, W. K.; Lewandowski, B. E.; Cadwell, E. E.; Newby, N. J.; Fincke, R. S.; Sheehan, C.; Mulugeta, L.

2012-01-01

NASA's Digital Astronaut Project (DAP) implements well-vetted computational models to predict and assess spaceflight health and performance risks, and enhance countermeasure development. DAP provides expertise and computation tools to its research customers for model development, integration, or analysis. DAP is currently supporting the NASA Exercise Physiology and Countermeasures (ExPC) project by integrating their biomechanical models of specific exercise movements with dynamic models of the devices on which the exercises were performed. This presentation focuses on the development of a high fidelity dynamic module of the Advanced Resistive Exercise Device (ARED) on board the ISS. The ARED module, illustrated in the figure below, was developed using the Adams (MSC Santa Ana, California) simulation package. The Adams package provides the capabilities to perform multi rigid body, flexible body, and mixed dynamic analyses of complex mechanisms. These capabilities were applied to accurately simulate: Inertial and mass properties of the device such as the vibration isolation system (VIS) effects and other ARED components, Non-linear joint friction effects, The gas law dynamics of the vacuum cylinders and VIS components using custom written differential state equations, The ARED flywheel dynamics, including torque limiting clutch. Design data from the JSC ARED Engineering team was utilized in developing the model. This included solid modeling geometry files, component/system specifications, engineering reports and available data sets. The Adams ARED module is importable into LifeMOD (Life Modeler, Inc., San Clemente, CA) for biomechanical analyses of different resistive exercises such as squat and dead-lift. Using motion capture data from ground test subjects, the ExPC developed biomechanical exercise models in LifeMOD. The Adams ARED device module was then integrated with the exercise subject model into one integrated dynamic model. This presentation will describe the development of the Adams ARED module including its capabilities, limitations, and assumptions. Preliminary results, validation activities, and a practical application of the module to inform the relative effect of the flywheels on exercise will be discussed.

Impact of an integrated disease management program in reducing exacerbations in patients with severe asthma and COPD.

PubMed

Jain, Vipul V; Allison, Richard; Beck, Sandra J; Jain, Ratnali; Mills, Paul K; McCurley, James W; Van Gundy, Karl P; Peterson, Michael W

2014-12-01

Conflicting data exists on the effectiveness of integrated programs in reducing recurrent exacerbations and hospitalizations in patients with Asthma and chronic obstructive lung disease (COPD). We developed a Pulmonologist-led Chronic Lung Disease Program (CLDP) for patients with severe asthma and COPD and analyzed its impact on healthcare utilization and predictors of its effectiveness. CLDP elements included clinical evaluation, onsite pulmonary function testing, health education, and self-management action plan along with close scheduled and on-demand follow-up. Patients with ≥2 asthma or COPD exacerbations requiring emergency room visit or hospitalization within the prior year were enrolled, and followed for respiratory related ER visits (RER) and hospitalizations (RHA) over the year (357 ± 43 days) after CLDP interventions. A total of 106 patients were enrolled, and 104 patients were subject to analyses. During the year of follow-up after CLDP enrollment, there was a significant decrease in mean RER (0.56 ± 1.48 versus 2.62 ± 2.81, p < 0.0001), mean RHA (0.39 ± 0.08 versus 1.1 ± 1.62, p < 0.0001), and 30 day rehospitalizations (0.05 ± 0.02 versus 0.28 ± 0.07, p < 0.0001). Reduction of healthcare utilization was strongly associated with GERD and sinusitis therapy, and was independent of pulmonary rehabilitation. Direct variable cost analyses estimated annual savings at $1.17 million. Multivariate logistic regression analysis revealed lack of spirometry utilization as an independent risk factor for severe exacerbations. A Pulmonologist-led disease management program integrating key elements of care is cost effective and significantly decreases severe exacerbations. Integrated programs should be encouraged for care of frequent exacerbators of asthma and COPD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Towards risk-based drought management in the Netherlands: quantifying the welfare effects of water shortage

NASA Astrophysics Data System (ADS)

van der Vat, Marnix; Femke, Schasfoort; Rhee Gigi, Van; Manfred, Wienhoven; Nico, Polman; Joost, Delsman; den Hoek Paul, Van; Maat Judith, Ter; Marjolein, Mens

2016-04-01

It is widely acknowledged that drought management should move from a crisis to a risk-based approach. A risk-based approach to managing water resources requires a sound drought risk analysis, quantifying the probability and impacts of water shortage due to droughts. Impacts of droughts are for example crop yield losses, hydropower production losses, and water shortage for municipal and industrial use. Many studies analyse the balance between supply and demand, but there is little experience in translating this into economic metrics that can be used in a decision-making process on investments to reduce drought risk. We will present a drought risk analysis method for the Netherlands, with a focus on the underlying economic method to quantify the welfare effects of water shortage for different water users. Both the risk-based approach as well as the economic valuation of water shortage for various water users was explored in a study for the Dutch Government. First, an historic analysis of the effects of droughts on revenues and prices in agriculture as well as on shipping and nature was carried out. Second, a drought risk analysis method was developed that combines drought hazard and drought impact analysis in a probabilistic way for various sectors. This consists of a stepwise approach, from water availability through water shortage to economic impact, for a range of drought events with a certain return period. Finally, a local case study was conducted to test the applicability of the drought risk analysis method. Through the study, experience was gained into integrating hydrological and economic analyses, which is a prerequisite for drought risk analysis. Results indicate that the risk analysis method is promising and applicable for various sectors. However, it was also found that quantification of economic impacts from droughts is time-consuming, because location- and sector-specific data is needed, which is not always readily available. Furthermore, for some sectors hydrological data was lacking to make a reliable estimate of drought return periods. By 2021, the Netherlands Government aims to agree on the water supply service levels, which should describe water availability and quality that can be delivered with a certain return period. The Netherlands' Ministry of Infrastructure and the Environment, representatives of the regional water boards and Rijkswaterstaat (operating the main water system) as well as several consultants and research institutes are important stakeholders for further development of the method, evaluation of cases and the development of a quantitative risk-informed decision-making tool.

Job Hazard Analyses for Musculoskeletal Disorder Risk Factors in Pressing Operations of Dry-cleaning Establishments.

PubMed

Park, Jung-Keun

2016-12-01

Job hazard analyses were conducted to assess exposure to musculoskeletal disorder (MSD) risk factors in seven workers of three dry-cleaning establishments. In accordance with the Washington State Ergonomics Rule, the analyses were performed in two separate steps: (1) observation and checklist approaches were made to identify a "caution zone job" in the seven workers' pressing operations across the three shops; and (2) detailed posture and motion analyses were undertaken to determine a "MSD hazard" in one worker's operation using a video technique. One "caution zone job" was identified and it was the pressing operation job in which five physical risk factors were found in the pressing operations. The detailed analyses confirmed that one "MSD hazard", i.e., awkward posture in shoulders, was prevalent in the pressing operations of the three dry-cleaning facilities. It would be desirable to reduce MSD risk factors including awkward shoulder posture in the dry-cleaning industry.

77 FR 4319 - Notification of Two Public Teleconferences of the Science Advisory Board Ecological Processes and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-27

..., ``Integrating Ecological Assessment and Decision-Making at EPA, 2011 RAF Ecological Assessment Action Plan... the EPA Risk Assessment Forum (RAF) document, ``Integrating Ecological Assessment and Decision-Making... Ecological Risk Assessment in Environmental Decision-Making'' (EPA-SAB-08-002), the EPA Risk Assessment Forum...

A Framework for Assessing Uncertainty Associated with Human Health Risks from MSW Landfill Leachate Contamination.

PubMed

Mishra, Harshit; Karmakar, Subhankar; Kumar, Rakesh; Singh, Jitendra

2017-07-01

Landfilling is a cost-effective method, which makes it a widely used practice around the world, especially in developing countries. However, because of the improper management of landfills, high leachate leakage can have adverse impacts on soils, plants, groundwater, aquatic organisms, and, subsequently, human health. A comprehensive survey of the literature finds that the probabilistic quantification of uncertainty based on estimations of the human health risks due to landfill leachate contamination has rarely been reported. Hence, in the present study, the uncertainty about the human health risks from municipal solid waste landfill leachate contamination to children and adults was quantified to investigate its long-term risks by using a Monte Carlo simulation framework for selected heavy metals. The Turbhe sanitary landfill of Navi Mumbai, India, which was commissioned in the recent past, was selected to understand the fate and transport of heavy metals in leachate. A large residential area is located near the site, which makes the risk assessment problem both crucial and challenging. In this article, an integral approach in the form of a framework has been proposed to quantify the uncertainty that is intrinsic to human health risk estimation. A set of nonparametric cubic splines was fitted to identify the nonlinear seasonal trend in leachate quality parameters. LandSim 2.5, a landfill simulator, was used to simulate the landfill activities for various time slices, and further uncertainty in noncarcinogenic human health risk was estimated using a Monte Carlo simulation followed by univariate and multivariate sensitivity analyses. © 2016 Society for Risk Analysis.

How the Effects of Aging and Stresses of Life Are Integrated in Mortality Rates: Insights for Genetic Studies of Human Health and Longevity

PubMed Central

Yashin, Anatoliy I.; Arbeev, Konstantin G.; Arbeeva, Liubov S.; Wu, Deqing; Akushevich, Igor; Kovtun, Mikhail; Yashkin, Arseniy; Kulminski, Alexander; Culminskaya, Irina; Stallard, Eric; Li, Miaozhu; Ukraintseva, Svetlana V.

2015-01-01

Background Increasing proportions of elderly individuals in developed countries combined with substantial increases in related medical expenditures make the improvement of the health of the elderly a high priority today. If the process of aging by individuals is a major cause of age related health declines then postponing aging could be an efficient strategy for improving the health of the elderly. Implementing this strategy requires a better understanding of genetic and non-genetic connections among aging, health, and longevity. Data and methods We review progress and problems in research areas whose development may contribute to analyses of such connections. These include genetic studies of human aging and longevity, the heterogeneity of populations with respect to their susceptibility to disease and death, forces that shape age patterns of human mortality, secular trends in mortality decline, and integrative mortality modeling using longitudinal data. Results The dynamic involvement of genetic factors in (i) morbidity/mortality risks, (ii) responses to stresses of life, (iii) multi-morbidities of many elderly individuals, (iv) trade-offs for diseases, (v) genetic heterogeneity, and (vi) other relevant aging-related health declines, underscores the need for a comprehensive, integrated approach to analyze the genetic connections for all of the above aspects of aging-related changes. Conclusion The dynamic relationships among aging, health, and longevity traits would be better understood if one linked several research fields within one conceptual framework that allowed for efficient analyses of available longitudinal data using the wealth of available knowledge about aging, health, and longevity already accumulated in the research field. PMID:26280653

Jordan Water Project: an interdisciplinary evaluation of freshwater vulnerability and security

NASA Astrophysics Data System (ADS)

Gorelick, S.; Yoon, J.; Rajsekhar, D.; Muller, M. F.; Zhang, H.; Gawel, E.; Klauer, B.; Klassert, C. J. A.; Sigel, K.; Thilmant, A.; Avisse, N.; Lachaut, T.; Harou, J. J.; Knox, S.; Selby, P. D.; Mustafa, D.; Talozi, S.; Haddad, Y.; Shamekh, M.

2016-12-01

The Jordan Water Project, part of the Belmont Forum projects, is an interdisciplinary, international research effort focused on evaluation of freshwater security in Jordan, one of the most water-vulnerable countries in the world. The team covers hydrology, water resources systems analysis, economics, policy evaluation, geography, risk and remote sensing analyses, and model platform development. The entire project team communally engaged in construction of an integrated hydroeconomic model for water supply policy evaluation. To represent water demand and allocation behavior at multiple levels of decision making,the model integrates biophysical modules that simulate natural and engineered hydrologic phenomena with human behavioral modules. Hydrologic modules include spatially-distributed groundwater and surface-water models for the major aquifers and watersheds throughout Jordan. For the human modules, we adopt a multi-agent modeling approach to represent decision-making processes. The integrated model was developed in Pynsim, a new open-source, object-oriented platform in Python for network-based water resource systems. We continue to explore the impacts of future scenarios and interventions.This project had tremendous encouragement and data support from Jordan's Ministry of Water and Irrigation. Modeling technology is being transferred through a companion NSF/USAID PEER project awarded toJordan University of Science and Technology. Individual teams have also conducted a range of studies aimed at evaluating Jordanian and transboundary surface water and groundwater systems. Surveys, interviews, and econometric analyses enabled us to better understandthe behavior of urban households, farmers, private water resellers, water use pattern of the commercial sector and irrigation water user associations. We analyzed nationwide spatial and temporal statistical trends in rainfall, developed urban and national comparative metrics to quantify water supply vulnerability, improved remote sensing methods to estimate crop-water use, and evaluated the impacts of climate change on future drought severity.

Lunar Exploration Architecture Level Key Drivers and Sensitivities

NASA Technical Reports Server (NTRS)

Goodliff, Kandyce; Cirillo, William; Earle, Kevin; Reeves, J. D.; Shyface, Hilary; Andraschko, Mark; Merrill, R. Gabe; Stromgren, Chel; Cirillo, Christopher

2009-01-01

Strategic level analysis of the integrated behavior of lunar transportation and lunar surface systems architecture options is performed to assess the benefit, viability, affordability, and robustness of system design choices. This analysis employs both deterministic and probabilistic modeling techniques so that the extent of potential future uncertainties associated with each option are properly characterized. The results of these analyses are summarized in a predefined set of high-level Figures of Merit (FOMs) so as to provide senior NASA Constellation Program (CxP) and Exploration Systems Mission Directorate (ESMD) management with pertinent information to better inform strategic level decision making. The strategic level exploration architecture model is designed to perform analysis at as high a level as possible but still capture those details that have major impacts on system performance. The strategic analysis methodology focuses on integrated performance, affordability, and risk analysis, and captures the linkages and feedbacks between these three areas. Each of these results leads into the determination of the high-level FOMs. This strategic level analysis methodology has been previously applied to Space Shuttle and International Space Station assessments and is now being applied to the development of the Constellation Program point-of-departure lunar architecture. This paper provides an overview of the strategic analysis methodology and the lunar exploration architecture analyses to date. In studying these analysis results, the strategic analysis team has identified and characterized key drivers affecting the integrated architecture behavior. These key drivers include inclusion of a cargo lander, mission rate, mission location, fixed-versus- variable costs/return on investment, and the requirement for probabilistic analysis. Results of sensitivity analysis performed on lunar exploration architecture scenarios are also presented.

Verbal understanding: Integrating the conceptual analyses of Skinner, Ryle, and Wittgenstein.

PubMed

Schoneberger, T

1991-01-01

Gilbert Ryle's (1949) and Ludwig Wittgenstein's (1953; 1958; 1974/78) conceptual analyses of verbal understanding are presented. For Ryle, the term understanding signifies simultaneously an acquired disposition and a behavioral episode. For Wittgenstein, it signifies simultaneously a skill and a criterial behavior. Both argued that episodes of understanding comprise heterogenious classes of behaviors, and that each member of such a class is neither a necessary nor a sufficient condition of understanding. Next, an approach integrating the analyses of Ryle and Wittgenstein with that of Skinner is presented. Lastly, it is argued that this integrated analysis adequately counters Parrott's (1984) argument that understanding, for Skinner, is potential behavior and not an event.

Verbal understanding: Integrating the conceptual analyses of Skinner, Ryle, and Wittgenstein

PubMed Central

Schoneberger, Ted

1991-01-01

Gilbert Ryle's (1949) and Ludwig Wittgenstein's (1953; 1958; 1974/78) conceptual analyses of verbal understanding are presented. For Ryle, the term understanding signifies simultaneously an acquired disposition and a behavioral episode. For Wittgenstein, it signifies simultaneously a skill and a criterial behavior. Both argued that episodes of understanding comprise heterogenious classes of behaviors, and that each member of such a class is neither a necessary nor a sufficient condition of understanding. Next, an approach integrating the analyses of Ryle and Wittgenstein with that of Skinner is presented. Lastly, it is argued that this integrated analysis adequately counters Parrott's (1984) argument that understanding, for Skinner, is potential behavior and not an event. PMID:22477637

Factors Associated with Post-Seasonal Serological Titer and Risk Factors for Infection with the Pandemic A/H1N1 Virus in the French General Population

PubMed Central

Lapidus, Nathanael; de Lamballerie, Xavier; Salez, Nicolas; Setbon, Michel; Delabre, Rosemary M.; Ferrari, Pascal; Moyen, Nanikaly; Gougeon, Marie-Lise; Vely, Frédéric; Leruez-Ville, Marianne; Andreoletti, Laurent; Cauchemez, Simon; Boëlle, Pierre-Yves; Vivier, Éric; Abel, Laurent; Schwarzinger, Michaël; Legeas, Michèle; Le Cann, Pierre; Flahault, Antoine; Carrat, Fabrice

2013-01-01

The CoPanFlu-France cohort of households was set up in 2009 to study the risk factors for infection by the pandemic influenza virus (H1N1pdm) in the French general population. The authors developed an integrative data-driven approach to identify individual, collective and environmental factors associated with the post-seasonal serological H1N1pdm geometric mean titer, and derived a nested case-control analysis to identify risk factors for infection during the first season. This analysis included 1377 subjects (601 households). The GMT for the general population was 47.1 (95% confidence interval (CI): 45.1, 49.2). According to a multivariable analysis, pandemic vaccination, seasonal vaccination in 2009, recent history of influenza-like illness, asthma, chronic obstructive pulmonary disease, social contacts at school and use of public transports by the local population were associated with a higher GMT, whereas history of smoking was associated with a lower GMT. Additionally, young age at inclusion and risk perception of exposure to the virus at work were identified as possible risk factors, whereas presence of an air humidifier in the living room was a possible protective factor. These findings will be interpreted in light of the longitudinal analyses of this ongoing cohort. PMID:23613718

JCL Implementation On A Human Spaceflight Program

NASA Technical Reports Server (NTRS)

Kulpa, Vyga; Karpowich, Mike; Abel, Diana; Archiable, Wes; Carson, William

2013-01-01

Joint Confidence Level (JCL) analysis focuses on the integration of traditionally stove-piped programmatic components (schedule, cost and risk) to establish projected resource and schedule requirements at various confidence levels and to identify programmatic cost and schedule risk drivers. SLS Program consists of multiple Prime Contractors managed by independent SLS Elements which are integrated using SE&I and Program Management. SLS further integrates with GSDO and MPCV through ESD integrated working groups.

Should Men who have sex with Men be allowed to donate blood in Israel?

PubMed

Ginsberg, Gary Michael; Shinar, Eilat; Kopel, Eran; Chemtob, Daniel

2016-01-01

The present permanent deferral policy in Israel for MSM was established in 1977 and was based on the previous (now outdated) USA Food and Drug Administration standards. This study analyses epidemiological data regarding blood donations among MSM, in order to estimate the risk for HIV transfusion transmitted infection (TTI) if the policy is changed to allow at-risk MSM to donate blood. An Excel based spreadsheet model integrated demographic, epidemiological data from the HIV National Register, laboratory, blood donation and testing data in order to calculate TTI due to false-negatives in known HIV+ donors, windows period donations, asymptomatic carriers and laboratory misclassification errors. A sensitivity analysis of our estimated TTIs for deferral periods for MSM was performed based on a literature review regarding this overall policy issue worldwide. MSM in Israel have a considerably higher relative risk (RR) of both prevalence (115) and incidence (143) of being HIV+ than persons without a risk factor. Allowing MSM to donate blood, without any deferral period, will add an additional five HIV TTI cases over the next decade. Imposition of a 1 or 5 years deferral of abstinence will increase the number of HIV TTI cases only by 0.10 and 0.05 cases, respectively. A 1 year deferral period for blood donations from MSM in Israel is recommended.

Antibodies to Plasmodium falciparum antigens predict a higher risk of malaria but protection from symptoms once parasitemic.

PubMed

Greenhouse, Bryan; Ho, Benjamin; Hubbard, Alan; Njama-Meya, Denise; Narum, David L; Lanar, David E; Dutta, Sheetij; Rosenthal, Philip J; Dorsey, Grant; John, Chandy C

2011-07-01

Associations between antibody responses to Plasmodium falciparum antigens and protection against symptomatic malaria have been difficult to ascertain, in part because antibodies are potential markers of both exposure to P. falciparum and protection against disease. We measured IgG responses to P. falciparum circumsporozoite protein, liver-stage antigen 1, apical-membrane antigen 1 (AMA-1), and merozoite surface proteins (MSP) 1 and 3, in children in Kampala, Uganda, and measured incidence of malaria before and after antibody measurement. Stronger responses to all 5 antigens were associated with an increased risk of clinical malaria (P < .01) because of confounding with prior exposure to P. falciparum. However, with use of another assessment, risk of clinical malaria once parasitemic, stronger responses to AMA-1, MSP-1, and MSP-3 were associated with protection (odds ratios, 0.34, 0.36, and 0.31, respectively, per 10-fold increase; P < .01). Analyses assessing antibodies in combination suggested that any protective effect of antibodies was overestimated by associations between individual responses and protection. Using the risk of symptomatic malaria once parasitemic as an outcome may improve detection of associations between immune responses and protection from disease. Immunoepidemiology studies designed to detect mechanisms of immune protection should integrate prior exposure into the analysis and evaluate multiple immune responses.

Methods for external event screening quantification: Risk Methods Integration and Evaluation Program (RMIEP) methods development

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

Ravindra, M.K.; Banon, H.

1992-07-01

In this report, the scoping quantification procedures for external events in probabilistic risk assessments of nuclear power plants are described. External event analysis in a PRA has three important goals; (1) the analysis should be complete in that all events are considered; (2) by following some selected screening criteria, the more significant events are identified for detailed analysis; (3) the selected events are analyzed in depth by taking into account the unique features of the events: hazard, fragility of structures and equipment, external-event initiated accident sequences, etc. Based on the above goals, external event analysis may be considered as amore » three-stage process: Stage I: Identification and Initial Screening of External Events; Stage II: Bounding Analysis; Stage III: Detailed Risk Analysis. In the present report, first, a review of published PRAs is given to focus on the significance and treatment of external events in full-scope PRAs. Except for seismic, flooding, fire, and extreme wind events, the contributions of other external events to plant risk have been found to be negligible. Second, scoping methods for external events not covered in detail in the NRC's PRA Procedures Guide are provided. For this purpose, bounding analyses for transportation accidents, extreme winds and tornadoes, aircraft impacts, turbine missiles, and chemical release are described.« less

Do drug warnings and market withdrawals have an impact on the number of calls to teratogen information services?

PubMed

Sheehy, O; Gendron, M-P; Martin, B; Bérard, A

2012-06-01

IMAGe provides information on risks and benefits of medication use during pregnancy and lactation. The aim of this study was to determine the impact of Health Canada warnings on the number of calls received at IMAGe. We analyzed calls received between January 2003 and March 2008. The impact of the following warning/withdrawal were studied: paroxetine and risk of cardiac malformations (09/29/2005), selective serotonin reuptake inhibitors (SSRIs) and risk of persistent pulmonary hypertension of the newborn (PPHN) (03/10/2006), and impact of rofecoxib market withdrawal (09/30/2004). Interrupted auto-regressive integrated -moving average (ARIMA) analyses were used to test the impact of each warning on the number of calls received to IMAGe. 61,505 calls were analyzed. The paroxetine warning had a temporary impact increasing the overall number of calls to IMAGe, and an abrupt permanent effect on the number of calls related to antidepressant exposures. The PPHN warning had no impact but we observed a significant increase in the number of calls following rofecoxib market withdrawal. Health Canada needs to consider the increase in the demand of information to IMAGe following warnings on the risk of medication use during pregnancy. © Georg Thieme Verlag KG Stuttgart · New York.

Failure environment analysis tool applications

NASA Astrophysics Data System (ADS)

Pack, Ginger L.; Wadsworth, David B.

1993-02-01

Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.

Flightdeck Automation Problems (FLAP) Model for Safety Technology Portfolio Assessment

NASA Technical Reports Server (NTRS)

Ancel, Ersin; Shih, Ann T.

2014-01-01

NASA's Aviation Safety Program (AvSP) develops and advances methodologies and technologies to improve air transportation safety. The Safety Analysis and Integration Team (SAIT) conducts a safety technology portfolio assessment (PA) to analyze the program content, to examine the benefits and risks of products with respect to program goals, and to support programmatic decision making. The PA process includes systematic identification of current and future safety risks as well as tracking several quantitative and qualitative metrics to ensure the program goals are addressing prominent safety risks accurately and effectively. One of the metrics within the PA process involves using quantitative aviation safety models to gauge the impact of the safety products. This paper demonstrates the role of aviation safety modeling by providing model outputs and evaluating a sample of portfolio elements using the Flightdeck Automation Problems (FLAP) model. The model enables not only ranking of the quantitative relative risk reduction impact of all portfolio elements, but also highlighting the areas with high potential impact via sensitivity and gap analyses in support of the program office. Although the model outputs are preliminary and products are notional, the process shown in this paper is essential to a comprehensive PA of NASA's safety products in the current program and future programs/projects.

Substantiating the need for primary care-based sexual health promotion interventions for ethnic minority adolescent women experiencing health disparities.

PubMed

Champion, Jane Dimmitt; Young, Cara; Rew, Lynn

2016-09-01

Assess the context of psychological distress, violence, and substance use among African- and Mexican-American adolescent women with a history of STI, violence, or high sexual risk behavior. These adolescents experience multiple health disparities, limited access to care, and are at particularly high risk of adverse sexual health outcomes. The results will inform sexual health promotion interventions provided by advanced practice nurses in primary care-based settings for women experiencing these disparities. Analysis of self-report data obtained at study entry from African- and Mexican-American adolescent women (n = 559) enrolled in a randomized trial of a behavioral intervention for sexual risk reduction. High levels of psychological distress, sexual risk behavior, sexually transmitted infection (STI), personal and friend/peer substance use, alcohol use, and violence were reported by women at study entry. Analyses found that STI, physical violence, and substance-using friends were twice as likely associated with personal substance use. Alcohol users were five times more likely to use other substances. Mexican Americans were three times more likely than African Americans to use substances. Recommendation is made for integration of multicomponent sexual health promotion interventions as advanced practice nurse provider services addressing these health disparities within primary care-based settings. ©2016 American Association of Nurse Practitioners.

Failure environment analysis tool applications

NASA Technical Reports Server (NTRS)

Pack, Ginger L.; Wadsworth, David B.

1993-01-01

Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.

Failure environment analysis tool applications

NASA Technical Reports Server (NTRS)

Pack, Ginger L.; Wadsworth, David B.

1994-01-01

Understanding risks and avoiding failure are daily concerns for the women and men of NASA. Although NASA's mission propels us to push the limits of technology, and though the risks are considerable, the NASA community has instilled within it, the determination to preserve the integrity of the systems upon which our mission and, our employees lives and well-being depend. One of the ways this is being done is by expanding and improving the tools used to perform risk assessment. The Failure Environment Analysis Tool (FEAT) was developed to help engineers and analysts more thoroughly and reliably conduct risk assessment and failure analysis. FEAT accomplishes this by providing answers to questions regarding what might have caused a particular failure; or, conversely, what effect the occurrence of a failure might have on an entire system. Additionally, FEAT can determine what common causes could have resulted in other combinations of failures. FEAT will even help determine the vulnerability of a system to failures, in light of reduced capability. FEAT also is useful in training personnel who must develop an understanding of particular systems. FEAT facilitates training on system behavior, by providing an automated environment in which to conduct 'what-if' evaluation. These types of analyses make FEAT a valuable tool for engineers and operations personnel in the design, analysis, and operation of NASA space systems.

Alcohol misuse, depressive symptoms, and HIV/STI risks of US Hispanic women.

PubMed

McCabe, Brian E; Schaefer Solle, Natasha; Peragallo Montano, Nilda; Mitrani, Victoria B

2017-10-01

Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study's objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = -.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women's health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.

Surveying hospital network structure in New York State: how are they structured?

PubMed

Nauenberg, E; Brewer, C S

2000-01-01

We determine the most common network structures in New York state. The taxonomy employed uses three structural dimensions: integration, complexity, and risk-sharing between organizations. Based on a survey conducted in 1996, the most common type of network (26.4 percent) had medium levels of integration, medium or high levels of complexity, and some risk-sharing. Also common were networks with low levels of integration, low levels of complexity, and no risk-sharing (22.1 percent).

[Functioning of integration in Secondary School according to the teachers' perception].

PubMed

Alvarez Martino, Eva; Alvarez Hernández, Marina; Castro Pañeda, Pilar; Campo Mon, María A; Fueyo Gutiérrez, Eva

2008-02-01

The main purpose of this article is to analyse integration in Compulsory Secondary School and the variables that teachers perceive as its indicators. More specifically, we wished to determine teachers' experience, their perceptions of integration students' achievement, participation, acceptance and involvement, and their appraisal of various measures in order to improve integration. Various preferred means of schooling and teachers' perception of the functioning of integration are analysed with a Likert-scaled questionnaire made up of 114 items. The sample comprised 242 secondary education teachers. The results show that the most poorly integrated group of students had behavioural problems and that a significant percentage of the teachers would prefer not to have these students in their classrooms. According to the teachers, integration does not work effectively with some groups of students, mainly due to the lack of resources and adequate strategies.

Risk Quantification of Systems Engineering Documents Improves Probability of DOD Project Success

DTIC Science & Technology

2009-09-01

comprehensive risk model for DoD milestone review documentation as well as recommended changes to the Capability Maturity Model Integration ( CMMI ) Project...Milestone Documentation, Project Planning, Rational Frame, Political Frame, CMMI Project Planning Process Area, CMMI Risk Management Process Area...well as recommended changes to the Capability Maturity Model Integration ( CMMI ) Project Planning and Risk Management process areas. The intent is to

Risk Interfaces to Support Integrated Systems Analysis and Development

NASA Technical Reports Server (NTRS)

Mindock, Jennifer; Lumpkins, Sarah; Shelhamer, Mark; Anton, Wilma; Havenhill, Maria

2016-01-01

Objectives for systems analysis capability: Develop integrated understanding of how a complex human physiological-socio-technical mission system behaves in spaceflight. Why? Support development of integrated solutions that prevent unwanted outcomes (Implementable approaches to minimize mission resources(mass, power, crew time, etc.)); Support development of tools for autonomy (need for exploration) (Assess and maintain resilience -individuals, teams, integrated system). Output of this exercise: -Representation of interfaces based on Human System Risk Board (HSRB) Risk Summary information and simple status based on Human Research Roadmap; Consolidated HSRB information applied to support communication; Point-of-Departure for HRP Element planning; Ability to track and communicate status of collaborations. 4

The integrated effect of moderate exercise on coronary heart disease.

PubMed

Mathews, Marc J; Mathews, Edward H; Mathews, George E

Moderate exercise is associated with a lower risk for coronary heart disease (CHD). A suitable integrated model of the CHD pathogenetic pathways relevant to moderate exercise may help to elucidate this association. Such a model is currently not available in the literature. An integrated model of CHD was developed and used to investigate pathogenetic pathways of importance between exercise and CHD. Using biomarker relative-risk data, the pathogenetic effects are representable as measurable effects based on changes in biomarkers. The integrated model provides insight into higherorder interactions underlying the associations between CHD and moderate exercise. A novel 'connection graph' was developed, which simplifies these interactions. It quantitatively illustrates the relationship between moderate exercise and various serological biomarkers of CHD. The connection graph of moderate exercise elucidates all the possible integrated actions through which risk reduction may occur. An integrated model of CHD provides a summary of the effects of moderate exercise on CHD. It also shows the importance of each CHD pathway that moderate exercise influences. The CHD risk-reducing effects of exercise appear to be primarily driven by decreased inflammation and altered metabolism.

Provider accountability as a driving force towards physician–hospital integration: a systematic review

PubMed Central

Trybou, Jeroen; Gemmel, Paul; Annemans, Lieven

2015-01-01

Background Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated. Purpose To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models. Results Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration. Conclusion The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately. PMID:26034469

A new multicriteria risk mapping approach based on a multiattribute frontier concept.

PubMed

Yemshanov, Denys; Koch, Frank H; Ben-Haim, Yakov; Downing, Marla; Sapio, Frank; Siltanen, Marty

2013-09-01

Invasive species risk maps provide broad guidance on where to allocate resources for pest monitoring and regulation, but they often present individual risk components (such as climatic suitability, host abundance, or introduction potential) as independent entities. These independent risk components are integrated using various multicriteria analysis techniques that typically require prior knowledge of the risk components' importance. Such information is often nonexistent for many invasive pests. This study proposes a new approach for building integrated risk maps using the principle of a multiattribute efficient frontier and analyzing the partial order of elements of a risk map as distributed in multidimensional criteria space. The integrated risks are estimated as subsequent multiattribute frontiers in dimensions of individual risk criteria. We demonstrate the approach with the example of Agrilus biguttatus Fabricius, a high-risk pest that may threaten North American oak forests in the near future. Drawing on U.S. and Canadian data, we compare the performance of the multiattribute ranking against a multicriteria linear weighted averaging technique in the presence of uncertainties, using the concept of robustness from info-gap decision theory. The results show major geographic hotspots where the consideration of tradeoffs between multiple risk components changes integrated risk rankings. Both methods delineate similar geographical regions of high and low risks. Overall, aggregation based on a delineation of multiattribute efficient frontiers can be a useful tool to prioritize risks for anticipated invasive pests, which usually have an extremely poor prior knowledge base. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

The joint contribution of neighborhood poverty and social integration to mortality risk in the United States.

PubMed

Marcus, Andrea Fleisch; Echeverria, Sandra E; Holland, Bart K; Abraido-Lanza, Ana F; Passannante, Marian R

2016-04-01

A well-established literature has shown that social integration strongly patterns health, including mortality risk. However, the extent to which living in high-poverty neighborhoods and having few social ties jointly pattern survival in the United States has not been examined. We analyzed data from the Third National Health and Nutrition Examination Survey (1988-1994) linked to mortality follow-up through 2006 and census-based neighborhood poverty. We fit Cox proportional hazards models to estimate associations between social integration and neighborhood poverty on all-cause mortality as independent predictors and in joint-effects models using the relative excess risk due to interaction to test for interaction on an additive scale. In the joint-effects model adjusting for age, gender, race/ ethnicity, and individual-level socioeconomic status, exposure to low social integration alone was associated with increased mortality risk (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.28-1.59) while living in an area of high poverty alone did not have a significant effect (HR: 1.10; 95% CI: 0.95-1.28) when compared with being jointly unexposed. Individuals simultaneously living in neighborhoods characterized by high poverty and having low levels of social integration had an increased risk of mortality (HR: 1.63; 95% CI: 1.35-1.96). However, relative excess risk due to interaction results were not statistically significant. Social integration remains an important determinant of mortality risk in the United States independent of neighborhood poverty. Copyright © 2016 Elsevier Inc. All rights reserved.

A Proactive and Top-Down Approach to Managing Risk at NASA

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon

2010-01-01

Our ultimate goal is to manage risk in a holistic and coherent fashion across the Agency: a) The RIDM process is intended to risk-inform direction-setting decisions. c) The CRM process is intended to manage risk associated with the implementation of baseline performance requirements. Currently we are working on: a) Enhancements to the CRM process. b) Better integration of the RIDM and CRM processes. c) Better integration of institutional risk considerations into RM framework.

Utilization of GIS/GPS-Based Information Technology in Commercial Crop Decision Making in California, Washington, Oregon, Idaho, and Arizona

PubMed Central

Thomas, C. S.; Skinner, P. W.; Fox, A. D.; Greer, C. A.; Gubler, W. D.

2002-01-01

Ground-based weather, plant-stage measurements, and remote imagery were geo-referenced in geographic information system (GIS) software using an integrated approach to determine insect and disease risk and crop cultural requirements. Weather forecasts and disease weather forecasts for agricultural areas were constructed with elevation, weather, and satellite data. Models for 6 insect pests and 12 diseases of various crops were calculated and presented daily in georeferenced maps for agricultural areas in northern California and Washington. Grape harvest dates and yields also were predicted with high accuracy. The data generated from the GIS global positioning system (GPS) analyses were used to make management decisions over a large number of acres in California, Washington, Oregon, Idaho, and Arizona. Information was distributed daily over the Internet as regional weather, insect, and disease risk maps as industry-sponsored or subscription-based products. Use of GIS/GPS technology for semi-automated data analysis is discussed. PMID:19265934

Human papillomavirus 16 E6 modulates the expression of miR-496 in oropharyngeal cancer.

PubMed

Mason, Dayna; Zhang, Xiaoying; Marques, Tânia Monteiro; Rose, Barbara; Khoury, Samantha; Hill, Meredith; Deutsch, Fiona; Lyons, J Guy; Gama-Carvalho, Margarida; Tran, Nham

2018-06-20

Human papillomavirus (HPV), notably type 16, is a risk factor for up to 75% of oropharyngeal squamous cell carcinomas (SCC). It has been demonstrated that small non-coding RNAs known as microRNAs play a vital role in the cellular transformation process. In this study, we used an LNA array to further investigate the impact of HPV16 on the expression of microRNAs in oropharyngeal (tonsillar) cancer. A number of miRNAs were found to be deregulated, with miR-496 showing a four-fold decrease. Over-expression of the high risk E6 oncoprotein down-regulated miR-496, impacting upon the post-transcriptional control of the transcription factor E2F2. These HPV specific miRNAs were integrated with the HPV16 interactome to identify possible mechanistic pathways. These analyses provide insights into novel molecular interactions between HPV16 and miRNAs in oropharyngeal cancers. Copyright © 2018. Published by Elsevier Inc.

Evaluation of Enhanced Risk Monitors for Use on Advanced Reactors

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

Ramuhalli, Pradeep; Veeramany, Arun; Bonebrake, Christopher A.

This study provides an overview of the methodology for integrating time-dependent failure probabilities into nuclear power reactor risk monitors. This prototypic enhanced risk monitor (ERM) methodology was evaluated using a hypothetical probabilistic risk assessment (PRA) model, generated using a simplified design of a liquid-metal-cooled advanced reactor (AR). Component failure data from industry compilation of failures of components similar to those in the simplified AR model were used to initialize the PRA model. Core damage frequency (CDF) over time were computed and analyzed. In addition, a study on alternative risk metrics for ARs was conducted. Risk metrics that quantify the normalizedmore » cost of repairs, replacements, or other operations and management (O&M) actions were defined and used, along with an economic model, to compute the likely economic risk of future actions such as deferred maintenance based on the anticipated change in CDF due to current component condition and future anticipated degradation. Such integration of conventional-risk metrics with alternate-risk metrics provides a convenient mechanism for assessing the impact of O&M decisions on safety and economics of the plant. It is expected that, when integrated with supervisory control algorithms, such integrated-risk monitors will provide a mechanism for real-time control decision-making that ensure safety margins are maintained while operating the plant in an economically viable manner.« less

System-wide effects of Global Fund investments in Nepal.

PubMed

Trägård, Anna; Shrestha, Ishwar Bahadur

2010-11-01

Nepal, with a concentrated HIV epidemic and high burden of tuberculosis (TB) and malaria, was perceived to have immensely benefited from grants by the Global Fund to Fight AIDS, Tuberculosis and Malaria in addressing the three diseases, amounting to total approved funding of US$80 million. This paper looks at the interaction and integration of Global Fund-supported programmes and national health systems. A mixed method 'case study' approach based on the Systemic Rapid Assessment Toolkit (SYSRA) was used to systematically analyse across the main health systems functional domains. The Country Coordinating Mechanism has been credited with providing the stewardship in attracting additional resources and providing oversight. The involvement of civil society for delivering key HIV and malaria interventions targeting high-risk groups was perceived to be highly beneficial. TB and malaria services were found to be well integrated into the public health care delivery system, while HIV services targeting at-risk groups were often delivered using parallel structures. Political instability, absence of continuity in leadership and sub-optimal investments in health were together perceived to have led to fragmentation of financing and planning activities, especially in HIV the programme. The demand for timely programmatic and financial reporting for donor-supported programmes has contributed to the creation of parallel monitoring and evaluation structures, with missed opportunities for strengthening and utilizing the national health management information systems.

An integrated approach for hazard assessment and mitigation of debris flows in the Italian Dolomites

NASA Astrophysics Data System (ADS)

Pasuto, Alessandro; Soldati, Mauro

2004-07-01

This paper shows the results of research on a debris flow occurring on 4 September 1997 in the territory of Cortina d'Ampezzo (Dolomites, Italy) where it caused a significant threat owing to the intense urban development, typical of several Alpine valleys. The event, which affected the talus fans at the foot of Mt. Pomagagnon near the village of Fiames, blocked the state road no. 51 "Alemagna" and, after sparing some houses, barred the course of the Torrent Boite and formed an impoundment. This debris flow aroused great concern among local authorities and the Belluno Civil Engineers Board; therefore, the construction of embankments for protecting the buildings threatened by the debris flow was started immediately. This area was studied in detail during this research in order to identify the hazard situations of the whole slope. The investigations made use of an integrated approach including historical, geomorphological, geostructural, meteorological, pedological, and forest-management aspects. Furthermore, assessments of the debris volumes potentially removable in the source area were carried out. The geomorphological evolution of the area was reconstructed, pinpointing the morphological changes occurring in the past 45 years. Taking into account the increased frequency and magnitude of recent events and considering the location of roads and buildings in the accumulation area, the risk conditions were analysed in order to identify a risk zonation and to propose mitigation measures.

New ventures require accurate risk analyses and adjustments.

PubMed

Eastaugh, S R

2000-01-01

For new business ventures to succeed, healthcare executives need to conduct robust risk analyses and develop new approaches to balance risk and return. Risk analysis involves examination of objective risks and harder-to-quantify subjective risks. Mathematical principles applied to investment portfolios also can be applied to a portfolio of departments or strategic business units within an organization. The ideal business investment would have a high expected return and a low standard deviation. Nonetheless, both conservative and speculative strategies should be considered in determining an organization's optimal service line and helping the organization manage risk.

Uncertainties in Earthquake Loss Analysis: A Case Study From Southern California

NASA Astrophysics Data System (ADS)

Mahdyiar, M.; Guin, J.

2005-12-01

Probabilistic earthquake hazard and loss analyses play important roles in many areas of risk management, including earthquake related public policy and insurance ratemaking. Rigorous loss estimation for portfolios of properties is difficult since there are various types of uncertainties in all aspects of modeling and analysis. It is the objective of this study to investigate the sensitivity of earthquake loss estimation to uncertainties in regional seismicity, earthquake source parameters, ground motions, and sites' spatial correlation on typical property portfolios in Southern California. Southern California is an attractive region for such a study because it has a large population concentration exposed to significant levels of seismic hazard. During the last decade, there have been several comprehensive studies of most regional faults and seismogenic sources. There have also been detailed studies on regional ground motion attenuations and regional and local site responses to ground motions. This information has been used by engineering seismologists to conduct regional seismic hazard and risk analysis on a routine basis. However, one of the more difficult tasks in such studies is the proper incorporation of uncertainties in the analysis. From the hazard side, there are uncertainties in the magnitudes, rates and mechanisms of the seismic sources and local site conditions and ground motion site amplifications. From the vulnerability side, there are considerable uncertainties in estimating the state of damage of buildings under different earthquake ground motions. From an analytical side, there are challenges in capturing the spatial correlation of ground motions and building damage, and integrating thousands of loss distribution curves with different degrees of correlation. In this paper we propose to address some of these issues by conducting loss analyses of a typical small portfolio in southern California, taking into consideration various source and ground motion uncertainties. The approach is designed to integrate loss distribution functions with different degrees of correlation for portfolio analysis. The analysis is based on USGS 2002 regional seismicity model.

Untangling Risk in Water Supply Systems: What Factors Drive Long-term Adaptation?

NASA Astrophysics Data System (ADS)

Zeff, H. B.; Lin, L.; Band, L. E.; Reed, P. M.; Characklis, G. W.

2016-12-01

Deeply uncertain factors like climate change, the hydrologic impacts of urbanization, forest evolution, and long-term demand forecasts make water supply planning a `wicked' problem. The traditional technique of assessing risk based on historical observations can be inadequate in the face of environmental non-stationarity. However, competing models and limited observational data make it difficult for decision makers and experts to agree on how much uncertainty should be built into analyses of risk, particularly at the timescales relevant to long-term investments in water infrastructure. Further, the physical connectivity of these deeply uncertain processes create inter-related systems, amplifying the challenges of a `worst case scenario'. The development of adaptive systems and planning processes provide solutions that have been shown to meet technical, environmental, and social objectives at lower costs. Instead of developing plans with fixed targets for the timing of actions, adaptive plans develop risk metrics and thresholds that are able to integrate new information to determine when conditions reach a `tipping point' which necessitates action. It is an open question as to how new information can be best integrated into the decision-making process (i.e. how much weight do we give new observations relative to the historical record), but a better understanding of the way the relevant systems are expected to evolve and change over time could inform these decisions. In this study, we use linked, dynamic models of temperature and precipitation changes, forest evolution, urbanization, hydrology, and water demand to develop scenarios for an adaptive water management framework that uses risk-based metrics to make short- and long-term decisions. The impact of individual environmental processes on the adaptive capability of this management framework is evaluated through problem formulations that successively increase the complexity of the uncertainty scenarios. Although this work is focused on a group of water utilities in the Research Triangle of North Carolina, results provide insights into the conditions under which environmental changes could outpace our adaptive skill. In turn, risk measures can be designed to identify these conditions and better inform adaptive planning methods.

From theoretical concepts to policies and applied programmes: the landscape of integration of oral health in primary care.

PubMed

Harnagea, Hermina; Lamothe, Lise; Couturier, Yves; Esfandiari, Shahrokh; Voyer, René; Charbonneau, Anne; Emami, Elham

2018-02-15

Despite its importance, the integration of oral health into primary care is still an emerging practice in the field of health care services. This scoping review aims to map the literature and provide a summary on the conceptual frameworks, policies and programs related to this concept. Using the Levac et al. six-stage framework, we performed a systematic search of electronic databases, organizational websites and grey literature from 1978 to April 2016. All relevant original publications with a focus on the integration of oral health into primary care were retrieved. Content analyses were performed to synthesize the results. From a total of 1619 citations, 67 publications were included in the review. Two conceptual frameworks were identified. Policies regarding oral heath integration into primary care were mostly oriented toward common risk factors approach and care coordination processes. In general, oral health integrated care programs were designed in the public health sector and based on partnerships with various private and public health organizations, governmental bodies and academic institutions. These programmes used various strategies to empower oral health integrated care, including building interdisciplinary networks, training non-dental care providers, oral health champion modelling, enabling care linkages and care coordinated process, as well as the use of e-health technologies. The majority of studies on the programs outcomes were descriptive in nature without reporting long-term outcomes. This scoping review provided a comprehensive overview on the concept of integration of oral health in primary care. The findings identified major gaps in reported programs outcomes mainly because of the lack of related research. However, the results could be considered as a first step in the development of health care policies that support collaborative practices and patient-centred care in the field of primary care sector.

Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis

PubMed Central

Leme, Ana Carolina Barco; Thompson, Debbe; Lenz Dunker, Karin Louise; Nicklas, Theresa; Tucunduva Philippi, Sonia; Lopez, Tabbetha; Baranowski, Tom

2018-01-01

Introduction Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusing on weight may contribute to excessive concern with diet and weight. Therefore, the proposed research will assess whether integrating obesity and eating disorder prevention procedures (‘integrated approach’) do better than single approach interventions in preventing obesity among adolescents, and if integrated approaches influence weight-related outcomes. Methods and analysis Integrated obesity and eating disorder prevention interventions will be identified. Randomised controlled trials and quasi-experimental trials reporting data on adolescents ranging from 10 to 19 years of age from both sexes will be included. Outcomes of interest include body composition, unhealthy weight control behaviours and body satisfaction measurements. MEDLINE/PubMed, PsycINFO, Web of Science and SciELO will be searched. Data will be extracted independently by two reviewers using a standardised data extraction form. Trial quality will be assessed using the Cochrane Collaboration criteria. The effects of integrated versus single approach intervention studies will be compared using systematic review procedures. If an adequate number of studies report data on integrated interventions among similar populations (k>5), a meta-analysis with random effects will be conducted. Sensitivity analyses and meta-regression will be performed only if between-study heterogeneity is high (I2 ≥75%). Ethics and dissemination Ethics approval will not be required as this is a systematic review of published studies. The findings will be disseminated through conference presentations and peer-reviewed journals. PMID:29674372

Can Vertical Integration Reduce Hospital Readmissions? A Difference-in-Differences Approach

PubMed Central

Fernandes, Óscar B.; Marques, Ana Patrícia; Moita, Bruno; Sarmento, João; Santana, Rui

2017-01-01

Background: Vertical integration is expected to improve communication and coordination between inpatient care and care after discharge. Despite being used across health systems worldwide, evidence about its impact on readmissions is sparse and contradictory. Objective: To assess the impact of vertical integration on hospital readmissions. Research Design, Subjects, and Measures: Using difference-in-differences we compared readmissions before and after vertical integration in 6 Portuguese hospitals for years 2004–2013. A control group with 6 similar hospitals not integrated was utilized. Considered outcome was 30-day unplanned readmission. We used logistic regression at the admission level and accounted for patients’ risk factors using claims data. Analyses for each hospital and selected conditions were also run. Results: Our results suggest that readmissions decreased overall after vertical integration [odds ratio (OR)=0.900; 95% confidence interval (CI), 0.812–0.997]. Hospital analysis indicated that there was no impact for 2 hospitals (OR=0.960; 95% CI, 0.848–1.087 and OR=0.944; 95% CI, 0.857–1.038), and a positive effect in 4 hospitals (greatest effect: OR=0.811; 95% CI, 0.736–0.894). A positive evolution was observed for a limited number of conditions, with better results for diabetes with complications (OR=0.689; 95% CI, 0.525–0.904), but no impact regarding congestive heart failure (OR=1.067; 95% CI, 0.827–1.377). Conclusions: Merging acute and primary care providers was associated with reduced readmissions, even though improvements were not found for all institutions or condition-specific groups. There are still challenges to be addressed regarding the success of vertical integration in reducing 30-day hospital readmissions. PMID:28403012

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

PubMed Central

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

2015-01-01

Occupational exposure limits have traditionally focused on preventing morbidity and mortality arising from inhalation exposures to individual chemical stressors in the workplace. While central to occupational risk assessment, occupational exposure limits have limited application as a refined disease prevention tool because they do not account for all of the complexities of the work and non-occupational environments and are based on varying health endpoints. To be of greater utility, occupational exposure limits and other risk management tools could integrate broader consideration of risks from multiple exposure pathways and routes (aggregate risk) as well as the combined risk from exposure to both chemical and non-chemical stressors, within and beyond the workplace, including the possibility that such exposures may cause interactions or modify the toxic effects observed (cumulative risk). Although still at a rudimentary stage in many cases, a variety of methods and tools have been developed or are being used in allied risk assessment fields to incorporate such considerations in the risk assessment process. These approaches, which are collectively referred to as cumulative risk assessment, have potential to be adapted or modified for occupational scenarios and provide a tangible path forward for occupational risk assessment. Accounting for complex exposures in the workplace and the broader risks faced by the individual also requires a more complete consideration of the composite effects of occupational and non-occupational risk factors to fully assess and manage worker health problems. Barriers to integrating these different factors remain, but new and ongoing community-based and worker health-related initiatives may provide mechanisms for identifying and integrating risk from aggregate exposures and cumulative risks from all relevant sources, be they occupational or non-occupational. PMID:26583907

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

PubMed

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

2015-01-01

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

The cumulative MeHg and PCBs exposure and risk of tribal ...

EPA Pesticide Factsheets

Studies have shown that the U.S. population continues to be exposed to methyl mercury (MeHg) and polychlorinated biphenyls (PCBs) due to the long half-life of those environmental contaminants. Fish intake of Tribal populations is much higher than the U.S. general population due to dietary habits and unique cultural practices. Large fish tissue concentration data sets from the Environmental Protections Agency’s (EPA’s) Office of Water, USGS’s EMMMA program, and other data sources, were integrated, analyzed, and combined with recent tribal fish intake data for exposure analyses using the dietary module within EPA’s SHEDS-Multimedia model. SHEDS-Multimedia is a physically-based, probabilistic model, which can simulate cumulative (multiple chemicals) or aggregate (single chemical) exposures over time for a population via various pathways of exposure for a variety of multimedia, multipathway environmental chemicals. Our results show that MeHg and total PCBs exposure of tribal populations from fish are about 3 to 10 and 5 to 15 times higher than the US general population, respectively, and that the estimated exposures pose potential health risks. The cumulative exposures of MeHg and total PCBs will be assessed to generate the joint exposure profiles for Tribal and US general populations. Model sensitivity analyses will identify the important contributions of the cumulative exposures of MeHg and total PCBs such as fish types, locations, and size, and key expos

Human Health Risks Associated with Metals from Urban Soil and Road Dust in an Oilfield Area of Southeastern Algeria.

PubMed

Benhaddya, Mohammed Lamine; Boukhelkhal, Abdelaziz; Halis, Youcef; Hadjel, Mohammed

2016-04-01

Hassi Messaoud town is a recent city that is situated inside the oil field, which hosts an important petroleum extraction field and refinery. Large-scale and long-term oil refinery and corresponding industrial activities may contaminate the surrounding soil/dust and could lead to pollution levels that can affect human health. The soil and road dust samples were analysed for different trace elements: copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn). Geo-accumulation index (I(geo)), pollution index (PI), and integrated pollution index (IPI) were calculated to evaluate the heavy metal contamination level of urban soil and road dust. The I(geo) values indicate unpolluted to moderate polluted of investigated metals in the soil samples. The assessment results of PI support the results of I(geo), and IPI indicates heavy metals in road dust polluted seriously. The noncarcinogenic health risk assessment shows that ingestion of soil/dust particles is the route for exposure to heavy metals, followed by dermal adsorption. The human exposure risk assessment based on different exposure pathways showed that the hazard index (HI) was <1.0 for all of the elements. The relative exposure risk (noncarcinogenic) was greater for toddlers. Although the overall risk was within the acceptable limit of 1.00, the HI of Pb from the soil (0.103) and road dust (0.132) was close to the threshold limits, which over the long-term may pose a health risk.

Reproductive risk factor associations with lobular and ductal carcinoma in the Carolina Breast Cancer Study.

PubMed

Williams, Lindsay A; Nichols, Hazel B; Hoadley, Katherine A; Tse, Chiu Kit; Geradts, Joseph; Bell, Mary Elizabeth; Perou, Charles M; Love, Michael I; Olshan, Andrew F; Troester, Melissa A

2018-01-01

Invasive lobular breast tumors display unique reproductive risk factor profiles. Lobular tumors are predominantly Luminal A subtype, and it is unclear whether reported risk factor associations are independent of molecular subtype. Polytomous logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations between risk factors and histologic subtype [ductal (n = 2,856), lobular (n = 326), and mixed ductal-lobular (n = 473)] in the Carolina Breast Cancer Study (1993-2013). Three-marker immunohistochemical clinical subtypes were defined as Luminal A (ER+ or PR+/HER2-), Luminal B (ER+ or PR+/HER2+), Triple Negative (ER-/PR-/HER2-), and HER2+ (ER-/PR-/HER2+). In case-case analyses compared to ductal, lobular tumors were significantly associated with lactation duration > 12 months [OR 1.86, 95% CI (1.33-2.60)], age at first birth ≥ 26 years [OR: 1.35, 95% CI: (1.03-1.78)], and current oral contraceptive use [OR: 1.86, 95% CI: (1.08-3.20)]. Differences in risk factor associations between ductal and lobular tumors persisted after restricting to Luminal A subtype. Lobular tumors were associated with older age at first birth, increased lactation duration, and current oral contraceptive use. Etiologic heterogeneity by histology persisted after restricting to Luminal A subtype, suggesting both tumor histology and intrinsic subtype play integral parts in breast cancer risk.

Condom use self-efficacy and HIV risk practices among men who use the internet to find male partners for unprotected sex.

PubMed

Klein, Hugh

2014-05-01

This research examines the levels of condom use self-efficacy in a population of men who have sex with men who are at great risk for contracting/transmitting HIV. It focuses on the relationship between condom use self-efficacy and risk involvement, and examines the factors associated with greater/lower levels of condom use self-efficacy. The data come from a national sample of men, randomly chosen, who used any of 16 websites specifically to identify other men with whom they could engage in unprotected sex. Data were collected between January 2008 and May 2009 from 332 men, via telephone interviews. Multivariate analyses and structural equation modeling were used to test a conceptual model based on syndemics theory. Overall levels of condom use self-efficacy were fairly high, and self-efficacy was related inversely to involvement in HIV risk practices. Six factors were found to be indicative of levels of condom use self-efficacy: the number of drug problems experienced, sexual role identity as a "bottom," not caring about the HIV serostatus of potential sex partners, experiencing childhood maltreatment, having confidence in HIV-related information provided in other men's online profiles, and level of HIV knowledge. Condom use self-efficacy plays an integral role in HIV risk practices among high-risk men who have sex with men. This is true despite the fact that, overall, condom use self-efficacy levels were fairly high in this population.

The Boeing 747 fatigue integrity program

NASA Technical Reports Server (NTRS)

Spencer, M. M.

1972-01-01

The fatigue integrity program which was established to insure economic operations and to provide foundation data for inspection and maintenance is discussed. Significant features of the 747 fatigue integrity program are: (1) fatigue analyses which are continually updated to reflect design changes, fatigue test results, and static and flight load survey measurements; (2) material selection and detail design by using initial fatigue analyses, service experience, and testing; and (3) fatigue testing to check detail design quality and to verify the analyses, culminated by the test of a structurally complete airframe. Fatigue stress analyses were performed with the aid of experimental as well as analytical procedures. Extensive application was made of the stress severity factor, developed at Boeing, for evaluating peak stresses in complex joints. A frame of reference was established by families of structural fatigue performance curves (S-N curves) encompassing the range of materials and fatigue qualities anticipated for the 747 airplane design.

RISK ASSESSMENT AND LIFE CYCLE IMPACT ASSESSMENT (LCIA) FOR HUMAN HEALTH CANCEROUS AND NONCANCEROUS EMISSIONS: INTEGRATED AND COMPLEMENTARY WITH CONSISTENCY WITHIN THE USEPA

EPA Science Inventory

The historical parallels, complementary roles, and potential for integration of human health risk assessment (RA) and Life-Cycle Impact Assessment (LCIA) are explored. Previous authors have considered the comparison of LCA and risk assessment recognizing the inherent differences ...

The Integrated Medical Model - A Risk Assessment and Decision Support Tool for Human Space Flight Missions

NASA Technical Reports Server (NTRS)

Kerstman, Eric; Minard, Charles G.; Saile, Lynn; FreiredeCarvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

2010-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission planners and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight.

78 FR 32865 - Procedures To Establish Appropriate Minimum Block Sizes for Large Notional Off-Facility Swaps and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... Financial Integrity of Markets c. Price Discovery d. Sound Risk Management Practices e. Other Public... Discovery d. Sound Risk Management Practices e. Other Public Interest Considerations E. Costs and Benefits..., Competitiveness and Financial Integrity c. Price Discovery d. Sound Risk Management Practices e. Other Public...

The Strategic and Legal Risks of Work-Integrated Learning: An Enterprise Risk Management Perspective

ERIC Educational Resources Information Center

Cameron, Craig

2017-01-01

Work-integrated learning (WIL) is a risky business for universities. WIL is a strategic risk worthy of pursuing by universities in the prevailing higher education environment, which is characterized by competition, changes in funding arrangements and stakeholder demand for WIL. Nevertheless the strategic opportunities that WIL presents cannot be…

Definition and GIS-based characterization of an integral risk index applied to a chemical/petrochemical area.

PubMed

Nadal, Martí; Kumar, Vikas; Schuhmacher, Marta; Domingo, José L

2006-08-01

A risk map of the chemical/petrochemical industrial area of Tarragona (Catalonia, Spain) was designed following a two-stage procedure. The first step was the creation of a ranking system (Hazard Index) for a number of different inorganic and organic pollutants: heavy metals, polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), polychlorinated biphenyls (PCBs) and polychlorinated aromatic hydrocarbons (PAHs) by applying self-organizing maps (SOM) to persistence, bioaccumulation and toxicity properties of the chemicals. PCBs seemed to be the most hazardous compounds, while the light PAHs showed the minimum values. Subsequently, an Integral Risk Index was developed taking into account the Hazard Index and the concentrations of all pollutants in soil samples collected in the assessed area of Tarragona. Finally, a risk map was elaborated by representing the spatial distribution of the Integral Risk Index with a geographic information system (GIS). The results of the present study seem to indicate that the development of an integral risk map might be useful to help in making-decision processes concerning environmental pollutants.

Pilot Test of an Integrated Sexual Risk Reduction Intervention for Women with a History of Childhood Sexual Abuse.

PubMed

Senn, Theresa E; Braksmajer, Amy; Urban, Marguerite A; Coury-Doniger, Patricia; Carey, Michael P

2017-11-01

HIV and childhood sexual abuse (CSA) are intersecting public health problems for women. We pilot tested an integrated sexual risk reduction intervention for women with a history of CSA that addressed both the consequences of CSA [based on the Traumagenic Dynamics (TD) framework] and the antecedents of sexual risk behavior (based on the Information-Motivation-Behavioral Skills [IMB] model). Women with a history of CSA who were attending a public STI clinic (n = 84) were randomly assigned to a five-session integrated TD/IMB (experimental) group intervention or to a time-matched IMB-guided sexual risk reduction (control) group intervention. Preliminary findings indicated that women in the integrated TD/IMB intervention reduced their average number of episodes of unprotected sex with a primary partner, their alcohol use, and their likelihood of being in a violent relationship, relative to women in the IMB-only group. Our findings suggest that sexual risk reduction interventions that address both the consequences of CSA and the antecedents of sexual risk behavior may be efficacious in reducing sexual risk behavior among women who were sexually abused.

Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer: Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses.

PubMed

Khankari, Nikhil K; Shu, Xiao-Ou; Wen, Wanqing; Kraft, Peter; Lindström, Sara; Peters, Ulrike; Schildkraut, Joellen; Schumacher, Fredrick; Bofetta, Paolo; Risch, Angela; Bickeböller, Heike; Amos, Christopher I; Easton, Douglas; Eeles, Rosalind A; Gruber, Stephen B; Haiman, Christopher A; Hunter, David J; Chanock, Stephen J; Pierce, Brandon L; Zheng, Wei

2016-09-01

Observational studies examining associations between adult height and risk of colorectal, prostate, and lung cancers have generated mixed results. We conducted meta-analyses using data from prospective cohort studies and further carried out Mendelian randomization analyses, using height-associated genetic variants identified in a genome-wide association study (GWAS), to evaluate the association of adult height with these cancers. A systematic review of prospective studies was conducted using the PubMed, Embase, and Web of Science databases. Using meta-analyses, results obtained from 62 studies were summarized for the association of a 10-cm increase in height with cancer risk. Mendelian randomization analyses were conducted using summary statistics obtained for 423 genetic variants identified from a recent GWAS of adult height and from a cancer genetics consortium study of multiple cancers that included 47,800 cases and 81,353 controls. For a 10-cm increase in height, the summary relative risks derived from the meta-analyses of prospective studies were 1.12 (95% CI 1.10, 1.15), 1.07 (95% CI 1.05, 1.10), and 1.06 (95% CI 1.02, 1.11) for colorectal, prostate, and lung cancers, respectively. Mendelian randomization analyses showed increased risks of colorectal (odds ratio [OR] = 1.58, 95% CI 1.14, 2.18) and lung cancer (OR = 1.10, 95% CI 1.00, 1.22) associated with each 10-cm increase in genetically predicted height. No association was observed for prostate cancer (OR = 1.03, 95% CI 0.92, 1.15). Our meta-analysis was limited to published studies. The sample size for the Mendelian randomization analysis of colorectal cancer was relatively small, thus affecting the precision of the point estimate. Our study provides evidence for a potential causal association of adult height with the risk of colorectal and lung cancers and suggests that certain genetic factors and biological pathways affecting adult height may also affect the risk of these cancers.